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Endobronchial obstruction

Peter B Terry, Richard J Traystman
Oxygen delivery and carbon dioxide removal being critical to cell survival, mammals have developed collateral vascular and ventilation systems to ensure tissue viability. Collateral ventilation, defined as ventilation of alveoli via pathways that bypass normal airways, is present in humans and many other species. The presence of collateral ventilation can be beneficial in certain disease states, while its relative absence can predispose to other diseases. These well defined anatomical pathways contribute little to ventilation in normal humans, but modulate ventilation perfusion imbalance in a variety of diseases including obstructive diseases such as asthma and emphysema...
October 14, 2016: Annals of the American Thoracic Society
Eman Mahmoud Fathy, Hanaa Shafiek, Tamer S Morsi, Bassma El Sabaa, Abdelaziz Elnekidy, Mohamed Elhoffy, Mohamed Samy Atta
BACKGROUND: Bronchial vascular remodeling is an underresearched component of airway remodeling in COPD. Image-enhanced bronchoscopy may offer a less invasive method for studying bronchial microvasculature in COPD. OBJECTIVES: To evaluate endobronchial mucosal vasculature and changes in COPD by image-enhanced i-scan3 bronchoscopy and correlate them pathologically by analyzing bronchial mucosal biopsies. METHODS: This case-control study analyzed 29 COPD patients (41...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Franziska C Trudzinski, Philipp M Lepper, Daniela Leppert, Frank Langer, Christian Lensch, Monika Flaig, Robert Bals, Heinrike Wilkens, Peter Minko, Sebastian Fähndrich
Reducing hyperinflated areas in chronic obstructive pulmonary disease, either surgically or endoscopically, leads to improvement of functional parameters. It is unclear if bilateral treatment with endobronchial valves (EBV) aiming at total lobar occlusion is beneficial. The aim of this study was to assess the results after staged bilateral endoscopic treatment with EBV. This is a retrospective analysis of patients with severe airflow obstruction, who were treated bilaterally with EBV in two stages, aiming at subsequent atelectasis...
October 5, 2016: Respiration; International Review of Thoracic Diseases
Hana Bartáková, Jan Novák, Radek Jakša, Jiří Beneš, Jiří Votruba
Pulmonary infiltration is an infrequent organ involvement in Waldenström's disease (WD). Diffuse infiltration, isolated parenchymatous nodules and pleural effusion are the most common manifestations of WD, while endobronchial mass is extremely rare. We present a case report of a 66-year-old man with a long-standing history of WD, who developed febrile neutropenia after therapy with rituximab, cyclophosphamide and dexamethasone. X-ray and CT scan showed consolidation consistent with right-sided pneumonia. Surprisingly, bronchoscopy revealed an endobronchial tumor obstructing the right lower lobe (RLL) and two smaller granulations...
October 3, 2016: Clinical Respiratory Journal
Hongwu Wang, Nan Zhang, Dongmei Li, Hang Zou, Jieli Zhang, Yunzhi Zhou, Xiuyun Bai
BACKGROUND: Pulmonary sarcoma is a rare malignant tumor in soft tissues. Resection is the preferred option to treat this tumor. The aim of this study is to explore the effect of interventional bronchoscopies in the treatment of pulmonary sarcoma if the patient is inoperable. METHODS: Sixteen cases with pulmonary sarcoma were retrospectively reviewed in our hospital from November 2008 to July 2014. The mean age was (53.1±5.4) years old. Rigid bronchoscopy was applied for the first procedure with general anesthesia, and electronic bronchoscopy was used for the second procedure or slight patients...
September 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Franziska C Trudzinski, Anna J Höink, Daniela Leppert, Sebastian Fähndrich, Heinrike Wilkens, Thomas P Graeter, Frank Langer, Robert Bals, Peter Minko, Philipp M Lepper
BACKGROUND: Patients with a forced expiratory volume in 1 s (FEV1) below 20% of the predicted normal values (pred.) and either homogeneous emphysema or low diffusing capacity for carbon monoxide (DLCO) have a high risk for adverse events including death when undergoing surgical lung volume reduction. OBJECTIVES: We hypothesized that selected patients can benefit from endoscopic lung volume reduction (eLVR) despite a very low FEV1. METHODS: This study is a retrospective analysis of consecutive patients with severe airflow obstruction, an FEV1 ≤20% of pred...
2016: Respiration; International Review of Thoracic Diseases
Gilda Diaz-Fuentes, Bharat Bajantri, Muhammad Adrish
BACKGROUND: Bronchoscopy with transbronchial and endobronchial biopsy and transbronchial needle aspiration is an important diagnostic tool in the pulmonologist's armamentarium. Safety in patients with pulmonary hypertension is controversial and many bronchoscopists consider this as a contraindication for the procedure. OBJECTIVES: To evaluate safety of bronchoscopy in patients with echocardiographic pulmonary hypertension and to compare with patients without it...
2016: Respiration; International Review of Thoracic Diseases
Ravish Manmohan Kshatriya, Nimit V Khara, Rajiv P Paliwal, Sateesh N Patel
It is not so common to aspirate foreign body in normal adults without any predisposing factors as compared to children and those with the altered neurological state. Endobronchial foreign bodies are one of the causes of obstructive pneumonia and difficult to diagnose as signs and symptoms are often nonspecific. However, once they are diagnosed, they can generally be removed, leading to rapid and drastic resolution of symptoms. Bronchoscopy is the gold standard in the identification and localization of an airway foreign body and also for better management of the ailment...
July 2016: Lung India: Official Organ of Indian Chest Society
Carlos Galvez, Julio Sesma, Sergio Bolufer, Francisco Lirio, Jose Navarro-Martinez, Maria Galiana, Benno Baschwitz, Maria Jesus Rivera
Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis...
August 2016: Annals of Translational Medicine
Dirk Skowasch, Andreas Fertl, Björn Schwick, Harald Schäfer, Andreas Hellmann, Felix J F Herth
BACKGROUND: Randomized controlled trials indicate that significant lung volume reduction (ELVR) can be obtained with Zephyr® valves by occluding the target lobe in the absence of collateral ventilation, leading to relevant functional benefits in advanced emphysema patients. OBJECTIVES: To observe the long-term effects of endobronchial valve (EBV) implantation in emphysema patients screened by Chartis assessment in the context of daily pulmonology practice. METHODS: The LIVE Study is a prospective, observational, open-label, single-arm, multicenter trial conducted in Germany...
2016: Respiration; International Review of Thoracic Diseases
M Bullone, P Hélie, P Joubert, J-P Lavoie
BACKGROUND: Remodeling of the peripheral airways persists during the asymptomatic phase of heaves. Assessing the histology of large bronchi could facilitate the diagnosis of heaves during remission of the disease. HYPOTHESIS: Airway inflammation and remodeling in endobronchial biopsy (EBB) specimens differentiate horses with heaves from controls, independently of their clinical status (exacerbation or remission). ANIMALS: Fourteen healthy horses and 24 horses with heaves...
September 2016: Journal of Veterinary Internal Medicine
Katarzyna Gorska, Piotr Korczynski, Michal Mierzejewski, Justyna Kosciuch, Malgorzata Zukowska, Marta Maskey-Warzechowska, Rafal Krenke
INTRODUCTION: Airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) results in bronchial wall thickening. Bronchial wall thickness (BWT) can be assessed in high-resolution computed tomography (HRCT) and endobronchial ultrasound (EBUS). AIMS: To compare BWT measured by EBUS and HRCT in patients with mild-to-moderate asthma and COPD, and to evaluate the relationship between the BWT and pulmonary function. METHODS: The study included patients with mild-to-moderate asthma (n = 24), COPD (n = 36) and controls (n = 12)...
August 2016: Respiratory Medicine
Duc Ha, Xiaoyan Liao, Huan-You Wang, Catriona Jamieson, Marisa Magaña, Samir Makani
Thoracic extramedullary hematopoiesis (EMH) is a rare manifestation in patients with myeloproliferative neoplasm. A 76-year-old woman with a long-standing history of polycythemia vera presented with a 2-month history of worsening dyspnea and left-sided wheezing. A chest computed tomography showed an ill-defined soft tissue mass encasing the left mainstem bronchus causing airway obstruction, associated with paratracheal and paraesophageal lymphadenopathy. Endobronchial ultrasound-guided fine needle aspiration of the soft tissue mass and mediastinoscopy with excisional biopsy of a paratracheal lymph node demonstrated EMH with increased myeloid blasts...
July 29, 2016: Journal of Bronchology & Interventional Pulmonology
Harry D Georgiou, John Taverner, Louis B Irving, Daniel P Steinfort
BACKGROUND: Peripheral pulmonary lesion (PPL) is a common scenario in patients with chronic obstructive pulmonary disease (COPD) and represents a high risk of malignancy. Severe COPD is associated with higher complication rates following percutaneous biopsy, and routine bronchoscopy. Safety and diagnostic performance of radial endobronchial ultrasound bronchoscopy (R-EBUS) in patients with advanced COPD has not been previously assessed. METHODS: We examined a retrospective cohort of patients with advanced COPD undergoing R-EBUS for the evaluation of PPL...
July 2016: Journal of Bronchology & Interventional Pulmonology
Keishi Ohtani, Norihiko Ikeda
In Japan, Photodynamic therapy (PDT) is recommended as a treatment option for centrally located early-stage lung cancers (CLELCs). It is a minimally invasive treatment with excellent anti-tumor effects. The 2nd generation photosensitizer, talaporfin sodium has strong anti-tumor effects with much less photosensitivity than porfimer sodium. Moreover, the laser equipment is compact and portable, and talaporfin sodium is now the current mainstay of PDT for lung cancer. For successful PDT, accurate evaluation of tumor extent and bronchial invasion is crucial...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Rie Tsuboi, Masahide Oki, Hideo Saka, Yoshihito Kogure, Saori Oka, Masashi Nakahata, Kazumi Hori, Yasushi Murakami, Yuko Ise, Shimaa Nour Moursi Ahmed, Meimei Tao, Chiyoe Kitagawa
BACKGROUND: Renal cell carcinoma is one of the major endobronchial metastases, and it occasionally causes life-threatening airway obstruction. Rigid bronchoscopy is useful as a palliative intervention; however, its utility for metastatic renal cell carcinoma has not been elucidated. The purpose of this study was to evaluate the safety and efficacy of rigid bronchoscopic treatment for endobronchial metastasis of renal cell carcinoma. METHODS: Among 550 patients who underwent rigid bronchoscopic intervention at a single center from January 2005 to June 2015, 9 with metastatic renal cell carcinoma were retrospectively reviewed...
July 2016: Respiratory Investigation
Karolina Górka, Jerzy Soja, Bogdan Jakieła, Hanna Plutecka, Iwona Gross-Sondej, Adam Ćmiel, Sławomir Mikrut, Piotr Łoboda, Anna Andrychiewicz, Paulina Jurek, Krzysztof Sładek
INTRODUCTION    Airway remodeling plays an important role in the development of chronic obstructive pulmonary disease (COPD). Imaging methods, such as computed tomography (CT) and endobronchial ultrasound (EBUS), may be useful in the assessment of structural alterations in the lungs. OBJECTIVES    The aim of this study was to evaluate a relationship between the severity of emphysema assessed by chest CT, the thickness of bronchial wall layers measured by EBUS, and the markers of remodeling in bronchoalveolar lavage fluid (BALF) in patients with COPD...
June 30, 2016: Polskie Archiwum Medycyny Wewnętrznej
Melissa McLenon, Gregory J Bittle, Kevin Jones, Jay Menaker, Si M Pham, Aldo T Iacono, Ashutosh Sachdeva, Keshava Rajagopal
Venovenous (V-V) extracorporeal membrane oxygenation (ECMO) is used for respiratory failure that is suspected to be reversible (bridge to recovery), or as a bridge to lung transplantation. Patients with proximal airway obstruction due to endobronchial malignancy can develop acute respiratory failure, and may benefit from V-V ECMO as a bridge to airway intervention, further treatment, and eventual recovery. We describe a case of a superior sulcus tumor with tracheobronchial and superior vena cava invasion causing both respiratory failure and superior vena cava syndrome...
July 2016: Annals of Thoracic Surgery
Eric Daniel Tenda, Abraham Yakub, Ceva Wicaksono Pitoyo, Fauziah Fardizza
Life threatening event due to central airway obstruction caused by very large blood clot formation with profuse on going bleeding its very challenging to manage. Interventional pulmonologist must aware about this situation which can lead to respiratory failure. There are several choices to treat this unlikely situation, in example flexible bronchoscopy with forceps, bronchial lavage, and suction. We present a case with post-surgical tracheostomy bleeding which caused a giant blood clot formation in a disseminated intravascular coagulation due to severe sepsis in end stage renal disease patient, successfully managed with cryoextraction and argon plasma coagulation...
2016: Respiratory Medicine Case Reports
Aditya Goud, William Krimsky, Marry Caldwel, Brandon Perry, Pooya Heiraty, Saiyad Sarkar, Daniel P Harley, Stephen Selinger
We present the first reported case of the treatment and management of a giant bulla using percutaneous bullectomy and endobronchial valve placement. A 74-year-old woman with chronic obstructive pulmonary disease and a known large bulla in the left chest presented to the emergency department with acute-onset confusion after a traumatic fall. She was subsequently diagnosed with an intracranial hemorrhage in the distribution of the right basal ganglia. Chest imaging revealed a giant apical bulla occupying 80% of the left hemithorax...
2016: Respiration; International Review of Thoracic Diseases
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