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G L Weisbrod

Publications and source records attributed to G L Weisbrod.

At least 37 records · Page 2Linked to original sources
PubMed1989

Single-lung transplantation: imaging features.

The imaging studies obtained after single-lung transplantation in 14 patients were reviewed. The reimplantation response occurred in 13 patients and was an early, transient process, which varied in its manifestations from a subtle perihilar haze to dense consolidation with air bronchograms. Nine episodes of acute rejection, an imprecise clinical diagnosis, occurred in eight of the patients. The associated chest radiographic changes were variable and included basal or diffuse reticular interstitial disease in three cases and basal and/or perihilar consolidation in three cases; no change was detected in three cases. On four occasions, the radiographic changes resolved within 24 hours of intravenous corticosteroid administration. The radiographic findings associated with the reimplantation response and rejection were nonspecific and could have been mistaken for those of fluid overload, atelectasis, mucous plugging, and pneumonia. Bronchial dehiscence was well demonstrated by the finding at computed tomography of extraluminal air adjacent to the bronchial anastomosis. One patient developed multiple pulmonary nodules due to cyclosporine-induced lymphoma.

Acute Disease↗
PubMed1989

Pulmonary lymphangioleiomyomatosis: high-resolution CT findings in four cases.

Lymphangioleiomyomatosis is a rare disease of unknown cause that affects women of reproductive age. It is characterized by progressive proliferation of smooth muscle in the lung. The patients present with progressive shortness of breath, pneumothorax, chylous effusion, and hemoptysis. Four patients with biopsy-proved lymphangioleiomyomatosis of the lung were evaluated using high-resolution CT. In all patients, the scan showed well-defined cystic air spaces, surrounded by uniformly thin walls, distributed diffusely throughout both lungs. The cystic air spaces ranged in size from a few millimeters to 5 cm. Pathologically, these cysts were predominantly bounded by normal-looking parenchymal components, with occasional patchy involvement by a smooth-muscle proliferative process. The CT appearance of lymphangioleiomyomatosis differs quite distinctly from that of other diseases that can cause cystic air spaces, such as fibrosing alveolitis, neurofibromatosis, and bronchiectasis, and less distinctly from pulmonary emphysema and eosinophilic granuloma. Our experience in these few cases suggests that the high-resolution CT findings in lymphangioleiomyomatosis are characteristic of the disease.

Adult↗
PubMed1989

Chest radiographic findings after bilateral lung transplantation.

We reviewed the postoperative chest radiographic and CT findings in the first 13 patients who underwent bilateral lung transplantation at our institution. Portable chest radiography was performed daily for about 10 days, after which upright posteroanterior studies were performed daily for about 10 days, and then as clinically required. CT was performed when a complication was suspected. The reimplantation response (noncardiogenic pulmonary edema due to ischemia, trauma, denervation, and lymphatic interruption) occurred in 12 patients and usually consisted of bilateral perihilar and basal consolidation. Twelve episodes of acute rejection, an imprecise clinical diagnosis, occurred in 10 patients. Radiographic changes consisted of bibasal (n = 2), right mid and lower (n = 2), or left basal consolidation (n = 1); there were no changes in seven episodes. Radiographic resolution occurred in four cases after administration of IV steroids. The radiographic findings associated with the reimplantation response and rejection were nonspecific and were mimicked by fluid overload and infection. Bronchial dehiscence and/or stricture formation occurred in seven patients; generally chest radiography was inaccurate and CT was very accurate in the assessment of these complications. Chest radiography was helpful but not definitive in sorting out the problems occurring in the postoperative period after bilateral lung transplantation. CT was excellent for use in demonstrating airway problems.

Adolescent↗
PubMed1989

Cyclosporine-induced lymphoma following a unilateral lung transplant. The Toronto Lung Transplant Group.

Lymphomas are a well-known complication of therapy following organ transplantation. To date we have seen one lymphoma develop in a group of 24 patients who have undergone single or double lung transplantation. We report a 16-year-old man who developed multiple, rapidly appearing pulmonary nodules four months following transplantation. The Epstein-Barr virus and immunosuppressant drugs such as cyclosporine A have been implicated in the pathogenesis of this patient's rapidly progressive and fatal course.

Adolescent↗
PubMed1989

Pulmonary angiitis and granulomatosis: a review.

Vasculitis is a clinical-pathological process characterized by inflammation and necrosis of blood vessels. It has been effectively classified by Fauci. Granulomatosis in the lung may be angiocentric or bronchocentric in distribution. The angiocentric forms of granulomatosis and vasculitis include Wegener's granulomatosis, allergic angiitis and granulomatosis of Churg and Strauss, lymphomatoid granulomatosis, and necrotizing sarcoid granulomatosis. Wegener's granulomatosis is a well-defined syndrome characterized by necrotizing granulomatous vasculitis of the upper and lower respiratory tracts, segmental necrotizing glomerulonephritis, and systemic small vessel vasculitis. Allergic angiitis and granulomatosis is a less common multisystem vasculitis with many features similar to polyarteritis nodosa. Lymphomatoid granulomatosis is an angiocentric and angiodestructive lymphoreticular proliferative and granulomatous disease involving predominantly the lungs and resembling lymphoma. Necrotizing sarcoid granulomatosis is probably a variant of sarcoidosis in which an angiitis is a prominent feature. Because the radiology of these diseases can be similar, their important differences are highlighted. The appearance of multiple nodules, often with cavities, and pleural-based consolidations resembling pulmonary infarcts should suggest pulmonary angiitis and granulomatosis, especially if improvement occurs in one area while disease is progressing elsewhere. Bronchocentric granulomatosis is not a primary vasculitis but is discussed because of its similarity to the other diseases.

Adult↗
PubMed1988

Computed tomography and pathologic correlations of thymic lesions.

Computed tomographic and pathologic correlations of the thymus gland were assessed in 69 patients. The sensitivity of computed tomography (CT) for undifferentiated thymic pathology is 87.1%; the specificity is 85.7%. The sensitivity of CT for neoplasm or mass is 97.1%, the specificity is 97.1%. The sensitivity of CT for lymphoid follicular hyperplasia (LFH) is 71.4%, the specificity is 97.6%. Therefore, a normal-sized thymus gland on CT does not exclude LFH. Completely preserved fat planes between thymic mass and adjacent structures on CT usually indicate a benign (noninvasive) neoplasm; completely absent fat planes usually indicate a malignant (invasive) neoplasm; partially preserved fat planes are indeterminate in assessing invasiveness. CT is also useful in showing recurrence or remnants of thymic tissue in patients who have had a previous thymectomy.

Adolescent↗
PubMed1988

Pulmonary blastoma, report of three cases and a review of the literature.

Pulmonary blastoma is one of the least common primary malignant tumors of the lung. There is considerable controversy as to its exact histogenesis; it is uncertain if it arises from a single cell or if it is a mixed tumor arising from two different cell lines. We report three patients with pulmonary blastomas, describing in detail their radiological, cytological, and histopathological features.

Adult↗
PubMed1988

Lymphomatoid granulomatosis: a review of 12 cases.

We retrospectively studied 12 patients with lymphomatoid granulomatosis (LYG), a form of angiitis and granulomatosis first described in 1972, with emphasis on radiographic findings and clinical presentation. Ten patients had bilateral disease, with middle and lower lung predominance of ill-defined nodular densities being the commonest radiographic presentation. In two patients, chest radiography showed mixed alveolar and interstitial disease. Symptoms of cough, dyspnea, and cutaneous disorders with or without neurologic complications, in a patient with an abnormal chest radiograph, are suggestive of the diagnosis of LYG.

Adult↗
PubMed1987

Mediastinal lymph node metastases from bronchogenic carcinoma: detection with MR imaging and CT.

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in a prospective study of 48 patients for the detection of metastatic mediastinal lymphadenopathy from bronchogenic carcinoma. The images were interpreted by three experienced radiologists using a five-point rating scale, enabling receiver operating characteristic (ROC) analysis. Imaging results were evaluated against "truth" data based on analysis of surgical specimens from mediastinoscopy and thoracotomy. All MR images were cardiac gated to reduce cardiac motion artifacts in the mediastinum. MR and CT both performed well, as indicated by similar areas under the ROC curves of 0.779 +/- 0.039 for MR imaging and 0.781 +/- 0.038 for CT scanning. No strong correlation between nodal size and metastatic involvement could be found for either MR or CT results. As long as nodal size remains the sole criterion in the detection of metastatic mediastinal lymphadenopathy, MR imaging is unlikely to enable better interpretations than CT scanning.

Adult↗
PubMed1987

Preliminary experience with a dual cutting edge needle in thoracic percutaneous fine-needle aspiration biopsy.

Results of 133 thoracic percutaneous fine-needle aspiration biopsies performed with a new dual cutting edge needle were analyzed to see if it could reduce the false-negative rate for malignancy compared with that achieved with a sharply beveled spinal needle. Results of cytologic examinations were compared with those of histopathologic examinations. Cores of tissue for histopathology could be obtained in only 51 biopsies (one of which was lost). Sensitivity of cytology (vs. histopathology) was 77.8% (vs. 57.1%); specificity and positive predictive value, 100% (same); and negative predictive value, 64.3% (vs. 46.4%). In 44 of 50 biopsies, cytologic results were equal to or better than histopathologic results diagnostically. In six biopsies (including two cases of hamartoma), the histopathologic result improved upon the cytologic result. There were no biopsies for which cytologic results were negative and histopathologic results were positive for malignancy. Use of this needle did not improve the false-negative rate for malignancy, although it did allow specific diagnosis of a hamartoma in two cases.

Biopsy, Needle↗
PubMed1987

Small cell anaplastic carcinoma: cytological-histological correlations from percutaneous fine-needle aspiration biopsy.

Small cell anaplastic carcinoma (SCAC) is usually treated non-surgically and, therefore, diagnosis is best done by the least invasive means. Percutaneous fine-needle aspiration biopsy is very accurate in diagnosing malignancy and reasonably accurate in diagnosing malignant cell type. An unequivocal cytological diagnosis of SCAC has a positive predictive value of 0.90 at our institution. The accuracy is lowered by uncertain or suggestive cytological diagnoses.

Aged↗
PubMed1987

Left upper lobe torsion following left lingulectomy.

A patient with torsion of the remaining left upper lobe following lingulectomy is described. Chest radiographs showed a mass-like homogeneous density in the left upper chest resembling atelectasis but associated with some shift of the mediastinum to the right. This appearance together with the clinical features should suggest the possibility of torsion.

Adult↗
PubMed1987

Percutaneous fine-needle aspiration biopsy of the mediastinum.

Percutaneous needle aspiration biopsy of the mediastinum has become a safe and reliable diagnostic technique that can decrease the need for mediastinoscopy in a large number of cases. It is particularly useful in detecting metastatic carcinoma, but it can also be helpful in the diagnosis of a number of other mediastinal lesions including thymoma, lymphoma, and cysts. Experience with the procedure and good cytopathological interpretation are important to the success of the procedure.

Biopsy, Needle↗
PubMed1986

Cytologic diagnosis of bronchioloalveolar carcinoma by fine-needle aspiration biopsy.

From 1970 to June 1984, 275 patients with bronchioloalveolar carcinoma were admitted to the Toronto General Hospital. Of these, 181 (190 aspiration biopsies, including nine repeat samples) had this diagnosis made following the use of transthoracic fine-needle aspiration biopsy. Based on the cytomorphologic features observed in the aspiration preparations, the tumor was subclassified into three types: nonsecretory, secretory, and poorly differentiated. The cytologic features of these three types of bronchioloalveolar carcinoma are presented and illustrated. Cytomorphologically, the three types of this tumor are distinctly different and their features are sufficiently distinctive from those of bronchogenic adenocarcinoma and metastatic adenocarcinomas to be of diagnostic value. Transthoracic fine-needle aspiration biopsy appears to be a definitive minimally invasive means of establishing the diagnosis of bronchioloalveolar carcinoma preoperatively and especially to be of value for those small peripheral cancers which are relatively inaccessible to direct method of study and are potentially surgically curable.

Adenocarcinoma↗
PubMed1986

Unusual radiologic presentations of bronchioloalveolar carcinoma.

Bronchioloalveolar carcinoma appears with variable radiologic features. The usual findings include a single nodule, multiple nodules, or areas of consolidation in lung. An air bronchogram in an area of nodular or mass-like density is also a well-known feature. We here report six patients whose disease illustrates interesting or unusual aspects of this neoplasm. The findings include: Minimal radiological signs despite diffuse disease found on CT scan or at surgery (two patients). Thickening of the wall of a preexisting lung cavity: presumed bronchogenic cyst. Expansile lobar consolidation without an air bronchogram simulating pleural disease. An elongated lobulated area of mass-like density resembling mucoid impaction. Homogeneous lobar atelectasis without an air bronchogram. Consideration of these varied features may aid in the radiological diagnosis of bronchioloalveolar carcinoma.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1985

Diagnosis of diffuse malignant infiltration of lung (lymphangitic carcinomatosis) by percutaneous fine-needle aspiration biopsy.

The diagnosis of diffuse malignant infiltration of lung is often made with certainty only by open lung biopsy or at autopsy. However, the clinical presentation and radiological examination are often sufficiently characteristic to suggest the diagnosis. Percutaneous fine-needle aspiration biopsy (PFNAB) has been reserved mainly for the diagnosis of focal lesions of lung and has been reported not to be useful in the diagnosis of diffuse lung disease, especially when the latter is mainly interstitial. We report 15 patients with radiologically diagnosed diffuse interstitial infiltration of lung, 13 of whom had lymphangitic carcinomatosis either on clinical follow-up, cytological or pathological examination. Cytology by percutaneous fine-needle aspiration biopsy was positive for malignant cells in 11 of the 13 patients. We propose that PFNAB be used early in investigation when the clinical and radiological findings suggest that a patient has diffuse malignant interstitial lung infiltration.

Adenocarcinoma↗