Acute cadmium pneumonitis: a 17-year follow-up.
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Biomedical subjects
Publications and source records attributed to R H Townshend.
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Percutaneous aspiration needle biopsy forms a simple method of obtaining histological material from solitary peripheral lung lesions. A new method for separating and preparing the material for histological examination is described. The results in 50 cases are recorded with a positive diagnosis in 46. The number of symptomatic complications with this technique is low. The clinical place of the biopsy in management is discussed.
Transbronchial lung biopsy using the fibreoptic bronchoscope was carried out in 85 patients. There were no serious complications; two patients had a 10% pneumothorax and 17 had slight haemoptysis lasting less than 24 hours. The problems of interpreting small biopsy specimens are considered. Satisfactory specimens were obtained without fluoroscopic guidance, particularly in diffuse and lobar lesions. A histological diagnosis was made in 62% of diffuse lesions and compatible histology was found in a further 22%. In a further case Pneumocytis carinii infection was diagnosed. Blind biopsy of discrete periheral lesions was less successful with only one positive diagnosis in 12 patients.
The apparent increase in the incidence of opportunist mycobacterial pulmonary infection is assessed. The clinical, bacteriological and radiological characteristics of 34 cases of such infections seen over a period of ten years in Sheffield are reviewed. The typical radiological appearances consisting of cavities, fibrosis and opacities are described and illustrated. There has been in the past conflicting reports on the specificity of such radiological features; it is concluded that although such appearances are not pathognomonic, their presence should arouse suspicion of such an infection and this should be confirmed or refuted by bacteriological investigations.
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