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

The clinical, laboratory, and pathological features of six primary lymphoproliferative conditions of the lung are described. These comprise two patients with malignant lymphomas, one with pseudolymphoma, one with lymphoid interstitial pneumonia (LIP), one with lymphomatoid granulomatosis, and one with plasma cell granuloma. We recommend that the term 'premalignant lymphoma' be used for pseudolymphoma since the condition, although tending to remain localised, has a malignant potential. A combination of dyspnoea, cough, and pyrexia were the presenting features in our cases of premalignant and malignant lymphoma although they may often be discovered accidentally by chest radiography. The patient with LIP presented with the usual symptoms of dyspnoea and cough. The initial manifestations of the patient with lymphomatoid granulomatosis were skin radh and peripheral neuropathy nine months before the pulmonary symptoms, a not unusual occurrence. Plasma cell granuloma is often asymptomatic but our patient presented with cough, chest pain, haemoptysis. Premalignant lymphoma tends to pursue a benign course although exceptionally it may become disseminated. Malignant lymphoma may remain localised for many years but a significant proportion metastasise. Lymphomatoid granulomatosis and LIP have a varied course but both may terminate in malignant lymphoma. Plasma cell granuloma is always benign. The interrelationships of these conditions and their differential diagnosis are discussed.
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PMID:Primary lymphoproliferative conditions of lung. 30 83

The cytologic diagnosis of a thymoma by transthoracic fine needle aspiration is described. A 64-year-old female was found toi have a left hilar mass following an episode of hemoptysis. Fine needle aspiration of the lesion demonstrated an intimate admixture of two cell types: epithelial and lymphoid. On the basis of the biphasic cytomorphology, the diagnosis of thymoma was suggested; this was confirmed by light and electron microscopic examination of tissue obtained at thoracotomy. Because of the paucity of cytologic descriptions of thymoma in the literature, pertinent morphologic features are emphasized, differential diagnostic possibilities are discussed, and the value of ultrastructural studies is confirmed.
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PMID:Thymoma diagnosed by transthoracic fine needle aspiration. 695 24

Middle lobe syndrome (MLS) is an uncommon lung disorder involving the right middle lobe and/or lingula and is characterized by a spectrum of clinical and pathological lesions ranging from recurrent atelectasis or pneumonias to bronchiectasis. Despite several series reporting the clinical features of MLS, histopathological descriptions are rare. We reviewed the clinical characteristics and pathological findings in 21 patients with MLS who underwent surgical resections. Six male and 15 female patients between the ages of 5 and 80 years (mean, 47 years) were studied. All patients were symptomatic and complained of chronic cough (8), hemoptysis (6), chest pain (4), dyspnea (3), or fever (2). The right middle lobe was involved in 11 patients, the lingula in four patients, and both right middle lobe and lingula in six patients. Chest radiographs, bronchograms, and/or computed tomography scans were available for review in 19 patients and showed consolidation (8), bronchiectasis (9), patchy infiltrates (5), and atelectasis (4) in various combinations. Pathological findings included bronchiectasis in 10 patients, chronic bronchitis/bronchiolitis with lymphoid hyperplasia in seven, patchy organizing pneumonia in six, atelectasis in five, granulomatous inflammation in five, and abscess formation in four. Three patients with granulomatous inflammation had associated atypical mycobacterial infection. Broncholithiasis was confirmed by pathological examination in one patient. No pathological cause for bronchial obstruction was identified in the remaining 20 patients, although one was thought to have had broncholithiasis on the basis of preoperative bronchoscopy. The presence of bronchiectasis, bronchitis or bronchiolitis, organizing pneumonia, or atelectasis in specimens from the right middle lobe or of lingula in the absence of an identifiable cause of bronchial obstruction should suggest a diagnosis of MLS.
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PMID:Middle lobe syndrome: a clinicopathological study of 21 patients. 789 Feb 82

We present the pulmonary findings in 36 autopsies of children affected by the acquired immunodeficiency syndrome (AIDS). Twenty-three patients were male and 13 were female, ranging in age between 3 days and 13 years. Twenty children had human immunodeficiency virus (HIV)-positive parents or parents who were at high risk of exposure (intravenous drug abusers and prostitutes), five had a history of transfusion, and one had a history of renal transplantation and blood transfusion. Clinically, the patients presented with recurrent infections, failure to thrive, hepatosplenomegaly, fever, cough, and/or hemoptysis. Histologically, specific infectious processes were the most common finding (75% of cases), with Pneumocystis carinii pneumonia being the most prevalent type of infection, followed by bacterial pneumonia. Neoplastic conditions and lymphoid interstitial pneumonia were less frequent (approximately 10% of cases). In addition, in approximately 10% of the cases the pulmonary findings were non-specific (ie, pulmonary edema and atelectasis) and probably unrelated to HIV infection. Our findings suggest that specific infectious conditions constitute the most common type of pulmonary pathology in children with AIDS. However, because there is a small percentage of children with nonspecific findings, a transbronchial biopsy is important for proper evaluation before institution of therapy.
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PMID:The spectrum of pathological changes in the lung in children with the acquired immunodeficiency syndrome: an autopsy study of 36 cases. 808 62

A 40-year-old man had new onset of hemoptysis and hematemesis. Bronchoscopy revealed red, inflamed mucosa with apparent rich blood supply in the left primary bronchus. Computed tomography revealed calcified subcarinal lymph nodes with a small extension into the left primary bronchus. Shortly after admission, the patient had an episode of gastrointestinal bleeding. Esophagogastroduodenoscopy showed a lesion in the posterior wall of the esophagus, 12 cm from the upper incisors. During exploratory thoracotomy, a single piece of irregular-shaped tan tissue measuring 3.5 x 2.5 x 2.0 cm and engulfing the esophagus, carina, and left primary bronchus was dissected. A single stonelike mass, or broncholith, was found to involve both the trachea and the esophagus. Microscopic examination showed multiple caseating granulomas with surrounding lymphoid tissue and germinal centers. During 12 months of follow-up, the patient has remained asymptomatic. The chronic inflammation in this case suggested granulomatous mediastinitis, a rare disease whose mass-like effects may contribute to structural compression. The trachea and esophagus are rarely involved. Tuberculosis and histoplasmosis are thought to be the two most common causes of granulomatous mediastinitis. Chronic inflammation leading to calcification and broncholith may invade bronchial lumen or esophageal wall, causing life-threatening hemorrhage and necessitating prompt surgical intervention.
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PMID:Hemoptysis and hematemesis due to a broncholith: granulomatous mediastinitis. 857 62

We describe an immunocompetent adult patient presenting with cough and hemoptysis who was found to have a pulmonary mass localized to the right upper lobe. Lobectomy was performed and pathological examination revealed nodular lymphoid hyperplasia (pseudolymphoma) of the bronchus-associated lymphoid tissue.
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PMID:Nodular lymphoid hyperplasia in the lung. 889 66

Acute rejection after lung transplantation occurs commonly and is usually characterized histologically by a perivascular mononuclear infiltrate. We report five cases of pulmonary capillaritis with a histologic appearance distinct from typical rejection, occurring in patients ranging in age from 18 to 45 years, with a variety of underlying diseases including alpha1 antitrypsin deficiency, pulmonary hypertension, cystic fibrosis, and rheumatoid arthritis. Four of the five patients had alveolar hemorrhage histologically, and two had frank hemoptysis. Time of onset ranged from 3 weeks to many months after transplantation. Three cases were fulminant, and there were two deaths. In only one case, with methicillin-resistant Staphylococcus aureus bronchitis, could infection be established. All were treated with intensification of immunosuppressive therapy. Plasmapheresis was carried out in two cases and coincided with temporary improvement, but its efficacy was questionable because of concurrent immunosuppressive therapy. Two had recurrent biopsy-proven acute rejection within 6 weeks of treatment, and one had recurrent severe pulmonary hemorrhage that abated with total lymphoid irradiation. Our experience suggests that pulmonary capillaritis in lung transplant recipients can be an acute, fatal illness with the potential for recurrence in the survivors. We speculate that it represents a form of acute vascular rejection. Early pathologic diagnosis and aggressive immunosuppressive therapy are recommended. Although a humoral component was not documented, the possible response to plasmapheresis requires continued evaluation.
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PMID:Pulmonary capillaritis: a possible histologic form of acute pulmonary allograft rejection. 958 87

We describe two patients with acute leukaemia who died of massive haemoptysis caused by invasive pulmonary aspergillosis (IPA). The fatal event occurred during the period of bone marrow remission which followed chemotherapy-induced neutropenia. This is a rare complication. We were able to find additional 17 similar cases in the English literature, which we review. Clinically, the picture consisted of unremitting fever with profound and prolonged neutropenia, cough and dyspnoea. Both our patients were treated with broad-spectrum antibiotics, fluconazole and amphotericin B. An upper lobe infiltrate in one case, and a progressive pleural effusion in the other, were late findings on chest radiographs during the period of bone marrow recovery. Both patients succumbed to sudden massive haemoptysis during the period of bone marrow and clinical improvement. In conclusion, patients with acute non-lymphoid leukaemia are at significant risk for IPA-induced fatal haemoptysis during bone marrow and clinical remission. A high index of suspicion should be sustained throughout the entire clinical course. In view of the potential fatal outcome, aggressive diagnostic and treatment efforts are mandatory.
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PMID:Fatal haemoptysis induced by invasive pulmonary aspergillosis in patients with acute leukaemia during bone marrow and clinical remission: report of two cases and review of the literature. 1112 Jun 21

A case of thoracic splenosis diagnosed by fine-needle aspiration (FNA) of subpleural lung lesions is presented. The patient, a 49-yr-old male with a history of gunshot wound to his trunk with splenic rupture and splenectomy several years previously, presented with recent hemoptysis and multiple subpleural solid nodules shown in the left lung field by CT scan. As the possibility of a metastatic malignancy vs. mesothelioma was entertained, an FNA was performed on one of these lesions, revealing lymphoid tissue with abundant vascularity simulating the structure of splenic tissue. In view of this finding, supported by the absence of splenic outline in the CT radiograph, the diagnosis of splenosis was made. This is the fourth reported case of thoracic splenosis in which FNA cytology was utilized for diagnosis, yet the first in which the diagnosis was based exclusively on the FNA cytologic findings. Clinical, pathologic, and diagnostic aspects of this entity are discussed.
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PMID:Thoracic splenosis diagnosed by fine-needle aspiration cytology: a case report. 1174 24

A 59-year-old man was admitted to our hospital for hemoptysis. Chest X-ray films showed a mass shadow in the left lower lobe. Any definitive diagnosis could not be made after examinations including sputum culture and bronchial cytology. Exploratory thoracotomy was performed since malignancy was not excluded. During the operation, mucosa-associated lymphoid tissue (MALT) lymphoma was suspected based on the pathological findings of the frozen section. The permanent section of the resected specimen contained colonies of actinomycetes in the bronchus, and the peripheral region demonstrated marked infiltration of lymphocytes and plasma cells through the interstitium of alveolar walls and peri-bronchovascular sheath, with many lymphoid follicles. This case revealed pulmonary actinomycosis coexisted with lymphocytic interstitial pneumonia (LIP). We concluded that lymphoproliferative disease should be considered another candidate for the differential diagnosis from pulmonary actinomycosis.
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PMID:[Pulmonary actinomycosis mimicking of mucosa-associated lymphoid tissue lymphoma by frozen section examination: report of a case]. 1263 31


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