ABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Hemoptysis/complications , Aneurysm, False/diagnostic imaging , Fever/etiology , Dyspnea/complications , Cough/complications , Diabetes Mellitus, Type 2/complications , Radiography, Thoracic , Pulmonary Artery/diagnostic imaging , Blood Glucose , Sputum/diagnostic imaging , AngiographyABSTRACT
Objective: To assess the impact of patient-, lesion- and procedure-related factors on the risks of complications and final diagnosis of malignancy in PCNB of mediastinal and lung lesions. Material and Methods: We studied a large single-center cohort of 235 consecutive patients (66.8% men; 58.5 ± 18.0 years) with a range of thoracic benign and malignant lesions, who underwent PCNB performed along 24 months by a single experienced radiologist. Diagnostic accuracy analyses of PCNB for malignancy were performed, as well as estimations of relative risk and logistic regression models in order to assess possible associations between such factors and malignancy/complications. Results: 155 lesions (65.9%) were diagnosed as malignant. Overall accuracy was 91.1%, with sensitivity of 87.1%, specificity of 98.8%, positive predictive value of 99.3%, and negative predictive value of 79.8%. Pneumothorax (49/235; 20.8%) and hemorrhage (37/235; 15.7%) were the most common complications. Emphysema, smoking, older age, intrapulmonary location, deeper location, smaller size, presence of cavitations and irregular contours of the lesions, and smaller needle-pleural angles were the most consistent factors related to the occurrence of complications. Emphysema, older age, smoking, solid and deeper lesions were also significantly associated with a final diagnosis of malignancy after PCNB. Conclusion: CT-guided PCNB of mediastinal and lung lesions is a safe procedure with high diagnostic accuracy for malignancy
Objetivo: Evaluar el impacto de los factores relacionados con el paciente, la lesión y el procedimiento en el riesgo de complicaciones y que el diagnóstico final sea cáncer en la biopsia percutánea con aguja gruesa (B.A.G) de lesiones mediastínicas y pulmonares. Materiales y métodos: Se estudió una cohorte unicéntrica grande de 235 pacientes consecutivos (66,8% hombres; 58,5 ± 18,0 años) con diversas lesiones torácicas benignas y malignas, a los que un único radiólogo experimentado practicó B.A.G. a lo largo de 24 meses. Se realizaron análisis de precisión diagnóstica del B.A.G para el cáncer, así como estimaciones del riesgo relativo y modelos de regresión logística para evaluar las posibles asociaciones entre esos factores y diagnóstico de cáncer y/o aparición de complicaciones. Resultados: Se determinó que 155 lesiones (65,9%) eran malignas. La precisión total fue del 91,1%, con una sensibilidad del 87,1%, una especificidad del 98,8%, un valor predictivo positivo del 99,3% y un valor predictivo negativo del 79,8%. Las complicaciones más frecuentes fueron el neumotórax (49/235; 20,8%) y la hemorragia (37/235; 15,7%). Los factores relacionados de forma más consistente con la existencia de complicaciones fueron el enfisema, el tabaquismo, la edad avanzada, la localización intrapulmonar, la localización profunda, el tamaño pequeño, la presencia de lesiones cavitadas con contornos irregulares y los ángulos aguja-pleura más pequeños. El enfisema, la edad avanzada, el tabaquismo y las lesiones sólidas y profundas también se asociaron significativamente con un diagnóstico final de cáncer después de la B.A.G. Conclusión: La B.A.G guiada por TC de lesiones mediastínicas y pulmonares es un procedimiento seguro con una elevada precisión diagnóstica para la detección del cáncer
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Biopsy, Fine-Needle/methods , Image-Guided Biopsy/methods , Lung Neoplasms/diagnostic imaging , Mediastinal Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Sensitivity and Specificity , Predictive Value of Tests , Risk Factors , Cohort StudiesABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Pneumonia/chemically induced , Pneumonia/classification , Pneumonia/diagnosis , Mineral Oil/adverse effects , Mineral Oil/toxicity , Medical History Taking/methods , Diagnosis, Differential , Tomography, X-Ray Computed/instrumentation , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed , Bronchoscopy/instrumentation , Bronchoscopy/methods , Bronchoscopy , Steroids/therapeutic use , Anti-Bacterial Agents/therapeutic useSubject(s)
Fires , Mineral Oil/toxicity , Pneumonia, Aspiration/diagnostic imaging , Tomography, X-Ray Computed , Adult , Bronchoalveolar Lavage Fluid/cytology , Bronchoscopy , Humans , Macrophages, Alveolar/chemistry , Macrophages, Alveolar/ultrastructure , Male , Mineral Oil/analysis , Pneumonia, Aspiration/etiologyABSTRACT
Multiple cystic lung disease represents a diverse group of uncommon disorders that can present a diagnostic challenge due to the increasing number of diseases associated with this presentation. High-resolution computed tomography of the chest helps to define the morphological aspects and distribution of lung cysts, as well as associated findings. The combination of appearance upon imaging and clinical features, together with extrapulmonary manifestations, when present, permits confident and accurate diagnosis of the majority of these diseases without recourse to open-lung biopsy. The main diseases in this group that are discussed in this review are lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and folliculin gene-associated syndrome (Birt-Hogg-Dubé); other rare causes of cystic lung disease, including cystic metastasis of sarcoma, are also discussed. Disease progression is unpredictable, and understanding of the complications of cystic lung disease and their appearance during evolution of the disease are essential for management. Correlation of disease evolution and clinical context with chest imaging findings provides important clues for defining the underlying nature of cystic lung disease, and guides diagnostic evaluation and management.
Subject(s)
Amyloidosis , Birt-Hogg-Dube Syndrome , Histiocytosis, Langerhans-Cell , Lung Neoplasms , Lymphangioleiomyomatosis , Pneumonia, Pneumocystis , Adult , Amyloidosis/diagnosis , Amyloidosis/epidemiology , Amyloidosis/therapy , Biopsy , Birt-Hogg-Dube Syndrome/diagnosis , Birt-Hogg-Dube Syndrome/epidemiology , Birt-Hogg-Dube Syndrome/therapy , Diagnosis, Differential , Disease Progression , Female , Histiocytosis, Langerhans-Cell/diagnosis , Histiocytosis, Langerhans-Cell/epidemiology , Histiocytosis, Langerhans-Cell/therapy , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/therapy , Lymphangioleiomyomatosis/diagnosis , Lymphangioleiomyomatosis/epidemiology , Lymphangioleiomyomatosis/therapy , Male , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Pneumocystis/epidemiology , Pneumonia, Pneumocystis/therapy , Predictive Value of Tests , Prognosis , Risk Factors , Tomography, X-Ray ComputedSubject(s)
Exanthema/microbiology , Multiple Pulmonary Nodules/microbiology , Respiratory Tract Infections/microbiology , Syphilis, Cutaneous/microbiology , Syphilis/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Biopsy , Exanthema/diagnosis , Exanthema/drug therapy , Humans , Male , Multiple Pulmonary Nodules/diagnosis , Multiple Pulmonary Nodules/drug therapy , Penicillins/therapeutic use , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/drug therapy , Syphilis/diagnosis , Syphilis/drug therapy , Syphilis, Cutaneous/diagnosis , Syphilis, Cutaneous/drug therapy , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Hernia/diagnosis , Thoracic Wall/physiopathology , Tomography, X-Ray ComputedSubject(s)
Hernia/diagnostic imaging , Multidetector Computed Tomography , Thoracic Diseases/diagnostic imaging , Thoracic Wall/diagnostic imaging , Bone Neoplasms/surgery , Female , Hemangioma/surgery , Hernia/etiology , Hernia/physiopathology , Herniorrhaphy , Humans , Intercostal Muscles/physiopathology , Middle Aged , Muscle Weakness/etiology , Muscle Weakness/physiopathology , Postoperative Complications/diagnostic imaging , Postoperative Complications/etiology , Postoperative Complications/physiopathology , Ribs/surgery , Thoracic Diseases/etiology , Thoracic Diseases/physiopathology , Thoracic Neoplasms/surgeryABSTRACT
A 35 years old rural worker presented with a 15 days history of progressive dyspnea, associated with dry cough, myalgia and fever. Few days before the symptoms, he had swim in a river. The chest radio- graphs demonstrated bilateral reticule-nodular infiltrates. The high-resolution CT showed patchy areas of ground-glass attenuation, irregular inter- lobular septal thickening, intralobular interstitial thickening, and small nodules, which are confluent in some regions. All the laboratory investigations were negative. The open lung biopsy shows parenchymal granulomatous inflammation, and numerous schistosome ova.
Subject(s)
Lung Diseases, Parasitic/diagnostic imaging , Lung Diseases, Parasitic/pathology , Schistosomiasis/diagnostic imaging , Schistosomiasis/pathology , Tomography, X-Ray Computed , Acute Disease , Adult , Humans , MaleABSTRACT
A 37-year-old man presented with thoracic pain and fever. The physical examination showed reddish skin lesions. He was investigated with radiography, high- resolution computed tomography and magnetic resonance of the chest, which revealed multiple small and large nodules with random distribution, mostly in the lower lungs zones. Biopsies of lung and skin lesions was performed and the diagnosis of secondary syphilis was defined. Other laboratories tests (venereal disease laboratory and FtA-abs) corroborated the diagnosis. The patient was treated with penicillin, and the pulmonary and skin lesions regressed in the follow- up examinations.
Subject(s)
Lung Diseases/diagnosis , Lung Diseases/microbiology , Magnetic Resonance Imaging , Syphilis/diagnosis , Tomography, X-Ray Computed , Adult , Humans , MaleABSTRACT
BACKGROUND: Exogenous lipoid pneumonia is a rare disorder caused by aspiration of mineral, vegetable and animal oils. High-resolution CT findings of lipoid pneumonia in children taking mineral oil for constipation have been rarely reported. OBJECTIVE: To evaluate the high-resolution CT findings in 17 children with exogenous lipoid pneumonia following aspiration of mineral oil. MATERIALS AND METHODS: The study included nine boys and eight girls, with ages ranging from 2 months to 9 years. All patients underwent high-resolution CT and the images were reviewed by two radiologists who reached decisions by consensus. The inclusion criteria were an abnormal radiograph, history of taking mineral oil and the presence of intrapulmonary lipids proved by bronchoalveolar lavage or open lung biopsy. RESULTS: The most common symptoms were cough (n = 13), mild fever (n = 11), and progressive dyspnea (n = 9). The main CT findings were air-space consolidations (100%), usually with areas of fatty attenuation (70.6%), areas of ground-glass attenuation (52.9%), and a crazy-paving pattern (17.6%), predominating bilaterally in the posterior and lower regions of the lungs. CONCLUSION: The high-resolution CT features in children with exogenous lipoid pneumonia are air-space consolidations and ground-glass attenuation, occasionally with a crazy-paving pattern, distributed bilaterally in the posterior and lower zones of the lungs.
