ABSTRACT
Impaired single breath carbon monoxide diffusing capacity (DLCO) is associated with emphysema. Small airways disease (SAD) may be a precursor lesion to emphysema, but the relationship between SAD and DLCO is undescribed. We hypothesized that in mild COPD, functional SAD (fSAD) defined by computed tomography (CT) and Parametric Response Mapping methodology would correlate with impaired DLCO. Using data from ever-smokers in the COPDGene cohort, we established that fSAD correlated significantly with lower DLCO among both non-obstructed and GOLD 1-2 subjects. The relationship between DLCO with CT-defined emphysema was present in all GOLD stages, but most prominent in severe disease. TRIAL REGISTRATION: NCT00608764. Registry: COPDGene. Registered 06 February 2008, retrospectively registered.
Subject(s)
Airway Obstruction/diagnostic imaging , Bronchioles/pathology , Pulmonary Disease, Chronic Obstructive/genetics , Pulmonary Emphysema/genetics , Aged , Airway Obstruction/pathology , Airway Remodeling/physiology , Bronchioles/abnormalities , Carbon Monoxide/metabolism , Cohort Studies , Female , Humans , Male , Middle Aged , Multivariate Analysis , Pulmonary Diffusing Capacity , Pulmonary Disease, Chronic Obstructive/diagnostic imaging , Pulmonary Emphysema/diagnostic imaging , Regression Analysis , Respiratory Function Tests , Retrospective Studies , Severity of Illness Index , Tomography, X-Ray Computed/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Thoracic Injuries , Bronchial Diseases/diagnostic imaging , Bronchioles/abnormalities , Accidents, Traffic , Incidental FindingsABSTRACT
INTRODUCTION: Congenital pulmonary airway malformation (CPAM) is a major indication of lobectomy in children. Early lobectomy had been proposed for the advantage of compensatory lung growth. Despite the increasing use of thoracoscopic lobectomy its effect on postoperative lung function was still not well established in the literature. This study was therefore performed to study the result of postoperative pulmonary function test (PFT) on a medium term basis. MATERIALS AND METHODS: All patients who underwent thoracoscopic lobectomy for CPAM between 2006 and 2010 were recruited into the study. PFT was performed 5 years after the operation. Age-matched healthy individuals with similar body size were recruited for PFT as the control group. Demographic data and PFT results were extracted for statistical analysis. Test result less than 80% of predicted value was considered abnormal. RESULTS: Fifteen consecutive patients were identified in the study period, 8 boys and 7 girls. The PFT was performed at a mean age of 9 years. None of the patients had respiratory symptoms. The forced vital capacity (FVC) (99.6% versus 97.0% predicted, P = .56), forced expiratory volume in 1 second (FEV1) (86.0% versus 89.1% predicted, P = .52), FEV1 to FVC ratio (96.6% versus 98.7% predicted, P = .60), total lung capacity (92.5% versus 94.5% predicted, P = .68), and alveolar volume adjusted diffusion capacity of carbon monoxide (106.4% versus 100.4% predicted, P = .35) showed no statistical difference from the control group. CONCLUSION: Patients who underwent thoracoscopic lobectomy have normal lung function 5 years after the operation. Further study is necessary to confirm the long-term result.
Subject(s)
Bronchioles/abnormalities , Bronchioles/surgery , Pneumonectomy/methods , Pulmonary Alveoli/pathology , Respiratory System Abnormalities/surgery , Thoracoscopy , Adolescent , Child , Female , Forced Expiratory Volume , Humans , Lung/surgery , Male , Organ Size , Pulmonary Diffusing Capacity , Time Factors , Total Lung Capacity , Vital CapacityABSTRACT
Congenital pulmonary airway malformation (CPAM) of the lung is an uncommon developmental anomaly. We report an unusual case of type 1 CPAM with abundant cartilage in a 5-year-old boy. On chest radiography, a left lung mass was detected incidentally, and tumor resection was performed under the impression of a benign tumor. The pathological examination of the mass revealed abundant cartilage in the walls of malformed bronchioles with partially cystic dilatation. We think that this case represents a cartilaginous variant of CPAM. The cartilaginous variant of CPAM should be differentiated pathologically from other pulmonary neoplasms containing abundant cartilage, such as chondroid hamartoma.
