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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The course and prognosis of all patients with mycetomas in the setting of pulmonary sarcoidosis from 1960 to 1978 were reviewed. Twelve patients were identified. All patients were managed conservatively without surgery or antifungal agents. Three patients died; however, only one death could be attributed to the presence of a mycetoma and all deaths were associated with severe pulmonary insufficiency. Episodes of both major and minor hemoptysis were managed successfully with supportive therapy alone in the remaining nine patients. Survival after the diagnosis of a mycetoma was 10-14 years in three patients, 5-7 years in three patients and 3-4 years in three patients. All nine surviving patients have required corticosteroids for control of their underlying sarcoidosis. Extracavitary invasive disease due to Aspergillus organisms was not seen in this group. In the setting of chronic pulmonary sarcoidosis with mycetoma formation, fatal hemoptysis is infrequent and episodes of hemorrhage may be safely managed with supportive medical therapy alone.
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PMID:Mycetomas in pulmonary sarcoidosis: non-surgical management. 49 36

Sarcoidosis ranges from asymptomatic lymphadenopathy to debilitating cavitary lung disease and involves surgeons in diagnostic and therapeutic procedures. In 89 patients two died of pulmonary insufficiency from Stage III sarcoidosis. Sixty-two patients underwent 74 diagnostic surgical procedures, with mediastinoscopy most frequently used, yielding 100 per cent diagnostic accuracy. Biopsies of other obviously diseased sites, including lung, liver and skin were effectively used. Surgical treatment of sarcoidosis involved both general and thoracic procedures in seven patients. The severity of pulmonary problems in Stage III sarcoidosis is emphasized in two patients with Aspergillus infections, hemoptysis and Aspergillus empyema with bronchopleural fistula. Sarcoidosis becomes a significant surgical problem in both diagnosis and the treatment of its complications.
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PMID:Surgical problems in sarcoidosis. 51 73

Anatomic and clinical observations of 28 cases, including 23 previously unpublished, of pulmonary lymphangiomyomatosis are recorded and discussed. This brings the total reported to 57. All patients were women in the reproductive age group with the major complaint of breathlessness. This was usually progressive, and death from pulmonary insufficiency resulted within 10 years. Functional changes were obstructive or restrictive, or both. Pneumothorax, chylous effusions and hemoptysis were frequent complications. Radiographically the lesions initially appear as fine, linear and nodular, predominantly basal densities, and progress to a pattern of bullous change, or honeycombing, involving all portions of the lungs not sparing the region of the costophrenic sinuses as is typical of eosinophilic granuloma. There may be associated pleural effusions. A progressively increasing lung volume is characteristic. The lesions consist of an irregular, nodular or laminar "irrational" proliferation of smooth muscle within all portions of the lung, with loss of parenchyma leading to honeycombing. Proliferated muscle can obstruct bronchioles (with air trapping and formation of bullae often complicated by pneumothorax), venules (with pulmonary hemorrhage and hemosiderosis accompanied clinically by hemoptysis) and lymphatics (with chylothorax or chyloperitoneum). Both thoracic and abdominal lymph nodes and the thoracic duct can also be involved in the myoproliferative process with formation of subsidiary minute channels and obstruction. Renal or perirenal angiomyolipomas can also occur, as exemplified by 2 patients in the present series. Identical pulmonary lesions occasionally occur in tuberous sclerosis. Especially since these patients usually have no neurologic disturbances and are almost women, the possibility of a relationship between tuberous sclerosis and lymphangiomyomatosis must be considered. One feature of note in pulmonary lesions of tuberous sclerosis is the presence of adenomatoid proliferations of epithelium. Such changes were also observed in 2 patients of the present series, and it is remarkable that both of these women had "retarded"children. At present the question of whether by lymphangiomyomatosis is a forme fruste of tuberous sclerosis must be considered as unresolved. It may yield to further investigation, possibility including chromosomal studies.
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PMID:Pulmonary lymphangiomyomatosis. A review. 114 65

Granulomatous necrosing ulcerations in the upper respiratory tract, a generalized arteritis developing lung infarcts, and a focal glomerulonephritis in this sequence characterize the classic progression of Wegener's granulomatosis (WG). Two cases of this rarely observed disease are being reviewed, comparing the typical course of illness with a non-typical form hard to diagnose. On the basis of these cases, considering the available publications, the clinical-roentgenological peculiarities, autoptical findings, and therapeutical possibilities of this usually fatal WG are set forth. Ulcerations of the mucous membrane of the nose and oral cavity or chronic sinusitis, haemoptysis with melted round foci of the lung, which can be roentgenologically proved, as well as increasing pulmonary insufficiency, proteinuria, and haematuria with subsequent renal failure are signs and symptoms of WG. Problems of diagnosis are discussed and difficulties in diagnosing are put forward. Histological confirmation in the early phase of the illness is desirable.
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PMID:[Clinical course of Wegener's granulomatosis]. 688 Feb 92

This paper is a review of the patients with pulmonary thromboembolism hospitalized at General hospital in Teanj starting from the first case recorded in 1980 till now and 172 patients were subjects of this study. Thromboembolism was a direct cause of death in 43.7% (75 patients). Clinical and laboratory records, etiology, chest radiography, ECG data of 89 patients hospitalised and treated in the last five years were analyzed in detail. The most frequent symptoms were dyspnea and tachypnea, often accompanied with other symptoms (84.2%), chest pain (65.2%), cough (52.4%), tachycardia (40.5%), hemoptysis (25.8%). At 74% of patients with pulmonary thromboembolism a significant simultaneous increase of all examined enzymes, except CPK was found. Pulmonary insufficiency (global or partial) was found at 75% of patients. According to our results, in 57.2% of the subjects the pathologic changes on Radiography (infiltrates of the lung, with or without affection of the pleura and changed position of diaphragm) were found, and 70.9% had changes on the ECG.
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PMID:[Clinical aspects of pulmonary thromboembolism]. 1032 Oct 63

Aortobronchic fistula is a very unusual complication of thoracic aneurysm. We report the case of a 71-year old man with rupture of a thoracic aortic aneurysm in the left main bronchus. The patient had suffered a car crash fifteen years ago, without any evidence of aortic rupture at the time. Thereafter, he developed an aortic isthmic dilation (36 mm in diameter). The patient suffered from long standing pulmonary insufficiency and emphysema and was admitted several times on an urgent basis for acute dyspnea. During an hospitalization for respiratory distress, he presented haemoptysis and left lung hyperinflation secondary to partial fistulization and extrinsic compression of the main left bronchus. Isthmic aortic resection and prosthetic grafting was performed and the left main bronchus was closed by an autologous pericardial patch. Ten days later, following an air-leak from the bronchial closure, a transposed latissimus dorsi flap was used by the plastic surgeon to repair the defect. Nevertheless, the patient died from multisystemic failure six weeks later.
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PMID:Rupture of a thoracic aneurysm in the left bronchus. 1092 18

Pulmonary alveolar microlithiasis is characterized by the presence in pulmonary alveolus of round shaped little bodies containing concentric calcareous lamellas. The incidence is similar in all continents, in both sexes and it is higher in age brackets between 20 and 50 years. The disease is prevalent among family units. Clinical reports may suggest the hypothesis that the disease may be hereditary. Pathogenetic hypotheses may indicate that a reduced lung mucociliary function leading to an excess of alveolar mucus may induce the formation of alveolar microliths by mucus condensation. Microliths may appear either confined in particular areas of the lung or widespread. Chemically, microliths consist of large amounts of calcium and phosphorus and, in reference to histology, they consist of calcareous concentric lamellas which are placed around an amorphous or granular central nucleus. The dissociation between definite X-ray pattern of lungs and relative poor clinical symptoms is the most common characteristics of the disease. However, a certain degree of dyspnea with a productive cough may occur together with a sporadic hemoptysis and thoracic pains. X-ray pattern of the lung reveals dissemination of radio-opaque nodules which may make lungs appear to be sprinkled with sand. The evolutive course of the disease leads to pulmonary insufficiency which is related to the increase of number of microliths in several areas of lungs. The inability to identify clear etiological and pathogenetic elements makes difficult therapeutic approach which is palliative such as the use of diphosphonate, steroids and therapeutic BAL.
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PMID:Pulmonary alveolar microlithiasis: an overview of clinical and pathological features together with possible therapies. 1456 Oct 14

Idiopathic pulmonary hemosiderosis (IPH) is an uncommon chronic disorder in children. It is characterized by recurrent pulmonary hemorrhage and may result in hemoptysis and pulmonary insufficiency. The most common hematologic manifestation of IPH is iron deficiency anemia. The etiology of IPH is not known and its diagnosis may be difficult due to the variable clinical courses. The most helpful signs for identifying IPH are iron deficiency anemia and recurrent or chronic cough, hemoptysis, dyspnea, wheezing. We report here 5 pediatric cases of IPH presenting with iron deficiency anemia and without pulmonary symptoms. Mean corpuscular volume was low in all patients; iron was low in 4 out of 5 cases; total iron binding capacity was high in all of them; ferritin was low in 3 patients. At follow up, none of them had responded successfully to the iron therapy. Although they didn't present with pulmonary symptoms, chest radiographs incidentally revealed diffuse reticulonoduler shadows in all of them. Computed tomography revealed diffuse ground-glass opacities, consolidation, increased density. The diagnosis was confirmed by the detection of hemosiderin-laden macrophages in bronchoalveolar lavage fluid and gastric aspirate. If patients with iron deficiency anemia don't respond to iron therapy, they should be examined for IPH. Chest radiographs should be taken even in absence of pulmonary symptoms. Early diagnosis is important for a timely management of IPH.
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PMID:Idiopathic Pulmonary Hemosiderosis Mimicking Iron Deficiency Anemia: A Delayed Diagnosis? 2867 Apr 34