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PubMed2006

[Surgical approach for lung cancer with multiple pulmonary nodules].

A computed tomography (CT) and high-resolution CT (HRCT) have provided us an increasing opportunity to find multiple small pulmonary nodules, which sometimes appear ground glass opacity (GGO). Recently, fluorodeoxyglucose-positron emission tomography (FDG-PET) had a great contribution to our assessment for these small pulmonary nodules. However, since it is yet difficult to establish a diagnosis for these nodules during preoperative workup, a surgical lung biopsy is often required for an accurate diagnosis. We have experienced 9 patients who had undergone lung resection for primary lung cancer accompanied by multiple pulmonary lesions. Since the multiple lesions were consisted of malignant and benign lesions, it is still uncertain whether excessive lung resection should be performed in such patients. In this brief article, we summarized the characteristics of the pulmonary lesions in those patients and discussed difficulty of preoperative diagnosis, viability of pulmonary resection and problems underlining a surgical treatment.

Aged↗
PubMed1998

[Multiple pulmonary nodules as a manifestation of varicella].

It is presented the case of pulmonary affectation by varicella in a woman with bronchial asthma. The hemoptysis and the multiple pulmonary nodules presence have been the principal manifestations of this entity. As evolution; to emphasize the of the hemoptysis and the radiological normality.

Adult↗
PubMed1997

Malignant chondroid syringoma presenting as multiple pulmonary nodules.

Malignant chondroid syringoma, a very rare tumour, presenting with multiple pulmonary metastases in a 50 year old woman is described. Initial diagnostic confusion with pulmonary hamartoma occurred due to histopathological similarities. However, re-examination of a skin biopsy specimen taken 17 years previously from a hand lesion yielded the necessary information to identify the pulmonary lesions definitively as metastases from the original skin lesion. The features of this very rare indolent tumour are described.

Adenoma, Pleomorphic↗
PubMed1997

Multiple pulmonary nodules in association with pyoderma gangrenosum.

This report describes a patient with extensive pyoderma gangrenosum in whom there were co-existent lung abnormalities. The patient's X-ray showed peripherally sited multiple pulmonary lesions bilaterally. A lung biopsy showed chronic non-specific inflammatory changes with neutrophil and lymphocyte infiltration which were similar to the skin lesions. This case was diagnosed as multiple aseptic nodules in pyoderma gangrenosum. The pulmonary infiltrative shadows were controlled only with prednisolone treatment. Steroid therapy is considered to be the first choice to control pulmonary lesions of this disease.

Anti-Inflammatory Agents↗
PubMed1995

Multiple pulmonary nodules as a manifestation of cat-scratch disease.

Cat-scratch disease is an unusual bacterial illness that only rarely shows pulmonary involvement. The authors describe a 19-year-old woman with chronic renal failure who presented with multiple pulmonary nodules, a previously undescribed manifestation of cat-scratch disease.

Adult↗
PubMed2002

Multiple pulmonary nodules: an unusual presentation of fludarabine pulmonary toxicity: case report and review of literature.

Fludarabine monophosphate, a purine analogue is used in the treatment of lymphoid malignancies. A 73-year-old woman presented with fever and cough 2 weeks after completing the third cycle of fludarabine for chronic lymphocytic leukemia (CLL). Chest roentgenogram showed multiple pulmonary nodules. Pulmonary histopathology demonstrated a mononuclear interstitial infiltrate without evidence of malignant, infectious, granulomatous, or vascular causes. Her symptoms and pulmonary nodules resolved following treatment with corticosteroids. To our knowledge, four cases of interstitial pneumonitis associated with fludarabine have been reported in medical literature. Fludarabine induced lung toxicity must be considered in all patients who develop unexplained lung disease while receiving fludarabine. It is reversible with discontinuation of drug and administration of corticosteroids. This case extends the spectrum of fludarabine pulmonary toxicity to include pulmonary nodules.

Aged↗
PubMed2001

[Pulmonary nocardiosis as a cause of radiographic imaging of multiple pulmonary nodules].

Lung nocardiosis is a rare disease affecting patients with lymphoreticular neoplasm, immunodeficiency or chronic obstructive pulmonary disease; it can also affect patients who have received transplants. We report a case of lung nocardiosis in which radiographic presentation was acute, with a pattern of multiple bilateral pulmonary nodules ("cannonballs"), requiring us to rule out metastatic disease to arrive at a diagnosis. The patient responded slowly to antibiotic treatment until full resolution.

Aged↗
PubMedDate not supplied

Multiple pulmonary nodules detected by computed tomography: diagnostic implications.

Prior to the advent of CT, the radiographic demonstration of multiple nonmiliary lung nodules usually indicated the presence of metastases or, less likely, granulomas. The increased sensitivity of CT at detecting small parenchymal pulmonary densities is accompanied by loss of specificity, creating uncertainty as to the significance of nodules detected at CT in any individual patient. During a 1 year period we reviewed all CT scans in our institution demonstrating three or more focal lung densities, noting these parameters: number of densities, maximum lesion size, presence of calcification as determined visually, and lesion morphology (linear or nodular). Of 137 patients with three or more focal lung densities at CT, nodule diagnosis was established on pathologic or clinical grounds in 114. Metastases accounted for 73%, with primary colon and lung malignancies and lymphoma the most common causes. Malignant nodules were statistically significantly larger, more numerous, and more rounded, whereas calcification was significantly associated with benign disease. However, no single criterion or combination of criteria was foolproof. Based on our results, we offer recommendations for further evaluation of nodules in several common clinical settings.

Adenocarcinoma↗
PubMed1994

Multiple pulmonary nodules manifested in a patient with NK cell granular lymphocyte proliferative disorder.

An 18-year-old man was admitted to our hospital with high temperature and dyspnea. A chest radiograph revealed the presence of multiple round nodules compatible with a metastatic lung cancer. The peripheral white blood cell count was 22,000/mm3 and more than 85 percent were atypical large lymphocytes with azurophilic granules. He was diagnosed as having natural killer (NK)-cell granular lymphocyte proliferative disorder (NK-GLPD) as the lymphocytes were positive with CD56, a cell surface marker characteristic for NK cells. The major pathologic finding of the tissue collected from the pulmonary nodules by transbronchial lung biopsy was infiltration of mostly large granular lymphocytes.

Adolescent↗
PubMed1985

Intrathoracic Hodgkin's disease. A case presentation with multiple pulmonary nodules in the absence of mediastinal or hilar node disease.

Patients with Hodgkin's disease (HD) most commonly present with peripheral lymph node enlargement. The finding of pulmonary parenchymal involvement is usually associated with hilar and/or mediastinal adenopathy; such instances are felt to represent spread to the lung by contiguity. Noncontiguous spread to peripheral lung parenchyma in the absence of hilar or mediastinal node involvement has rarely been reported. This is the first documented case report in a 32-year-old woman with nodular sclerosing HD. The unusual clinical presentation in this patient was associated with the histologic detection of vascular invasion in the lymph node and open-lung biopsy specimens.

Adult↗