1/721. Spontaneous partial expectoration of an endobronchial carcinoid. Typical pulmonary carcinoid tumors often present as proximal endobronchial masses discovered during the evaluation of cough and/or hemoptysis. We present a case of a carcinoid tumor that presented with spontaneous partial expectoration. A review of the literature revealed 16 cases of expectoration of fragments from various primary and metastatic tumors. Our case appears to be the first report of the expectoration of a carcinoid tumor. ( info) |
2/721. Late massive haemoptyses from bronchopulmonary collaterals in infarcted segments following pulmonary embolism. Massive, recurrent haemoptyses requiring blood transfusions occurred in a patient who had been diagnosed as having pulmonary thromboembolism 3 months earlier. To the authors' knowledge this is the first case report of this kind, in which massive haemoptyses were proved to be caused by large bronchopulmonary collaterals that had developed in the infarcted lung segments affected by embolism. Selective embolization of the collaterals proved to be therapeutic and life saving. ( info) |
3/721. Endovascular stent graft repair of aortopulmonary fistula. Two patients who had aortopulmonary fistula of postoperative origin with hemoptysis underwent successful repair by means of an endovascular stent graft procedure. One patient had undergone repeated thoracotomies two times, and the other one time to repair anastomotic aneurysms of the descending aorta after surgery for Takayasu's arteritis. A self-expanding stainless steel stent covered with a Dacron graft was inserted into the lesion through the external iliac or femoral artery. The patients recovered well, with no signs of infection or recurrent hemoptysis 8 months after the procedure. Endovascular stent grafting may be a therapeutic option for treating patients with aortopulmonary fistula. ( info) |
4/721. Catamenial hemoptysis--a case report. Thoracic endometriosis is rare. Its associated clinical syndromes should be considered in menstruating women with pneumothorax or hemoptysis. The availability of chest CT scanning and danazol provide new technique in diagnosis and therapy. ( info) |
5/721. Aorto--bronchial fistula resulting from an accidental fall one year earlier. A 75-year-old woman presented with massive haemoptysis 12 months after tripping over her shopping trolley. CT scanning and transoesophageal echocardiography demonstrated a traumatic false aneurysm which was confirmed at surgery to be partially ruptured. Aortobronchial fistula is an unusual cause of massive haemoptysis. It should be considered particularly in patients known to have abnormalities of the thoracic aorta. ( info) |
6/721. Sequestration of the lung in children. Three instances of intralobar pulmonary sequestration are reported to call attention to the occurrence of this lesion in children. In all three patients, the sequestration was diagnosed by arteriography and treated by lobectomy. Extralobar and intralobar sequestrations are described and the differential diagnosis is discussed. ( info) |
7/721. A silicosis patient presenting with an enlarged supraclavicular lymph node. A stone splitter was discovered to have an enlarged supraclavicular lymph node which showed nodules with bi-refringent crystals on histological examination. He had worked in a dusty environment for more than 10 years with ineffective respiratory protection. He gave a history of occasional cough with blood-stained sputum for 10 years for which no definite diagnosis was made. silicosis (classified as type s/s with profusion 1/1) was confirmed after his chest radiographs were reviewed. The presentation was unusual and illustrated the importance of an occupational history in clinical practice. ( info) |
8/721. Unilateral lung volume reduction in preparation for contralateral pneumonectomy. A case of staged trans-sternal unilateral lung volume reduction (LVR) on the right followed by contralateral pneumonectomy for a locally advanced left lung malignancy is presented. The predicted symptomatic and functional benefit offered by LVR was felt to be necessary before the removal of the left lung. The patient, a 50-year-old male, with a history of chronic air flow limitation secondary to bullous emphysema, underwent a left pneumonectomy six weeks following a right LVR procedure for poor pulmonary function secondary to generalized emphysema. On admission, forced expiratory volume in 1 s (FEV1) was 1.37 L, 47% of predicted with an FEV1/forced vital capacity of 56%. Five weeks after the unilateral LVR, the patient's FEV1 was 1.85 L, and one year postdischarge from hospital, FEV1 was 0.9 L. One year after discharge, the patient did not require oxygen support, and was active and free of malignant disease. ( info) |
9/721. Pulmonary hydatid cyst as a cause of recurrent haemoptysis and responding to treatment with albendazole. A 28 year old Ethiopian male who presented with recurrent haemoptysis, fever, and multiple well defined masses on a chest x-ray and subsequently responded to treatment with albendazole is reported. Complete remission of the symptoms and improvement of chest x-ray findings was attained within 2 months of initiation of treatment. The unusual presentation of pulmonary hydatid cyst and the response to pharmacotherapy is briefly reviewed. ( info) |
10/721. Munchausen's syndrome. A case of factitious hemoptysis. Factitious hemoptysis is the bleeding type of Munchausen's syndrome, rarely reported in the literature (only seventeen cases). After a careful and detailed literature review, the authors report the case of a 22-year-old working-woman, with a history of asthma, Mediterranean anaemia and recurrent hemoptysis, who was admitted several times to the cardiovascular and Respiratory Sciences Department in the Carlo Forlanini Hospital in 1994 for an asthmatic attack and wheeziness at rest. During the admissions the patient underwent laboratory tests (such as the examination of sputum specimens, urinalysis, tuberculin test, cold agglutinins and pneumotropic virus tests) and diagnostic studies (fiberoptic bronchoscopy with bronchoalveolar lavage, computerized tomography and radiography of the chest, bronchial arteriography, bronchography, perfusion and ventilation lung scan), because she continually presented with hemoptysis, in order to spot and discover the nature of the bleeding. Since such examinations failed (a few of them-namely fiberoptic bronchoscopies--were even performed when she was coughing up blood) and psychiatric consultations revealed the presence of psychologically traumatic events in the patient's history which could explain the psychopathic traits of her personality (in fact she was aggressive and unstable in interpersonal relations), a diagnosis of factitious hemoptysis in Munchausen's syndrome was made. ( info) |