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Solitary pulmonary nodule

Anna Stainer, Paola Faverio, Francesca Bono, Alberto Pesci
Primary lung lymphoma (PLL) is a rare type of lymphoma confined to the lung at the time of diagnosis. Pulmonary diffuse large B cells lymphoma (P-DLBCL) is the second most common type of PLL and it usually appears radiologically as solitary or multiple nodules or areas of consolidation. We present the case of a 63-year-old Caucasian male who developed severe acute respiratory failure and diffuse ground glass opacities (GGO) on chest computerized tomography. Diffuse GGO may be the radiological expression of very different diseases, ranging from infectious processes to interstitial lung diseases (ILDs) and neoplastic diseases...
May 14, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Paolo Albino Ferrari, Antonella Grisolia, Stefano Reale, Rosa Liotta, Alessandra Mularoni, Alessandro Bertani
BACKGROUND: Human pulmonary dirofilariasis is a rare zoonosis caused by the dog worm Dirofilaria spp., a parasite transmitted by mosquitos and resulting in peripheral lung nodules. The filarial nematode enters the subcutaneous tissue, travels to the right ventricle and dies causing a small pulmonary infarction that may embolize through the pulmonary vessels and may appear as a solitary nodule. These nodules are usually incidentally identified in asymptomatic patients undergoing chest imaging studies, and are generally interpreted to be malignant...
June 11, 2018: Journal of Cardiothoracic Surgery
F Fang, L Pan, L Y Bo, W P Li, E Q Fu, C C Li, F G Jin
Objective: To explore the diagnostic value and safety of endobronchial ultrasonography with guide-sheath (EBUS-GS) combined with virtual bronchoscopy navigation (VBN) in peripheral lung cancer. Methods: Between Dec. 2015 to Dec. 2016, patients with pulmonary solitary nodule suspected of early lung cancer on computed tomography (CT) in Department of Respiratory, Tangdu Hospital, Fourth Military Medical University were enrolled for this study. The patients underwent EBUS-GS transbronchoscopic lung biopsy (TBLB) with or without VBN...
June 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Ateeque Ahmed Khan, Mahnoor Hafeez
We report a case of 65-year male patient, a known hypertensive and a chronic smoker, who presented to the Civil Hospital, Karachi with complaints of cough, hemoptysis and shortness of breath for three weeks. The chest radiograph showed left apical solitary pulmonary nodule (SPN) and aneurysmal dilatation of the descending thoracic aorta. He was further investigated with contrast enhanced computed tomography (CECT) scan of chest, which apart from demonstrating malignant pulmonary lesion, surprisingly revealed Stanford type B descending thoracic aortic dissecting aneurysm with intramural hematoma, jeopardising renal and splanchnic circulation...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Takafumi Sakuma, Norio Takayashiki, Kesato Iguchi, Katsunori Kagohashi, Hiroaki Satoh, Kensuke Nakazawa, Nobuyuki Hizawa
Chronic expanding hematoma (CEH) is a rare disease that is usually present as a large solitary pulmonary nodule. CEHs are slow growing, but processes underlying their development remain unknown. The present study herein reports the case of a 76-year-old male patient with CEH and discusses a number of CEH cases published in the literature. The majority of these previously described patients were Asians. The CEH in the present case was not a successfully resected one, but the patient's clinical course provided information concerning the natural history of the disease...
June 2018: Experimental and Therapeutic Medicine
Xiaoming Wang, Liang Lv, Qinyun Zheng, Xianlong Huang, Biqiang Li
The present study aimed to evaluate the diagnostic value of 64-slice spiral multivariate computed tomography (CT) combined with dynamic contrast-enhanced scanning for benign and malignant solitary pulmonary nodules (SPNs). A total of 93 patients with SPN as diagnosed by CT were included. All these patients were subjected to routine and dynamic enhancement CT scanning. After reconstruction, the morphological characteristics following dynamic enhancement were analyzed, and compared for the benign and malignant SPN cases...
June 2018: Experimental and Therapeutic Medicine
Girish S Shroff, Bradley S Sabloff, Mylene T Truong, Brett W Carter, Chitra Viswanathan
Applications of positron emission tomography/computed tomography (PET/CT) in the thorax include the evaluation of solitary pulmonary nodules, staging and restaging of oncologic patients, assessment of therapeutic response, and detection of residual or recurrent disease. Accurate interpretation of PET/CT requires knowledge of the physiological distribution of [18F]-fluoro-2-deoxy-D-glucose, as well as artifacts and quantitative errors due to the use of CT for attenuation correction of the PET scan. Potential pitfalls include malignancies that are PET negative and benign conditions that are PET positive...
June 2018: Seminars in Ultrasound, CT, and MR
Eung Koo Yeon, Jung Im Kim, Kyu Yeoun Won, Han Na Lee
Clear cell tumor of the lung is a rare benign mesenchymal tumor and only sporadic cases have been previously reported. The present study reports the case of a 58-year-old man who presented with an incidentally detected solitary pulmonary nodule. Based on comparisons with serial previous chest and spine radiographs, a growth pattern change in the nodule (initial gradual growth over 4.5 years, then recent no growth over 2.5 years) was identified. The nodule was diagnosed as a benign clear cell tumor of the lung (CCTL) following surgical resection...
June 2018: Oncology Letters
Ling Wang, Yao Chen, Kun Tang, Jie Lin, Hong Zhang
Purpose: To establish an 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) mathematical prediction model to improve the diagnosis of solitary pulmonary nodules (SPNs). Materials and Methods: We retrospectively reviewed 177 consecutive patients who underwent 18 F-FDG PET/CT for evaluation of SPNs. The mathematical model was established by logistic regression analysis. The diagnostic capabilities of the model were calculated, and the areas under the receiver operating characteristic curve (AUC) were compared with Mayo and VA model...
2018: BioMed Research International
Long Jiang, Jianxing He
Following the development of radiological technology, there has been an increase in the number of pulmonary nodules found. The management of pulmonary nodules represents a specific challenge to thoracic surgeons. Pulmonary nodules are small, focal, rounded radiographic opacities that may be solitary or multiple. The definite histopathologic diagnosis is crucial in determining management ranging from interval imaging to surgical resection. The choice of a particular biopsy technique depends on the risks/benefits of the procedure, the diagnostic yield, and local expertise...
April 2018: Journal of Thoracic Disease
Masaoki Ito, Yoshihiro Miyata, Morihito Okada
Pulmonary nodules are often detected during the clinical course of several diseases or through routine screening. Various guidelines have proposed management algorithms for suspicious solitary nodules in lung cancer. Generally, solitary pulmonary nodules are managed according to nodule appearance and risk of lung cancer using low-dose, thin section computed tomography (CT). Liquid biopsy is promising for diagnosis, therapeutic-monitoring and follow-up in lung cancer; however, diagnosis and management pathways based on genetic examination alone have not been established...
April 2018: Journal of Thoracic Disease
Mingzhi Ye, Shiyong Li, Weizhe Huang, Chunli Wang, Liping Liu, Jun Liu, Jilong Liu, Hui Pan, Qiuhua Deng, Hailing Tang, Long Jiang, Weizhe Huang, Xi Chen, Di Shao, Zhiyu Peng, Renhua Wu, Jing Zhong, Zhe Wang, Xiaoping Zhang, Karsten Kristiansen, Jian Wang, Ye Yin, Mao Mao, Jianxing He, Wenhua Liang
Background: A non-invasive method to predict the malignancy of surgery-candidate solitary pulmonary nodules (SPN) is urgently needed. Methods: Super-depth next generation sequencing (NGS) of 35 paired tissues and plasma DNA was performed as an attempt to develop an early diagnosis approach. Results: Only ~6% of malignant nodule patients had driver mutations in the circulating tumour DNA (ctDNA) with >10,000-fold sequencing depth, and the concordance of mutation between tDNA and ctDNA was 3...
April 2018: Journal of Thoracic Disease
Jingxu Li, Tingting Xia, Xinguan Yang, Xiao Dong, Jiamin Liang, Nanshan Zhong, Yubao Guan
Background: The differentiation of benign and malignant solitary pulmonary nodules (SPNs), especially subsolid nodules, is still challenging because of the small size, slow growth, and atypical imaging characteristics of these nodules. We aimed to determine the significance of mass growth rate (MGR) and mass doubling time (MDT) at follow-up CT of malignant SPNs. Methods: This retrospective study included 167 patients (169 SPNs, diameter 8-30 mm). Among the 169 SPNs, 114 malignant SPNs were classified into three types: pure ground-glass nodules (pGGNs), part-solid nodules (pSNs), and solid nodules (SNs)...
April 2018: Journal of Thoracic Disease
Duilio Divisi, Mirko Barone, Luca Bertolaccini, Gino Zaccagna, Francesca Gabriele, Roberto Crisci
Background: In the setting of solitary pulmonary nodules (SPNs), fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG-PET/CT) is considered a useful non-invasive diagnostic tool though false positive (FP) and false negative (FN) results affects accuracy due to different conditions, such as inflammatory diseases or low-uptake neoplasms. Aim of this study is to evaluate overall diagnostic performance of 18 F-FDG-PET/CT for malignant pulmonary nodules...
April 2018: Journal of Thoracic Disease
Zixiang Wu, Shuai Fang, Qi Wang, Cong Wu, Tianwei Zhan, Ming Wu
BACKGROUND: Paravertebral block (PVB) has been proven to be an efficient way to control postoperative pain in patients who have undergone a thoracotomy. This study aimed to explore whether the utilization of a patient-controlled PVB can provide benefits over intravenous patient-controlled analgesia (PCA) for three-port single-intercostal video-assisted thoracic surgery. METHODS: From May 2015 to December 2016, patients who had solitary pulmonary nodules or spontaneous pneumothorax and underwent single-intercostal video-assisted thoracic surgery were randomly allocated to receive patient-controlled PVB or intravenous PCA...
May 12, 2018: Annals of Thoracic Surgery
Tomohito Tarukawa, Katsutoshi Adachi
We report a case of an atypical pulmonary carcinoid with high serum ProGRP. A 78-year-old man was found to have an abnormal shadow by a chest X-ray. Chest computed tomography (CT) revealed a solitary pulmonary nodule in the right middle lobe, which was homogeneous, well demarcated, and round. The level of serum ProGRP was elevated to 104.6 pg/ml (normal<81 pg/ml). The nodule was suspected to be a pulmonary carcinoid tumor, and a right middle lobectomy with mediastinal lymph node dissection was performed...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Laura Evangelista, Alberto Cuocolo, Leonardo Pace, Luigi Mansi, Silvana Del Vecchio, Paolo Miletto, Silvia Sanfilippo, Sara Pellegrino, Luca Guerra, Giovanna Pepe, Giuseppina Peluso, Marco Salvatore, Rosj Galicchio, Michele Zuffante, Salvatore Annunziata, Mohsen Farsad, Agostino Chiaravalloti, Marco Spadafora
PURPOSE: The aim of this study was to determine the performance of 18 F-FDG-PET/CT in patients with solitary pulmonary nodule (SPN), stratifying the risk according to the likelihood of pulmonary malignancy. METHODS: FDG-PET/CT of 502 patients, stratified for pre-test cancer risk, were retrospectively analyzed. FDG uptake in SPN was assessed by a 4-point scoring system and semiquantitative analysis using the ratio between SUVmax in SPN and SUVmean in mediastinal blood pool (BP) and between SUVmax in SPN and SUVmean in liver (L)...
May 7, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Marco Spadafora, Leonardo Pace, Laura Evangelista, Luigi Mansi, Francesco Del Prete, Giorgio Saladini, Paolo Miletto, Stefano Fanti, Silvana Del Vecchio, Luca Guerra, Giovanna Pepe, Giuseppina Peluso, Emanuele Nicolai, Giovanni Storto, Marco Ferdeghini, Alessandro Giordano, Mohsen Farsad, Orazio Schillaci, Cesare Gridelli, Alberto Cuocolo
PURPOSE: Diagnosis of solitary pulmonary nodule (SPN) is an important public health issue and 18 F-FDG PET/CT has proven to be more effective than CT alone. Pre-test risk stratification and clinical presentation of SPN could affect the diagnostic strategy. A relevant issue is whether thoracic segmental (s)-PET/CT could be implemented in patients with SPN. This retrospective multicenter study compared the results of FDG whole-body (wb)-PET/CT to those of s-PET/CT. METHODS: 18 F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, were retrospectively analyzed...
May 5, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Kisoo Pahk, Jae Ho Chung, Sungeun Kim, Sung Ho Lee
AIMS AND BACKGROUND: Distinction between primary lung adenocarcinoma and metastatic adenocarcinoma from extrapulmonary origin in solitary pulmonary nodule (SPN) is crucial for cancer treatment. We investigated the predictive role of dual-time-point 18 F-FDG PET/CT to distinguish primary and metastatic lung adenocarcinoma in SPN. METHODS: A total of 96 consecutive patients with newly diagnosed SPN and biopsy-proven adenocarcinoma were enrolled in this study, retrospectively (54 male; 42 female; age 59...
April 1, 2018: Tumori
Chunhua Xu, Qi Yuan, Chuanzhen Chi, Qian Zhang, Yuchao Wang, Wei Wang, Like Yu, Ping Zhan, Yong Lin
To evaluate the diagnostic value of computed tomography (CT)-guided percutaneous lung biopsy for solitary pulmonary nodules (SPN) < 20 mm.A total of 248 patients who were diagnosed a SPN of < 20 mm underwent CT-guided percutaneous transthoracic needle biopsy were reviewed.Specimens of 248 patients were obtained successfully. Around 174 cases were proved to be malignancies and 74 cases of benign lesions by biopsy. About 178 malignancies (71.8%) and 70 benign lesions were proved by surgery and clinical course...
April 2018: Medicine (Baltimore)
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