ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Bronchoscopy plays a central role in the evaluation of pulmonary complications of human immunodeficiency virus (HIV) infection. Some recommend routinely performing bronchoalveolar lavage (BAL) without bronchoscopic lung biopsy (BLB) because of the high sensitivity of BAL in diagnosingPneumocystis cariniipneumonia (PCP). This retrospective, consecutive case study sought to clarify the complementary role of BLB performed in addition to BAL. One hundred eighty-two patients with known or suspected HIV infection had 205 bronchoscopic procedures to diagnose a pulmonary disorder. PCP was the final diagnosis in 111 (54%). An additional 16 disorders accounted for the remaining 82 diagnoses. Overall, bronchoscopy had a sensitivity of 91% for all diagnoses. BLB, when it was performed, was the exclusive source of a rapid diagnosis by microbiologic stains or histology in 42 of 162 (26%) of all diagnoses. This additive role was most important in noninfectious diagnoses, where BLB was the only test yielding the diagnosis in 20 of 32 (54%), and for infections other than PCP, where it was the only positive test in 14 of 35 (40%). BLB was the only test that yielded a diagnosis in 8 of 95 (8%) cases of PCP. This study supports the routine inclusion of BLB during bronchoscopy of HIV-infected patients.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

BackgroundBronchoscopic needle aspiration of mediastinal lymph nodes (BNA/N2) is a safe, but underutilized, procedure for staging patients with lung cancer. This study compared survival duration between lung cancer patients with positiveversusnegative cytologic studies of mediastinal bronchoscopic needle aspirates.MethodsSurvival was calculated for all patients who had BNA/N2 for staging as part of their initial diagnostic bronchoscopy for the evaluation of lung cancer. Kaplan-Meier plots and Cox proportional hazards regression were used to compare survival of BNA/N2-positive versus BNA/N2-negative patients.ResultsWe studied 744 patients at two hospitals in eastern Maine over an 8-year period. In non-small cell lung cancer (NSCLC), a 3-year survival was 15% among BNA/N2-negative patients and 3% among BNA/N2-positive patients. In small cell lung cancer (SCLC), survival was not significantly different for BNA/N2-negative versus BNA/N2-positive patients.ConclusionsNSCLC patients with a positive BNA/N2 experienced decreased survival. In SCLC, longevity was unaffected by BNA/N2 results.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

To determine the safety of flexible bronchoscopy in nonintubated patients on high concentrations of inspired oxygen, we undertook a retrospective review of medical records and statistical analysis of findings in a tertiary care university hospital. Thirty-four consecutive nonintubated patients underwent flexible bronchoscopy while receiving high concentrations of oxygen (Fio2> 0.5; 28 of 34 receiving Fio2of 1.0). All patients tolerated the procedure and only four of the 34 required intubation and mechanical ventilation for worsening respiratory failure in the 4 h after the bronchoscopy. There were no deaths or other complications related to the procedure. This study supports the premise that flexible bronchoscopy can be safely performed in nonintubated patients receiving high concentrations of inspired oxygen. It does not appear necessary prophylactically to intubate the patient before the procedure. However, final recommendations will have to await a prospective, randomized trial.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study evaluates the efficacy of using the water-soluble nonionic dimer iotrolan (300 mg iodine/ml) in bronchography via the flexible bronchoscope in diagnosing airway diseases. Forty bronchograms via the flexible bronchoscope were performed in 38 patients (mean age, 65.5 years) with suspected airway disease. Two hundred ninety-five lung segments were examined (mean, 8 segments/examination) using a mean 15 ml of iotrolan 300 per examination. The bronchograms were independently reviewed by two pulmonary radiologists. Disagreement about the findings occurred in 10 examinations (25%) with mild bronchographic abnormalities. Independent agreement on the diagnosis was observed in 72% of the cases with bronchiectasis but only 40% of the cases with chronic bronchitis. All the bronchograms were considered diagnostic with the exception of two examinations (5%). No serious side effects occurred in the study. In conclusion, bronchography via the flexible bronchoscope with iotrolan 300 seems to be an efficient technique for diagnosing airway disease and is well tolerated by the patients.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A 46-year-old male patient was treated for a chronic obstructive pulmonary disease (COPD) over 8 months because of progressive shortness of breath (SOB). When a plain chest x-ray showed atelectasis of the left lower lobe, a computed tomography (CT) scan was performed followed by a flexible bronchoscopy; both showed a tumor obstructing the left main bronchus. This lesion was successfully removed by Nd:YAG laser through a flexible bronchoscopy. A follow-up flexible bronchoscopy performed 6 months later showed a normal airway without any mucosal abnormality at the area of previous tumor.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Pulmonary manifestations of coccidioidomycosis may present with insignificant clinical symptoms and a variety of radiographic abnormalities including patchy infiltrates with or without hilar adenopathy or thin-walled cavities. Coast-to-coast travel is common and many patients are exposed toCoccidioides immitiswhile traveling or visiting in endemic areas. They are then at risk to manifest coccidioidomycosis when they return to nonendemic parts of the country. This report describes five patients with radiographic findings suggestive of bronchogenic cancer who were subsequently documented to have coccidioidomycosis. These cases highlight two unusual radiographic features of coccidioidomycosis—irregular or enlarging lung masses and significant mediastinal/hilar adenopathy that can mimic bronchogenic cancer. These cases emphasize the crucial importance of obtaining a travel history and the need for invasive testing to secure a diagnosis of coccidioidomycosis in this situation.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Primary pulmonary lymphoma is a rare entity and bronchoscopy is reported to have a low diagnostic yield in lymphomas. A case of primary pulmonary lymphoma is presented where the patient had had sporadic respiratory symptoms and abnormal chest radiographs for the past 14 years. Diagnosis was confirmed by biopsies taken at bronchoscopy from the left lower lobe, where the mucosa had an unusual uniform gray-white appearance.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A patient with a solitary tracheal metastasis of a colon carcinoma is presented. Multimodality treatment, using endoscopic neodymium: YAG laser therapy, radiotherapy, and endotracheal stenting, was helpful in achieving adequate local control and should thus be considered for extending survival in such patients.

ISSN:1070-8030    

出版商:OVID    

年代:1996

数据来源: OVID