Asimetría radiológica como clave diagnóstica de agenesia de la arteria pulmonar en el adulto / Radiological lung asymmetry as a key image of unilateral absence of pulmonary artery in adulthood

Las malformaciones vasculares pulmonares son entidades infrecuentes y como consecuencia, infradiagnosticadas. La agenesia unilateral de la arteria pulmonar (AUAP) se debe tener en cuenta en el diagnóstico diferencial de infecciones respiratorias recurrentes, hemoptisis, e incluso hipertensión pulmonar en la edad adulta. La radiografía de tórax es una herramienta útil para una aproximación inicial, pero el diagnóstico deberá confirmarse mediante una angiotomografía computarizada (angio-TC), resonancia magnética o angiografía pulmonar. Presentamos el caso de una mujer de 26 años diagnosticada de AUAP derecha. El diagnóstico se sospechó inicialmente ante una radiografía de tórax solicitada por infección respiratoria. Los hallazgos radiológicos fueron pérdida de volumen en el hemitórax derecho con desplazamiento mediastínico ipsilateral y opacidades alveolares en lóbulo inferior derecho. El diagnóstico de AUAP derecha posteriormente se confirmó mediante una angio-TC pulmonar

Pulmonary vascular malformations are rare entities and they are, as a consequence, underdiagnosed. Unilateral absence of pulmonary artery (UAPA) should be considered in differential diagnosis of recurrent respiratory infections, hemoptysis, and pulmonary hypertension in adulthood. Chest radiography is a useful test in the initial approach, but the diagnosis should be confirmed by pulmonary angio-computed tomography (pulmonary angio-CT), magnetic resonance imaging, or angiography. We report the case of a 26-year-old woman diagnosed with right UAPA. The diagnosis was initially suspected from a chest radiography requested due to respiratory infection. The chest X-ray showed volume loss in the right hemithorax with ipsilateral mediastinal displacement and alveolar opacities in the right lower lobe. The diagnosis of right UAPA was later confirmed by a pulmonary angio-CT

[Idiopathic pulmonary hemosiderosis with good course in the adult: an atypical form?]. / Hemosiderosis pulmonar idiopática en el adulto con buena evolución: una presentación atípica?

We present the cases of two adult patients hospitalized due to alveolar hemorrhage. In the absence of data regarding the affection of other organs and after a follow-up of 20 months and 4 years respectively, they were diagnosed as idiopathic pulmonary hemosiderosis (IPH). These patients represent two opposed extremes in the clinical spectrum of the disease, yet none of them needed therapy once they overcame the acute episode, remaining asymptomatic. Although the usual clinical course of IPH involves a short survival, given the evolution of our cases and of others previously described in the literature, one may think that at least a subgroup of adult patients have just one alveolar hemorrhagic episode as the result of the exposition to an unknown inhaled stimulus.

[The functional sequelae of Mycoplasma pneumoniae pneumonia]. / Secuelas funcionales de la neumonía por Mycoplasma pneumoniae.

To check the possible existence of long-term pulmonary functional sequelae in patients with pneumonia due to Mycoplasma pneumoniae, 17 patients who showed evident spirometric disorders during the recovery from the acute phase of a pneumonia due to Mycoplasma pneumoniae were studied. In the acute phase of the disease, 7 patients showed a ventilatory restriction, 6 of them had an obstructive pattern while in four patients a mixed pattern was observed. After a latency period, which mean length was 39 months, it was seen that there was a return to normal values of the spirometric conventional parameters initially altered in all cases. However 5 patients (33%) who did not smoke, showed a significant decrease on the maximum flows at low volume. These results suggest that in a high percentage of adult patients, as has been previously described in children, pneumonia due to M. pneumoniae could leave as a sequelae the persistent affectation of small airway.