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PubMed1980

A serological proof of adiaspiromycosis in wild rodents.

Using serological and histological methods, we examined 92 specimens of small, wild rodents (Apodemus sylvaticus, Clethrionomys glareolus, Micromys minutus, Microtus agrestis, M. arvalis, Mus musculus and Pitymys subterraneus) for the incidence of adiaspiromycosis. In addition, we examined 16 white, laboratory mice after their exposure to a natural biotope in which the incidence of adiaspiromycosis had been confirmed earlier. The results of serological tests were in correlation with those obtained with histological methods. While the immunodiffusion test showed a discrepancy of 6% only between the two methods, this was 19% for the complement fixation test. In animals with a negative histological finding, the immunodiffusion test confirmed antibodies in 3% the CF-test in 11%. An evident from results of serological methods, these might play an important role in the diagnosis of a spontaneous adiaspiromycosis even in wild rodents.

Animal Population Groups↗
PubMed1994

[Aspergillosis and renal, heart and lung transplantation].

The increase of organ transplantations during the last decades conjointly with the prescription of heavy immunosuppressive drugs, has led to an increased incidence of new invasive aspergillosis (IA). This study is a report of the Broussais Hospital experience from 1968 to 1993 on kidney, heart and heart and lungs transplantations. It concerns 21 IA cases. Incidence was 0.5% for kidney, 4.5% for heart and 18% for heart and lungs transplantations. The most important risk factors were the increase of immunosuppressive therapy (66% of the cases), neutropenia (19%), and renovation of the hospital wards (36%). Lung was the most frequent site of infection (95% of the cases), clinical symptoms were no significant. Diagnosis procedures were realised on biopsy (23%) and on bronchoalveolar lavage (66%). Usual amphotericin B treatment was disappointing: mortality rate of 77%, the liposomal preparation of the drug seemed to be more efficient: mortality rate of 50%. Itraconazole appeared to be used in succession with a careful adaptation of posology. Prophylactic amphotericin B in a local way (sprays and aerosols) led to a good efficiency jointly with the patient isolation during constructions in the hospital area.

Adolescent↗
PubMed1994

[Three-dimensional CT imaging of pulmonary nodules using helical scan CT].

To evaluate the usefulness of three-dimensional (3D) imaging of pulmonary nodules from helical scan CT images, 3D reconstructions were performed in 23 patients, using a CEMAX VIPstation. These cases included 15 lung cancers, six metastatic lung cancers, an aspergilloma and a tuberculoma. The equipment used was a Toshiba CT system, the X force. Helical scan CT data were acquired using up to 20 continuous 1.5 sec rotations with an X-ray beam width of 5 mm and a couchtop movement speed of 5 mm/1.5 sec, and during a single breath-hold. Axial images were reconstructed at a section interval of 2 mm. Helical scan CT permits axial images to be reconstructed at any desired position within the scanned area, and provides images without interslice gaps caused by respiratory movement. Therefore, high-quality 3D images can be obtained from these data. Concerning the optimum threshold range of CT number of 3D reconstruction, we clarified the lower and upper limits (lower/upper), as follows: 1) Solid pulmonary nodule: (-700-(-)400/-100 HU) 2) Tumor invaded to pleura or chest wall: (-700-(-)400/-200 HU) 3) Pulmonary nodule with cavity: (-700-(-)400/50 HU) 4) Small pulmonary nodule (< 10 mm): (-750-(-)600/-100 HU) In all cases, it was possible not only to demonstrate abnormal findings three-dimensionally, but also to grasp anatomical relationships among the pulmonary nodule, bronchi, vessels and chest wall. In conclusion, it was considered that 3D CT imaging provided additional anatomical information and was very useful.

Adenocarcinoma↗
PubMedDate not supplied

Utility of intraoperative fine needle aspiration biopsy in the surgical management of patients with pulmonary masses.

Sporadic reports have postulated that intraoperative fine needle aspiration biopsy (FNAB) is a useful adjunct in the surgical management of patients with pulmonary masses. We reviewed 38 consecutive intraoperative pulmonary FNABs performed at our institution in order to assess the efficacy of this technique, as measured by (1) its sensitivity, specificity, predictive values and concordance rates, and (2) the appropriateness of the resultant surgical therapy. Six cases were benign (16%) and 32 malignant (84%); none were small cell carcinomas. Aspirates from the six benign lesions were designated either benign or nondiagnostic; there were no false-positive diagnoses (specificity = 100%). Aspirates from 30 of the 32 malignant neoplasms were diagnosed as malignant, one was considered suspicious for carcinoma, and one was interpreted as benign (sensitivity = 97%). The positive and negative predictive values were 100% and 86%, respectively. The concordance rate for benignancy/malignancy between the intraoperative FNAB interpretation and final diagnosis was 97%. The intraoperative FNAB diagnosis contributed to less-than-optimal surgical therapy in only one case. Thus, we conclude that intraoperative pulmonary FNAB has utility in the proper surgical management of pulmonary masses.

Adenocarcinoma↗
PubMed1994

[A case of lung cancer with cryptococcal infection in resected lymph nodes].

A 68-year-old female was admitted because of an abnormal shadow on chest X-ray film. Chest CT showed a nodular shadow in right S3a. Right upper lobectomy with mediastinal lymph node resection was performed under a diagnosis of lung cancer made by TBLB. Pathological examination of the resected lung revealed well differentiated adenocarcinoma. In addition, examination of the resected lymph nodes showed granulomas, some of which contained numerous cryptococci and showed central caseous necrosis, and others showed non-caseating epithelioid cell granulomas suggesting sarcoid reaction. No cryptococcal infection was found in the resected lung. Mediastinal lymph node involvement of cryptococcus in this case was considered to be the lymph node component of the primary pulmonary complex of cryptococcosis. Such a primary complex was demonstrated in 1% of the cases of cryptococcosis in previous reports.

Adenocarcinoma↗
PubMed1993

[A case of pulmonary actinomycosis that was difficult to distinguish from pulmonary carcinoma].

A 45-year-old male was admitted with chief complaint of hemoptysis. Prior to admission, a tumor in the S3 segment of the right lung had been detected by chest radiography. Despite a detailed examination after admission, no definite diagnosis was made, and right upper lobectomy was performed. Histopathological examination of the surgically resected tissue led to the diagnosis of pulmonary actinomycosis. In Japan, 52 cases of this condition were reported between 1964 and 1991. This paper discusses the epidemiology, diagnosis and diagnostic imaging of the condition, with reference to the literature.

Actinomycosis↗
PubMedDate not supplied

Aspergillus and lung transplantation.

BACKGROUND: Aspergillus infection is a known complication of transplantation. METHODS: We describe our experience with 37 patients who received lung transplants over 2 years at Loyola University Medical Center. All patients who had evidence of aspergillus on culture of clinical specimens or had biopsies with hyphal forms consistent with aspergillus were categorized according to the clinical manifestations. Important risk factors were analyzed in comparison with other lung transplant recipients during the same period. RESULTS: The incidence of invasive aspergillosis was high (16%). No patient with disseminated disease survived. Locally invasive disease responded well to treatment with amphotericin B and itraconazole. CONCLUSIONS: Lung transplantation patients may have a higher incidence of aspergillosis as compared with other transplantation groups. Prophylactic measures need to be explored.

Adult↗
PubMed1997

[An approach to lobectomy under a thoracoscopic surgery].

Lobectomy under a thoracoscope is a minimally invasive surgery and full consideration must also be given to the length of access thoracotomy and the number of access ports inserted. On the other hand, securing a full visual field within a limited access and treating the pulmonary artery/vein and bronchus safely and for sure are needed. However, it would not be too much to say that the easiness of lobectomy under a thoracoscope depends on the length of access thoracotomy and the number of access ports inserted. In the experiment this time we discussed an approach to the access area in lobectomy under a thoracoscope in our cases.

Aged↗
PubMed1997

Bronchial-pulmonary artery fistula after unilateral lung transplantation: a case report.

We report on a right bronchial-pulmonary artery fistula resulting in fatal hemoptysis in a 54-year-old man, 3 months after right unilateral transplantation for end-stage emphysema. The posttransplantation period was complicated by ulcerative tracheobronchial aspergillosis. Early treatment with itraconazole was performed. All samples of bronchial washing, bronchoalveolar lavage, and bronchial and transbronchial biopsy specimens were free of aspergillus after 3 weeks of treatment. Necropsy showed a fistula between the right pulmonary artery and the main right bronchus, situated just beneath the suture line.

Anastomosis, Surgical↗
PubMed1997

[Two resected cases of cavitary lung cancer with pulmonary aspergillosis].

Two cases of cavitary lung cancer with pulmonary aspergillosis were experienced. Case 1 was a 45-year-old male. Chest X-ray and Chest CT revealed a round shadow in the thin-wall cavity of the upper lobe of the right lung. Upper lobectomy of the right lung was performed. Histologically large cell carcinoma was found to invade the entire cavity wall, and aspergillus was not detected in the intracavitary space. Case 2 was a 75-year-old male. Chest X-ray and Chest CT revealed a round shadow in the thin-wall cavity of the upper lobe S1 + 2 of the left lung. As a result of upper lobectomy of the left lung and S6 partial resection, large cell carcinoma was found to invade the entire cavity wall, and aspergillus was not detected in the intracavitary space. Only 19 cases including ours are reported about cases of lung cancer complicated by pulmonary aspergillosis at the same site in Japan. The mechanism of aspergillus infection had not been clarified in the discussions of the reported literature and nothing characteristic could be pointed out in our cases except for the assumption that the presence of cancer was a factor triggering Aspergillus implantation.

Aged↗