[Clinical case of the month. Pierre Marie Bamberger syndrome].
We report the case of a lung adenocarcinoma revealed by clubbing and secondary hypertrophic osteoarthropathy or Pierre-Marie Bamberger syndrome.
Biomedical subjects
Publications and source records attributed to B Duysinx.
We report the case of a lung adenocarcinoma revealed by clubbing and secondary hypertrophic osteoarthropathy or Pierre-Marie Bamberger syndrome.
We report the case of a patient treated by chemotherapy for a diagnosis of mesothelioma. A quickly progressive dyspnea developed which was due to compression of the right main bronchus by mediastinal extension of the tumor. This obstruction was treated by interventionnal bronchoscopy and stenting.
In a healthy individual, a dyspnoea of abrupt onset raises the suspicion of a spontaneous pneumothorax. The clinical examination and standard chest X-ray usually permit the correct diagnosis. The risk of reccurence can be assessed by the clinical history and examination. The functional consequences (which can be lethal) and the risk of recurrence will guide the short- and long-term therapy.
During recent years the endobronchial prostheses has become an essential part of the therapeutic bronchoscopy in order to remove obstructions from the proximal airways, in malignant diseases, (principally lung cancer) are in benign disorders. In this article we report our last ten year experience in stenting of the tracheo-bronchial tree. We will retrospectively review the indications of the stents, the type of prostheses and their modes of insertion, their complications, the clinical and functional results.
MacLeod syndrome is a rare cause of localized hypertransradiancy of the lung. This syndrome is defined by radiological features: localized hypertransradiancy due to oligemia and presence of air-trapping on expiratory chest radiography. Involvement of one entire lung is called "unilateral hyperlucent lung". Whereas the etiology is different, the physiopathology is probably identical to that of the panacinar emphysema of chronic obstructive pulmonary disease. The syndrome is believed to be related to acute bronchiolitis during infancy. Clinical manifestations and prognosis depend mainly on the presence of other lesions due to the same infectious agent like bronchiectasis. Pulmonary function tests, chest CT-scan, ventilation and perfusion scintigraphy and, if necessary, bronchoscopy help the differential diagnosis and detect associated bronchiectasis.
A 49 year old woman was admitted because of general poor health condition having lasted for 15 days and been associated for 6 months with sinusitis. During hospitalisation, she developed thrombosis of the retina central artery and signs of cerebral vasculitis. A diagnosis of Wegener disease was suggested based on one side on the presence of multiple excavated pulmonary macronodules and, on the other side, on the signs of cerebral vasculitis. No renal dysfunction was documented in our patient. The detection of serum antineutrophil antibodies (c-ANCA and anti-PR3) confirmed the diagnosis of Wegener disease without the need of surgical pulmonary biopsy. In addition to the typical ENT and pulmonary symptoms, this particular clinical presentation of unusual ocular and cerebral symptoms, reminds us that Wegener disease is a vasculitis that can give multisystemic disorders.
The etiological diagnosis of chronic thoracic pain is wide, from benign mechanical disorders to tumors. Reaching the exact diagnosis in often time consuming. Despite the availability of new techniques of imagery, a meticulous clinical history and physical examination remain mandatory. They will lead the exploration. Idiopathic intercostal neuralgia does not exist.
Explore the source record for details and available documents.
PositIon emission tomography using 18-fluorodeoxyglucose (FDG-PET) is an imaging technique based on metabolic criteria rather than morphological criteria. We discuss the contribution of this technique in the field of pulmonary oncology and we summarize our work which has demonstrated the performance capacity of PET: to discriminate the malignant nature of a solitary pulmonary nodule; to improve sensitivity over CT for mediastinal assessment in non-small cell lung cancer; to seRach for distant metastasis in patients with non-small cell lung cancer; to complement CT imaging to better dissociate tumor residue or recurrence from post-therapeutic sequelae in non-small cell lung cancer. Finally, we present different expected progress for the future.
Explore the source record for details and available documents.
Continuing advances in PET imaging have resulted in an improved ability to evaluate thoracic malignancies. Published reports demonstrate that PET provides accurate noninvasive detection of malignancy that is useful in the characterization of a pulmonary solitary nodule and in the mediastinal or extrathoracic staging of known lung cancer. Preliminary studies suggest that PET may also be able to assess the therapeutic response after surgery or radiation therapy.
In order to evaluate the usefulness of 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the assessment of therapeutic effects, a study was performed before and after therapy in 126 patients with non-small cell lung cancer (NSCLC) codified stage I to stage IIIB. Treatment with an early curative result was given in 58 patients, whereas in 68 cases it was limited to palliation. During the treatment follow-up period (8-40 months), each patient was evaluated every 3 months by clinical examination and < or =6 months by imaging techniques (PET and computed tomography (CT)). A diagnosis of persistent or recurrent tumour was established by means of pathological analysis in 31 patients and by clinical evolution and subsequent imaging progression in 29 other patients. PET showed increased FDG uptake in all cases (n = 60) of persistent or recurrent tumour, whereas CT was nonspecific in 17 cases. Conversely, there were five false positive cases via PET imaging and three via CT. In detecting residual or recurrent NSCLC, PET had a sensitivity of 100% and specificity of 92%, whereas CT had a sensitivity and specificity of 71% and 95% respectively. In conclusion, 18-fluorodeoxyglucose positron emission tomography correctly identified response to therapy in 96% (121 of 126) of patients. Positron emission tomography appears to be more accurate (p = 0.05) than conventional imaging in distinguishing persistent or recurrent tumour from fibrotic scar in patients undergoing treatment for non-small cell lung cancer.
In this study, we analysed the cellular component of induced sputum in healthy control subjects (n = 30), asthmatics (n = 44), patients suffering from COPD (n = 15), pulmonary tuberculosis (PTB) (n = 14) and healthy steel workers (HSW) (n = 14). Sputum was induced by inhalation of hypertonic saline (NaCl 5%) for 20 min. When compared to the healthy control group, all the disease groups as well as the one of healthy steelworkers exhibited significantly higher total sputum cell counts. Analysis of the differential cell counts showed that there was a significant increase in % eosinophils in asthmatics, in % neutrophils in COPD, asthmatics, tuberculosis and healthy steelworkers and in % lymphocytes in pulmonary tuberculosis. Our study illustrates the feasibility and the possible clinical application of induced sputum analysis in several pulmonary diseases and shows how this technique could be useful in assessing airway inflammatory processes in subjects exposed to industrial pollutants.
Explore the source record for details and available documents.