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https://www.readbyqxmd.com/read/28640655/usual-interstitial-pneumonia-can-be-detected-in-transbronchial-biopsies-using-machine-learning
#1
Daniel G Pankratz, Yoonha Choi, Urooj Imtiaz, Grażyna M Fedorowicz, Jessica D Anderson, Thomas V Colby, Jeffrey L Myers, David A Lynch, Kevin K Brown, Kevin R Flaherty, Mark P Steele, Steve D Groshong, Ganesh Raghu, Neil M Barth, P Sean Walsh, Jing Huang, Giulia C Kennedy, Fernando J Martinez
RATIONALE: Usual interstitial pneumonia (UIP) is the histopathologic hallmark of idiopathic pulmonary fibrosis. While UIP can be detected by high-resolution computed tomography (HRCT) of the chest, HRCT results are frequently inconclusive, and pathology from transbronchial biopsy (TBB) has poor sensitivity. Surgical lung biopsy (SLB) may be necessary for a definitive diagnosis. OBJECTIVES: To develop a genomic classifier in tissue obtained by TBB that distinguishes UIP from non-UIP, trained against central pathology as the reference standard...
June 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28637080/the-prognostic-importance-of-bronchoalveolar-lavage-fluid-cxcl9-during-minimal-acute-rejection-on-the-risk-of-chronic-lung-allograft-dysfunction
#2
M Y Shino, S S Weigt, N Li, A Derhovanessian, D M Sayah, R Saggar, Richard H Huynh, A L Gregson, A Ardehali, D J Ross, J P Lynch, R M Elashoff, J A Belperio
The clinical significance and treatment strategies for minimal acute rejection (grade A1), the most common form of acute rejection (AR), remains controversial. In this retrospective single-center cohort study of 441 lung transplant recipients, we formally evaluate the association between minimal AR and chronic lung allograft dysfunction (CLAD) and test a novel hypothesis using BAL CXCL9 concentration during minimal AR as a biomarker of subsequent CLAD development. In univariable and multivariable models adjusted for all histopathologic injury patterns, minimal AR was not associated with CLAD development...
June 21, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28635201/hamman-rich-syndrome-a-forgotten-entity
#3
William Newmarch, Angelica Puopolo, Madina Weiler, Brian Casserly
The following report outlines the case of a 76-year-old gentleman who presented to the hospital with acute interstitial pneumonitis, a rare and rapidly progressive type of idiopathic interstitial pneumonia. The patient initially presented with a three-week history of progressive shortness of breath and cough which was diagnosed as community acquired pneumonia. Treatment with oral antibiotics was unsuccessful resulting in re-presentation the following week with type one respiratory failure. Investigations revealed widespread inflammatory changes consistent with an acute inflammatory process...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28632694/multiorgan-involvement-of-chemotherapy-induced-sarcoidosis-mimicking-progression-of-lymphoma-on-fdg-pet-ct
#4
Prateek Sanan, Yang Lu
A 35-year-old woman with biopsy-proven recurrent Hodgkin lymphoma in the neck lymph nodes received salvage chemotherapy of brentuximab/insulin growth factor-methotrexate. Although the patient continued doing well clinically with no constitutional symptoms or significant laboratory abnormalities following the second recurrence, subsequent FDG PET CT examinations over the next 2 years revealed multiple new FDG-avid foci including lymph nodes above/below the diaphragm, liver, spleen, lungs, and bone. An alternate diagnosis of chemotherapy-induced sarcoidosis was suggested and confirmed on both bone marrow and right inguinal node biopsy...
June 19, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28631653/hodgkin-s-lymphoma-with-unusual-pulmonary-presentations-reporting-two-cases
#5
Brett Matthew Lowenthal, Xiangdong Xu, Meera Subash, Lily J Jih
Classical Hodgkin's lymphoma (CHL) presenting with exclusively pulmonary symptoms is very unusual. We report two cases of CHL with atypical clinical presentations mimicking pulmonary infections. The first case represents a stage IV CHL with secondary lung involvement, and the second case demonstrates a very rare case of CHL with isolated lung involvement, also known as primary pulmonary Hodgkin's lymphoma. The second patient was initially misdiagnosed and treated with six months of antibiotics before the correct diagnosis was made by a lung biopsy...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631159/distinctive-pathological-and-clinical-features-of-lung-carcinoids-with-high-proliferation-index
#6
Caterina Marchiò, Gaia Gatti, Federica Massa, Luca Bertero, Pierluigi Filosso, Giuseppe Pelosi, Paola Cassoni, Marco Volante, Mauro Papotti
Typical (TCs) and atypical carcinoids (ACs) are defined based on morphological criteria, and no grading system is currently accepted to further stratify these entities. The 2015 WHO classification restricts the Ki-67 role to biopsy or cytology samples, rather than for prognostic prediction. We aimed to investigate whether values and patterns of Ki-67 alone would allow for a clinically meaningful stratification of lung carcinoids, regardless of histological typing. Ki-67 proliferation index and pattern (homogeneous versus heterogeneous expression) were assessed in a cohort of 171 TCs and 68 ACs...
June 19, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28631156/diagnosis-of-secondary-pulmonary-lymphangiectasia-in-congenital-heart-disease-a-novel-role-for-chest-ultrasound-and-prognostic-implications
#7
Christopher Z Lam, Tanmay Anant Bhamare, Tamadhir Gazzaz, David Manson, Tilman Humpl, Mike Seed
BACKGROUND: Secondary pulmonary lymphangiectasia is a complication of congenital heart disease that results from chronic pulmonary venous obstruction. OBJECTIVES: We aimed to evaluate the performance of chest ultrasound (US) in diagnosing secondary pulmonary lymphangiectasia and to review the clinical course of children with secondary pulmonary lymphangiectasia. MATERIALS AND METHODS: Chest US was performed on 26 children with hypoplastic left heart syndrome, total anomalous pulmonary venous connection or cor triatriatum in a prospective observational study...
June 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28631096/a-case-of-nivolumab-related-cholangitis-and-literature-review-how-to-look-for-the-right-tools-for-a-correct-diagnosis-of-this-rare-immune-related-adverse-event
#8
Francesco Gelsomino, Giovanni Vitale, Andrea Ardizzoni
Anti-programmed cell death-1 (PD-1) monoclonal antibodies, such as nivolumab, used for the treatment of several tumors, can trigger effector T-cells against tumor- and self-antigens, leading to the occurrence of different immune-related adverse events. Among them, liver injuries are rare and usually transient. To date, only four cases of immune-related cholangitis in non-small cell lung cancer (NSCLC) patients have been described during nivolumab treatment. Here, we describe laboratory tests, imaging and liver biopsy features that confirm this diagnosis as opposed to other forms of autoimmune liver disease; nevertheless, we also provide evidence of the presence of different clinical-pathological patterns of immune-related cholangitis...
June 20, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/28631088/etiologies-diagnostic-work-up-and-outcomes-of-acute-respiratory-distress-syndrome-with-no-common-risk-factor-a-prospective-multicenter-study
#9
Nicolas de Prost, Tài Pham, Guillaume Carteaux, Armand Mekontso Dessap, Christian Brun-Buisson, Eddy Fan, Giacomo Bellani, John Laffey, Alain Mercat, Laurent Brochard, Bernard Maître
BACKGROUND: Patients meeting the Berlin definition for the acute respiratory distress syndrome (ARDS) might lack exposure to one or more "common" risk factors and exhibit different clinical phenotype and outcomes. We aimed to compare the clinical presentation and outcome of ARDS patients with or without risk factors, the impact on hospital mortality, and to assess the diagnostic work-up performed. The current study is an ancillary analysis of an international, multicenter, prospective cohort study (the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure, LUNG SAFE)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#10
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630242/tumour-necrosis-factor-tnf-inhibitor-induced-isolated-pleural-granulomas-a-rare-adverse-effect
#11
Muhammad Sajawal Ali, Rose Franco, Dheeraj Dhotre, Nagarjun Rao
A 53-year-old man with a history of Crohn's disease on infliximab, presented with several weeks of cough and dyspnoea. He had a right-sided pleural effusion, found to be exudative with lymphocytic predominance. He underwent right-sided video-assisted thoracic surgery (VATS) with biopsies and pleurodesis. Histopathology showed pleural-based non-caseating granulomas with unremarkable lung parenchyma. Cultures were only positive for Propionibacterium acnes 8 months later, he was found to have a left-sided exudative, lymphocytic predominant pleural effusion...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28627833/comparison-of-the-analytical-performance-between-cobas-egfr-assay-and-pcr-clamp-method-in-the-detection-of-egfr-mutations-in-japanese-non-small-cell-lung-cancer-patients
#12
Tomohiko Ai, Maiko Yuri, Yoko Tabe, Atsushi Kakimoto, Soji Morishita, Koji Tsuchiya, Kazuya Takamochi, Yuzo Kodama, Fumiyuki Takahashi, Misawa Shigeki, Takashi Horii, Kenji Suzuki, Kazuhisa Takahashi, Takashi Miida, Akimichi Ohsaka
BACKGROUND: EGFR, a tyrosine-kinase, plays an important role in the progression of lung cancer. Since genetic abnormality of EGFR alters the effects of tyrosine-kinase inhibitors targeting EGFR, molecular analyses of EGFR have recently gained more attention in the treatment of lung cancer. However, several different techniques are available and which method is superior has not been determined. In this study, we compared two recently developed PCR-based techniques, PCR-clamp method and cobas EGFR assay...
May 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28626634/an-unusual-late-onset-of-pulmonary-alveolar-microlithiasis-a-case-report-and-literature-review
#13
Alexandros Stamatopoulos, Davide Patrini, Sofoklis Mitsos, Reena Khiroya, Elaine Borg, Martin Hayward, David Lawrence, Nikolaos Panagiotopoulos
Pulmonary alveolar microlithiasis (PAM) is an uncommon genetic disorder associated with alveolar cell injury. This injury is caused in most cases by inactivating mutations in SLC34A2 gene, which is responsible for the production of a sodium-dependent phosphate co-transporter. The dysfunction or deficiency of this transporter leads to the aggregation of local phosphate intra-alveolarly and formation of microliths. Most of the patients are asymptomatic at the time of the diagnosis but as the disease progress it leads to fatal respiratory or cardiac failure...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626632/synchronous-mucinous-and-non-mucinous-lung-adenocarcinomas-with-different-epidermal-growth-mutational-status
#14
Rita Linhas, David Tente, Margarida Dias, Ana Barroso
In recent years, the spread of more-sensitive diagnostic methods has resulted in an increase of synchronous multiple primary lung cancer diagnosis. Nevertheless, its occurrence is still rare. Distinction between synchronous lesions from second independent primary tumors is a problem when dealing with multiple lung tumors, particularly if the histological type is the same. We present a case report of a 78-year-old female patient referred to our institution due to pneumonia. A subsequent thoracic computed tomography (CT) was performed showing two suspicious lesions, one in the right upper lobe and the other in the right inferior lobe...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626398/esophageal-metastasis-from-rectal-cancer-successfully-treated-with-fluorouracil-based-chemotherapy-with-bevacizumab-a-case-report-and-review-of-the-literature
#15
Sho Watanabe, Atsuo Takashima, Hirokazu Taniguchi, Yusaku Tanaka, Shoko Nakamura, Natsuko Okita, Yoshitaka Honma, Satoru Iwasa, Ken Kato, Tetsuya Hamaguchi, Narikazu Boku
Esophageal metastasis from colorectal carcinoma is uncommon, and diagnosis of esophageal metastasis is difficult. We report a case of a 54-year-old woman with postoperative recurrence of rectal cancer metastasizing to the esophagus. She underwent rectectomy and adjuvant chemotherapy with fluorouracil, leucovorin plus oxaliplatin for stage IIIB rectal cancer. Three years later, she presented with dysphagia and cough. Computed tomography showed thickening of the esophagus wall, enlargement of the lymph nodes in the mediastinum and abdomen, and ground-glass opacities in the right lung...
May 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28626260/a-case-of-api2-malt1-positive-gastric-malt-lymphoma-with-concomitant-diffuse-large-b-cell-lymphoma
#16
Akashi Fujita, Masahiro Tajika, Tsutomu Tanaka, Makoto Ishihara, Yutaka Hirayama, Nobumasa Mizuno, Kazuo Hara, Susumu Hijioka, Hiroshi Imaoka, Tsukasa Yoshida, Nozomi Okuno, Nobuhiro Hieda, Takashi Hirayama, Hitoshi Shibuya, Hisashi Kondo, Hirotaka Suzuki, Kazuhiro Toriyama, Yasushi Yatabe, Kenji Yamao, Yasumasa Niwa
API2-MALT1 translocation-positive gastric marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT) lymphoma is thought to transform to diffuse large B-cell lymphoma (DLBCL) rarely. A 69-year-old man presented with epigastralgia. Esophagogastroduodenoscopy showed multiple ulcerations in the stomach. Endoscopic biopsies revealed MALT lymphoma, with Helicobacter pylori infection. The patient underwent eradication therapy with no improvement, and was thereafter followed without additional therapy at his request...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28626190/miliary-tuberculosis-in-a-young-woman-with-hemophagocytic-syndrome-a-case-report-and-literature-review
#17
Mina Asaji, Kazunori Tobino, Koujin Murakami, Yuki Goto, Takuto Sueyasu, Saori Nishizawa, Kohei Yoshimine, Miyuki Munechika, Yuki Ko, Yuki Yoshimatsu, Kosuke Tsuruno, Hiromi Ide, Hiroyuki Miyajima, Noriyuki Ebi
We herein report a rare case of miliary tuberculosis-associated hemophagocytic syndrome (HPS) complicated with respiratory failure. A 19-year-old Japanese woman with a fever, general malaise, and chest radiograph abnormalities was referred to our hospital. After admission, she developed respiratory failure with pancytopenia. A histological examination of lung and bone marrow biopsy samples revealed noncaseating granulomas without evidence of acid-fast bacilli or lymphoma. In addition, a bone marrow biopsy showed marked histiocyte hyperplasia with hemophagocytosis, and a bronchoalveolar lavage fluid culture grew Mycobacterium tuberculosis...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626185/miliary-tuberculosis-that-developed-after-intravesical-bacillus-calmette-guerin-therapy
#18
Kyohei Kaburaki, Keishi Sugino, Muneyuki Sekiya, Yujiro Takai, Kazutoshi Shibuya, Sakae Homma
As a treatment for superficial transitional cell carcinoma, Bacillus Calmette-Guerin (BCG) intravesical instillation can rarely cause unpredictable systemic side effects. We describe a patient admitted due to continuous pyrexia and general fatigue. He was previously treated with intravesical BCG. Laboratory data indicated a hepatic disorder, and chest computed tomography revealed extensive bilateral miliary nodules. Transbronchial lung biopsy specimens showed several small noncaseating granulomas. The diagnosis was unsolved on the basis of acid fast staining, polymerase chain reaction and microbiological cultures, so we considered the possibility of BCG side effect-induced granuloma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626184/a-16-year-follow-up-case-of-interstitial-pneumonia-with-systemic-sclerosis-rheumatoid-arthritis-overlap-syndrome
#19
Hideaki Yamakawa, Eri Hagiwara, Yumie Yamanaka, Satoshi Ikeda, Akimasa Sekine, Hideya Kitamura, Tomohisa Baba, Koji Okudela, Tae Iwasawa, Tamiko Takemura, Takashi Ogura
Interstitial pneumonia is a common and major comorbidity affecting the prognosis of patients with systemic sclerosis (SSc). However, there are few reported cases of SSc-rheumatoid arthritis (RA) overlap-associated interstitial pneumonia. We herein report a case in which the clinical behavior and histopathology of interstitial pneumonia with SSc-RA overlap syndrome was followed over a long clinical course. When clinicians are deciding on the treatment strategy for patients with SSc-RA overlap syndrome-associated interstitial pneumonia, a pathological examination of a surgical lung biopsy may be useful...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28626182/small-cell-lung-cancer-in-a-20-year-old-non-smoking-man-with-systemic-sclerosis
#20
Go Saito, Torahiko Jinta, Hiroshi Nakaoka, Atsushi Kitamura, Kenichi Yamaguchi, Naoki Nishimura
Small cell lung cancer (SCLC) is a neuroendocrine tumor, and the median age of onset is about 70 years old. A 20-year-old non-smoking man with known systemic sclerosis presented with discomfort in his left chest. Chest X-ray showed a mass shadow in the left upper zone. A transbronchial lung biopsy revealed small cell carcinoma, and imaging studies reached the diagnosis of extensive disease small cell lung cancer. He had concurrent interstitial lung disease with a non-specific interstitial pneumonia pattern and anti-Scl-70 antibodies...
2017: Internal Medicine
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