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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review covers the papers that we believe represent the most interesting and innovative developments in hilar and mediastinal imaging over the past year. One of the most exciting of these is the expanded role for sonography in imaging extracardiac mediastinal pathology. A number of reports highlight its use in directing mediastinal biopsy, for tissue characterization, and for staging lymphoma. The comparative merits of CT and MR imaging in staging bronchogenic carcinoma have been further clarified. The past year has also seen further attempts to characterize tumor versus postobstructive pneumonitis or collapse using MR imaging and CT. Other useful clinical work includes the documentation of signs distinguishing paramediastinal lung masses from primary mediastinal pathology. References are also made to clinically relevant aspects of MR scanning and advances in imaging of the airway, particularly cine and high-resolution CT of the trachea.
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PMID:Imaging of the mediastinum and hila. 152 80

The accuracy of high resolution computed tomography (HRCT) in the diagnosis of pulmonary lesions arising in patients with leukemia, lymphoma, or other hematopoietic proliferative disorders was evaluated in postmortem lung specimens from 35 patients with one of these neoplasms. Lungs were obtained from autopsied patients and prepared in a manner that allowed for direct pathologic-radiologic correlation. Eighty-eight pulmonary lesions with one of five radiographic patterns were identified in these 35 lungs. The gross, histologic, and radiographic changes were examined and the radiologic and pathologic diagnoses for each lesion were compared. A diffuse alveolar pattern on HRCT was primarily the result of pneumonia or intraalveolar hemorrhage, while irregular focal densities were produced by foci of hemorrhage, infarcts, lymphoma, and fungal infections. HRCT of the lung from a patient with pulmonary histiocytosis X showed a wedge-shaped subpleural density in association with a "crab-like" interstitial pattern, which was histologically shown to be an infarct with interstitial enlargement by infiltration of histiocytosis X. Air bronchograms were seen in two settings. In patients with necrotizing pneumonia, air bronchograms were associated with bronchiectasis. In contrast, air bronchograms seen in a patient with a bronchocentric lymphoproliferative disorder showed a pattern of bronchial constriction. These results suggest that HRCT may play an important role in the evaluation of pulmonary lesions in patients with leukemia, lymphoma, or other hematopoietic malignancies.
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PMID:High resolution computed tomography of inflation-fixed lungs: pathologic-radiologic correlation of pulmonary lesions in patients with leukemia, lymphoma, or other hematopoietic proliferative disorders. 154 Aug 57

A 60-year-old man born in Miyazaki prefecture was admitted to our hospital complaining of skin rash in December 1989. On hematological examinations, leukocyte count was 14,200/microliters with 49% of abnormal lymphocytes showing lobulated nuclei. The surface marker study revealed their phenotype as CD4+8-. Anti human T cell leukemia virus type I (HTLV-I) antibody and monoclonal integration of proviral DNA were positive. From the above results, he was diagnosed as adult T-cell leukemia (ATL). Abnormal lymphocytes gradually decreased without treatment after the first admission. In January, 1990, he began to complain of neck pain. Two months later he was readmitted because of paresis of extremities and disturbance of urination. Vertebral bone mass and a compressed spinal cord in the 4th cervic level were confirmed by MR imaging. He received a resection of tumor and an anterior fusion of vertebrae. The bone tumor was histologically diagnosed as malignant lymphoma, diffuse medium-size cell type and the infiltrating cells had their phenotype as CD4+8+. He was postoperatively treated with combination chemotherapies, but neurological abnormalities did not improve. He died of pneumonia on 35 days after the operation. A postmortem examination revealed extradural tumor formation with ATL cells. This case is considered to be rare in respect of both the disappearance of most peripheral abnormal lymphocytes without any treatments and the cervical bone tumor showing immunophenotypic change.
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PMID:[Adult T-cell leukemia with cervical bone tumor showing immunophenotypic change]. 154 18

Since 1982, voluntary anonymous reports that meet the criteria of the WHO/CDC-AIDS definition are being collected by the Federal Health Office. By December 31st, 1989 a total of 4,306 AIDS cases has been registered. More than 80% of the reported cases are homo- and bisexual men and injection drug-users. The remaining cases are divided between hemophiliacs, persons who get infected by heterosexual contacts, blood transfusion recipients, and children infected pre- or perinatally. In 16% of all cases AIDS was diagnosed only on the basis of a Kaposi's sarcoma (KS) and in another 6% on the basis of KS and an opportunistic infection (OI). KS occurred mostly in homo- and bisexual men. The relative proportion of KS has steadily decreased from 30% up to 1986 to less than 20% in 1989. The overall incidence of KS decreased mainly due to the decrease of KS in homosexual men with AIDS. OI were diagnosed in 70% of the cases. Pneumocystis-carinii-pneumonia is most frequent (47%), followed by candida-oesophagitis (19%) and toxoplasmosis of brain in 9.5%. A malignant lymphoma was diagnosed in 3% of the cases. Furthermore, HIV-encephalopathy was seen in 2.8% and HIV-wasting-syndrome in 1.6% of cases. There is a different spectrum of diseases at the first manifestation of AIDS diagnosed in injecting drug-users. The reasons for this may be due to different life-style in this group.
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PMID:[AIDS in Germany: clinical manifestations of AIDS]. 154 64

Thoracic disease in the HIV negative immunocompromised host is most frequently caused by infection. Patterns of involvement produced on the chest radiograph include (1) lobar or segmental consolidation, (2) nodules with rapid growth and/or cavitation, and (3) diffuse lung disease. The lung also may be directly involved by lymphoma, metastases, drug reactions, radiation pneumonitis, or nonspecific interstitial pneumonitis. The lung is a frequent target organ for opportunistic infections in AIDS patients, particularly of Pneumocystis carinii pneumonia and tuberculosis. Computed tomography may be particularly helpful in these patients in the detection of early disease and in the characterization of patterns and extent of involvement as well as complications.
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PMID:Thoracic disease in the immunocompromised patient. 157 Mar 94

Indium-111-labeled-leukocyte scintigraphy was performed on three febrile patients, two of whom had no signs or symptoms referable to the respiratory tract. The third patient had dyspnea on exertion, unchanged over two months. Their past histories were remarkable in that all three had recently undergone chemotherapy for malignancy (2 lymphoma, 1 malignant thymoma). Diffuse pulmonary uptake of labeled leukocytes was observed in all three individuals. As a direct result of leukocyte imaging, all three underwent fiberoptic bronchoscopy and transbronchial biopsy. The final diagnosis in each of these patients was drug-induced pneumonitis, which responded to treatment with corticosteroids. This entity should be added to the group of conditions, both infectious and noninfectious, that cause diffuse pulmonary uptake on labeled leukocyte images. Moreover, in the appropriate clinical setting, even in the absence of pulmonary signs or symptoms, diffuse pulmonary uptake of labeled leukocytes should alert the physician to the possibility of drug-induced pneumonitis.
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PMID:Diffuse pulmonary uptake of indium-111-labeled leukocytes in drug-induced pneumonitis. 159 34

A successfully treated case of cyclophosphamide pneumonitis, which developed during treatment for a leukemic phase of B-cell non-Hodgkin's lymphoma, is documented. Subtyping of lymphocytes in the peripheral blood and the bronchoalveolar lavage fluid easily excluded a possible diagnosis of pulmonary involvement of lymphoma. Bronchoalveolar lavage is a useful approach to determine the correct etiology of pneumonitis.
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PMID:A case of cyclophosphamide-induced interstitial pneumonitis diagnosed by bronchoalveolar lavage. 162 Sep 83

A 52 year old male presenting chronic myeloid leukemia (CML) Philadelphia chromosome positive (Ph) four years after the diagnosis of a non Hodgkin's lymphoma is described. The patient had received high total doses of alkylating drugs (cyclophosphamide and chlorambucil) as part of chemotherapy treatment for a diffuse mixed lymphoma. At four years of diagnosis of the lymphoma the appearance of hepatosplenomegaly, leukocytosis with myeloma and basophilia and thrombocytosis were observed. These alterations augmented progressively until a cytogenetic study of the bone marrow two years late established the diagnosis of CML upon demonstrating the presence of the Ph chromosome with no other karyotypic anomalies being observed. The explorations carried out at that time confirmed that the lymphoma continued to be in remission. The CML initially responded to treatment with busulphan. However, following a year and a half the disease evolved to a phase of acceleration and the patient died a few weeks later due to pneumonia with no signs indicative of lymphoma activity having been detected since the diagnosis of the CML.
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PMID:[Chronic myeloid leukemia after chemotherapy treatment for non-Hodgkin's lymphoma]. 163 10

The impact of 4300 serial autopsies performed in Shiraz, Iran, on scientific and clinical medicine is discussed. These studies in geographic pathology led to the recognition of the importance in disease patterns of persistent, life-long changes in the human immune response brought about by serious perinatal infection and/or malnutrition. Elucidation of the pathogenesis of primary upper small intestinal lymphoma serves as an example of the importance of the field of geographic pathology for the understanding of disease processes. The immune response in infantile infection with Pneumocystis carinii with interstitial plasma-cell pneumonia helped to elucidate the basic conditions and mechanisms underlying all forms of pneumocystosis. The first effective prophylaxis of pneumocystosis was thus developed. The response of the gut to different forms of nutritional deficiency and its relationship to gastroenterological cancer was also investigated.
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PMID:Autopsy pathology and disease patterns in Shiraz, Iran, 1960-1974. 164 95

The frequent reactivation of disease in immunosuppressed patients represents a serious health complication for acquired immunodeficiency syndrome (AIDS) patients with herpesviruses. Since the herpesviruses are often associated with the development of complication such as pneumonia and lymphoma, an emphasis is being placed on the rapid laboratory diagnosis of herpes simplex viruses 1 and 2, varicella- zoster, Epstein-Barr virus, and cytomegalovirus. Diagnostic methods that utilize monoclonal antibodies to detect viral antigens in clinical specimens are now within the scope of general laboratories and detection methods for viral DNA in clinical specimens are being advanced. Each of the viruses requires its own diagnostic procedures, however, and consideration should be given to practical and economic issues. The World Health Organization (WHO) has recommended that developing countries use rapid diagnostic techniques that do not require expensive, labor-intensive virus replication. Serological diagnosis can facilitate disease surveillance of the herpesviruses in different population groups in countries with little information on this infection's epidemiology. Who is recommending that regional or national reference laboratories establish confirmatory testing facilities to support the routing virological or microbiological services offered by local laboratories. Other WHO recommendations include the development of international standard preparations and reference reagents, compilation of a list of monoclonal antibodies available for collaborative diagnostic studies, and promotion of studies on the rapid diagnosis of herpesvirus-promoted encephalitides.
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PMID:Diagnosis of human herpesviruses: memorandum from a WHO meeting. 165 24


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