ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study describes the computed tomography features of various fulminant forms of idiopathic interstitial pneumonia and to clarify the usefulness of computed tomography in such patients. Computed tomography scans in 19 patients with fulminant forms of idiopathic interstitial pneumonia were reviewed. This study included patients with acute interstitial pneumonia (n= 7), an accelerated form of idiopathic pulmonary fibrosis (n= 2), and an acute exacerbation of idiopathic pulmonary fibrosis (n= 10). Pathologic confirmation of the diagnosis was obtained in all patients. Follow-up computed tomography scans were available for eight patients, and postmortem computed tomography scans were available for three patients. All patients had progressive ground-glass attenuation, consolidation, or both. In patients with an acute exacerbation of idiopathic pulmonary fibrosis, subpleural honey combing was also seen. Follow-up computed tomography showed a change from ground-glass attenuation to consolidation with distortion. Architectural distortion, traction bronchiectasis, and ground-glass opacity were the prominent features in the initial computed tomography scans obtained more than 7 days after the onset of symptoms, and cystic lesions were seen in follow-up computed tomography obtained more than 1 month after the onset. High-resolution computed tomography was more sensitive than the plain radiographs in the early detection of these entities. Computed tomography examination at the onset of the acute symptoms is useful in classifying these fulminant forms of idiopathic interstitial pneumonia.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors performed a prospective cohort study to define the high-resolution computed tomography features of 31 pediatric patients with postinfectious bronchiolitis obliterans. All patients underwent chest radiographs and lung perfusion scans, and 27 of the 31 patients underwent high-resolution computed tomography of the lung. The most common abnormal features shown on computed tomography included bronchial wall thickening, bronchiectasis, and areas of increased and decreased attenuation. High-resolution computed tomography showed a higher sensitivity than both chest radiography and lung perfusion scanning in detecting pulmonary abnormalities in these patients.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors determine the success rate, safety, and potential complications of computed tomography-guided preoperative hookwire localization of small peripheral pulmonary nodules. One hundred one consecutive wire localizations with addition of methylene blue injection were performed in 94 patients immediately before thoracoscopic resection of small lung lesions. Sixty-two patients had a known primary malignancy, whereas 32 had an asymptomatic nodule. Eighty-eight patients underwent single lesion localization, five underwent double localization, and one underwent triple wire placement. Five patients had previously undergone percutaneous biopsy that was nondiagnostic. The nodule was within the first wedge biopsy of lung tissue in 95 of 97 specimens (98%). A second wedge and an open lobectomy were required in one patient each. Three additional biopsies were intraoperatively deferred after the histologic diagnosis was established after removal of another nodule. The procedure was terminated before wire placement in one patient who was unable to successfully hold his breath. The wire dislodged with the tip in the pleural space rather than in the lung parenchyma in 22 cases; however, methylene blue tattoo allowed localization in 13 of these (59%). In the other nine cases, extra portals, digital palpation, or expanded wedge resection was required. Complications included pneumothorax in 48 cases, moderate pleuritic pain in five cases, seven small intercostal hematomas, and a 7-mm wire fragment retained in one patient's lung along the suture line. No patient required a preoperative drain for treatment of pneumothorax. Wire dislodgement occurred in 6 of 52 (12%) cases without an initial pneumothorax and in 16 of 48 (33%) cases if a pneumothorax occurred. Wires dislodged less frequently if placed either directly into or through the nodule in 11 of 64 (17%) cases than if placed adjacent to the nodule in 11 of 36 (31%) cases. Average wire tip depth from the visceral pleura was significantly less when the wire dislodged (11 mm) than when the wire remained in place (25 mm). Wire localization of small peripheral pulmonary nodules is a safe and effective procedure to assist thoracoscopic sublobectomy resection.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Extrapleural administration of dilute contrast was used to facilitate biopsy of a posterior mediastinal mass.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The objective of this study was to correlate contrast-enhanced computed tomography images of noncalcified hamartomas with histologic specimens to find specific computed tomography enhancement patterns. Over 4 years, 30 noncalcified hamartomas were surgically resected. Enhanced computed tomography images of these hamartomas were reviewed and correlated with histologic findings. Contrast-enhancing septa were present in 24 of 30 hamartomas (80%). Five hamartomas (15%) showed a nonspecific enhancement pattern. The presence of an air bronchogram was a rare finding (5%). Comparison between computed tomography images and pathologic specimens showed that areas with less enhancement corresponded to cartilagineus tissue, and enhancing septa corresponded to loose connective tissue within the cartilagineus core. The rare finding of an air bronchogram corresponded to bronchial epithelium within cartilagineus tissue.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In order to clarify the characteristic computed tomographic findings of peripheral small cell lung cancer, the authors investigated 12 patients with surgically resected and histologically proven peripheral small cell lung cancer. Conventional computed tomography was performed on all, and additional high-resolution computed tomographic images were obtained for nine patients. Marginal, internal, and surrounding features of the tumors were analyzed, and these findings were correlated with histologic findings. All 2 tumors appeared as homogenous masses, and eight had well-defined margins. Lobulation was found in seven, marginal grouund-glass opacity in three, fine speculation in two, and both ground-glass opacity and speculation in one. Cut specimens showed whitish medullary masses without large areas of necrosis, and microscopic specimens showed small areas of necrosis in 11 patients. Marginal ground-glass opacities corresponded to focal edema and hemorrhage in two patients and to intraalveolar invasion in one. Fine spiculation corresponded to vascular/lymphatic invasion in one patient and to irregular intraalveolar spread in another. The authors concluded that a homogenous mass without necrosis is the most characteristic feature of peripheral small cell carcinoma on computed tomography.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

On computed tomography (CT) scanning, a ground-glass opacity zone surrounding a pulmonary nodule has been named thecomputed tomography (CT) halo sign.To investigate the frequency and diagnostic value of the CT halo sign, the authors reviewed the CT examinations of 305 patients with proven diseases producing solitary or multiple nodules. The CT halo sign was seen in 22 patients (7%). Eleven patients had a solitary nodule; five patients had multiple nodules; and six patients had nodules associated with areas of pulmonary consolidation, or ground-glass opacity, or both. Solitary nodules were the result of bronchioloalveolar carcinoma (n= 5), tuberculoma (n= 2), squamous cell carcinoma, non-Hodgkin lymphoma, myxovirus infection, and metastasis (n= 1 each). Multiple nodules were the result of metastasis (n= 2), Kaposi sarcoma (n= 2), and Wegener granulomatosis (n= 1). Nodules associated with areas of consolidation or ground-glass opacity were the result of metastasis (n= 2), bronchioloalveolar carcinoma, bronchiolitis obliterans organizing pneumonia, eosinophilic pneumonia, and invasive pulmonary aspergillosis (n= 1 each). The data showed that the CT halo sign is a nonspecific finding. It is known that in immuno-compromised patients the CT halo sign should suggest invasive pulmonary aspergillosis, Kaposi sarcoma, and lymphoproliferative pulmonary disorders. However, in immunocompetent patients, the authors found that a solitary nodule with the CT halo sign and pseudocavitations has a high likelihood of being a bronchioloalveolar carcinoma.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors used chest computed tomography to determine the distribution of pulmonary lymphadenopathy in 40 patients with sarcoidosis. Using the American Thoracic Society lymph node map, the number and distribution of significant lymph nodes was calculated. Overall, lymphadenopathy was identified in 39 of the 40 patients. Mediastinal adenopathy was present in 38 patients, and hilar adenopathy was present in 27. Commonly involved nodal stations were 4R, 5, 7, 10R, 11R, and 11L, and little involvement was seen in stations 1, 6, and 14. An understanding of the common sites of adenopathy in sarcoidosis is useful when assessing adenopathy in patients without a known diagnosis.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The authors describe three patients with apical bullous disease that showed partial to near complete spontaneous regression over time. This phenomenon, termedautobullectomy, is a heretofore little known or recognized manifestation of a common pulmonary disease.

ISSN:0883-5993    

出版商:OVID    

年代:1999

数据来源: OVID