PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “LUNG DISEASES, FUNGAL”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

Lung adenocarcinoma with coexisting pulmonary cryptococcoma.

A 73-year-old female was referred to our hospital in June 2000 for the evaluation of an abnormal shadow in the left upper lobe of her lung and two other shadows in the left lower lobe. A computed tomography examination revealed an ill-defined tumor with ground glass opacity in the left upper division segment, suggesting a primary lung adenocarcinoma, and two well-defined nodules in the left lower lobe, suggesting metastatic carcinomas. A transbronchial lung biopsy of the tumor in the upper division segment confirmed the presence of an adenocarcinoma but failed to provide a histological diagnosis for the nodules in the lower lobe. A partial resection of the left lower lobe using video-assisted thoracoscopy revealed granulomatous tissue with no signs of malignancy. A curative resection of the adenocarcinoma in the left upper division segment was therefore performed. Histologically, the resected specimens obtained from the left lower lobe were diagnosed as cryptococcomas. The patient was diagnosed as having a stage IA lung adenocarcinoma and two cryptococcomas. The patient is presently well and has not experienced any recurrences or relapse for 3 years since the resection.

Adenocarcinoma↗

Pulmonary cryptococcosis mimicking pulmonary metastases in a patient treated with Tegafur-uracil after lung cancer surgery.

A 71-year-old man who had undergone surgery for stage II adenocarcinoma of the lung followed by adjuvant tegafur-uracil (UFT; 300 mg/day) therapy was admitted. Multiple nodules were found in both lungs on chest radiographs obtained 1.5 years after the surgery. Imaging characteristics of the nodules resembled those of pulmonary metastases. Histologic assessment of a biopsy specimen obtained during thoracoscopic resection revealed pulmonary cryptococcosis. The patient was administered 200 mg/day fluconazole for 6 months. Physicians need to be aware of the possibility of pulmonary cryptococcosis mimicking pulmonary metastases in patients treated with UFT after surgery for lung cancer.

Adenocarcinoma↗

Double-lung transplantation for cystic fibrosis. The Cystic Fibrosis Transplant Study Group.

One hundred twenty cystic fibrosis patients were accepted for transplantation. Twenty-five patients underwent double-lung transplantation. Twenty-five patients died awaiting transplantation (20.6%). There were 13 female and 12 male patients. Their mean age was 28 years (range, 7 to 34 years), and mean percentage ideal body weight was 76% (range, 58.5% to 91.9%). Most patients were hypoxic and hypercarbic. Two patients underwent tracheal anastomosis, 15 had en bloc bronchial anastomoses, and 8 had sequential single-lung transplants. Operative mortality was 16%; all deaths were related to bleeding from extensive adhesions. Actuarial survival at 1 year was 64%. Rejection and infection were frequent during the first month and decreased thereafter. Airway complications occurred in 5 patients but were amenable to laser therapy and stenting. We conclude that double-lung transplantation is an acceptable modality for the treatment of cystic fibrosis patients with end-stage lung disease. It may be a better alternative to heart-lung transplantation considering the paucity of thoracic organ donors.

Adolescent↗

New developments in the diagnosis and treatment of infections in lung transplant recipients.

Infections remain a serious and common problem in lung transplant recipients. Recent years have seen an explosion in the knowledge regarding this major cause of morbidity and mortality. Novel diagnostic and therapeutic techniques are revolutionizing the approach to infectious diseases in transplant recipients. Multicenter trials will expand the scope of diagnosis and management of these infections. A team approach by transplant physicians and infectious diseases experts is critical to the success of managing these complex patients.

Adult↗

Pulmonary resection in patients after pneumonectomy.

In 15 patients with a previous pneumonectomy (eight on the right and seven on the left), a new "lesion" developed in the remaining lung. Fourteen had the pneumonectomy for carcinoma (13 men and 1 woman), and 1 woman had a pneumonectomy for blastomycosis. At the second operation (4 months to 16 years after the pneumonectomy), limited resection of a primary or metastatic malignancy was done. The excision ranged from lobectomy to multiple wedges. One patient died on the sixth postoperative day, presumably a cardiac death. Eight patients died 2 to 33 months postoperatively. Six patients are now living: 3 have no evidence of disease (18, 35, and 70 months), and 3 have recurrent disease (26, 41, and 73 months). There is evidence that pulmonary resection after pneumonectomy is feasible with a low operative mortality and that resection of these "secondary" tumors can result in prolonged, worthwhile survival.

Adult↗

The role of transbronchial lung biopsy in diffuse pulmonary disease.

Forty consecutive patients underwent flexible fiberoptic transbronchial lung biopsy for diagnosis of diffuse nodular or infiltrative lung disease. Biplane fluoroscopic examination with image intensification greatly facilitated accurate placement of the biopsy forceps near the pleura; Specimens of lung parenchyma were obtained for culture and histological study in every case. A pathological diagnosis was correctly established in 34 of 40 patients. Transbronchial biopsy was helpful in the clinical management of an additional 4 patients. Biopsy results were not accurate in 2 patients. No significant morbidity was associated with the procedure. Fiberoptic transbronchial lung biopsy is a safe and useful adjunct to the diagnosis of parenchymal lung disease.

Adolescent↗

Approach to the patient with pulmonary disease.

The approach to the HIV-infected patient with pulmonary disease is summarized by the algorithms in Figures 3 and 4. These are not intended to be followed in a rigid step-wise fashion. Rather, the practitioner's knowledge of the patient with his or her accompanying medical risks influences the path taken, including the depth and the speed of the evaluation. For example, the patient with cough who is afebrile and breathing at 18 breaths a minute, with a normal chest radiograph and a CD4 count of 350 cells/mm3, is reasonably treated with a macrolide or cephalosporin for bacterial bronchitis and clinical follow-up while awaiting cultures (see Fig. 4). A febrile patient with a cough productive of thin mucus, but known to have a CD4 count of 60 cells/mm3 should be started on anti-PCP therapy while being evaluated for PCP with an induced sputum and if nondiagnostic, a bronchoscope despite a normal chest radiograph. Screening can be as simple as placing an oximeter on the patient's finger in the clinic. If the oxygen saturation of a patient with a normal chest radiograph is low, then the patient should be hospitalized and begun on treatment for PCP while diagnostic evaluation is initiated. If the oxygen saturation is normal, the patient can be exercised to elicit desaturation. If there is no desaturation, PCP is unlikely. If the results are equivocal (i.e., a decrease in saturation, but less than 3%), rest and exercise arterial blood gases can be performed, along with a Dlco-Gallium scanning can be done in patients known to have abnormal Dlco or those who cannot exercise. Patients with focal infiltrates who have acute onset of symptoms (see Fig. 4) commonly have bacterial infections, but the possibility of PCP or TB should not be dismissed. Induced sputum should be examined if TB or PCP is suspected. Patients who are severely ill might go quickly to bronchoscopy without awaiting improvement on empiric therapy. The patient with diffuse infiltrates (see Fig. 4) needs no screening because the presence of disease is apparent from the radiograph. The diagnostic part quickly leads to bronchoscopy for these patients and the initiation of therapy for PCP when suspected. In patients with known pulmonary KS, gallium scanning can be helpful to rule out acute infection, but bronchoscopy is warranted if the patient is severely ill, or at high risk for PCP. This approach should avoid unnecessary procedures in patients with simple bacterial infections, without missing opportunistic infections and tumors.

AIDS-Related Opportunistic Infections↗

[Bronchial embolization in the treatment of hemoptysis].

The aim of this retrospective study was to evaluate the efficacy of bronchial artery embolization to treat hemoptysis. Eight hundred sixty-five patients were admitted to our hospital with hemoptysis during the study period. Bronchial arteriographs were obtained for 48, who suffered life-threatening hemoptysis refractory to medical treatment. The likely origin of bleeding was identified in 37: embolization was performed with particles measuring 250 to 1000 micra in size (Contour Emboli, Interventional Therapeutic Corporation, South San Francisco, California, USA) in 35 and with hemostatic collagen sponges in 2. The most common causes of hemoptysis were bronchiectasis (40%), pulmonary tuberculosis (33%), pulmonary aspergilloma (8%) and malignant neoplasm (8%), chronic bronchitis (6%); 4% of the cases were idiopathic. Immediate technical success was achieved in 34 patients (92%) as defined by the absence of hemorrhage for at least 24 hours. All embolized patients were followed until the first recurrence of bleeding or until discharge. Recurrence of hemoptysis (in the first month) was early in 5 patients (13.5%) and late (2 to 96 months) in 9 (24%). The severity of the initial and later episodes of hemoptysis was similar in all early recurrences and most late recurrences. A second embolization was performed six times, and medical and/or surgical treatment was given in all other cases. No significant complications attributable to the technique were observed. The results show that bronchial embolization is valid for the immediate control of life-threatening hemoptysis and has a low rate of severe complication; recurrence is relatively common.

Adult↗