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Biomedical subjects

F Arbib

Publications and source records attributed to F Arbib.

18 recordsLinked to original sources
PubMed2004

Clinical prognostic indicators of high-grade pre-invasive bronchial lesions.

Lung cancer arises from multistep genetic damage of bronchial epithelium, driving multifocal progressive dysplastic lesions. However, the risk of progression of high-grade pre-invasive bronchial lesions to cancer is poorly assessed. The purpose of this study was to better define the parameters that predict the outcome of these lesions. The current authors prospectively studied 27 patients with 31 histologically proven severe dysplasia (SD) and carcinoma in situ (CIS), with repeated bronchoscopy and endobronchial treatment. The influence of respiratory-cancer history, histopathological classification, tobacco consumption, and number of biopsies on the progression rate into cancer was studied. The actuarial progression rate to cancer was 17% at 1 yr and 63% at 3 yrs. A total of 11 cases of CIS progressed to invasive cancer, 17 were stable or regressed during the study, two with SD regressed and one progressed to invasive cancer. Progression of CIS appeared more frequent in lesions diagnosed as "questionable CIS". Persistence of smoking did not influence high-grade lesion outcome. The existence of synchronous lung cancer did not seem to impact on progression. The number of biopsies did not influence the outcome. In conclusion, the current study suggests that the outcome of high-grade pre-invasive lesions is not modified by the number of biopsies performed on these lesions. Careful pathological examination of these lesions and pathological revision seem necessary, since questionable cases have the worse progression rate.

Aged↗
PubMed2003

Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy.

The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy ( n=13) or benign diseases ( n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration ( n=6); external compression with persistent stenosis ( n=4); local recurrence of malignancy ( n=4); fracture ( n=1); and non-congruence between the airway and the stent ( n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions ( p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting.

Adult↗
PubMed2003

[Multiple congenital stenoses of the segmental pulmonary arteries in an elderly patient].

Congenital stenoses of the pulmonary artery are a rare cause of pulmonary arterial hypertension, usually diagnosed in childhood. We report the first description of multiple arterial pulmonary malformations in an elderly patient, revealed by an acute severe pulmonary embolism. Despite an immediate excellent response to fibrinolysis, persistent and elevated arterial pulmonary pressures were consistent with the presence of an underlying arterial pulmonary disease. Pulmonary angiography led to the diagnosis of type III multiple segmental arterial pulmonary stenoses. Eight years later, the patient remained well. This original report underlines the potential good outcome of pulmonary artery stenoses, and suggests the presence of such silent or misdiagnosed lesions in adulthood.

Angiography↗
PubMed2000

Benign abnormalities and carcinoid tumors of the central airways: diagnostic impact of CT bronchography.

OBJECTIVE: The purpose of this retrospective study was to determine the added diagnostic value, if any, of CT bronchography for the detection and characterization of benign abnormalities and typical carcinoid tumors of the central airways. MATERIALS AND METHODS: We used bronchoscopy and helical CT to examine 238 bronchial sections in 28 patients with 32 bronchial abnormalities and in five patients with normal bronchoscopy results. Postprocessing consisted of CT bronchography based on surface rendering. Images were interpreted independently by two observers (a radiologist and a pneumonologist) who were not informed of the bronchoscopy results. After initial interpretation of axial CT scans, the observers analyzed the axial CT scans with CT bronchograms. Results were evaluated for gain in diagnostic accuracy and in confidence. RESULTS: Mean sensitivity for detection of abnormal bronchial sections was 89% (range, 87-90%) for axial CT and 92% (range, 90-94%) for axial CT with CT bronchography (not significant). Mean specificity of both approaches exceeded 99%. A correct diagnosis of the nature of the bronchial abnormalities was proposed for 68% of the cases in which axial CT was used alone and in 76% in which both axial CT and CT bronchography were used (not significant). The addition of CT bronchography significantly increased the confidence of the pneumonologist in the diagnoses. CONCLUSION: Axial CT remains the technique of choice to detect and characterize benign abnormalities of the airways. CT bronchography provides little diagnostic gain but increases the confidence of chest physicians in the interpretation of CT scans for the assessment of benign abnormalities and typical carcinoids of the central airways.

Adolescent↗
PubMed1996

[Endobronchial stenoses in Wegener's granulomatosis].

The authors describe a case of a patient suffering from Wegener's disease with endobronchial manifestations which progressively developed tracheal stenosis which was not accessible to the usual immunodepressive therapy. Repeated endobronchial dilatation using a balloon introduced via supple fibroscope was carried out with success. The balloon dilatation seems a useful alternative approach to other therapies such as surgery. It is a non-aggressive technique which is easily performed and has no complications.

Biopsy↗
PubMed1995

[Subacute idiopathic eosinophilic pneumopathy with favorable outcome without corticotherapy].

The authors report a case of acute idiopathic eosinophilic pneumonia, a recently described entity of unknown etiology. The patients develop a rapidly progressive respiratory failure which is reversible following steroid therapy. The key to the diagnosis is an eosinophilia in the broncho-alveolar lavage or in the lung biopsy. Our observation of a favourable outcome in this case without steroid therapy is evidence perhaps of a less aggressive form of the disease.

Adrenal Cortex Hormones↗
PubMed1994

[Acute eosinophilic pneumonia and the larva migrans syndrome: apropos of a case in an adult].

Toxocariasis is a frequent disease in children, but the severe clinical manifestations are rare in the literature (diffuse interstitial pneumonia with hypoxaemia and acute severe asthma). The diagnosis is made thanks to the reliability of serological techniques (the ELISA test and using antigen excretion-secretion tests of the larvae of Toxocara canis). The authors report a case of acute severe eosinophilic pneumonia whose outcome was rapidly favourable following steroid therapy; the existence of positive Toxocara canis serology with a contamination risk of the patient in the domestic environment leads us to integrate the clinical picture into the larva migrans syndrome.

Adult↗
PubMed1993

[Thymoma and primary Gougerot-Sjögren syndrome progressing to severe bronchiolitis].

The authors report a case of a thymoma associated with Gougerot-Sjögren's syndrome in a patient aged 40 years. The excision of the thymic tumour and complementary radiotherapy lead to a remission in the patient. There was an unfavourable progression of this syndrome from a respiratory stand-point with the development of a predominantly bronchiolitic picture over four years.

Adult↗
PubMed1991

[Primary tumor of the thoracic wall unusual in aged patients: costal osteosarcoma].

Osteosarcoma is a tumour that is encountered in children and young adults but is exceptional in elderly people. Moreover, it is very rarely located in the chest. A case of costal osteosarcoma revealed by a pleural blood effusion is reported in a 66-year old male patient. Full surgical excision completed by parietal reconstruction was performed. The diagnosis of osteosarcoma was definitely confirmed at pathological examination. A few months later, a local recurrence associated with ipsilateral lung metastasis, was discovered and the patient was put on chemotherapy. The clinical, radiological and therapeutic aspects of this case are discussed.

Age Factors↗