ABSTRACT
The authors analyze their proceeding in the etiological diagnosis of 40 diffuse pneumopathies in patients admitted to hospital. In 31 cases, diagnosis was made 10 times at the radioclinical stage, 14 times at the endoscopical stage, 6 times at the surgical stage, and once at autopsy. After, they analyze the problems of interpreting the data obtained at each stage, particularly the limited contribution of the X-ray, the necessity of discussing the anatomo-pathological diagnosis (the problem of fibrosis, of sarcoidosis reactions and of pneumoconioses). They insist on the multiplicity of tests to be done on each sample and on the importance of systematic research of K.B. Finally, all the difficulties in diagnosing toxic pneumopathies (whether iatrogenic or not) are recalled.
Subject(s)
Lung Diseases/diagnosis , Adult , Female , Humans , MaleABSTRACT
Two cases of bird-breeders' disease with negative precipitins are reported. An electron microscopical study of pulmonary parenchyma and alveolar macrophages is presented, revealing the activated appearance of macrophages. The significance of negative precipitins is discussed.
Subject(s)
Alveolitis, Extrinsic Allergic/pathology , Bird Fancier's Lung/pathology , Macrophages/ultrastructure , Adult , Female , Humans , Male , Middle Aged , Precipitins/analysis , Pulmonary Alveoli/ultrastructureABSTRACT
Emergency bronchial fibroscopy is often asked for by intensive care units. It is usually easy to make examination. The authors tried to evaluate its diagnostic and therapeutical efficiency. They gathered 48 observations of endoscopies performed in the intensive care unit. The diagnostic efficiency is valued at 70% and the therapeutical one at 85%. The main indication is the pulmonary obstruction besides tracheal stenoses, tracheal ruptures, hemoptysis and searching for opportunistic germs.
Subject(s)
Bronchoscopy , Emergencies , Fiber Optic Technology , HumansABSTRACT
From 200 observations, the authors study the results of laboratory examinations and paraclinical testings of the pleura. Neoplastic etiologies represent a 1/3 of all pleurisies. In 20% of cases a definite etiological diagnosis could not be obtained in spite of exploring thoracotomies. The limit of 30 g/l of proteins for the differentiation of mechanical transsudates and inflammatory exsudates was inaccurate. Cytodiagnosis was efficient in 75% of mesotheliomas but the percentage fell to 53 in secondary cancers. For needle biopsy results were respectively of 66% and 57%. Thoracotomy (24 cases) enabled a diagnosis in half the cases where it was performed. Thorascopy seems to bring similar results.
Subject(s)
Pleural Effusion/diagnosis , Evaluation Studies as Topic , HumansABSTRACT
Alveolar cancer is the only true cancer of the lung as opposed to the common bronchial cancer. The authors defend this thesis by contesting the excessive usage of the expression bronchiolo-alveolar cancer and by supporting it with 12 original observations together with the literature review. The anatomo-pathological data are reported and discussed in order to analyze the reliability of the observations; diagnosis can vary according to the methods used in comparing the bronchial cytology and the examination of the operation tissue samples; the evolutive back search of observations revealed that out of 9 operated cases with localized involvement, 5 patients were still alive 2 years later. Complementary examinations by scintigraphy with labelled bleomycin were disappointing; this test performed 4 times was only once positive. Data from electron-microscopy and tissue culture seem to point towards a histogenesis from type II pneumocyte.
