Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Organ transplant and AIDS patients are at a much higher risk for developing non-Hodgkin's lymphoma than is the general population. This increased risk is directly related to chronic immunosuppression and often is associated with viral infections. In contrast to lymphomas occurring in nonimmunocompromised patients, these tumors typically are of higher grade, are more aggressive, have a worse prognosis, and exhibit a higher frequency of extranodal disease. The most frequent organs involved are the head and neck, bowel, liver, and lungs. Thoracic manifestations of ARL and PTLD are similar, consisting of nodular, diffuse alveolar, and interstitial pulmonary disease, mild to moderate mediastinal adenopathy, and pleural effusions. Of these findings, pulmonary nodules are the most specific, although they can be difficult to differentiate from Kaposi's sarcoma and opportunistic infections. Abdominal findings are also similar for the two diseases, with the most common lesions appearing as low attenuation, hypoechoic masses in the solid abdominal organs; ulcerating nodular or diffusely infiltrating bowel lesions; and bulky retroperitoneal, mesenteric, or omental adenopathy. The identification of solid masses in the abdominal organs in AIDS and transplant patients is highly suspicious for ARL and PTLD. Due to the overlap of imaging characteristics of different pathologies, however, biopsy usually is necessary to confirm the diagnosis. Both ARL and PTLD respond to therapy; however, the prognosis for patients with ARL is uniformly poor, whereas the prognosis for treated PTLD is remarkably good. An awareness of the imaging characteristics of ARL and particularly PTLD can have significant impact on prognosis by allowing for timely diagnosis and therapy.
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PMID:Thoracic and abdominal manifestations of lymphoma occurring in the immunocompromised patient. 157 Mar 97

Pulmonary Kaposi's sarcoma (KS) was diagnosed by pulmonary biopsy in a heterosexual parenteral drug abuser (PDA). The patient had previously been diagnosed of Pneumocystis carinii pneumonia and pulmonary tuberculosis. Thoracic computed tomography (CT) showed bilateral nodular lesions which were less apparent in conventional radiological study and which increased in size in spite of correct therapy. As cutaneous lesions suggesting KS subsequently appeared, the possibility of pulmonary KS was considered and confirmed by open biopsy. The rarity of a primarily pulmonary presentation of KS in a PDA, the difficulty in diagnosis owing to concomitant infective diseases and the diagnostic value of thoracic CT for the diagnosis of pulmonary KS are discussed.
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PMID:[Kaposi's sarcoma with primary pulmonary involvement in a parenteral drug addict with acquired immunodeficiency syndrome]. 207 77

The acquired immune deficiency syndrome is characterized by the development of multiple recurrent opportunistic infections or unusual neoplasms in individuals with no prior history of immune suppression. This report summarizes the thoracic diseases encountered in such patients before after death and the role of diagnostic techniques currently used in the evaluation of thoracic disease in 15 patients with this syndrome. Efficacy of treatment was determined by correlation with postmortem findings in all patients. Pulmonary disease was present in all 15 patients and necessitated 23 transbronchial biopsies in 11 patients. Pneumocystis carinii pneumonia and cytomegalovirus pneumonia were the most common findings. Nine open lung biopsies in eight patients disclosed either Pneumocystis carinii pneumonia or Kaposi's sarcoma. Esophageal disease was present in four patients, and endoscopic evaluation demonstrated Candida esophagitis (two), esophageal Kaposi's sarcoma (one), and cytomegalovirus esophagitis and Kaposi's sarcoma (one). Mean time to death from diagnosis of acquired immune deficiency syndrome was 7.7 months, with respiratory insufficiency being the most common cause of death (9/15, 60%). Pneumocystis carinii pneumonia was successfully eradicated in 70% of the patients. Candida esophagitis was ameliorated in both patients with the disease. Unsuspected pulmonary Kaposi's sarcoma, cytomegalovirus pneumonitis, and other infectious pathogens were documented at autopsy. These data reveal that Pneumocystis carinii pneumonia and Candida esophagitis can be managed successfully in patients with acquired immune deficiency syndrome if appropriately diagnosed. The major cause of death in this series was pulmonary insufficiency, often the result of severe cytomegalovirus infection. Thoracic surgeons must continue to play an aggressive and important role in the early diagnosis and management of potentially treatable pulmonary and esophageal disease in these patients.
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PMID:Thoracic manifestations of the acquired immune deficiency syndrome. 633 56

Since chest X-ray and CT scan features of Kaposi's sarcoma (KS) are nonspecific, we wanted to test the hypothesis that the histological components of this tumour and/or the associated haemorrhagic component, may result in a characteristic signal pattern on magnetic resonance imaging (MRI). Thoracic MRI was performed in a prospective manner in ten patients with acquired immune deficiency syndrome (AIDS) and pulmonary KS. MRI examinations (1.5 Tesla) included Spin-echo T1 (SE-T1), before and after gadolinium injection, as well as T2-weighted sequences (SE-T2). For each sequence the signal intensity of lesions was measured and compared with each other as well as with the signal intensity of muscle. Results were compared to the hemosiderin content of macrophages in the bronchoalveolar lavage (BAL) in all patients and with histological findings in three. The results were compared to values obtained in a control group of seven patients with pneumocystis carinii pneumonia. SE-T1 showed focally increased signal intensity in the pulmonary parenchyma (n = 5). Signal enhancement in parenchymal lesions (n = 10) and along peribronchovascular trees (n = 5) was observed after gadolinium injection. The second echo of SE-T2 showed a markedly reduced signal intensity in pathologic areas (n = 10). This last finding was not observed in the control group. In conclusion, we have identified a pattern of MRI signal abnormalities suggestive of Kaposi's sarcoma. The MRI signal intensity of KS lesions may be related to the angiomatous and fibrous components of the tumour.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Magnetic resonance imaging findings in pulmonary Kaposi's sarcoma: a series of 10 cases. 792 8

The case of a 31 year-old intravenous drug addict female patient with infection by the human immunodeficiency virus who had recurrent cardiac tamponade and who was diagnosed by pericardic biopsy as Kaposi's sarcoma is reported. The patient demonstrated involvement by cutaneous, mucosal, lymph node and probably pleuropulmonary Kaposi's sarcoma. Thoracic radiography, computerized tomography and echocardiography only showed the presence of pericardic effusion. Neither did the pericardic fluid obtained by pericardiocentesis provide any significant ethiologic data. Only the pericardic biopsy showed the typical lesions of Kaposi's sarcoma in this localization confirming diagnosis. This is the first case of pericardic Kaposi's sarcoma described in an alive patient and the difficulties of achieving the diagnosis of the cardiac involvement by Kaposi's sarcoma in AIDS patients are commented upon.
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PMID:[Cardiac tamponade and Kaposi's sarcoma]. 820 10

Human herpes virus-8 (HHV-8)-associated primary effusion lymphoma (PEL) is an unusual lymphoma confined to the body cavities, which primarily affects human immunodeficiency virus (HIV)-positive men at high risk for Kaposi's sarcoma (KS). We describe two HIV-negative elderly Italian men, who developed pleural HHV-8-positive PEL in association with other diseases (systemic hypertension, colonic carcinoma, chronic obstructive airways disease, dilated cardiomyopathy), but without KS. Thoracic computed tomography revealed unilateral pleural effusion and pleural thickening. Thoracentesis disclosed large lymphoma cells, with no T- or B-cell associated antigens, clonal rearrangement of the immunoglobulin heavy chain gene and the presence of HHV-8 but not Epstein-Barr virus deoxyribonucleic acid sequences. Our cases differ from most pleural effusion lymphomas, in that they are non-acquired immunodeficiency syndrome-related. This highlights the possible human herpes virus-8-associated primary effusion lymphoma risk among elderly human immunodeficiency virus-negative patients, particularly Italians, in whom human herpes virus-8 seroprevalence rates and incidence of classic Kaposi's sarcoma are high.
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PMID:Human herpes virus-8 associated primary effusion lymphoma of the pleural cavity in HIV-negative elderly men. 1059 17