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Pneumologie ; 69(9): 553-9, 2015 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-26205841


In two patients with bilateral micronodular pulmonary changes a diffuse pulmonary meningotheliomatosis was found. A 73-year-old woman presented with bilateral disseminated miliary pulmonary nodules as a radiological incidental finding. The surgical lung biopsy showed multiple tiny nodular proliferations meningothelial-like cells, corresponding "minute pulmonary meningothelial-like nodules", MPMN. A 60-year-old lady with similar radiological findings showed also proliferations of meningothelial-like cells in a transbronchial cryo-biopsy. These lesions are well known to pathologists as curious isolated incidental findings on histological examination of lung specimens. The here described diffuse form of these changes is very rare; its knowledge is important for the differential diagnosis with neoplastic proliferations and other diffuse parenchymal diseases of the lung. This rare diagnosis is made on histological grounds and is also possible in transbronchial biopsies when careful correlation with clinical and radiological data, knowledge of the entity and adequate specimens are provided.

Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Pulmão/patologia , Meningioma/diagnóstico , Meningioma/patologia , Tomografia Computadorizada por Raios X/métodos , Idoso , Diagnóstico Diferencial , Humanos , Pessoa de Meia-Idade
Pneumologie ; 65(7): 406-11, 2011 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-21512974


The papillary adenoma of the lung is a rare benign neoplasia with intraparenchymal localisation and is thus, in general, difficult to access for biopsy diagnosis. Due to the rarity of this lesion, the intra-operative histological diagnosis by frozen section may be problematic. We report on a 75-year-old male patient with a lung nodule, biopsied by means of bronchoscopy with TBNA. The tissue obtained was processed histologically as a cell block and examined microscopically. The diagnosis of a papillary adenoma was made. Our case is the first report on the diagnosis of a papillary adenoma of the lung by TBNA biopsy. For our patient with impaired lung function the diagnostic procedure described here represented a less invasive alternative to the diagnostic evaluation by surgery with intraoperative frozen section examination. This case shows that the TBNA biopsy combined with processing of the tissue as a cell block may represent a contribution to the appropriate management of the patients and serve as an aid for therapy planning.

Adenoma/diagnóstico por imagem , Adenoma/patologia , Biópsia por Agulha Fina/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Cirurgia Assistida por Computador/métodos , Ultrassonografia de Intervenção/métodos , Idoso , Brônquios/diagnóstico por imagem , Brônquios/patologia , Humanos , Masculino
Pneumologie ; 65(4): 219-22, 2011 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-21412707


Bronchoscopic training courses are an essential part of the education in bronchoscopy for all kinds of specialisations and professions performing such investigations. All aspects of the application should be mentioned during a course. These recommendations are necessary because the number of bronchoscopies performed in the last years has increased due to the increasing number of patients, improved equipment and better availability. Courses should provide the basic knowledge including main points of indications, preconditions for the procedure and decisions of consequence after bronchoscopy. Participants should be trained in the skills of correct handling and performing flexible bronchoscopies in training dummies. Necessary competence requirements on the course instructor are adequate professional qualifications, paedagogic skills and the availability of appropriate teaching material. Quality assurance of the course should be achieved by consequent evaluation. A widely spread field of bronchoscopic applications can improve patient care in many medical specialisations.

Broncoscopia/educação , Currículo , Educação Médica Continuada/normas , Garantia da Qualidade dos Cuidados de Saúde , Alemanha
Pneumologie ; 61(11): 697-9, 2007 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-17886196


The case of a 66-year-old, asymptomatic patient with a papillary adenoma of type-II pneumocytes is reported. Following the coincidental radiologic finding of a solitary pulmonary nodule, the diagnosis could be established in a bronchoscopically obtained endobronchial biopsy. A resection of the involved segments S8-10 on the left side was performed. Papillary adenoma of type-II pneumocytes is a rare tumor, whose origin is suspected in progenitor cells of the bronchioloalveolar epithelium with the potential to differentiate towards type-II pneumocytes and clara cells. The tumor is regarded as benign, however, a malignant potential is not excluded by some authors.

Adenoma/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pulmão/patologia , Nódulo Pulmonar Solitário/etiologia , Adenoma/patologia , Adenoma/cirurgia , Idoso , Biópsia , Broncoscopia , Diagnóstico Diferencial , Humanos , Achados Incidentais , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pneumonectomia , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/cirurgia , Tomografia Computadorizada por Raios X
Onkologie ; 23(6): 584-588, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11441266


BACKGROUND: Acquired hemophilia is a rare condition which can be associated with lymphoproliferative disease. CASE REPORT: Eleven years after the diagnosis of immunocytoma had been made, a 72-year-old man developed a high-titer factor VIII inhibitor. At this time, the lymphoma was without significant progress and there was no paraprotein in the serum. Partial thromboplastin time (PTT) was 83s, factor-VIII clotting activity was <1%, and inhibitor level was 50.4 Bethesda units. The patient presented with spontaneous hematomas in the skin and musculature of the extremities. Following combination chemotherapy with cyclophosphamide, vincristine and prednisolone (COP), there was a prompt disappearance of the inhibitor and normalization of coagulation; however, the patient developed serious infectious complications. When the inhibitor recurred he was treated with low-dose cyclophosphamide and prednisolone. This time there was a more delayed response, but the inhibitor disappeared again completely. Two months after cessation of therapy, there was again relapse. CONCLUSION: Causal relationship between lymphoma and acquired hemophilia remains speculative. At least in some cases of factor VIII inhibitors associated with malignant disease, immunosuppressive therapy may be sufficient to suppress the inhibitor. Copyright 2000 S. Karger GmbH, Freiburg