ABSTRACT
Pathology developing within the confines of the superior mediastinum may produce changes that appear quite subtle on conventional radiographs. The zone of contact of lung with the left superior mediastinum is represented radiographically as a series of interrelated pleural reflections. These reflections may be altered by mediastinal disease, and an understanding of this anatomy can facilitate detection of abnormalities.
Subject(s)
Mediastinal Diseases/diagnosis , Mediastinum/anatomy & histology , Pleura/anatomy & histology , Humans , Magnetic Resonance Imaging , Mediastinal Diseases/diagnostic imaging , Mediastinum/diagnostic imaging , Pleura/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
An occurrence of multiple chronic lung abscesses managed by lobectomy is described. These abscesses were present for 13 years in the patient, a nonimmunocompromised wood pulp worker. The patient had hemoptysis at presentation. The organism isolated was Ochroconis gallopavum, a dematiaceous fungus known to cause disease in immunocompromised patients and epidemic encephalitis in poultry. The fungus is typically found in warm environments and in decaying compost; for this reason, we postulate that his illness was occupationally acquired.
Subject(s)
Lung Abscess/diagnosis , Lung Diseases, Fungal/diagnosis , Mitosporic Fungi , Occupational Diseases/diagnosis , Wood , Adult , Chronic Disease , Hemoptysis/microbiology , Humans , Lung Abscess/surgery , Lung Diseases, Fungal/surgery , Male , Occupational Diseases/surgery , Occupational Exposure , Pneumonectomy , Pulmonary Fibrosis/microbiologyABSTRACT
PURPOSE: To demonstrate the value of ultrasound (US) guidance during flexible bronchoscopic procedures in a series of patients with known or suspected pulmonary neoplasms. MATERIALS AND METHODS: US-guided bronchoscopy was carried out as an adjunct to conventional bronchoscopy for the diagnosis of mediastinal, hilar, or parenchymal neoplasms in 25 patients with masses previously detected with chest radiography or computed tomography. Miniature transducer-containing catheters were inserted through the biopsy port of the flexible bronchoscope, and cross-sectional real-time US scans of tumors, lymph nodes, and blood vessels were obtained. RESULTS: Among six cases of peripheral masses and 19 cases of central masses, additional information was provided in 18 cases (72%). This information was used to choose the optimal site for transmural biopsy. CONCLUSION: These preliminary results suggest that this US procedure may become an important diagnostic tool during bronchoscopy, due to the ability to identify structures beyond the lumen of the tracheobronchial tree.
Subject(s)
Bronchoscopy/methods , Catheterization/instrumentation , Ultrasonography, Interventional/instrumentation , Adult , Aged , Aged, 80 and over , Bronchoscopes , Female , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Miniaturization , Transducers , Ultrasonography, Interventional/methodsABSTRACT
1) PURPOSE: To demonstrate usefulness of chlorambucil in patients with severe sarcoidosis unresponsive to, or intolerant of, corticosteroids. 2) PATIENTS AND METHODS: Corticosteroid therapy was required in 192 (48%) of 401 patients with sarcoidosis seen at Thomas Jefferson University Hospital 1985-89. Chlorambucil was given to 31 of these patients because complicating diseases or problems made adequate corticosteroid dosage impossible (5 cases) or because of failure of corticosteroid in tolerable doses to control the disease (26 cases). 3) RESULTS: Marked improvement was observed in 15 cases, and moderate improvement in 13 others. Chlorambucil was well tolerated and complications attributable to immunosuppression did not occur. A six month course of chlorambucil was often followed by relapse, and prolonged therapy in reduced dosage appears necessary in most patients requiring this treatment. 4) CONCLUSION: Failure of corticosteroids in tolerable dosage to control sarcoidosis is not uncommon, and in such patients chlorambucil treatment is a useful alternative.
Subject(s)
Chlorambucil/therapeutic use , Sarcoidosis/drug therapy , Adult , Female , Humans , Lung/diagnostic imaging , Male , Middle Aged , Radiography , Sarcoidosis, Pulmonary/diagnostic imaging , Sarcoidosis, Pulmonary/drug therapyABSTRACT
Calcification in bronchogenic carcinoma is rare. When found it is usually focal in nature and felt by many to be coincidental granulomatous disease. To our knowledge this case report is the first computerized tomography (CT) description of diffuse, amorphous calcification in bronchogenic carcinoma, specifically, small cell.
Subject(s)
Calcinosis/diagnostic imaging , Carcinoma, Small Cell/diagnostic imaging , Lung Neoplasms/diagnostic imaging , Biopsy , Calcinosis/pathology , Carcinoma, Bronchogenic/diagnostic imaging , Carcinoma, Bronchogenic/pathology , Carcinoma, Small Cell/pathology , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Neoplasms/pathology , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
CT scans demonstrated a localized collection of gas adjacent to a normal sacroiliac joint in 5 patients. In each case the lesion was sharply demarcated by a thin sclerotic rim. A benign bone cyst was confirmed histologically in 2 cases. The radiologist should be aware of this appearance so as to avoid invasive procedures based on a misdiagnosis of infection or neoplasm.
