ABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Emphysema , Pulmonary Alveoli , Dyspnea , Cough , Non-SmokersABSTRACT
Tuberculosis (TB) remains one of the world's leading infectious cause of morbidity and mortality. Positron emission tomography (PET) associated with computed tomography (CT) allows a structural and metabolic evaluation of TB lesions, being an excellent noninvasive alternative for understanding its pathogenesis. DOTATOC labeled with gallium-68 (68Ga-DOTATOC) can bind to somatostatin receptors present in activated macrophages and lymphocytes, cells with a fundamental role in TB pathogenesis. We describe 68Ga-DOTATOC uptake distribution and patterns in thoracic lymph nodes (LN) and pulmonary lesions (PL) in immunocompetent patients with active postprimary TB, analyze the relative LN/PL uptake, and compare this two tracer's uptake. High uptake of both radiotracers in PL and LN was demonstrated, with higher LN/PL ratio on 68Ga-DOTATOC (P < 0.05). Considering that LN in immunocompetent patients are poorly studied, 68Ga-DOTATOC can contribute to the understanding of the complex immunopathogenesis of TB.
ABSTRACT
INTRODUCTION: Systemic endemic mycoses are prevalent in specific geographical areas of the world and are responsible for high rates of morbidity and mortality in these populations, and in immigrants and travelers returning from endemic regions. The most common fungal infections that can affect the lungs of immunocompetent patients include histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, aspergillosis, and cryptococcosis. Diagnosis and management of these diseases remain challenging, especially in non-endemic areas due to the lack of experience. Therefore, recognition of the various radiologic manifestations of pulmonary fungal infections associated with patients' clinical and epidemiologic history is imperative for narrowing the differential diagnosis. Areas covered: This review discusses the clinical and radiological findings of the main endemic fungal diseases affecting the lungs in immunocompetent patients. Specific topics discussed are their etiology, epidemiology, pathogenesis, clinical manifestations, methods of diagnosis, pathology and main imaging findings, especially in computed tomography. Expert commentary: Imaging plays an important role in the diagnosis and management of pulmonary fungal infection and may reveal useful signs. Although definitive diagnosis cannot be made based on imaging features alone, the use of a combination of epidemiologic, clinical and imaging findings may permit the formulation of an adequate differential diagnosis.
Subject(s)
Immunocompetence , Lung Diseases, Fungal/diagnostic imaging , Lung/diagnostic imaging , Aspergillosis/diagnostic imaging , Blastomycosis/diagnostic imaging , Coccidioidomycosis/diagnostic imaging , Cryptococcosis/diagnostic imaging , Endemic Diseases , Female , Histoplasmosis/diagnostic imaging , Humans , Lung/pathology , Lung Diseases, Fungal/epidemiology , Lung Diseases, Fungal/pathology , Male , Sporotrichosis/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Objectives. To evaluate tomographic changes in pulmonary tuberculosis (TB), degree of agreement among three radiologists regarding tomographic diagnoses, and sequelae following treatment. Methods. Cross-sectional and descriptive study of 74 TB patients confirmed by sputum culture and chest computed tomography before (CT1) and 6 months after (CT2) drug therapy. Results were performed by three radiologists blinded to clinical and laboratory results. Results. Main findings in CT1 included nodules indicating the presence of a tree-in-bud pattern in 93% of cases, ill-defined nodules in 84% of cases, consolidation in 77% of cases, architectural distortion in 71% of cases, cavitary lesions in 62% of cases, and ground glass opacities in 37% of cases. Airway involvement, characterized by increased thickness and dilatation of the bronchial walls, occurred in 93% of cases. Pleural involvement occurred in 54%. There was an agreement on active TB among the three radiologists in 85% of cases. The results in CT2 indicated the presence of architectural distortion in 91% of cases and cylindrical bronchiectasis in 86%. Conclusions. The study established a tomographic pattern for diagnosis of active TB characterized by the presence of airway nodules, consolidation, architectural distortion, and cavitary lesions, and an almost complete degree of agreement (Kappa) was observed among the radiologists (0.85). CT after treatment assists in defining the cure.
Subject(s)
Lung/diagnostic imaging , Tomography, X-Ray Computed , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/drug therapy , Adolescent , Adult , Aged , Antitubercular Agents/therapeutic use , Bronchi/diagnostic imaging , Bronchiectasis/diagnostic imaging , Bronchiectasis/microbiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Observer Variation , Pleura/diagnostic imaging , Single-Blind Method , Treatment Outcome , Tuberculosis, Pulmonary/complications , Young AdultABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Lung Diseases/complications , Lung Diseases/diagnosis , Lung Diseases/prevention & control , Cysts/classification , Cysts/complications , Cysts/diagnosis , Lung Diseases/classification , Lung Diseases/mortality , Cysts/prevention & control , Cysts/therapyABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Lipoma/diagnosis , Lipoma , Lipoma/therapy , Tomography, X-Ray Computed/instrumentation , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy/instrumentation , Magnetic Resonance Spectroscopy/therapeutic use , Pneumonectomy/instrumentation , Pneumonectomy/methods , Pneumonectomy , Lung Injury/diagnosis , Lung Injury , Lung Injury/surgeryABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Silicosis/diagnosis , Occupational Diseases/diagnosis , Occupational Exposure/adverse effectsABSTRACT
No disponible
