Correlation of C-reactive protein with disease severity in CT diagnosed emphysema.

BACKGROUND AND OBJECTIVE: Recent studies suggest that CRP levels are related to airflow obstruction. However, limited data exist on the relevance of CRP levels in individuals with or without emphysema. The aim of this study was to assess the relationship between the extent of emphysema, COPD severity and serum CRP levels. METHODS: Lung function tests and high-sensitivity CRP were examined in 651 males with stable disease who underwent CT screening for lung cancer. CRP levels were examined cross-sectionally in individuals with various degrees of emphysema and in those without emphysema. RESULTS: Emphysema was detected in 179 (34.7%) of 516 current smokers. Airflow obstruction was observed in 47 (28.8%) of 163 smokers with mild emphysema, in eight (57.1%) of 14 smokers with moderate emphysema, and in two of two individuals with severe emphysema. CRP levels were not higher in individuals with mild or moderate emphysema compared with individuals without emphysema. Among 98 individuals with airflow obstruction (19.0% of the 516 current smokers), there was a modest correlation between CRP levels and FEV(1)%. CONCLUSIONS: The severity of COPD varied in individuals with similar degrees of emphysema. CRP levels were not significantly higher in individuals with mild or moderate emphysema compared with individuals without emphysema but CRP levels were modestly correlated with FEV(1)% among individuals with airflow obstruction.

Case report of intralobar pulmonary sequestration detected by lung cancer screening with low-dose spiral CT.

A 52-year-old man underwent lung cancer screening with low-dose spiral computed tomography (CT) in a medical check-up at the Japanese Red Cross Kumamoto Health Care Center. He was asymptomatic. Chest x-ray on a medical check-up showed no abnormal shadows. CT scans revealed a nodule in the right lower lung, suggestive of its connection to the descending thoracic aorta. A diagnosis of pulmonary sequestration was considered. He was transferred to Kumamoto University Hospital for further examination. Contrast enhanced multidetector CT images demonstrated that a nodule in the right lower lobe and an anomalous artery ran from the descending thoracic aorta, flowed through the right lower lobe and returned to the right inferior pulmonary vein. Intralobar pulmonary sequestration was confirmed by contrast enhanced multidetector CT. We report this case of asymptomatic intralobar pulmonary sequestration diagnosed using contrast enhanced multidetector CT.

Repeated relapses of acute myelogenous leukemia in the isolated extramedullary sites following allogeneic bone marrow transplantations.

Isolated extramedullary (EM) relapses of acute myelogenous leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) have been reported to be rare, and are usually followed by bone marrow relapses. We report a 49-year-old man with AML with the unfavorable chromosome abnormality 7q-, who was treated by allo-HSCT. Fifteen months after allo-HSCT, the patient initially developed a relapse only in his inguinal lymph nodes, and then bone marrow relapse became evident one month after the EM relapse. Subsequently, the patient received chemotherapy and a second allo-HSCT from another donor, but he suffered another relapse in different EM sites including the skin and central nervous system with a persistently normal marrow. This case is characterized by repeated relapses in isolated EM sites after allo-HSCT and suggests that the anti-leukemic effects of chemotherapy and/or graft-versus-leukemia effects in the EM sites might not be so uniformly effective as that in the marrow. Accordingly, we should be aware that AML relapses can occur repeatedly only in isolated EM sites post allo-HSCT, resulting in treatment failure and a poor prognosis.