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Biomedical subjects

G L Weisbrod

Publications and source records attributed to G L Weisbrod.

At least 19 recordsLinked to original sources
PubMed2002

Mycobacterium avium complex lung disease in immunocompetent patients: radiography-CT correlation.

This study aimed to describe and correlate the chest radiography and CT findings of Mycobacterium avium complex (MAC) lung disease in immunocompetent patients. 26 patients fulfilled The American Thoracic Society criteria for MAC lung disease and underwent chest radiography and CT within 6 weeks of positive cultures. All abnormalities and predominant lobar involvement were recorded and abnormalities on chest radiography were correlated with those on CT. The images were evaluated by two chest radiologists and decisions were reached by consensus. 21 females and 5 males, with an overall mean age of 69 years, were included in the study. All chest radiographs and CT scans were abnormal. On chest radiography, overinflation was demonstrated in 18 patients. CT scan abnormalities included atelectasis (n=17), bronchiectasis (n=24), cavities (n=13), consolidation (n=3), emphysema (n=11), ground-glass opacity (n=8), linear opacities (n=26), mediastinal lymphadenopathy (n=3), nodules (n=25) and pleural disease (n=15). CT findings were at variance with chest radiography findings in 15 lobes. A new feature from this study is that the majority of patients with MAC lung disease demonstrate overinflation on chest radiography. 19% of cases had predominant upper lobe disease, indistinguishable from post-primary Mycobacterium tuberculosis infection. 77% of cases demonstrated the major imaging criteria of MAC lung disease. These are ill defined nodules, bronchiectasis, predominant middle lobe and/or lingular abnormalities, with or without overinflation. We believe that these characteristic radiological signs will assist the physician in the diagnostic work-up of patients with MAC lung disease.

Aged↗
PubMed1999

Correlation of chest radiographic findings with biopsy-proven acute lung rejection.

The purpose of this study was to determine the chest radiographic findings of acute rejection and the accuracy of chest radiography in making this diagnosis in patients undergoing lung transplantation. For each of 100 transbronchial biopsies performed on 25 lung transplant recipients (single lung in three, double lung in 22), chest radiographs obtained within 24 hours before the biopsy were reviewed retrospectively without knowledge of clinical or biopsy information. Transbronchial biopsy revealed 42 instances of acute rejection in 17 patients and 58 instances of no acute rejection (normal, n = 43; other processes, n = 15). All pulmonary parenchymal radiographic abnormalities were assessed. Acute rejection was associated with the presence of middle or lower lung reticular interstitial or airspace disease in 21 lungs (sensitivity = 0.50 [21/42]). This pattern was seen in 18 lungs without acute rejection (specificity = 0.69 [40/58]). There was no difference in the appearance of the lungs between grades 1 and 2 acute rejection. Normal lungs were noted in 20 instances of acute rejection (48%). The authors conclude that chest radiograph findings are abnormal in about 50% of instances of biopsy-proven acute rejection. Because the appearance of acute rejection is similar to that of other conditions, the diagnosis cannot be made accurately by chest radiography.

Acute Disease↗
PubMed1995

Cystic change (pseudocavitation) associated with bronchioloalveolar carcinoma: a report of four patients.

Cavitation in bronchioloalveolar carcinoma is uncommon, but apparent radiologic cavitation may be produced by other causes of abnormal air collections in and around the tumor. We report four patients whose plain films and computed tomography scans were interpreted as showing cavitary masses. Paracicatricial emphysema, fibrosis with honeycombing, and localized bronchiectasis were present pathologically to explain the abnormal air collections.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1994

Bronchioloalveolar carcinoma and the air bronchogram sign: a new pathologic explanation.

Bronchioloalveolar carcinoma (BAC) is one of the few lung tumors known to demonstrate the air bronchogram sign. Production of this valuable radiologic sign by this tumor has been ascribed to an "alveolar" filling process in which tumor grows along alveolar walls with preservation of the architecture and secretes copious amounts of mucus. Thus, aerated bronchi are surrounded by alveoli that are filled with mucus and tumor. We present a case in which the air bronchogram sign and pulmonary consolidation are associated with a nonsecretory BAC. Alternative mechanisms that may produce the air bronchogram sign in BAC are offered.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1994

Mediastinal invasion by bronchogenic carcinoma: CT signs.

PURPOSE: To determine the accuracy of computed tomographic (CT) signs in assessment of direct mediastinal invasion by primary bronchogenic carcinoma. MATERIALS AND METHODS: In 90 patients with primary bronchogenic carcinoma who underwent CT with thoracic surgical staging and thoracotomy, the pathologic and CT findings in 14 mediastinal structures were compared retrospectively. The degree of contact of the primary tumor with each structure and whether the structure was distorted or contained intraluminal tumor were recorded. A total of 785 mediastinal structures (25 with tumor invasion) were analyzed. RESULTS: When greater than 90 degrees of contact was considered a positive CT finding, the sensitivity of CT was 40% (10 of 25 structures); specificity, 99% (752 of 760 structures); and positive and negative predictive values, 56% and 98%. All structures with > 180 degrees of contact had pathologic involvement, but only 11 of 17 distorted structures (65%) and five of seven structures with intraluminal tumor (71%) were involved. CONCLUSION: CT is insensitive in detection of mediastinal invasion by primary bronchogenic carcinoma. The positive predictive value may be higher, depending on the criteria used.

Carcinoma, Bronchogenic↗
PubMed1994

Congenital bronchopulmonary diseases in adults: CT findings.

Congenital lung disease is divided into two types: lesions that arise from the primitive foregut (i.e., bronchopulmonary malformations) and lesions that originate in the pulmonary vasculature. The latter often are detected early in life because of signs and symptoms or other serious associated anomalies. Conversely, many of the bronchopulmonary anomalies are asymptomatic and therefore are not discerned until adulthood. This essay illustrates the spectrum of CT findings of many congenital bronchopulmonary malformations that are seen in adults, including pulmonary agenesis, anomalous bronchial branching, bronchial atresia, foregut cysts, bronchopulmonary sequestration, and pulmonary arteriovenous malformations.

Adult↗
PubMed1994

Pulmonary manifestations of coccidioidomycosis.

Pulmonary coccidioidomycosis is a fungal disease seen primarily in the southwestern United States and Mexico. However, with the advent of mass travel it is being seen increasingly in countries outside the zone where it is endemic. Pulmonary coccidioidomycosis, which has a high infectivity, is acquired by inhalation of fungal arthrospores. Its infectivity is increased in immunosuppressed patients, particularly those with the acquired immunodeficiency syndrome. Because of these factors, it is important for radiologists (particularly those practising outside the area of endemicity) to recognize the various manifestations of this disease. The authors review the major clinical syndromes and their radiologic manifestations.

Coccidioidomycosis↗
PubMed1993

Precocious emphysema in intravenous drug abusers.

It is becoming increasingly clear that obstructive airway disease and early emphysema occur in some drug addicts who intravenously abuse drugs intended for oral use. We report four patients with such a history who had clinical, pathophysiologic, and radiologic evidence of severe obstructive airway disease with hyperinflation. Three patients had bullae. All had radiologic changes of intravenous talc granulomatosis. One patient had moderately severe emphysema at autopsy. The pathogenesis of this disease is uncertain but may involve synergism with cigarette smoke, direct toxic effects of the drug, or induced intravascular leukocyte sequestration causing proteolytic pulmonary injury.

Adult↗
PubMed1992

Thin-walled cystic lesions in bronchioalveolar carcinoma.

In a retrospective study, thin-walled cystic lesions were identified in four patients with proved bronchioalveolar carcinoma (BAC). The radiographic appearances are described, and possible mechanisms of formation of the lesions are discussed. Although such appearances due to BAC have rarely been described in the literature, the authors believe that the differential diagnosis of thin-walled cystic lesions associated with consolidation should include BAC.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1991

Bronchiolitis obliterans after lung transplantation: findings at chest radiography and high-resolution CT. The Toronto Lung Transplant Group.

Although bronchiolitis obliterans (BO) is seen commonly after heart-lung transplantation, its occurrence after lung transplantation appears to be relatively infrequent. In the 55 single- and double-lung transplantations performed at Toronto General Hospital, 41 patients have survived longer than 3 months and four (10%) have developed pathologically proved BO. Chest radiographic findings in these four patients included slight to moderate decreased peripheral vascular markings (n = 3), slight to moderate volume loss (n = 2), subsegmental atelectasis (n = 2), and new, thin, linear, irregular areas of increased opacity (n = 2). High-resolution computed tomography (HRCT) demonstrated mild peripheral bronchiectasis (n = 4) and decreased peripheral vascular markings (n = 3). Although the radiographic and HRCT findings did not appear to be specific for posttransplantation BO, they may be of value in suggesting the diagnosis of BO within this patient population.

Adult↗
PubMed1991

Anterior mediastinal masses: utility of transthoracic needle biopsy.

The results of 143 transthoracic needle biopsies (TNBs) in 126 patients with anterior mediastinal masses were compared with the final diagnosis, which was proved with pathologic study (n = 95) or clinicoradiologic methods (n = 31). In the 26 patients with lymphoma, the sensitivity of TNB was 42%; the specificity, 96%. In the 15 patients with Hodgkin disease, the sensitivity was 20%. In the 28 patients with thymoma, the sensitivity was 71%; the specificity, 94%. In the 11 patients with germ cell tumors, the sensitivity was 91%; specificity, 98%. The sensitivity in the 33 patients with metastatic disease was 70%; specificity, 100%. The cytologic specimens were examined with light microscopy and the Papanicolaou method only, a limitation that explains the difficulty in differentiating lymphoma from thymoma and that can now be overcome with immunohistochemical study. TNB of anterior mediastinal masses is useful in metastatic disease and germ cell tumors. Lymphoma and thymoma are less reliably diagnosed unless immunohistochemical cytologic methods are applied.

Adolescent↗
PubMed1990

Usefulness of the blood patch technique after transthoracic needle aspiration biopsy.

The authors investigated the effectiveness of the blood patch technique in reducing the pneumothorax and chest tube insertion rates after transthoracic needle lung biopsy. Biopsy of 100 pulmonary nodules was performed with a coaxial system. In this prospective, randomized study, patients either received a blood patch (group A, n = 46) or did not (group B, n = 47). Seven procedures were excluded: five for technical reasons and two because of lack of follow-up information. Comparison of the two groups by means of X2 analysis and the Student t test revealed no difference in the mean age, gender, smoking history, proportion of heavy smokers, nodule size, presence of cavitation, or number of needle passes. The pneumothorax rate was 24% (11 of 46 patients) in group A and 30% (14 of 47 patients) in group B. The chest tube insertion rate was 2.2% (one patient) in group A and 2.1% (one patient) in group B. The difference between the groups in either rate was not significant (P greater than .5). The blood patch technique did not lower the rate of pneumothorax or chest tube insertion.

Biopsy, Needle↗
PubMed1990

Transthoracic percutaneous lung biopsy.

Percutaneous fine-needle aspiration biopsy of the lung is a relatively simple invasive procedure with good patient acceptance, low morbidity, and almost negligible mortality. It provides a diagnosis of pulmonary, hilar, and mediastinal masses quickly and accurately, eliminating many laboratory tests and saving hospital days, thereby saving time and money. Percutaneous fine-needle aspiration biopsy should be performed early in the investigation of many types of intrathoracic lesions.

Biopsy, Needle↗
PubMed1990

Atypical collapse of the upper lobe of the right lung simulating combined right upper and middle lobe collapse: report of two cases.

The authors describe two cases of collapse of the upper lobe of the right lung simulating the appearance on plain chest radiographs of collapse of the right upper and middle lobes combined. Computed tomography and bronchoscopy in both cases and surgery in one case showed that the middle lobe was normal. Possible mechanisms for this appearance on plain chest radiographs include the presence of adhesions between the obstructed upper lobe and pleura and the presence of obstructive pneumonia in the upper lobe, preventing typical collapse.

Aged↗