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Hunter Martinez
Hunter Martinez

2021 Download Nodules Sein Pdf

Sarcoidosis is a relatively common inflammatory disorder of unknown etiology that frequently affects the lungs (19). Plain chest radiographic findings are often nonspecific; conventional and high-resolution computed tomography are better modalities for showing characteristic features of pulmonary sarcoidosis (266). Hilar and mediastinal lymphadenopathy are usually present, with or without concomitant parenchymal abnormalities. Lung nodules are frequently observed and tend to be distributed along the bronchovascular bundles, interlobular septa, major fissures, and subpleural regions (266). Cavitation occasionally occurs within these nodules; for example, one study demonstrated cavitation in 3/44 (6.8%) patients with pulmonary sarcoidosis (29). Additional findings by computed tomography include fibrosis (honeycomb, linear, or associated with bronchial distortion), pleural thickening, and ground-glass opacities (1, 29).

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A less common disorder associated with lung cavities is bronchiolitis obliterans organizing pneumonia, also called cryptogenic organizing pneumonia when there is no underlying etiology. This disorder, which is a pathological diagnosis, may be triggered by drug or toxin exposure, autoimmune diseases, viral infections, or radiation injury but is most often idiopathic (272). Patients with bronchiolitis obliterans organizing pneumonia usually present with fever, cough, weight loss, and dyspnea over weeks to months, similar to many infectious diseases associated with lung cavities (76). The most common computed tomography appearance of this disorder is patchy consolidation, often accompanied by ground-glass opacities and nodules (214). Cavitation has been reported in 0 to 6% of cases, varying with the series and the imaging modality (76, 101, 214). Unfortunately, none of the clinical or radiographic manifestations of this disorder are specific, and diagnosis must be made by lung biopsy (101).

Invasive aspergillosis in a 52-year-old man with systemic lupus erythematosus who had been on chronic high-dose corticosteroids and azathioprine. The plain chest radiograph (left) is suggestive of septic pulmonary emboli, with multiple large nodules bilaterally, at least two of which contain central cavities. The right panel demonstrates one of these thick-walled cavities as seen by computed tomography. This patient also had Aspergillus in the brain, which is a common site of metastatic spread in immunocompromised hosts.

Endometriosis of the thorax is a clinical entity that includes the presence of ectopic endometrial tissue in the pleura, the pericardium and rarely the diaphragm. This is often expressed as catamenial pneumothorax. Catamenial pneumothorax is the most common clinical expression of thoracic endometriosis syndrome, which includes four other entities. These are in brief, catamenial hemothorax, catamenial hemoptysis, endometriotic lung nodules, and catamenial chest pain. The catamenial character of all these symptoms mentioned above is a result of the menstrual cycle [68].

The other four clinical entities that form the thoracic endometriosis syndrome such as catamenial hemoptysis, catamenial hemothorax, lung nodules and catamenial chest pain can be a result of the lung lesions caused by the metastatic spread of endometrial tissue. In fact endometrial cells have been shown to embolize peripheral blood vessels of the lung as well as to invade the respiratory epithelium [70]. Another cause of catamenial hemoptysis can be the mensessynchronous increase of prostagalandine F2, which may cause rupture of bullae and blebs that may exist in normal lungs [70]. Additionally, to the cases of endometriosis of the lower respiratory system, there are two case reports in the literature tha refer to upper respiratory system endometriosis and more specifically to nasal endometriosis. Nasal endometriosis causes cyclic epistaxis and nasal pain, which is synchronous to the menstrual cycle [72] (Figure 11).

Four subjects in control group 1 met EORTC/MSG criteria for possible IPA with dense nodules visualized on CT thorax, but alternate pulmonary diagnoses were present for all - one had nocardiosis, one had Mycobacterium abscesses infection, one had mucormycosis, and the last had chronic pulmonary graft-versus-host disease. None of the four had BAL galactomannan OD indices exceeding 0.5, and three recovered without anti-Aspergillus therapy. The patient with mucormycosis died from subsequent gram-negative septicemia. CT features for the other subjects in this group comprised mainly pulmonary ground-glass infiltrates and/or consolidative changes. Only 11 (64.7%) subjects in control group 1 underwent serum galactomannan testing as the others were not considered at-risk for IFD. 041b061a72


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