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1.
Rheumatology (Oxford) ; 59(12): 3645-3656, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33313932

RESUMO

OBJECTIVES: Pleuroparenchymal fibroelastosis (PPFE) is characterized by predominantly upper lobe pleural and subjacent parenchymal fibrosis; PPFE features were described in patients with rheumatic autoimmune diseases (RAID). A systematic literature review was performed to investigate the prevalence, prognosis and potential association of PPFE with previous immunosuppression in RAID. METHODS: EMBASE, Web of Science and PubMed databases were questioned from inception to 1 September 2019. Articles published in English and addressing PPFE in patients with RAID were selected. RESULTS: Twenty out of 794 papers were selected with a total of 76 cases of RAID-PPFE patients (20 SSc, 9 RA, 6 IIM6 primary SS, 5 overlap syndromes, 3 ANCA-associated vasculitides, 2 granulomatosis with polyangiitis, 1 microscopic polyangiitis, 1 UCTD, 1 SLE, 1 GCA and 21 patients with non-specified RAID). Dyspnoea was the most frequently reported symptom (37/48 patients, 77%). Patients frequently presented with a restrictive pattern and decline in diffusing lung capacity for carbon monoxide. During the follow-up, 7/12 patients had progression at imaging, 22/39 presented a generic clinical worsening, 19/38 had a functional deterioration and 15/43 remained stable. CONCLUSION: The present systematic literature review confirms that PPFE features are present in RAID. Rheumatologists should be aware of this new radiological pattern that holds a bad prognosis.


Assuntos
Doenças Autoimunes/complicações , Doenças Pleurais/etiologia , Fibrose Pulmonar/etiologia , Doenças Reumáticas/complicações , Humanos , Doenças Pleurais/diagnóstico , Doenças Pleurais/terapia , Fibrose Pulmonar/diagnóstico , Fibrose Pulmonar/terapia , Doenças Reumáticas/imunologia
2.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1343-1346, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018237

RESUMO

Asbestos is a toxic ore widely used in construction and commercial products. Asbestos tends to dissolve into fibers and after years inhaling them, these fibers calcify and form plaques on the pleura. Despite being benign, pleural plaques may indicate an immunologic deficiency or dysfunctional lung areas. We propose a pipeline for asbestos-related pleural plaque detection in CT images of the human thorax based on the following operations: lung segmentation, 3D patch selection along the pleura, a convolutional neural network (CNN) for feature extraction, and classification by support vector machines (SVM). Due to the scarcity of publicly available and annotated datasets of pleural plaques, the proposed CNN relies on architecture learning with random weights obtained by a PCA-based approach instead of using traditional filter learning by backpropagation. Experiments show that the proposed CNN can outperform its counterparts based on backpropagation for small training sets.


Assuntos
Asbestos , Doenças Pleurais , Asbestos/efeitos adversos , Humanos , Redes Neurais de Computação , Pleura/diagnóstico por imagem , Doenças Pleurais/diagnóstico , Máquina de Vetores de Suporte
3.
J Cancer Res Ther ; 16(4): 933-934, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32930145

RESUMO

Hemothorax cannot always be treated by thoracic surgeon. Rapidly improved interventional pulmonology broadens the application of medical thoracoscopy. We attempt to share our experiences of medical thoracoscopy for hemothorax and discuss the value of medical thoracoscopy in pleural diseases. We reported a 76-year-old male with hemothorax who was cured by medical thoracoscopy under local anesthesia together with argon plasma coagulation. Moreover, final pathological diagnosis was acquired as pleural sarcomatoid carcinoma. The unusual manifestation under medical thoracoscopy of such a relative rare disease was also described in this paper. The medical thoracoscopy could be used successfully for hemothorax instead of treating with surgeon, especially for those who cannot tolerate procedure of operation or surgical thoracoscopy.


Assuntos
Carcinossarcoma/patologia , Hemotórax/diagnóstico , Hemotórax/terapia , Derrame Pleural/patologia , Toracoscopia/métodos , Idoso , Biópsia , Carcinossarcoma/diagnóstico , Carcinossarcoma/terapia , Hemotórax/patologia , Humanos , Masculino , Doenças Pleurais/diagnóstico , Doenças Pleurais/patologia , Doenças Pleurais/terapia
4.
Rev. cir. (Impr.) ; 72(3): 241-244, jun. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1115549

RESUMO

Resumen Introducción: Las complicaciones torácicas secundarias a pancreatitis aguda son excepcionales y más aún la presencia de un pseudoquiste mediastinal. Caso Clínico: Hombre de 36 años. Consumidor de marihuana y alcohol. Historia de 6 meses de dolor abdominal y adelgazamiento de 20 kilos. Instalando en la evolución sintomatología respiratoria. Discusión: Se discuten las formas de presentación de esta entidad. Sus etiologías más frecuentes. Se hace énfasis en el rol de la imagenología así como en el análisis del líquido pleural. El enfoque terapéutico es conservador al inicio y en algunos pacientes es quirúrgico en la evolución; con diversas opciones.


Introduction: The thoracic complications secondary to acute pancreatitis are exceptional and even more so the presence of a mediastinal pseudocyst. Case report: 36 year old man. Marijuana and alcohol consumer. History of 6 months of abdominal pain and weight loss of 20 kilos. Installing respiratory symptomatology evolution. Discussion: The forms of presentation of this entity are discussed. Its most frequent etiologies. Emphasis is placed on the role of imaging as well as the analysis of pleural fluid. The therapeutic approach is conservative at the beginning and in some patients it is surgical during evolution; with several options.


Assuntos
Humanos , Masculino , Adulto , Pseudocisto Pancreático/etiologia , Pseudocisto Pancreático/terapia , Pancreatite/complicações , Doenças Pleurais/etiologia , Doenças Pleurais/terapia , Fístula/etiologia , Fístula/terapia , Pseudocisto Pancreático/diagnóstico , Doenças Pleurais/diagnóstico , Período Pós-Operatório , Tomografia Computadorizada por Raios X
5.
Postgrad Med ; 132(5): 406-411, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32077354

RESUMO

BACKGROUND: Patients with undiagnostic pleural effusions are routinely examined by conventional medical thoracoscopy under the white light (WL). The endoscopic appearance of pleural diseases under WL could be misleading. Narrow-Band Imaging (NBI) has been applied as an interesting and effective diagnostic tool for endoscopy. However, there is also controversy about its value in the application of thoracoscopy. OBJECTIVE: The objective of this study was to investigate the diagnostic value of NBI technology during thoracoscopy. METHODS: Patients with undiagnosed pleural effusions admitted to our hospital between September 2017 and September 2019 were enrolled. During the thoracoscopy, we performed WL mode first and then NBI. Pictures of endoscopic real-time lesions were recorded under two modes, and at least five pieces of tissue were taken, respectively, on pleura lesions. Biopsy specimens were respectively taken for pathologic analysis. Diagnostic sensitivity, specificity were calculated to compare with pathologic results. RESULTS: 100 eligible patients were enrolled, including 63 with malignancy, 23 with tuberculous pleurisy, 3 with systemic disease and 11 with the negative condition. Compared with pathological results, the sensitivity of WL was 91.01%, and NBI 84.27%; while the specificity of WL was 27.27%, and NBI 81.82%. Compared NBI with WL, the former's specificity is superior to the latter's, which is statistically significant (P < 0.05). CONCLUSIONS: The advantage of NBI lies in its high specificity. It's useful to diagnose unknown pleural effusions in clinical practice. With better visualization of blood vessels, we can enhance the accuracy of biopsy and reduce the risk of unexpected bleeding arose from the biopsy.


Assuntos
Imagem de Banda Estreita/métodos , Doenças Pleurais/diagnóstico , Doenças Pleurais/patologia , Toracoscopia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico por imagem , Derrame Pleural/diagnóstico , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/patologia , Sensibilidade e Especificidade , Tuberculose Pleural/diagnóstico , Tuberculose Pleural/patologia , Adulto Jovem
6.
Ann Thorac Surg ; 110(1): e31-e33, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31926159

RESUMO

Characterized by pleural and subpleural fibrosis with alveolar septal elastosis, pleuroparenchymal fibroelastosis is a rare restrictive lung disease. Symptoms are often subtle, including dyspnea, cough, and weight loss; while acute presentations of spontaneous pneumothorax have been recorded. We report a patient who developed a spontaneous hemothorax, who upon evacuation of the chest was found to have a hemorrhagic lower lobe mass consistent with pleuroparenchymal fibroelastosis. Various conditions are associated with pleuroparenchymal fibroelastosis, suggesting chronic lung injury as a factor in pathogenesis. Hemothorax of this magnitude with relatively no known inciting risk factors, represents an exceptionally rare case presentation.


Assuntos
Hemotórax/etiologia , Pulmão/diagnóstico por imagem , Pleura/diagnóstico por imagem , Doenças Pleurais/complicações , Fibrose Pulmonar/complicações , Adulto , Biópsia , Fibrose/complicações , Fibrose/diagnóstico , Hemotórax/diagnóstico , Hemotórax/cirurgia , Humanos , Masculino , Doenças Pleurais/diagnóstico , Fibrose Pulmonar/diagnóstico , Toracoscopia , Tomografia Computadorizada por Raios X
7.
Interact Cardiovasc Thorac Surg ; 30(1): 146-148, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31586418

RESUMO

Oesophago-pleural fistula is an uncommon complication after pneumonectomy, usually related to high morbidity and mortality. Due to its rarity and heterogeneous clinical presentation, its diagnosis and management are challenging issues. Here, we report the case of a patient with a history of pneumonectomy for a tracheal tumour, who developed an asymptomatic oesophago-pleural fistula 7 years after primary surgery. In consideration of the patient's good clinical status and after verifying the preservation of respiratory and digestive functions, a bold conservative approach was adopted. Five-year follow-up computed tomography did not disclose any sign of recurrence of disease and showed a stable, chronic fistula.


Assuntos
Tratamento Conservador/métodos , Fístula Esofágica/terapia , Doenças Pleurais/terapia , Pneumonectomia/efeitos adversos , Broncoscopia , Fístula Esofágica/diagnóstico , Fístula Esofágica/etiologia , Feminino , Fístula/diagnóstico , Fístula/etiologia , Fístula/terapia , Humanos , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico , Doenças Pleurais/etiologia , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/diagnóstico , Neoplasias da Traqueia/cirurgia
8.
Vet Clin North Am Small Anim Pract ; 50(2): 467-487, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31813554

RESUMO

Exudative pleural diseases are a common cause of respiratory distress and systemic illness in dogs and cats. This article covers the pathophysiology, development, and classification of exudative pleural effusions. The most current diagnostic strategies, causes, imaging findings, and medical or surgical treatment options for select diseases are reviewed in detail.


Assuntos
Doenças Pleurais/veterinária , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/etiologia , Doenças do Gato/terapia , Gatos , Doenças do Cão/diagnóstico , Doenças do Cão/etiologia , Doenças do Cão/terapia , Cães , Doenças Pleurais/diagnóstico , Doenças Pleurais/etiologia , Doenças Pleurais/terapia
12.
Tunis Med ; 97(3): 445-454, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31729719

RESUMO

INTRODUCTION: Resistant tuberculosis is a topical subject given the difficulties of its management. OBJECTIVE: To evaluate the role of imaging in the diagnosis and follow-up of multidrug-resistant tuberculosis (MDR-TB). METHODS: Retrospective study of MDR-TB cases followed in Hall C of Abderrahmane Mami Hospital (2010 to 2016). RESULTS: Forty four patients included. The average age was 33 (15-58). The sex ratio was 1.7. Chest radiographs at the start of treatment showed lesions dominated by nodules (n = 39) and cavities (n = 36). The parenchymal lesions were bilateral (n = 32), associated pleural (n = 4) and mediastinal lesions (n = 7). During treatment, radiological improvement dominated during the first 7 months of treatment. Computed tomography was performed as part of the preoperative assessment of MDR-TB (n = 2), lung cancer extension assessment (n = 1) and etiological assessment of haemoptysis. It allowed to refute a suspected pulmonary embolism (n = 1) and to drain a pleural effusion. Parenchymal lesions on CT were dominated by nodules (n = 8) and cavities (n = 6). Mediastinal nodes (n = 4) and pleural effusions (n = 3) were noted. Ultrasonography showed pleural effusion with pleural thickening (n = 2) and permits its ponction. CONCLUSION: Imaging is a key element in the diagnostic approach to tuberculosis. It permits to evaluate tuberculous lesions and to detect tuberculous complications. It helps to guide the therapeutic management and evaluate its effectiveness.


Assuntos
Diagnóstico por Imagem/métodos , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/terapia , Adolescente , Adulto , Antibióticos Antituberculose/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Doenças Pleurais/diagnóstico , Doenças Pleurais/terapia , Radiografia Torácica , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/terapia , Ultrassonografia , Adulto Jovem
13.
Adv Respir Med ; 87(5): 257-260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31680224

RESUMO

INTRODUCTION: Pleural biopsy is the commonest mode of obtaining thoracoscopic pleural specimens from suspected pleural lesions. However, this may be associated with arisk of bleeding in certain cases. The decision to perform biopsy could be difficult, especially when the lesions are close to vascular structures and the visceral pleura. So, pleural brushing can be used to get safely thoracoscopic specimens in addition to biopsy samples. AIM: To determine the sensitivity and specificity of thoracoscopic pleural brushing in exudative pleural effusions. MATERIAL AND METHODS: This prospective study was done in the Department of Pulmonary Medicine, Sri Manakula Vinayagar Medical College, Pondicherry, India on 80 patients with exudative pleural effusion in whom pleural fluid analysis and closed pleu-ral biopsy results were inconclusive. All these patients were subjected to medical thoracoscopy after getting informed consent. Pleural biopsy and pleural brushings were taken and sent for analysis. RESULTS: Thoracoscopic pleural biopsy was diagnostic in 76 of 80 patients (95%). Thoracoscopic pleural brushing was diagnostic in 74 patients (92.5%). Histopathology revealed malignancy (82.7%), granulomatous inflammation (11.5%) and nonspecific inflam-mation (5.7%). The sensitivity and specificity of pleural brushing were 96% and 75%, respectively. Interestingly, pleural brushing was the only diagnostic modality in one patient that was reported to be adenocarcinoma. CONCLUSIONS: Thoracoscopic pleural brushing is an easy, convenient and safe procedure as it can augment the diagnostic yield of thoracoscopy. It is of significant value, especially in sampling pleural lesions close to vessels and the visceral pleura compared to pleural biopsy.


Assuntos
Pleura/patologia , Doenças Pleurais/diagnóstico , Manejo de Espécimes/métodos , Toracoscopia/métodos , Adulto , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/patologia , Derrame Pleural/diagnóstico , Estudos Prospectivos , Tuberculose Pleural/diagnóstico
14.
Arch. bronconeumol. (Ed. impr.) ; 55(11): 565-572, nov. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-186324

RESUMO

Introducción: Predecir cuándo un derrame pleural infeccioso puede evolucionar hacia una infección complicada/empiema es difícil de establecer. Nuestro propósito es analizar si un modelo predictivo construido con parámetros bioquímicos del líquido pleural puede ayudar a identificar estos derrames. Métodos: Se estudió de forma prospectiva a todos los pacientes diagnosticados de derrame pleural infeccioso y se clasificaron en no complicados y complicados/empiemas. Se realizó un análisis de regresión logística para estimar la probabilidad de infección pleural complicada/empiema. Con base en parámetros bioquímicos del líquido pleural, se construyó un modelo predictivo y se determinaron su discriminación (áreas bajo la curva ROC), calibración y precisión diagnóstica. Resultados: Se incluyó a 177 pacientes (74 infecciones pleurales no complicadas y 103 complicadas/empiemas). El área bajo la curva del modelo construido (pH, lactato deshidrogenasa e interleucina 6) fue 0,9783, significativamente mejor que cualquiera de las variables bioquímicas utilizadas de forma individual (0,921, 0,949 y 0,837, respectivamente; p < 0,001 usando todos los parámetros). La tasa de clasificación correcta fue del 96% de los derrames (170/177; 72/74 [97,3%] de los no complicados y 98/103 [95,1%] de los complicados/empiemas). Conclusión: El modelo predictivo analizado tiene una buena rentabilidad para el diagnóstico de las infecciones pleurales complicadas/empiemas, superior a la de cualquiera de las variables individuales que lo componen


Introduction: Identifying infectious pleural effusions (IPE) that will progress to complicated infection or empyema is challenging. The purpose of this study was to determine whether a model based on multiple biochemical parameters in pleural fluid can predict which IPEs will produce empyema. Methods: A prospective study was performed of all cases of IPEs treated in our unit. IPEs were classified as uncomplicated or complicated (empyema). Logistic regression was used to estimate the risk for complicated pleural infection (empyema). A predictive model was developed using biochemical parameters in pleural fluid. Discriminatory power (areas under the ROC curve), calibration, and diagnostic accuracy of the model were assessed. Results: A total of 177 patients were included in the study (74 with uncomplicated infectious pleural effusion, and 103 with complicated pleural effusion/empyema). The area under the curve (AUC) for the model (pH, lactate dehydrogenase and interleukin 6) was 0.9783, which is significantly superior to the AUC of the individual biochemical parameters alone (0.921, 0.949, and 0.837, respectively; P <.001 using all parameters). The rate of correct classification of infectious pleural effusions was 96% [170/177: 72/74 (97.3%) for uncomplicated and 98/103 (95.1%) for complicated effusion (empyema)]. Conclusion: The multiple-marker model showed better diagnostic performance for predicting complicated infectious pleural effusion (empyema) compared to individual parameters alone


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico , Empiema Pleural/complicações , Derrame Pleural/complicações , Valor Preditivo dos Testes , Biomarcadores , Estudos Prospectivos , Modelos Logísticos , Curva ROC , Sensibilidade e Especificidade
15.
Khirurgiia (Mosk) ; (9): 5-12, 2019.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-31532160

RESUMO

OBJECTIVE: To assess severity, safety and functional advisability of distal pancreatectomy using original surgical technique developed in the Blokhin National Medical Research Centre of Oncology. MATERIAL AND METHODS: There were 10 patients with duodenal malignancies who have undergone distal pancreatectomy in the Blokhin National Medical Research Centre of Oncology for the period 2006-2018. Distal pancreatectomy for primary duodenal tumors was performed in 8 patients, 2 patients underwent surgery for external invasion of the duodenum. RESULTS: Postoperative complications Clavien-Dindo grade 1 and 2 occurred in 4 (40%) patients. Surgical complication grade 2 occurred in 1 (10%) patient (pancreatic fistula with effective conservative management). There were no cases of leakage of duodenal stump and duodenojejunostomy, impaired bile flow and stenosis of anastomosis with delayed stomach emptying. CONCLUSION: Distal duodenectomyis associated with low postoperative morbidity, good functionality and quality of life. This procedure is preferred for non-epithelial and neuroendocrine tumors, as well as with secondary malignant duodenal invasion.


Assuntos
Fístula Brônquica/cirurgia , Empiema Pleural/cirurgia , Pneumopatias/cirurgia , Pneumonectomia/efeitos adversos , Fístula Brônquica/diagnóstico , Fístula Brônquica/etiologia , Doença Crônica , Empiema Pleural/diagnóstico , Empiema Pleural/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico , Doenças Pleurais/etiologia , Doenças Pleurais/cirurgia , Pneumonectomia/mortalidade , Recidiva , Reprodutibilidade dos Testes , Fístula do Sistema Respiratório/diagnóstico , Fístula do Sistema Respiratório/etiologia , Fístula do Sistema Respiratório/cirurgia , Retalhos Cirúrgicos/transplante
17.
J Orthop Surg (Hong Kong) ; 27(3): 2309499019865470, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31382818

RESUMO

BACKGROUND: Dural tear and cerebrospinal fluid (CSF) leakage is known to be a complication of anterior thoracic spine surgery. If dural tear occurs on the ventral side of dura in combination with a pleural injury, it potentially becomes a subarachnoid-pleural fistula. The pressure gradient permits continuous flow of CSF from the subarachnoid space into the cavum thorax, resulting in an intractable subarachnoid-pleural fistula. We report two cases of successfully treated subarachnoid-pleural fistula using noninvasive positive-pressure ventilation (NPPV). METHODS: Two patients, a 52-year-old man and a 54-year-old woman, underwent anterior thoracic spine surgery to treat thoracic myelopathy caused by spinal tumor and ossification of the posterior longitudinal ligament. During surgery, dural tear and CSF leakage to the cavum thorax due to perforation of the dura was observed. We treated with polyglycolic acid sheet (Neovel®) in combination with fibrin glue; a suction drainage tube was placed at the subfascial level and the wound was drained with negative pressure. However, after removal of the drainage tube, subarachnoid-pleural fistula was proven. We applied NPPV to the patients. RESULTS: We used the application of NPPV for 2 weeks in the first patient and 1 week in the second patient. In both of them, subarachnoid-pleural fistula was attenuated without apparent adverse events. CONCLUSION: NPPV is noninvasive and potentially useful therapy to attenuate subarachnoid-pleural fistula after thoracic spinal surgery.


Assuntos
Doenças do Sistema Nervoso Central/terapia , Fístula/terapia , Doenças Pleurais/terapia , Respiração com Pressão Positiva/métodos , Doenças do Sistema Nervoso Central/diagnóstico , Feminino , Fístula/diagnóstico , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico , Complicações Pós-Operatórias , Espaço Subaracnóideo , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Vértebras Torácicas
19.
JSLS ; 23(3)2019.
Artigo em Inglês | MEDLINE | ID: mdl-31427853

RESUMO

Background: Endometriosis is characterized by the presence of endometrial-like glands and stroma outside the uterine cavity and is believed to affect 6%-10% of reproductive-age women. Endometriosis within the lung parenchyma or on the diaphragm and pleural surfaces produces a range of clinical and radiological manifestations. This includes catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules, resulting in an entity known as thoracic endometriosis syndrome (TES). Database: Computerized searches of MEDLINE and PubMed were conducted using the key words "thoracic endometriosis," "catamenial pneumothorax," "catamenial hemothorax," and "catamenial hemoptysis." References from identified sources were manually searched to allow for a thorough review. Conclusion: TES can produce incapacitating symptoms for some patients. Symptoms of TES are nonspecific, so a high degree of clinical suspicion is warranted. Medical management represents the first-line treatment approach. When this fails or is contraindicated, definitive surgical treatment for cases of suspected TES uses a combined video laparoscopy performed by a gynecologic surgeon and video-assisted thoracoscopic surgery performed by a thoracic surgeon. Postoperative hormonal suppression may further reduce disease recurrence.


Assuntos
Endometriose/cirurgia , Hemotórax/cirurgia , Pneumotórax/cirurgia , Doenças Torácicas/cirurgia , Cirurgia Torácica Vídeoassistida , Adulto , Diafragma/cirurgia , Endometriose/diagnóstico , Feminino , Hemotórax/diagnóstico , Humanos , Laparoscopia , Doenças Pleurais/diagnóstico , Doenças Pleurais/cirurgia , Pneumotórax/diagnóstico , Recidiva , Doenças Torácicas/diagnóstico
20.
Innovations (Phila) ; 14(5): 473-475, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31337248

RESUMO

The investigation of pleural lesions is challenging. Thoracoscopic pleural biopsies are often the chosen approach for diagnosis and, in case of malignancy, for disease staging and palliation pleurodesis. Minimally invasive techniques represent a valid option in patients that cannot undergo surgery, minimizing the risks related to more aggressive procedures. Here we report the case of a 63-year-old man with computed tomography evidence of paratracheal pleural thickening that was successfully sampled with endobronchial ultrasound-guided transbronchial needle aspiration. This technique should be considered for the diagnosis of pleural lesions adjacent to the main airway; it represents a safer, better tolerated, and less invasive alternative to operation.


Assuntos
Doenças Pleurais/diagnóstico , Biópsia por Agulha/métodos , Broncoscopia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Pleura/patologia , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia de Intervenção
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