Sonographic characteristics of various chest diseases in 154 cases were analysed according to margin of the lesion, internal echogenecity, posterior echo enhancement, air bronchogram etc. We intended to present the basic sonographic patterns of common chest diseases. The study included 10 normal cases, 10 cases with lung abscesses, 31 cases of pneumonia, 24 cases of tumors, 11 cases of obstructive atelectasis, 8 cases of pleuropericarcadial effusions, 10 cases of minimal effusions, 6 cases with pleural thickening, 32 cases of massive pleural effusion with simple compression atelectasis and 12 cases of pneumonia with parapneumonic effusion. Sonographically, normal lung showed hyperechoic zone beneath the chest wall. Identification of arc or ring-shaped wall favored lung abscess. Air bronchogram could only be found in pneumonia. Mass showed various internal echogenecity. The internal echogenecity in obstructive atelectasis was very homogeneous which could not be found in tumor. Pleural thickening showed linear hyperechogenecity beneath the chest wall. In minimal effusion, the line of the diaphragm could be easily identified. Pleuropericardial effusion could be easily diagnosed by chest sonography. The line of the pericarcadium could be clearly identified. The internal echogenecity of massive effusion were various. The internal echogenecity of simple compression atelectasis showed very homogeneous hyperdense internal echogenecity. The internal echogenecity of lung parenchyma in pneumonia with parapneumonic effusion was similar to that of pneumonia. Obstructive atelectasis, mass, consolidation and encapsulated effusion could be differentiated by chest sonography without much difficulty. Sonography could aid chest radiography by giving more morphologic information and was cheaper than computed tomography.
<i>Objective:</i> Detection of tumor-related mRNA in blood has become a potential cancer diagnostic approach. However, the sensitivity of single-marker assays is not high enough for clinical applications. The present study was aimed to evaluate the efficacy of a multimarker panel for molecular diagnosis of non-small cell lung cancer (NSCLC). <i>Methods:</i> Carcinoembryonic antigen (CEA), cytokeratin 19 (CK-19), c-met and heterogeneous nuclear ribonucleoprotein (hnRNP) B1 mRNAs were quantified by quantitative real-time reverse transcriptase polymerase chain reaction in 34 tumor tissues and 69 peripheral blood samples of NSCLC patients. <i>Results:</i> All four markers displayed high overexpression rates (range 82.3–97.1%) in NSCLC tumors. When used as single markers in blood for NSCLC diagnosis, CEA, CK-19, c-met and hnRNP B1 could only reach sensitivities of 52.2, 50.7, 42 and 17.4%, respectively. However, the sensitivity was enhanced up to 85.5% when CEA, CK-19 and c-met were combined in a 3-marker panel. Moreover, the expression of c-met and hnRNP B1 in blood was significantly correlated with patients’ pathological stages. <i>Conclusions:</i>The combined detection of CEA, CK-19 and c-met mRNAs in blood provided a valuable tool for molecular diagnosis of NSCLC. In addition, our results also suggested that hnRNP B1 was not a valuable diagnostic marker but a potential prognostic marker for NSCLC.
Abstract: Ruptured cystic teratomas (dermoid cysts) are rare and always symptomatic, presenting as haemothorax, pleural effusion or pericardial effusion. We present an extremely rare case of a 45‐year‐old woman who, during a routine health assessment was noted to have a well‐defined anterior mediastinal tumour with peripheral ground glass opacity on chest CT. The patient was asymptomatic. She underwent video‐assisted thoracoscopic surgery and a ruptured dermoid cyst was observed and the contents had infiltrated into the right pulmonary parenchyma. There were no complications and no evidence of recurrence 10 months later. Despite most cystic teratomas being asymptomatic and benign, rupture into the pulmonary parenchyma may induce further damage, for which emergency surgical intervention is always necessary.
Agyrophil staining was applied to nucleolar organizer regions (NOR) to differentiate cells of adenocarcinoma and histiomesotheliosis in pleural effusion. The smears were either nuclearly unstained, but cytoplasmically counterstained by Papanicolaou method or Papanicolaou-destained before agyrophil staining of nucleolar organizer regions (AgNOR). The purposes of this study were to assess the feasibility and usefulness of AgNOR staining in diagnostic cytology and to try to set up a procedure that could be used on prestained smears for retrospective study. All smears showed good background and cellular outline. The distribution of NOR was either intranuclearly or in the nucleoplasm diffusely. In previously nuclearly unstained smears, NOR showed granular to powder-like appearance. The mean number of NOR in adenocarcinoma (38.4 +/- 12.5) was significantly higher than that in histiomesotheliosis (15.6 +/- 2.9). In Papanicolaou-destained smears, the NOR showed confluent dots. The mean number of NOR was much lower as compared to that of previously nuclearly unstained smears. Furthermore, the mean number of NOR in adenocarcinoma (3.6 +/- 1.4) showed no significant difference with that of histiomesotheliosis (2.7 +/- 0.8). In conclusion, AgNOR staining is one of the methods to differentiate benign from malignant cells, but not in Papanicolaou-destained smears.
Lipoid pneumonia is an uncommon disease that results from pulmonary accumulation of a fat-like component. The diagnosis is based on clinical history, radiologic presentation and bronchoalveolar lavage (BAL) sample analysis. We report the case of a 46-year-old male who presented with cough, fever and pleuritic chest pain after diesel oil aspiration. Chest radiograph on admission revealed consolidation in the right lower lung field; an antibiotic was administered to treat aspiration pneumonia. Bronchoscopy revealed some oily, transparent, yellowish fluid in the right lower bronchus, but culture and cytology of BAL fluid showed negative results. The follow-up chest radiograph revealed no obvious improvement after antibiotic treatment. Chest computed tomography (CT) revealed consolidation in the right middle lobe with heterogeneous density, and CT-guided biopsy revealed necrotizing inflammation. A follow-up bronchoscopy showed mucosal inflammation. Steroid was administered to treat the lipoid pneumonia and inflammation, and obvious improvement of the clinical symptoms and radiologic manifestations was seen. No specific adverse effect or complication was noted during therapy. In patients with lipoid pneumonia, careful history-taking and diagnosis are important. Steroid is effective for these patients.
We reviewed 400 cases whose P-A and lateral chest radiographs were used. These were divided into three groups. Group A was composed of 235 cases of normal radiographs. This group was used to evaluate the incidence of visibility of some anatomic structures on a lateral radiograph. Group B consisted of 143 cases with various diseases including pleural effusion (20 cases), peri-diaphragmatic lesions (15 cases), abscess (12 cases), emphysema (20 cases), lung tumor (15 cases), mediastinal tumor (10 cases), obstructive atelectasis (16 cases), infiltrative pattern (15 cases), and pneumonia (20 cases). This group was used to evaluate what information the lateral view could add to an abnormal chest P-A radiograph. Group C had 22 cases with additional findings on the lateral view which were not seen on the chest P-A radiographs. This group was used to evaluate the applicability of sings of thickening of the posterior tracheal band, thickening of the posterior wall of the bronchus intermedius and posterior displacement of the left main bronchus in the diagnosis of specific diseases. The results showed A) there was no difference in the incidence of visibility of anatomic structures evaluated in this study on the right and the left lateral view. The visible incidence of these structures in 235 cases was 97% for the posterior tracheal band, 45% for the right upper lobe bronchus orifice, 83% for the left upper lobe bronchus orifice, 70% for the inferior vena cava, 92% for the posterior wall of the bronchus intermedius, 87% for the aorta, 97% for the right pulmonary artery, 71% for the left pulmonary artery, 69% for stomach air and 99% for the tracheal air column. B) unless the diagnosis could not be reached on the chest P-A radiograph or localization of the lesion was expected, the lateral view should be ordered only for patients with lesions of the peridiaphragm, mediastinum, hilum, midline, middle or lingual lobe, sternum, retrosternum or spine. C) the high incidence of visibility of the posterior tracheal band, posterior wall of the application of these signs available for diagnosis of specific diseases.
Self‐contained underwater breathing apparatus (scuba) diving is increasingly popular in Taiwan. There are few references in the literature regarding pulmonary hemorrhage as the sole manifestation of pulmonary barotrauma in scuba divers, and no study from Taiwan was found in the literature. We present the case of a 25‐year‐old man who suffered alveolar hemorrhage related to pulmonary barotrauma as a complication of scuba diving. To our knowledge, this is the first case report describing a Taiwanese subject suffering from non‐fatal pulmonary hemorrhage after scuba diving.
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