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

Pulmonary tuberculosis in adults is typically localised in the apices of the lungs. Lower lung field tuberculosis, although uncommon, is a well recognised entity which still occurs in countries with low or high prevalence of tuberculosis. Six patients with lower lung field tuberculosis, seen at the University of Papua New Guinea hospital over a period of one year, are described in this report. All six were Melanesian with a mean age of 32 years. Five were female. Fever, productive cough, pleuritic chest pain and localised crepitant rales over the affected area of the lungs were the most common clinical findings. Duration of symptoms prior to hospitalisation ranged from two to 12 months (mean: eight months). Four patients had haemoptysis. Right lung was affected more often than the left. The diagnosis of tuberculosis was delayed in four patients owing to the atypical localisation of the pulmonary infiltrates and to the absence of acid fast bacilli in the first three sputum smears. Lower lung field tuberculosis occurs more commonly in young females, affects the right lung more often and is associated with haemoptysis, early cavitation and hilar lymphadenopathy. Atypical location of the infiltrate may result in mis-diagnosis as lobar pneumonia, lung abscess or carcinoma of the lung.
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PMID:Tuberculosis of the lower lung field. 693 31

The rise in incidence of lung abscess due to opportunistic organisms has reemphasized the need for early recognition and treatment. Opportunistic organisms can cause lung abscess in immunocompromised hosts. Most lung abscesses are primary, occurring as a result of aspiration of oral contents into the dependent portions of the lung in persons with dysphagia or decreased consciousness. Symptoms of lung abscess include productive cough, fever, leukocytosis, weight loss, and putrid sputum. Among the complications are progression to a chronic stage, empyema, massive hemoptysis, metastatic brain abscess, and bronchopleural fistula. Treatment of lung abscess is primarily medical, consisting of an appropriate antibiotic regimen and chest physical therapy. Surgery is reserved for unresponsive patients or those with complications.
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PMID:Lung abscess: back for an encore? 708 45

Tracheobronchopathia osteochondroplastica (TPO) is a rare condition of unclear cause. Sporadic cases have been published from all over the world, but some geographical differences in the occurrence may exist. The condition is characterized by cartilaginous or bony outgrowths into the lumen of the tracheobronchial tree. Clinicians should include this disease in the list of differential diagnoses when confronted with symptoms like persistent and often productive cough, haemoptysis, dyspnoea and wheeze. If the condition is extensive, there may occur unexpected and acute clinical problems. We describe the case of a young man in whom we diagnosed a severe form of TPO while examining him for asthma. This patient suffered also from ozaena and the combination of these two conditions is rather common. We also retrospectively reviewed our material of 18 cases with this condition.
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PMID:Tracheobronchopathia osteochondroplastica. Report of a young man with severe disease and retrospective review of 18 cases. 756 36

Although the capacity for some pulmonary carcinomas to mimic sarcomas is well recognized, their potential resemblance to selected benign lesions of the lung is currently underappreciated. The authors herein report three examples of sarcomatoid bronchogenic carcinoma with a deceptively bland appearance and an investment of reactive inflammation, such that they resembled pseudotumors histologically. These lesions occurred in two men and one woman who were 44, 61, and 63 years old, respectively, at diagnosis. All patients presented with a productive cough, hemoptysis, or chest pain. Their pulmonary masses were irregularly marginated radiographically, and ranged in size from 2.5 to 5.5 cm. Two were treated with lobectomy, and one underwent a wedge excision, followed by radiotherapy to the thorax. Despite these measures, each patient with inflammatory sarcomatoid carcinoma (ISC) died of disease or is likely to do so. Microscopically, ISCs were composed of uniform spindle cell proliferations with only modest nuclear pleomorphism, limited mitotic activity, and an arrangement in fascicles, storiform configurations, or haphazard arrays. Lymphocytes and plasma cells were interspersed throughout each of them, and keloidal stromal collagen was apparent internally in two examples. Two of the neoplasms also invaded pulmonary blood vessels or bronchi. A comparison group of 10 adults with pulmonary inflammatory pseudotumors (IPs) of the fibrous histiocytoma type shared several clinical attributes with ISC and showed closely similar histological features, except that the IPs lacked mitoses and invasiveness, and contained xanthoma cells or multinucleated elements in some cases in this series. Immunohistochemical analyses showed consistent dissimilarities between ISC and IP; keratin and epithelial membrane antigen were present in ISC but not IP, whereas actin was observed only in the proliferating spindle cells of IP. In summary, the potential clinicopathologic overlap between ISC and IP suggests that caution should be exercised in the separation of these two lesions. In particular, it is unwise to attempt to make this distinction in an intraoperative frozen section setting.
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PMID:Inflammatory sarcomatoid carcinoma of the lung: report of three cases and clinicopathologic comparison with inflammatory pseudotumors in adult patients. 767 83

We describe the first known case of pneumonia caused by a mucoid Stenotrophomonas maltophilia (Xanthomonas maltophilia) strain in a patient with bronchiectasis. The patient was admitted because of mild hemoptysis and productive cough with infiltrative shadow in the right lower lung field on chest X ray. The clinical symptoms were mild, and treatment with minocycline was effective.
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PMID:Pneumonia caused by Stenotrophomonas maltophilia with a mucoid phenotype. 785 87

A 23-yr-old female with a history of dyspnea, palpitation, productive cough, occasional hemoptysis, intermittent diarrhea, and abdominal pain was found to have metastatic carcinoid tumor and a "jejunized colon." Carcinoid tumors are relatively rare neoplasms found throughout the gastrointestinal tract, the ovaries, and the lungs. Barium enema showed a normal rectum and a pattern identical to jejunum in the proximal colon. Endoscopic biopsies confirmed the presence of small intestinal mucosa in the colon. Foreshortening of the colon was probably due to a desmoplastic reaction secondary to the carcinoid tumor. Histologic confirmation of these findings has never been described before.
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PMID:Jejunized colon: a rare complication of carcinoid tumor. 812 59

Bronchiectasis as a feature of rheumatoid arthritis is considered rare and, in most series, has preceded rheumatoid arthritis. We identified 23 patients with rheumatoid arthritis and bronchiectasis at the Brigham and Women's Hospital followed between 1984 and 1991, 18 of whom had arthritis preceding lung disease. The 18 patients with rheumatoid arthritis and subsequent bronchiectasis had a mean age of 63.8 years. Fourteen were women and 4 were men, with a mean arthritis duration of 24.7 years before bronchiectasis developed. Most patients had seropositive and nodular disease. All but 1 had advanced radiographic changes of rheumatoid arthritis, and many had received joint replacement surgery. In addition to standard treatment regimens, 17 patients had received corticosteroids. Productive cough, hemoptysis, and dyspnea were the most common respiratory symptoms and were present for an average of 4.3 years prior to bronchiectasis diagnosis. The most common radiographic abnormalities were bibasilar diffusely increased interstitial markings and focal infiltrates, although nodules, bullae, cysts, and air-fluid levels were found. Common pulmonary-function abnormalities were obstructive and/or restrictive abnormalities. Three patients died of complications relating to bronchiectasis. Five patients with rheumatoid arthritis had antecedent bronchiectasis. Compared with patients with rheumatoid arthritis and subsequent bronchiectasis, those with antecedent lung disease had milder arthritis (stage I or II radiographic changes, p < 0.001), a lower frequency of rheumatoid nodules (p < 0.05) and a lower comorbidity score (5.8 versus 9.4, p < 0.01). They also had received fewer disease-modifying agents for the treatment of their rheumatoid arthritis. Bronchiectasis can be a feature of rheumatoid arthritis and is often found in patients with severe, long-standing nodular disease. Recurrent pulmonary infections and respiratory failure occur and may be fatal.
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PMID:Bronchiectasis. A late feature of severe rheumatoid arthritis. 819 39

An 84-year-old woman was admitted because of fever, hemoptysis and productive cough with infiltrative shadows in the right lung field on chest X-ray. Chronic necrotizing pulmonary aspergillosis was diagnosed on the basis of her clinical and radiographic features, positive cultures and positive serological tests. Conventional chemotherapy with fluconazole and 5-FC produced only minimal improvement. A course of itraconazole was initiated and proved to be effective.
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PMID:[A case of chronic necrotizing pulmonary aspergillosis treated with itraconazole]. 825 32

A 47-year-old man was referred to our hospital because of hemoplysis. He had a history of chronic sinusitis and surgical treatment of a spinal arteriovenous malformation. A chest X-ray film and computed tomographic scan showed dextrocardia, diffuse bronchiectasis, and an aspergilloma in the right upper lung field. The source of the bleeding could not be detected by fiberoptic bronchoscopy. Transbronchial mocosal biopsy was done and examination of a specimen by transmission electron microscopy revealed the lack of inner and outer dynein arms. A chest X-ray film and computed tomographic scan of his nephew, who had a long history of productive cough showed dextrocardia and right lower-lobe bronchiectasis. These findings indicate that hemoptysis in patients with Kartagener's Syndrome can be caused not only by bronchiectasis but also by aspergilloma.
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PMID:[Kartagener's syndrome with aspergilloma]. 916 58

A 43-year-old man was admitted because of severe and recurring haemoptysis, which was eventually ascribed to Goodpasture's syndrome. In case of an aspecific sign such as haemoptysis experienced clinicians will try to restrict the differential diagnosis by concentrating on other signs that are relevant to the main problem. In haemoptysis these other signs are general illness, fever, shortness of breath, painful respiration, chronic productive cough, and signs or a history of cardiac or pulmonary disease. If the differential diagnosis consists mainly of rare disorders or rare manifestations of common disorders, all possibilities should be considered. If Goodpasture's syndrome is suspected, further specific diagnostic tests should be done without delay.
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PMID:[Clinical judgement and decision making in practice. A patient with hemoptysis]. 919 May 7


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