Nature Of Pulmonary Lesions Research Articles

PERFUSION COMPUTED TOMOGRAPHY IN DETERMINING THE NATURE OF FOCAL PULMONARY LESIONS: CLINICAL AND STATISTIC ANALYSIS

Introduction . Advances in diagnostic imaging techniques have made it possible to measure a large number of blood flow parameters of pathological processes, and one of these techniques is perfusion computed tomography (PCT). The aim of the study was to confirm the reliability of CT perfusion findings in determining the nature of focal pulmonary lesions using statistical analysis data. Material and Method s. A 128-slice CT scanner was used to analyze PCT findings in60 patients with benign and malignant lung tumors. Conclusion. The average PS and TTP values are the main factors in determining the nature of pulmonary lesions. Conclusion : multi-slice CT perfusion imaging is a valuable technique in determining the nature of focal pulmonary lesions. Practical recommendations are given for performing CT-perfusion imaging of the lungs.

Lung Lesions During Fever of Unknown Origin.

Fever of unknown origin (FUO) remains one of the most difficult diagnostic challenges. The causes of FUO can be various diseases located in different organs. The aim of the study was to determine the prevalence and nature of pulmonary lesions during FUO. One hundred and sixty one patients with FUO participated in this prospective study. We performed a detailed comprehensive history, physical examination, and a wide spectrum of tests. The most common causes of FUO were infections (39%), autoimmune conditions (28%), and neoplasms (17%). Lung lesions were found in 30% of patients. In this group 35% were infections, 30% autoimmune diseases, and 4% cancer. Among patients with respiratory infections, there were cases of tuberculosis, atypical pneumonia, lung abscess, and bronchiectases. Autoimmune pulmonary lesions were observed during vasculitis and systemic lupus. The causes of FUO in the group of patients with lung lesions were also pulmonary embolism, sarcoidosis, and pulmonary fibrosis. Chest CT played an important role in the diagnosis of the causes of FUO with pulmonary manifestations. Pulmonary lesions are a common cause of FUO. Most FUO with pulmonary lesions are recognized during infections and autoimmune diseases. An important part of diagnosing FUO is a detailed evaluation of the respiratory system.

The pathogenesis of experimental endo-bronchial Mycobacterium bovis infection in brushtail possums (Trichosurus vulpecula)

Aim. To study the nature and development of experimentally induced respiratory tuberculosis in possums and compare the lesions observed with those seen in the natural disease. Methods. Thirty-three adult possums were inoculated via the endo-bronchial route with 20–100 colony forming units of Mycobacterium bovis. The possums were killed at 1, 2, 3 and 4 weeks after inoculation and the nature and distribution of the lesions studied in detail histopatbologically. Alveolar macrophages recovered from the infected possums were also studied ultrastructurally. Results. Macroscopic lesions were largely confined to the respiratory tract, increasing in size and number with time. Histology greatly increased the detection of the total number of lesions. The most common sites affected outside the respiratory tract were the liver and hepatic lymph nodes, but lesions were less common in peripheral lymph nodes than is observed in the natural disease. Intra-pulmonary lesions were centred on blood vessels and their associated lymphatics. Peripheral blood lymphocyte blastogenic responses to M. bovis antigens were first detected at 3 weeks after inoculation, which was 1 week after lymphocyte infiltrations were detected in the lungs, but 1 week before the majority of infections became generalised. Conclusions. Differences in the nature of pulmonary lesions and the distribution of lesions were observed between experimentally induced and the natural disease. Rapid haematogenous and lymphatic spread occurs early in the experimentally induced disease.

Detection of Pulmonary Metastases in a Patient with Synovial Cell Sarcoma Using ln-111 Labeled Monoclonal Antibody 19-24

A 35-year-old man was diagnosed in 1984 as having a synovial cell sarcoma of his right wrist without evidence of metastatic spread. The patient underwent regional hyperthermic chemoperfusion, wide-field excision, post-operative radiation therapy and systemic adjuvant chemotherapy. In 1986 and in 1987, because of new lesions found on chest radiographs, the patient underwent bilateral staging thoracotomies with resection of pulmonary metastases, followed by chemotherapy and radiotherapy. Later in 1987, a chest radiograph showed a large left hilar mass and multiple bilateral pulmonary nodules. Computerized tomography of the chest demonstrated a left hilar mass and two nodules in the right lower lung, raising the possibility of recurrent pulmonary metastatic cancer. As a diagnostic procedure, In-111 labeled monoclonal antibody (Mab) 19-24, produced against a human malignant fibrous histiocytoma, was infused intravenously, and 48-hour images revealed focal areas of increased uptake corresponding to the lesions seen on CT. At surgery, the lesions were confirmed to be synovial cell sarcoma. Imaging with Mabs specific for sarcoma may be particularly useful in sarcoma patients in whom there is clinical uncertainty regarding the nature of pulmonary lesions. In this case, the Mab was useful in distinguishing tumor deposits from postsurgical scarring and helped to guide subsequent surgery and treatment.

Role of percutaneous fine needle aspiration in the diagnosis of lung cancer: our experience with 140 patients.

The authors have performed percutaneous fine needle aspiration (FNA) biopsy in 140 patients with pulmonary lesions of suspected neoplastic nature. In 63% of the cases histologic diagnosis could be made on the bioptic sample. Comparison of these findings with those obtained with conventional exfoliative cytology suggest that the latter technique gives higher percentage of histological characterization, it is free of complications and easier to perform. Thus, FNA appears to be an additional, irreplaceable tool when conventional methods fail to provide clear-cut information regarding the histologic nature of pulmonary lesions.

The Flexible Broncho-Fiberscope

In the Department of Thoracic Surgery, Bispebjerg Hospital, Copenhagen, 750 patients were examined for pulmonary lesions during the nine-month period from August 1, 1972, to May 1, 1973. All the patients underwent conventional rigid bronchoscopy. in 100 of them accurate diagnosis could not be obtained by this method and they were consequently all examined with the flexible broncho-fiber-scope. the experience gained with the use of the flexible broncho-fiberscope combined with bronchial brushing and forceps biopsy is discussed. It is important to establish the nature of pulmonary lesions in order to avoid unnecessary thoracotomies and possibly serious complications, particularly in persons of advanced age. Broncho-fiberscopy has proved to be the most appropriate method for obtaining a diagnosis in case of central lesions of the upper lobes and of intermediate lung lesions. A diagnosis of peripheral lung lesion is most readily obtained by transthoracic fine-needle biopsy. It is concluded that a combination ...

The Flexible Broncho-Fiberscope

In the Department of Thoracic Surgery, Bispebjerg Hospital, Copenhagen, 750 patients were examined for pulmonary lesions during the nine-month period from August 1, 1972, to May 1, 1973. All the patients underwent conventional rigid bronchoscopy. in 100 of them accurate diagnosis could not be obtained by this method and they were consequently all examined with the flexible broncho-fiber-scope. the experience gained with the use of the flexible broncho-fiberscope combined with bronchial brushing and forceps biopsy is discussed. It is important to establish the nature of pulmonary lesions in order to avoid unnecessary thoracotomies and possibly serious complications, particularly in persons of advanced age. Broncho-fiberscopy has proved to be the most appropriate method for obtaining a diagnosis in case of central lesions of the upper lobes and of intermediate lung lesions. A diagnosis of peripheral lung lesion is most readily obtained by transthoracic fine-needle biopsy. It is concluded that a combination ...

Bronchoscopy in the diagnosis and treatment of bronchopulmonary disease

Although bronchoscopy is used in the treatment of certain pulmonary conditions, this phase remains secondary to its aid in diagnosis. The information gained by bronchoscopy is particularly valuable in the diagnosis of (1) obscure pulmonary disease, (2) the etiology of bronchial obstruction both complete and partial and (3) the determination of the cause of unexplained pulmonary symptoms. While one cannot rely entirely upon bronchoscopy in the diagnosis ol bronchogenic carcinoma, it remains the best means of providing a positive diagnosis, usually by histologic and cytologic study of tissue and secretions, and determining preoperatively the limits of the growth so that operability can be ascertained. When used in conjunction with roentgenography, a greater insight is gained into the nature of pulmonary lesions and the establishment of a more exact diagnosis. In treatment the major benefits are derived from the relief of bronchial obstruction, whether due to foreign bodies, benign or semi-malignant tumors, retained secretions or fibrous stenoses.