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Pleural effusion

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https://www.readbyqxmd.com/read/29024544/squamous-cell-carcinoma-in-serous-effusions-avoiding-pitfalls-in-this-rare-encounter
#1
Christopher LePhong, Elizabeth W Hubbard, Stuart Van Meter, Laurentia Nodit
BACKGROUND: With advent of personalized medicine, precise classification of malignant tumors becomes essential. Squamous cell carcinoma (SCC) is rarely found in serous effusions and has morphologic and immunohistochemical (IHC) overlap with other neoplasms. METHODS: 17-year review identified 49 fluids from 26 patients where SCC was recognized. RESULTS: SCC was more frequent in pleural fluid (84%) and rare in other effusions. Lung SCC was common (65%), followed by head and neck (16%), with other origins less represented...
October 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29024191/non-specific-pleuritis-in-patients-with-active-malignancy
#2
Erik Vakil, David Ost, Macarena R Vial, John Stewart, Mona G Sarkiss, Rodolfo C Morice, Roberto F Casal, Georgie A Eapen, Horiana B Grosu
BACKGROUND AND OBJECTIVE: Pleuroscopy is the test of choice for patients with suspected malignant pleural effusion and negative cytology. Biopsies negative for malignancy are frequently attributed to non-specific pleuritis, which poses a dilemma in patients with a known active malignancy, raising concern for a false-negative result. Our primary objective was to determine the outcomes of patients with active malignancy who had a non-malignant diagnosis on pleuroscopy. METHODS: Retrospective review of all pleuroscopy cases from January 2005 to January 2015 at our institution was conducted...
October 12, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29021929/rare-presentation-of-a-posterior-mediastinal-cystic-schwannoma-as-a-large-pleural-effusion
#3
Mujtaba Mubashir, Abdus Salam, Amyn Sonawalla, Huma Fatima, Saulat H Fatimi
A 46-year-old man presented with shortness of breath and recurrent, left-sided pleural effusions. A computed tomography (CT) scan of the chest showed a large, left-sided pleural effusion with a mass in the posterior mediastinum. A pleural tap showed lymphocytic exudate. The biopsy of the mass was inconclusive. A left posterolateral thoracotomy was performed, which showed a large posterior mediastinal mass adherent to the left lung. The mass was completely excised and the histopathology proved it to be giant predominantly cystic schwannoma...
August 10, 2017: Curēus
https://www.readbyqxmd.com/read/29021638/real-time-pcr-assay-for-the-diagnosis-of-pleural-tuberculosis
#4
Martha Alejandra Casallas-Rivera, Ana María Cárdenas Bernal, Luis Fernando Giraldo-Cadavid, Enrique Prieto Diago, Sandra Paola Santander
INTRODUCTION: The diagnosis of pleural tuberculosis requires an invasive and time-consuming reference method. Polymerase chain reaction (PCR) is rapid, but validation in pleural tuberculosis is still weak. OBJECTIVE: To establish the operating characteristics of real-time polymerase chain reaction (RT-PCR) hybridization probes for the diagnosis of pleural tuberculosis. METHODS: The validity of the RT-PCR hybridization probes was evaluated compared to a composite reference method by a cross-sectional study at the Hospital Universitario de la Samaritana...
June 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/29021577/interleukin-17a-as-a-good-predictor-of-the-severity-of-mycoplasma-pneumoniae-pneumonia-in-children
#5
Mingyue Yang, Fanzheng Meng, Kuo Wang, Man Gao, Ruihua Lu, Mengyao Li, Fangxing Zhao, Lijuan Huang, Yining Zhang, Genhong Cheng, Xiaosong Wang
Early distinction between severe Mycoplasma pneumoniae pneumonia (MPP) and mild MPP is still difficult. The aim of this study was to analyze cytokines in bronchoalveolar lavage fluid (BALF) and explore predicting factors of severe MPP in children. Retrospective analysis was performed on 150 children with MPP or bronchial foreign body (FB) admitted in our hospital. The mRNA levels of IL17A were found significantly lower in severe MPP group comparing with mild MPP group or FB group. However, no significant difference was found in the levels of IL4, IL10 or interferon beta1 (IFNβ1) between the two groups...
October 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29021516/human-herpesvirus-8-unrelated-primary-effusion-lymphoma-like-lymphoma-following-tyrosine-kinase-inhibitor-treatment-for-chronic-myelogenous-leukemia
#6
Minoru Kojima, Naoya Nakamura, Jun Amaki, Hiroki Numata, Masashi Miyaoka, Tadashi Motoori, Koshi Matsumoto, Kiyoshi Ando
A 69-year-old man was diagnosed with chronic myelogenous leukemia (CML) and treated with dasatinib. After two years on dasatinib, the patient achieved complete molecular response, but dasatinib treatment was discontinued due to exacerbation of pleural effusion. Nilotinib and imatinib were started but stopped due to an increase in pleural effusion. Thoracentesis was performed and he was diagnosed with human herpesvirus 8-unrelated primary effusion lymphoma (PEL)-like lymphoma. Complex chromosomal abnormality, including BCL6 rearrangement, was found on chromosome analysis...
2017: Journal of Clinical and Experimental Hematopathology: JCEH
https://www.readbyqxmd.com/read/29021481/cryptococcal-pleuritis-presenting-with-lymphocyte-predominant-and-high-levels-of-adenosine-deaminase-in-pleural-effusions-coincident-with-pulmonary-tuberculosis
#7
Yoshitomo Kushima, Hidenori Takizawa, Yasutaka Machida, Takafumi Umetsu, Naoya Ikeda, Masaaki Miyoshi, Kazuyuki Chibana, Yasuo Shimizu, Akihiro Takemasa, Yoshiki Ishii
Co-infection with cryptococcus and tuberculosis has rarely been reported. We herein report a case of an 80-year-old man with cryptococcal pleuritis concurrent with pulmonary tuberculosis. He was admitted for progression of left pleural effusion and consolidation in the left upper lobe. Culture for Mycobacterium tuberculosis was positive in sputum, and analyses of pleural effusion revealed lymphocyte-predominant high levels of adenosine deaminase (ADA). Medical thoracoscopy revealed massive infiltration of Cryptococcus neoformans in pleura without granuloma...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29021431/a-case-of-tocilizumab-resistant-tafro-syndrome-complicated-by-type-ii-respiratory-failure
#8
Tatsuya Aoki, Mikio Wada, Atsushi Kawashima, Kouichi Hirakawa, Akihiro Nagata, Keizo Kagawa
A 66-year-old man with a several year history of thrombocytopenia, pleural effusion and ascites, anasarca, and organomegaly presented with general fatigue, appetite loss, dyspnea with type II respiratory failure. The precise history of the patient and the re-evaluation of lymph node and bone marrow biopsies conducted by the previous physician indicated TAFRO syndrome. The patient's laboratory data improved for a year with tocilizumab, but then worsened to the point that the patient required artificial ventilation due to the deterioration of type II respiratory failure...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29021430/crizotinib-induced-rectal-perforation-with-abscess
#9
Asako Yanagisawa, Noriko Hayama, Hiroyuki Amano, Makoto Nakamura, Satoshi Hirano, Sukeyuki Nakamura, Hiroshi Tabeta
An 86-year-old Japanese man was diagnosed with stage IV lung adenocarcinoma. The patient was treated with crizotinib after EML4-ALK rearrangement was detected from his pleural effusion. He subsequently developed abdominal pain and rebound tenderness in the right lower abdomen. Contrast-enhanced abdominal CT showed a low-density area in the abdominal cavity. The size of the abscess was decreased by drainage and the administration of antibiotics. Fistulography revealed a fistula from the rectum to the abscess, and a diagnosis of lower intestinal tract perforation with abscess formation was made...
October 11, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29018997/gastrointestinal-perforation-related-to-lenvatinib-an-anti-angiogenic-inhibitor-that-targets-multiple-receptor-tyrosine-kinases-in-a-patient-with-metastatic-thyroid-cancer
#10
Emi Date, Kunio Okamoto, Souichi Fumita, Hiroyasu Kaneda
Lenvatinib, a novel potent multikinase inhibitor, was approved for the treatment of radioiodine-refractory differentiated thyroid cancer based on results from phase III trial (SELECT study). Thyroid cancer is a diverse disease that includes anaplastic thyroid cancer (ATC), which the most aggressive form of the disease, although it accounts for <2% of all thyroid cancers. Current treatments for ATC have limited efficacy. We report the case of a woman with recurrent well-differentiated papillary carcinoma of the thyroid that had transformed into ATC who developed a perforation of the small intestine secondary to a marked effect of lenvatinib...
October 11, 2017: Investigational New Drugs
https://www.readbyqxmd.com/read/29017676/rare-cause-of-pleuropnemonia-tularemia-disease
#11
Meltem Agca, Dildar Duman, Ebru Sulu, Fatma Ozbaki, Orcun Barkay, Derya Ozturk, Tulay Yarkin
Tularemia is a zoonotic infection which is caused by gram negative coccobacilli, Francisella tularensis. The disease occurs after contact with blood and body fluids of infected animals, bites and ingestion of infected food and water. Although it commonly presents with skin lesions, there may also be serious organ involvements. A55-year woman was consulted for presumptive diagnosis of tuberculosis. Multiple lymphadenopathy in right cervical area was present on physical examination. Pleural effusion on left side was detected with computed tomography...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28994887/hepatic-hydrothorax-about-a-hospital-serie-of-63-cases
#12
Leila Mouelhi, Oussama Daboussi, Nadia Cheffi, Kaouther El Jery, Yosra Said, Sana Khedher, Mohamed Salem, Radhouane Dabbèche, Fatma Houissa, Taoufik Najjar
BACKGROUND: Hepatic hydrothorax is a less common complication of cirrhosis with an estimated prevalence of 10- 15%. In the vast majority of cases, ascites are also present but significant pleural effusion may develop in patients without ascites. Hepatic hydrothorax is associated with cirrhosis whatever its etiology. The prognosis of hepatic hydrothorax remains unclear and is closely related to available therapeutic options. The aim of our study is to determine the prevalence of hydrothorax in cirrhotic patients, detail its clinical and therapeutic characteristics, and study the evolutive profile of cirrhotic patients with hydrothorax by comparing it to those without hydrothorax...
December 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28994508/loss-of-brca1-associated-protein-1-bap1-expression-is-useful-in-diagnostic-cytopathology-of-malignant-mesothelioma-in-effusions
#13
Ilaria Cozzi, Florina Anca Oprescu, Emma Rullo, Valeria Ascoli
BACKGROUND: The important diagnostic challenge facing the cytopathologist is whether a mesothelial proliferation on effusions represents a malignant mesothelioma (MM) or a benign mesothelial hyperplasia (MH). Here, we evaluated the diagnostic utility of BAP1 immunohistochemistry (IHC) in distinguishing between reactive and neoplastic mesothelial cells. METHODS: In pleural and peritoneal effusions from 147 patients with diagnosed MM or with a differential diagnosis of MM and MH, the expression of BAP1 was examined by IHC on paraffin-embedded cell blocks (n = 121) and biopsies (n = 44)...
October 10, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28991771/surgical-treatment-of-pleural-empyema-our-results
#14
Goran Kondov, Zoran Spirovski, Irena Kondova-Topuzovska, Anita Kokareva, Risto Colanceski, M Srceva, Borislav Kondov, I Dzikovski, N Toleska-Dimitrovska, Sanja Petrusevska-Marinkovic
Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce morbidity, mortality and duration of hospital stay. Unfortunately, advanced stages of empyema need to use extensive surgery - decortications or thoracoplasty. Early recognition of the parapneumonic effusion and the adequate treatment with thoracentesis or pleural drainage, which is minimally invasive, is possible not to prograde the process and not to become empyema. AIM: To analyze the results of the surgical treatment in patients with empyema treated at Clinic for thoracic surgery...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28988189/recurrent-chylothorax-a-clinical-mystery
#15
Eva Otoupalova, Shaiva Ginoya Meka, Sanjay Dogra, Bhavin Dalal
Chylothorax is an unusual cause of pleural effusion, typically caused by trauma or malignancy. Waldenstrom's macroglobulinaemia (WM) is a clinicopathological entity demonstrating lymphoplasmacytic lymphoma in the bone marrow with an IgM monoclonal gammopathy in the blood. Recurrent chylous effusions are often resistant to conservative treatment and may require surgical intervention. We present a unique case of a 50-year-old woman with recurrent chylothorax secondary to WM that completely resolved with ibrutinib therapy...
October 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28987680/diagnosing-acute-pancreatitis-clinical-and-radiological-characterisation-of-patients-without-threefold-increase-of-serum-lipase
#16
Maxim Avanesov, Anastassia Löser, Sarah Keller, Julius M Weinrich, Azien Laqmani, Gerhard Adam, Murat Karul, Jin Yamamura
OBJECTIVES: Diagnosing acute pancreatitis (AP) may be challenging in patients with acute abdominal pain but missing threefold increased serum lipase levels (Lip-). This studyaims both to characterize these patients using clinical, radiological and mortality data, and to assess the group of patients who need contrast-enhanced computed tomography (CECT). METHODS: In this retrospective, IRB approved study 234 consecutive patients with AP were investigated. Inclusion criteria were single (SAP) and recurrent attacks (RAP) of AP and CECT ≥72h after onset of symptoms...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28986615/perforations-associated-with-peripherally-inserted-central-catheters-in-a-neonatal-population
#17
Andrew J Sertic, Bairbre L Connolly, Michael J Temple, Dimitri A Parra, Joao G Amaral, Kyong-Soon Lee
BACKGROUND: Peripherally inserted central catheters (PICCs) are increasingly used in neonates but perforations can result in devastating complications such as pericardial and pleural effusions. Identifying risk factors may guide surveillance and reduce morbidity and mortality. OBJECTIVE: To determine the risk factors for PICC perforation in neonates. MATERIALS AND METHODS: Retrospective case:control (1:2) study of neonates admitted between 2004-2014...
October 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28980363/old-age-and-underlying-interstitial-abnormalities-are-risk-factors-for-development-of-ards-after-pleurodesis-using-limited-amount-of-large-particle-size-talc
#18
Yuki Shinno, Hidenori Kage, Haruka Chino, Atsushi Inaba, Sayaka Arakawa, Satoshi Noguchi, Yosuke Amano, Yasuhiro Yamauchi, Goh Tanaka, Takahide Nagase
BACKGROUND AND OBJECTIVE: Talc pleurodesis is commonly performed to manage refractory pleural effusion or pneumothorax. It is considered as a safe procedure as long as a limited amount of large particle size talc is used. However, acute respiratory distress syndrome (ARDS) is a rare but serious complication after talc pleurodesis. We sought to determine the risk factors for the development of ARDS after pleurodesis using a limited amount of large particle size talc. METHODS: We retrospectively reviewed patients who underwent pleurodesis with talc or OK-432 at the University of Tokyo Hospital...
October 4, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28977977/addition-of-bevacizumab-for-malignant-pleural-effusion-as-the-manifestation-of-acquired-egfr-tki-resistance-in-nsclc-patients
#19
Tao Jiang, Aiwu Li, Chunxia Su, Xuefei Li, Chao Zhao, Shengxiang Ren, Caicun Zhou, Jun Zhang
This study aimed to investigate the role of bevacizumab in patients with advanced non-small cell lung cancer (NSCLC) who had developed acquired resistance to EGFR-TKIs therapy that manifested as malignant pleural effusion (MPE). In total, 86 patients were included. 47 patients received bevacizumab plus continued EGFR-TKIs and 39 patients received bevacizumab plus chemotherapy. The curative efficacy rate for MPE in bevacizumab plus EGFR-TKIs group was significantly higher than that in bevacizumab plus chemotherapy group (89...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28977200/the-efficacy-of-thoracic-ultrasonography-in-postoperative-newborn-patients-after-cardiac-surgery
#20
Erkut Ozturk, Ibrahim Cansaran Tanidir, Okan Yildiz, Yakup Ergul, Alper Guzeltas
OBJECTIVE: In this study, the efficacy of thoracic ultrasonography during echocardiography was evaluated in newborns. METHODS: Sixty newborns who had undergone pediatric cardiac surgery were successively evaluated between March 1, 2015, and September 1, 2015. Patients were evaluated for effusion, pulmonary atelectasis, and pneumothorax by ultrasonography, and results were compared with X-ray findings. RESULTS: Sixty percent (n=42) of the cases were male, the median age was 14 days (2-30 days), and the median body weight was 3...
July 2017: Brazilian Journal of Cardiovascular Surgery
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