ABSTRACT
The yield of fiberoptic bronchoscopy (FB) in the diagnosis of pulmonary metastases has not been conveniently analyzed. With the advances in the surgery of pulmonary metastases, there is a need to evaluate the diagnostic yield and the usefulness of FB to exclude other diseases with similar radiological patterns. To determine the value of FB in the diagnosis of pulmonary metastases we have retrospectively analyzed our experience in 113 patients with proven pulmonary metastases. An endobronchial lesion was identified in 57/113 (50.4%). The most frequent tumors with endobronchial lesions were thyroid (100%), head-neck (67%) and breast carcinomas (59%). The highest diagnostic yield was obtained combining techniques of brushing, washing and biopsy (72.6%); in cases with endobronchial lesions (84.2%) and with certain histological types (head-neck 100%; breast 90.9% and colon 84.6%). The most frequent radiological findings were single or multiple nodules (77.9%). Atelectasis were associated with endobronchial lesions. In conclusion, bronchoscopy is a valuable diagnostic procedure in selected patients with metastatic lung disease.
Subject(s)
Bronchoscopy/methods , Lung Neoplasms/secondary , Female , Fiber Optic Technology , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Retrospective Studies , Sensitivity and SpecificitySubject(s)
Bronchi , Foreign Bodies/diagnostic imaging , Female , Foreign Bodies/therapy , Humans , Middle Aged , RadiographyABSTRACT
No disponible
Subject(s)
Humans , Bronchoscopy , Tomography, X-Ray Computed , Biopsy, Needle , Carcinoma, Bronchogenic , Lung NeoplasmsSubject(s)
Bronchoscopy , Echinococcosis, Pulmonary/diagnosis , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Fiberoptic endoscopy has brought about significant progress in the management of so-called difficult intubations. We describe the techniques applied and results in one hospital service performing intubation guided by fiberoptic bronchoscope (FB). A total of 512 consecutive intubations (64.18% men and 35.15% women) performed over the past 18 years were analyzed. Non-tumor related disease of the cervical column (28.91%) was the most frequent cause of difficult intubation requiring FB guidance, followed by trauma (18.16%) and technical difficulties (17.39%). A nasal route was used most often (80.86%). In 93.16% of cases, intubation was needed for surgery. Thirty-five (6.84%) complications of various types were recorded, and intubation was impossible in 3 (0.59%) cases. Intubation in patients under general anesthesia presented special technical difficulties due to loss of muscle tone and the need to maintain ventilation. We recommend intubation only in patients who are breathing spontaneously through the nose, using lidocaine as a local anesthetic and a large caliber endotracheal tube with as small a tip as possible.
Subject(s)
Bronchoscopy/statistics & numerical data , Intubation, Intratracheal/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Bronchoscopy/adverse effects , Bronchoscopy/methods , Child , Child, Preschool , Female , Fiber Optic Technology , Humans , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/methods , Male , Middle AgedABSTRACT
Tracheobronchial ruptures represent a serious pathology difficult to diagnose at the first examination. The authors review 6 cases: four as acute types with pneumomediastinum, pneumothorax and subcutaneous emphysema with a delay in diagnosis of 3.25 days, meanwhile 2 cases were chronic forms with a delay in diagnosis of 124.5 days. Diagnosis should be performed as soon as possible based in the presence of uni or bilateral pneumothorax with pneumomediastinum being confirmed by fiber bronchoscopy. The treatment is based in the resection of the fractured fragments, followed by bronchoplasty always with reabsorbable sutures the most frequent surgical technique, meanwhile in the atelectatic forms it is not possible to perform sometimes and we must practise lung resections.
Subject(s)
Bronchi/injuries , Trachea/injuries , Accidents, Traffic , Adolescent , Adult , Bronchi/surgery , Bronchography , Bronchoscopy , Female , Fiber Optic Technology , Humans , Intubation, Intratracheal/adverse effects , Male , Middle Aged , Multiple Trauma/diagnosis , Multiple Trauma/surgery , Rupture , Trachea/diagnostic imaging , Trachea/surgeryABSTRACT
Endobronchial hamartomas are not very common and they are usually symptomatic because of bronchial obstruction. The diagnosis is made by fiberoptic bronchoscopy of thoracotomy and there are several possibilities of treatment but until now the most common has been surgical resection. We report the case of a man with an endobronchial hamartoma who was diagnosed by fiberoptic bronchoscopy and successfully treated by rigid bronchoscopy.
Subject(s)
Bronchial Diseases/surgery , Bronchoscopy , Hamartoma/surgery , Bronchial Diseases/diagnosis , Hamartoma/diagnosis , Humans , Male , Middle AgedABSTRACT
We analyse our own experience of a rare tuberculosis presentation that we call pseudotumoral bronchial tuberculosis. 9 cases were studied, which due to radiological, endoscopic and clinical features, a diagnosis of bronchogenic carcinoma was made. The median age was 63.7 years, 7 were male and 2 were female. The hilar or mediastinic radiological pattern was frequent. The bacterial diagnosis was made through the study of the samples obtained by bronchoscopy, except in 2 cases which were diagnosed through post-bronchoscopy sputum examination. The bronchial biopsy showed the typical necrotic granulomas of tuberculosis in only one case. Supported by the bad evolution of our patients treated without steroids, the possible efficacy of early use of steroid is suggested to avoid the most important sequelae, bronchial stenosis.
Subject(s)
Tuberculosis, Pulmonary/diagnosis , Adult , Aged , Aged, 80 and over , Carcinoma, Bronchogenic/diagnosis , Diagnosis, Differential , Female , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Tuberculosis, Pulmonary/pathologySubject(s)
Bronchoscopy , Foreign Bodies/therapy , Lung , Child , Child, Preschool , Humans , InfantABSTRACT
We report our experience in 8 patients with osteochondroplastic tracheopathy and consider the importance of its diagnosis y biopsy in order to confirm histology and if possible etiology, because specific treatment could change the course of the disease. Methods such as radiology, CT-scan, respiratory function tests only give diagnostic suspicion, which is a previous step before confirmation by bronchoscopy with biopsy. To date, with the exception of a few cases, the diagnosis is made by necropsy. Thus, this justifies our emphasis in the diagnosis of this rare disease when it is suspected in living patients.
Subject(s)
Osteochondrodysplasias/diagnosis , Tracheal Diseases/diagnosis , Adult , Aged , Biopsy , Bronchial Diseases/diagnosis , Bronchial Diseases/pathology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Osteochondritis/diagnosis , Osteochondritis/pathology , Osteochondrodysplasias/pathology , Tomography, X-Ray Computed , Trachea/pathology , Tracheal Diseases/pathologySubject(s)
Lung Neoplasms/immunology , Macrophages/immunology , Smoking , Adult , Aged , Aged, 80 and over , Chemotaxis , HLA-DR Antigens/analysis , Humans , Middle Aged , PhagocytosisABSTRACT
The distribution of Ia like (HLA-DR) antigens on human alveolar macrophages (HAM phi) has been investigated by indirect immunofluorescence staining of viable macrophages with a panel of monoclonal antibodies (MoAb) to common determinants of these antigens. HAM phi were characterized by non-specific esterase stain, plastic adherence, phagocytosis and IgG-Fc receptor expression. Ia like antigens were expressed in approximately 45-80% of HAM phi, being localized as patchy and lineal fluorescence along the membrane. Ia like expression was higher in macrophages from non-smoker subjects (P less than 0.025). No difference in Ia like antigen expression was found between adherent and non-adherent HAM phi subsets. Ia like positive HAM phi from both smoker and non-smoker subjects consisted of a large subpopulation of phagocytic cells (60-70%) and a smaller non-phagocytic subpopulation (20-25%). These subpopulations were also present in the Ia like negative HAM phi. The percentage of Ia like positive macrophages showed variable results depending on the MoAb used, suggesting that not all anti-Ia like antibodies recognize the same antigenic determinants. Moreover, lack of staining of one macrophage subset occurred with all MoAb tested, over a large range of concentrations.
