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

Intralobar pulmonary sequestration signifies an abnormal and non-aerated mass in the lung, supplied by a systemic artery. Twelve cases are submitted, 10 treated by surgery and two conservatively. There was a male preponderance 11:1, and half the patients were over 25 years. In 66% the abnormality was situated basally on the left side A definite diagnosis can be made only by arteriography, visualizing the number, site, and size of the anomalous vessel(s). Clinically, the symptoms may range from no symptoms at all (four of the present patients) to recurrent pneumonia, cough, and haemoptysis (five of the present patients). In two patients the excised tissue showed epithelial proliferations, tumourlets and slight epithelial dysplasia, but no manifest malignancy. Surgical resection is the only curative treatment for intrapulmonary sequestration. In "silent" cases it is felt justified to apply conservative treatment should primary surgery be contra-indicated.
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PMID:Intralobar pulmonary sequestration. A report of 12 cases. 65 24

We have used flexible fibreoptic bronchoscopy using sedation and local anaesthesia in 50 children aged 2-19 years (median 10) using an Olympus BFP20 instrument. Indications were opportunistic pneumonias (n = 11), persistent atelectasis (n = 11), recurrent pneumonia (n = 7), miscellaneous lower airway disease (n = 7), recurrent wheezing (n = 3), haemoptysis (3), to diagnose infection or rejection of heart-lung transplants (n = 3), stridor (n = 2), suspected airway compression (n = 1), evaluation of tracheostomy (n = 1), and suspected foreign body (n = 1). In 43 cases (86%) the diagnosis was related to the primary indication. In five (10%) unrelated abnormalities were found, and five (10%) were normal. In 13 (26%) treatment was altered as a result of flexible fibreoptic bronchoscopy. Complications were transient respiratory arrest (n = 2), hypoxia (n = 2), pneumonia (n = 2), and laryngospasm (n = 1). All complications were followed by complete recovery. Our results suggest that flexible fibreoptic bronchoscopy is safe. Advantages over rigid bronchoscopy include greater visual range, fewer complications, and the avoidance of a general anaesthetic. Though invasive it can yield important diagnostic and therapeutic information.
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PMID:Fibreoptic bronchoscopy without general anaesthetic. 203 4

Twenty-two cases of bronchopulmonary carcinoid tumor diagnosed in Iceland in the 30-year period 1955-1984 were analyzed. Carcinoid comprised 2% of all primary lung tumors registered in that period. The crude incidence was 0.36 cases/100,000 population/year. The patients' mean age was 48 years and 68% were female. The most common presenting symptom was recurrent pneumonia; only three patients had hemoptysis. One patient had carcinoid syndrome. Two of the 22 tumors were peripheral. Tumor size was 0.8-9 cm, mean 2.8 cm. Of the resectable bronchial tumors, 80% had invaded the pulmonary parenchyma and 18% had metastasized to lymph nodes. Four carcinoid tumors were atypical and showed more malignant behavior. One of them was originally diagnosed as oat-cell carcinoma. Sixteen patients with resectable carcinoid tumor were alive 3 1/2 to 29 years after removal of the tumor.
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PMID:Bronchopulmonary carcinoids in Iceland 1955-1984. A retrospective clinical and histopathologic study. 261 47

Although the availability of flexible fiberoptic bronchoscopy (FFB) has been a major advance in adult pulmonary medicine, the role of FFB in pediatrics has remained less well defined. Therefore, a two-year retrospective study was undertaken to determine the indications for FFB in 95 pediatric patients (mean age, 6.9 years) who underwent 129 FFB procedures. Indications for FFB included stridor (41/129), abnormal chest roentgenogram (38/129), airway evaluation in patients with tracheostomy (13/129), airway obstruction (11/129), hoarseness (9/129), recurrent pneumonia (7/129), chronic cough (4/129), failed extubation (3/129), tracheal injury (2/129), and hemoptysis (1/129). Overall, a specific diagnosis was made in 88% of cases, of which 48% involved a lower airway disorder. A minor complication rate of 2% was observed with no major complications.
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PMID:Indications for flexible fiberoptic bronchoscopy in pediatric patients. 684 95

We reviewed 69 patients with documented carcinoid tumors, 67 of whom had resectable disease. Operations included nine pneumonectomies, 31 lobectomies, 12 bilobectomies, five segmental resections, and 10 sleeve resections. Follow-up on 65 patients reveals 40 surviving beyond 5 years and 13 beyond 20 years since resection. There were no operative deaths and only one recurrence (local) that was subsequently successfully resected. Twenty patients had had recurrent unifocal pneumonitis or hemoptysis for up to 5 years prior to diagnosis. Two patients had the carcinoid syndrome. Biopsy was performed on 23 tumors and resulted in "moderate-to-severe" hemorrhage in six cases. Lymphatic spread was present in seven cases. All seven are alive and free of disease, six of whom have been followed from 5 to 24 years. Diseased resection margins were present in two cases, with both surviving 20 years after resection. All 10 sleeve resections were performed more than 5 years ago. We conclude that carcinoid tumors carry a favorable prognosis upon resection, even when intrathoracic lymphatic metastases are present and are resected. Lung-sparing resections including sleeve resections should be utilized. Recurrent pneumonia or hemoptysis or both requires diligent investigation. Biopsy of the tumors may be performed with care.
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PMID:Bronchial carcinoid tumors: twenty years' experience. 735 32

Pulmonary sequestration is a complex anomaly involving the pulmonary parenchyma and its vascularity. From 1975 to 1992, 10 cases have been treated at the UCLA Medical Center. The ages of the seven females and three males were bimodal, the median age of the seven children was 29 days (range 1 day-6 years); it was 32 years (range 28-39) for the three adults. One child was delivered by cesarean section for fetal distress and another was born at 29 weeks gestation. Symptoms included: recurrent pneumonia (5), respiratory distress (5), hemoptysis (2), stridor (1), and pleuritis (1). Chest radiographs were consistent with sequestration in seven patients and diaphragmatic hernia in another, but incorrectly diagnosed one diaphragmatic eventration and one pulmonary varix. Computed tomographs suggested sequestration in five patients, but mistakenly interpreted a pulmonary varix in one case. Angiography, ultrasonography, and magnetic resonance imaging were infrequent investigative studies and yielded variable results. All patients underwent thoracotomy and lobectomy without morbidity or mortality. Five had intralobar and five had extralobar sequestration. All adults had intralobar sequestration. Two had aberrant subdiaphragmatic arterial vessels. Eight had vessels originating from the descending thoracic aorta. Nine patients are asymptomatic at six months to 10 years follow up. The 29-week-old premature infant died 30 days postoperatively due to necrotizing enterocolitis. Pulmonary sequestration remains an uncommon entity. The radiologic investigations that provide the most information are the chest radiography and computed tomography. Definitive diagnosis is made at thoracotomy. Pulmonary sequestrations are resected with excellent results by the trained thoracic surgeon who is aware of the unusual vascular connections.
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PMID:Pulmonary sequestration: 17-year experience at UCLA. 825 32

The present paper describes eight patients (two teenagers and six adults) who had chronic symptoms (haemoptysis, cough, recurrent pneumonia) caused by foreign body (FB) inhalation which went undetected for 3 months to 25 yr. None of the patients had the usual predisposing conditions like mental retardation, seizures or brain tumour. The diagnosis of FB was made by radiography in one patient only. Computerized tomography visualized one FB (a beef bone), and bronchoscopy identified FB in another two patients. The remaining four cases were diagnosed at thoracotomy. Removal of FB was curative in three of five cases who required surgical resection for irreversible bronchiectatic changes. The severity of pulmonary changes correlated with duration of symptoms. It is concluded that chronic, unexplained respiratory symptoms should warrant further investigation to exclude FB despite negative history and normal chest radiography. Finding of granulation tissue or cicatricial stenosis of the bronchus could be the only clue to the presence of a FB. Early diagnosis would avoid irreversible parenchymal changes which necessitate lung resection.
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PMID:Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery. 917 48

Lung cancer is the most common malignant cancer in males and it's incidence is rapidly rising in females. Factors linked to this are associated with cigarette smoking, urbanization along with atmospheric pollution. The lack of success in the treatment of lung cancer has to do with in many cases late diagnosis at the stage when surgical treatment is not possible and radio and chemotherapy being of minimal effectiveness. The WHO has proposed the following classification of lung cancer: 1. Squamous cell carcinoma; 2. Small cell carcinoma; 3. Adenocarcinoma; 4. Giant cell carcinoma; 5. Adeno-squamous cell carcinoma 6. Carcinoid. 7. Carcinoma of mucous gland. 8. Others. Early physical signs of lung cancer are: cough (50-80% of patients), dyspnea (10-15%), chest pain (15-20%), hemoptysis (20-50%), recurrent pneumonia and bronchitis (30-50%). More serious clinical signs associated with growth of the neoplasm are hoarseness, pleural effusion, vena cava superior syndrome, and Pancoast's syndrome. The growing neoplasm secrets many biochemical substances, which are them activity passed on the bloodstream or make their way into the blood as a result of degeneration of the tumor. These substances may then be detected in the patient's plasma and act as markers of malignant disease. The characteristics of these markers is varied, e.g.: hormones, enzymes and tissue antigens. Methods used in the diagnosis of lung-cancer which should be stressed, are apart from the obvious physical examination are chest x-rays, ultrasound, CAT scans, nuclear magnetic resonance, PET scans, and scintigraphy. Fine needle aspiration in changes in the peripheral regions, cytology of sputum, bronchial lavage, cytogenetic analysis. This underlines the need for prophylaxis, particularly the cessation of cigarette smoking.
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PMID:[Current capabilities and procedures for diagnosing lung neoplasms]. 919 23

A 78-year-old individual, who had a previous transthoracic Nissen fundoplication 20 years earlier, presented to our institution with hemoptysis. Initial workup included chest roentgenogram, upper gastrointestinal series, and upper endoscopy, all of which were nondiagnostic. A repeat upper endoscopy diagnosed a gastrobronchial fistula by revealing a large gastric ulcer that penetrated into the lung parenchyma. The patient underwent surgery for takedown of the fistula. One of the most common symptoms associated with gastrobronchial fistula is hemoptysis, although insidious cough, recurrent pneumonia, or gastrointestinal bleeding are also observed. The most useful diagnostic study is an upper gastrointestinal series, which must be read with a high index of suspicion. Gastrobronchial fistula is most commonly a long-term complication from hiatal hernia repair. The most frequently used procedure for repair of this disorder is the Nissen fundoplication. This can be done from either an abdominal or transthoracic approach. When the procedure is done such that the gastric wrap is left above the diaphragm, serious complications can occur. These include gastric ulceration, gastric herniation with gastric outlet obstruction, slippage or perforation of the wrap, and gastrobronchial fistula. Because of these serious complications, the Nissen fundoplication with the wrap left above the diaphragm should only be used in certain situations, such as obesity and shortened esophagus.
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PMID:Unusual presentation of hemoptysis in a 78-year-old with previous Nissen fundoplication. 984 51

Tracheobronchopathia osteochondroplastica (TO) is a rare disease characterized by the presence of osseous and cartilaginous submucosal nodules in the tracheobronchial tree. The majority of patients remain asymptomatic; however, a small number develop severe airway stenosis. Symptoms may include dyspnea, hoarseness, cough, hemoptysis, and recurrent pneumonia. Plain chest X-ray films are often unremarkable but may demonstrate atelectasis, consolidation, tracheal nodularity, or narrowing. CT reveals tracheal nodularity with calcification and narrowing. This article reviews the cross-sectional imaging characteristics of TO.
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PMID:Tracheobronchopathia osteochondroplastica: report of three cases. 1180 2


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