1/23. Segmental bronchial atresia--a case report and a literature review.Bronchial atresia is a short and juxtahilar bronchus interruption. This uncommon malformation leads to an obstructive and systematized emphysema, often associated with mucoid impaction. The authors report the case of a 5-year-old boy and review the literature in order to recall the radiologic features of this affection, which are characterized by an obstructive segmental or lobar emphysema often located in the upper lobe. The modern imaging means are not necessary for diagnosis. bronchography confirms the atresia. Neonatal bronchial atresia appears as an opaque segment or lobe with retention of the alveolar liquid.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
2/23. Demonstration of communication between alveolus and interstitium in persistent interstitial pulmonary emphysema: case report.Persistent interstitial pulmonary emphysema (PIPE) is an uncommon complication of premature infants suffering from hyaline membrane disease who have been treated with mechanical ventilation. The presumed mechanism for the development of the disease is via a break in the bronchioalveolar system that allows air to escape into the interstitium. We report a case of a 9-week-old child who developed the localized form of the disease and underwent a lobectomy. Immunohistochemical stains helped to demonstrate the communication between the airway system and interstitium. This report strengthens the theory that the disease develops from airway rupture at the alveolar level.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
3/23. CT imaging of pulmonary lobar interstitial emphysema in a spontaneous breathing preterm infant.Pulmonary interstitial emphysema (PIE) is a well-recognized severe complication of neonatal respiratory distress syndrome (RDS). However, its occurrence under spontaneous breathing conditions has been described rarely. We present a case of PIE of the left upper lung lobe in an extremely low birth weight infant. Recurrent episodes of spontaneous pneumothorax led to the diagnosis, which was confirmed by histopathology. Plain chest X-ray did not show typical signs of PIE, whereas extra-alveolar air accumulation could be visualized by helical computed tomography (CT)-scan. We stress the role of predispositional factors increasing the risk of PIE development in spontaneous breathing preterm infants.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
4/23. titanium particles identified by energy-dispersive X-ray microanalysis within the lungs of a painter at autopsy.A 72-year-old male painter, who complained of his "lungs burning" for 2 weeks, died suddenly. autopsy examination revealed severe coronary atherosclerosis with plaque rupture as the cause of death. Examination of the lungs revealed emphysema, interstitial fibrosis, and multinucleated giant cells with intra- and extracellular brown-black, crystalline, polarizable foreign material. Energy-dispersive X-ray microanalysis showed the material to contain titanium, aluminum, silicon, and iron. An increased incidence of respiratory disease has been reported in professional painters. titanium is widely used as a pigment in the manufacturing of commercial paints. Cases of pneumoconiosis and alveolar proteinosis have been described in painters in which analysis of lung tissue revealed increased levels of titanium. This case is presented as an example of a rarely reported phenomenon, which may have clinical implications for evaluation and management of lung disease in painters.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
5/23. recurrence of pulmonary emphysema in an alpha-1 proteinase inhibitor-deficient lung transplant recipient.Several types of primary disease may recur after lung transplantation, but recurrence of pulmonary emphysema has so far never been published. We report the case of a 49-year-old white male who underwent single lung transplantation for emphysema related to alpha-1 antitrypsin deficiency and to superimposed smoking. The postoperative course was complicated by several rejection episodes. Subsequently, the patient remained stable without evidence of graft dysfunction for more than 10 years, but he resumed light smoking at 8 years after transplant. At 11 years after transplant, although the patient was still asymptomatic and had a stable lung function, recurrence of emphysema on the grafted side was diagnosed on computerized tomography of the thorax. One year later, the patient began to experience a moderate decline in lung function. Two separate bronchoalveolar lavages performed after the onset of the recurrence disclosed a significant elastolytic activity related to neutrophil serine-elastase in lavage fluid. In summary, we describe a case of recurrence of pulmonary emphysema in a patient with alpha-1 antitrypsin deficiency. The resumption of smoking has probably played a central role in the presence of elastolytic activity in lavage fluid and in the recurrence of emphysema.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
6/23. The CT appearances of delayed amniotic fluid clearance from the lungs in an infant with absent pulmonary valve and congenital lobar emphysema.Congenital lobar emphysema (CLE) is a cause of severe neonatal respiratory distress. Overexpansion of the affected pulmonary lobe in the fetus is due to narrowing of the airway, with a resultant 'ball-valve' effect. At birth, there may be delayed clearance of fetal lung fluid. Early chest radiographs show opacification of the hyperexpanded lobe. The CT findings in the immediate neonatal period have not been previously reported. We describe the imaging in a neonate with tetralogy of fallot and absent pulmonary valve with secondary CLE. CT demonstrates the hyperexpanded lobe with initial thickening of the interlobular septa and alveolar ground glass attenuation, with subsequent clearing. This resorption of fetal lung fluid via the pulmonary interstitium should not be confused with interstitial lung disease.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
7/23. Pulmonary capillaritis and its relationship to development of emphysema in hypocomplementaemic urticarial vasculitis syndrome.Hypocomplementaemic urticarial vasculitis syndrome (HUVS) is a rare disorder characterised by complement activation and the presence of C1q precipitins together with a syndrome of urticarial vasculitis, angioedema, arthralgia, ocular inflammation, glomerulonephritis and obstructive lung disease. The pathophysiology of the obstructive airways disease is poorly understood. We report a 46 year-old woman with HUVS who developed progressive obstructive airways disease. Lung biopsy early in the course of her disease revealed pulmonary capillaritis. The disease progressed despite treatment with steroids and cyclosporin and the patient eventually underwent successful double lung transplantation. The explanted lung showed the coexistence of a patchy active vasculitis with severe panacinar emphysema. This is the first description of the histopathological process of HUVS in an explanted lung. Through analysis of serial histopathological specimens and clinical data we show the evolution of pulmonary capillaritis to emphysema, and demonstrate that active vasculitis can coexist with emphysema in patients with HUVS and obstructive airways disease. We suggest that there is a role for ongoing immunosuppressive therapy in these patients.- - - - - - - - - - ranking = 0.0017462687361187keywords = process (Clic here for more details about this article) |
8/23. Emphysema-like pulmonary disease associated with human immunodeficiency virus infection.OBJECTIVE: To describe a possible association between prolonged infection with human immunodeficiency virus (hiv) and a pathophysiologic process suggestive of pulmonary emphysema. DESIGN: Case series. SETTING: The ohio State University Hospital, Columbus, ohio. MEASUREMENTS AND MAIN RESULTS: We describe four hiv-seropositive individuals ranging in age from 32 to 55 years who presented with dyspnea. Radiographic examination of the chest showed no infiltrates. All patients were presumed to have had prolonged hiv infection (mean CD4 count, 99.8 /- 43 cells/mm3), but none had a previous history of pneumonia or opportunistic infections. Comprehensive examination of bronchoalveolar lavage fluid showed no pathogens or other complications of hiv infection. All patients had markedly abnormal pulmonary function tests that were suggestive of emphysema with air-trapping, hyperinflation, and a markedly decreased diffusing capacity. However, only minimal evidence of airflow obstruction was noted. Three patients subsequently had high-resolution computed tomographic scans of the chest that revealed emphysema-like bullous changes. Known causes of emphysema were not present in these patients. CONCLUSIONS: Our findings support an association between prolonged hiv infection and an emphysema-like process. This syndrome may occur in the absence of previous pulmonary infections or apparent pulmonary complications and is characterized by unusual pulmonary function test abnormalities.- - - - - - - - - - ranking = 1.0034925374722keywords = alveolar, process (Clic here for more details about this article) |
9/23. Surgical pathology of bullae with and without pneumothorax.Experience with 2030 patients admitted for an actual episode of spontaneous pneumothorax, and with 370 patients hospitalized for bullous emphysema is thoroughly analyzed. Out of these groups, 400 patients (318 and 82 respectively) underwent an open thoracotomy. Macroscopic operative findings were divided into 8 groups. Descriptions of the aspect, size and site of bullae, respiratory function, mortality and follow-up data, are presented. Pathogenesis of the localised apical disease in comparison to the extended and diffuse types is outlined. attention is drawn to the high operative risk in generalized emphysema and airway obstruction when associated with tension bullae and/or pneumothorax. More than 30% of the patients could not be included in either the juvenile type, isolated apical disease, or in the category of bullae associated with generalized emphysema. Reasons for an early rupture of apical subpleural blebs and the high resistance to check valve pressure of bullae following alveolar disruption are discussed. The observations lead to the conclusion that surgical pathology and treatment problems in bullous emphysema and in spontaneous pneumothorax have a lot in common and their arbitrary separation is not justified.- - - - - - - - - - ranking = 1keywords = alveolar (Clic here for more details about this article) |
10/23. Rapid onset of emphysema associated with diffuse parenchymal disease.In experimental models pulmonary emphysema may be produced in hours to days; however, in human subjects emphysema commonly develops over a period of many years. In this report we document a case of severe emphysema which developed in less than six months in association with an unexplained illness characterized by dyspnea, hypoxemia and bilateral lung parenchymal disease. There was no hereditary predisposition. The diffuse alveolar injury syndrome must be considered as a potential cause of alveolar disruption.- - - - - - - - - - ranking = 2keywords = alveolar (Clic here for more details about this article) |
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