ABSTRACT
The authors report the association of organizing pneumonia (OP) and a Pneumocystis jiroveci infection in a woman who benefited from a kidney transplant 13 years before and was under corticoids, cyclosporine and mycophenolate mofetil. The diagnosis was based on progressive dyspnoea with fever with an alteration in the general state associated with diffuse micronodular pneumopathy suggesting bronchiolitis. The conformation was obtained by the analysis of the alveolar bronchial washings and the histological examination of the distal biopsies revealing endo-alveolar vegetant fibromas. Transbronchial biopsies may be used for the diagnosis and thereby, avoid an invasive surgical pulmonary biopsy. The aetiology of OP may be related to the immunosuppressant treatment or infection by Pneumocystis jiroveci. The evolution in this case was favourable with trimethoprime and sulfamethoxazole associated with a transient increase in the corticoid treatment. This association is rarely described in patients undergoing solid organ transplants.
Subject(s)
Cryptogenic Organizing Pneumonia/diagnosis , Kidney Transplantation , Opportunistic Infections/diagnosis , Pneumocystis carinii , Pneumonia, Pneumocystis/diagnosis , Biopsy , Bronchoscopy , Cryptogenic Organizing Pneumonia/pathology , Diagnosis, Differential , Drug Therapy, Combination , Female , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Kidney Transplantation/immunology , Lung/pathology , Middle Aged , Opportunistic Infections/pathology , Pneumonia, Pneumocystis/pathology , Postoperative Complications/diagnosis , Pulmonary Alveoli/pathology , Tomography, X-Ray ComputedABSTRACT
The CT and MR imaging features of the main cardiac tumors will be reviewed. Cross-sectional imaging features may help differentiate between cardiac tumors and pseudotumoral lesions and identify malignant features. Based on clinical features, imaging findings are helpful to further characterize the nature of the lesion. CT and MR imaging can demonstrate the relationship of the tumor with adjacent anatomical structures and are invaluable in the presurgical work-up and postsurgical follow-up.
Subject(s)
Heart Neoplasms/diagnosis , Image Enhancement , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Diagnosis, Differential , Heart Atria/pathology , Heart Neoplasms/pathology , Heart Neoplasms/secondary , Heart Neoplasms/surgery , Heart Septum/pathology , Heart Valves/pathology , Heart Ventricles/pathology , Humans , Incidental Findings , Lipoma/diagnosis , Lipoma/pathology , Lipoma/surgery , Liposarcoma/diagnosis , Liposarcoma/pathology , Liposarcoma/surgery , Mesothelioma/diagnosis , Mesothelioma/pathology , Mesothelioma/surgery , Myxoma/diagnosis , Myxoma/pathology , Myxoma/surgery , Sarcoma/diagnosis , Sarcoma/pathology , Sarcoma/surgery , Sensitivity and SpecificityABSTRACT
INTRODUCTION: Superior vena cava obstruction is an urgent complication of lung cancer. Superior vena cava stent insertion can be considered to provide rapid relief of the symptoms. METHODS: To estimate the efficiency and the complications of this procedure, we retrospectively analyzed 41 consecutive patients treated during the last 5 years by self-expanding nitinol stent insertion for superior vena cava obstruction due to lung cancer. It was combined with anticoagulation and corticosteroids. RESULTS: 41 patients benefited from this treatment (30 men and 11 women) with an average age of 59 years. Etiologies of the vena cava obstruction were: small cell carcinoma (11), adenocarcinoma (8), squamous cell carcinoma (9), large cell carcinoma (9) and others (4). All patients were symptomatic. The average period between the onset of symptoms and the vascular stenting was 14 days. Specific treatment was chemotherapy (18 patients), radiotherapy (1 patient), or both (14 patients), and no specific treatment for 6 patients. The procedure consisted of the insertion of 1 (73%) or 2 (27%) stents, with an average length and caliber of 7.5 cm and 14 mm respectively. No major complication was reported in short and long-term follow up. Symptomatic improvement was observed for all the patients within 48 hours. Median survival after the stenting was of 6.7 months. CONCLUSION: In our study, vascular stenting for malignant superior cava vena obstruction allows a rapid improvement of the symptoms with very few complications, suggesting a possible role as first line treatment for chemo or radio-resistant tumours.
Subject(s)
Adenocarcinoma/complications , Blood Vessel Prosthesis Implantation , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Squamous Cell/complications , Lung Neoplasms/complications , Small Cell Lung Carcinoma/complications , Stents , Superior Vena Cava Syndrome/surgery , Adult , Aged , Data Interpretation, Statistical , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recurrence , Retrospective Studies , Superior Vena Cava Syndrome/etiology , Superior Vena Cava Syndrome/mortality , Superior Vena Cava Syndrome/therapy , Time FactorsABSTRACT
The authors report a case of an X-linked-adrenoleukodystrophy (ALD) in a young adult presenting with hemianopsia. Adult onset cerebral ALD is rare and represents only 3% of cases of ALD. The observation describes clinical data, as well as conventional and spectroscopic MR imaging and related value in prognosis evaluation.
Subject(s)
Adrenoleukodystrophy/diagnosis , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Adult , Aspartic Acid/analogs & derivatives , Aspartic Acid/metabolism , Choline/metabolism , Diagnosis, Differential , Humans , MaleABSTRACT
Percutaneous and endovascular techniques have shown their efficacy in the treatment of a great variety of pathologies. The advances in diagnostic imaging as well as the development of new materials have made it possible to carry out new procedures that were unthinkable not many years ago. The irruption of this new form of treating patients has had, is having, and will have a clear impact on the multidisciplinary approach to numerous diseases.
Subject(s)
Leg/blood supply , Vascular Diseases/therapy , Adult , Aged , Angiography , Angioplasty , Angioplasty, Balloon , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/drug therapy , Arterial Occlusive Diseases/surgery , Arterial Occlusive Diseases/therapy , Balloon Occlusion , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation , Carotid Stenosis/therapy , Embolization, Therapeutic , Female , Gastrointestinal Hemorrhage/therapy , Hemostasis, Endoscopic , Hemostasis, Surgical , Humans , Hypertension, Portal/therapy , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Male , Middle Aged , Randomized Controlled Trials as Topic , Stents , Vascular Diseases/diagnostic imaging , Vascular Diseases/drug therapy , Vascular Diseases/surgeryABSTRACT
Las técnicas percutáneas y endovasculares han demostrado su eficacia en el tratamiento de una gran variedad de patologías. Los avances en la imagen diagnóstica así como en el desarrollo de nuevos materiales han posibilitado la realización de nuevos procedimientos, impensables hace no mucho años. La irrupción de esta nueva forma de tratar a los pacientes ha tenido, tiene y tendrá, aún más, un claro impacto en el enfoque multidisciplinar de múltiples enfermedades
Percutaneous and endovascular techniques have shown their efficacy in the treatment of a great variety of pathologies. The advances in diagnostic imaging as well as the development of new materials have made it possible to carry out new procedures that were unthinkable not many years ago. The irruption of this new form of treating patients has had, is having, and will have a clear impact on the multidisciplinary approach to numerous diseases
