Subsolid pulmonary nodules: CT-pathologic correlation using the 2011 IASLC/ATS/ERS classification.

Adenocarcinoma is the most common histologic subtype of lung cancer. Recent advances in oncology, molecular biology, pathology, imaging, and treatment have led to an increased understanding of this disease. In 2011, the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society published a new international multidisciplinary classification. Using this taxonomy, we review the spectrum of subsolid pulmonary nodules seen on computed tomography together with their histopathologic correlates and current management guidelines.

Catheter-directed interventions for acute iliocaval deep vein thrombosis.

Acute deep vein thrombosis (DVT) is associated with significant morbidity in the form of acute limb-threatening compromise from phlegmasia cerulea dolens, development of the postthrombotic syndrome (PTS), and even death secondary to pulmonary embolism. Initial therapy for DVT is anticoagulation, which inhibits thrombus propagation but lacks the thrombolytic properties to facilitate active thrombus removal. The existing thrombus burden can cause increased venous hypertension from occlusion as well as damage to venous valves by initiating an inflammatory response, which can ultimately result in PTS in up to half of patients on anticoagulation. The manifestations of PTS include leg pain, swelling, lifestyle-limiting venous claudication, skin hyperpigmentation, venous varicosities, and, in rare cases, venous stasis ulcers. Furthermore, patients with iliocaval DVT and large, free-floating thrombus are at an increased risk for pulmonary embolism despite adequate anticoagulation. Early attempts at thrombus removal with surgical thrombectomy or systemic thrombolysis or both demonstrated reductions in the incidence of PTS but were of limited utility owing to their invasiveness and increased risk of bleeding complications. New minimally invasive endovascular therapies, such as pharmacomechanical catheter-directed thrombolysis, have been proposed, which focus on rapid thrombus removal while decreasing the rate of bleeding complications associated with systemic therapy. This article provides an overview of the current pharmacomechanical catheter-directed thrombolysis protocol utilized at the Mount Sinai Hospital for acute iliocaval DVT.