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Clinical Nuclear Medicine Jun 2022This study aimed to summarize the clinical and 18F-FDG PET/CT manifestations of hilar tumor-induced pulmonary infarction.
PURPOSE
This study aimed to summarize the clinical and 18F-FDG PET/CT manifestations of hilar tumor-induced pulmonary infarction.
METHODS
A retrospective analysis was performed on patients with hilar masses who underwent FDG PET/CT scans between July 2015 and January 2021 and had complete clinical data. Pulmonary infarction was confirmed by concurrent chest CT and imaging follow-up or pathology.
RESULTS
A total of 58 patients (mean age, 56 [SD, 13] years; 44 males) with 122 infarcts were included in the study. Hilar masses were mostly associated with small cell lung cancer (64%). The most common clinical manifestations were cough (64%) and hemoptysis (36%). Most patients (62%) had multiple pulmonary infarcts. The CT findings of pulmonary infarcts included the "Hampton hump" (48%) and patchy consolidation (52%). The density of infarcts included "bubbly consolidation" (61%) and "homogenous consolidation" (39%). The metabolic activity of 95 infarcts (78%) was higher than lung parenchyma, with the SUVmax of 3.3 (SD, 1.1). The metabolic patterns on PET/CT were "rim sign," "mismatch between PET and CT," and "no metabolism." Pulmonary vein involvement was found in 25 patients (43%), pleural effusion in 22 patients (38%), and the pleural curvilinear sign in 8 patients (14%).
CONCLUSIONS
The clinical manifestations of hilar tumor-induced pulmonary infarction are not specific, and 18F-FDG PET/CT could be an effective diagnostic tool.
Topics: Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Pulmonary Infarction; Radiopharmaceuticals; Retrospective Studies; Small Cell Lung Carcinoma
PubMed: 35426843
DOI: 10.1097/RLU.0000000000004180 -
Revue Des Maladies Respiratoires Jan 2020Cocaine can be responsible for many psychiatric and/or somatic disorders. The aim of this systematic literature review of data was to expose relations between cocaine...
Cocaine can be responsible for many psychiatric and/or somatic disorders. The aim of this systematic literature review of data was to expose relations between cocaine use and pulmonary complications. Cocaine can be responsible for acute respiratory symptoms (cough, black sputum, hemoptysis, dyspnea, wheezing, chest pain) and for various pulmonary disorders including barotrauma (pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumopericardium), airway damage, asthma, bronchiolitis obliterans with organizing pneumonia, acute pulmonary edema, alveolar hemorrhage, alveolar pneumonia with carbonaceous material, bullous emphysema, acute eosinophilic pneumonia, pulmonary granulomatosis caused by talc or cellulose, interstitial pneumonitis and pulmonary fibrosis, vasculitis, pulmonary hypertension, pulmonary embolism and pulmonary infarction, mycotic pulmonary arterial aneurysms, septic emboli, aspiration pneumonia, community-acquired pneumonia, HIV-related opportunistic infections, latent tuberculosis infection, pulmonary tuberculosis, lung cancer and crack lung. Some of these complications are serious and may have a fatal outcome. Pulmonary function tests, thoracic tomodensitometry, bronchial fibroscopy with bronchoalveolar lavage and lung scintigraphy may be an aid to the diagnosis of these pulmonary compications. Cocaine use must be sought in case of respiratory symptoms in young persons.
Topics: Cocaine; Cocaine-Related Disorders; Drug Users; Humans; Lung Diseases
PubMed: 31883817
DOI: 10.1016/j.rmr.2019.11.641 -
International Journal of Molecular... Sep 2020Left heart disease is the main cause of clinical pulmonary arterial hypertension (PAH). Common types of left heart disease that result in PAH include heart failure, left... (Review)
Review
Left heart disease is the main cause of clinical pulmonary arterial hypertension (PAH). Common types of left heart disease that result in PAH include heart failure, left ventricular systolic dysfunction, left ventricular diastolic dysfunction and valvular disease. It is currently believed that mechanical pressure caused by high pulmonary venous pressure is the main cause of myocardial infarction (MI) in individuals with ischemic cardiomyopathy and left ventricular systolic dysfunction. In the presence of decreased cardiac function, vascular remodeling of pulmonary vessels in response to long‑term stimulation by high pressure in turn leads to exacerbation of PAH. However, the underlying pathological mechanisms remain unclear. Elucidating the association between the development of MI and PAH may lead to a better understanding of potential risk factors and better disease treatment. In this article, the pathophysiological effects of multiple systems in individuals with MI and PAH were reviewed in order to provide a general perspective on various potential interactions between cardiomyocytes and pulmonary vascular cells.
Topics: Animals; Humans; Lung; Myocardial Infarction; Myocytes, Cardiac; Pulmonary Arterial Hypertension
PubMed: 32582962
DOI: 10.3892/ijmm.2020.4650 -
The Journal of International Medical... Jan 2022Pulmonary embolism and splenic infarction are rare in patients with polycythemia vera. We herein describe a man in his early 60s whose main symptoms were chest...
Pulmonary embolism and splenic infarction are rare in patients with polycythemia vera. We herein describe a man in his early 60s whose main symptoms were chest tightness, cough, and sputum expectoration. Antibiotics, bronchodilators, and mucoactive agents did not improve his symptoms. Pulmonary artery computed tomography angiography showed pulmonary embolism, and abdominal computed tomography showed multiple hypodense foci in the spleen. Bone marrow aspiration cytology, biopsy, and genetic testing confirmed polycythemia vera. The patient's symptoms were relieved after treatment with hydroxyurea and rivaroxaban. This case emphasizes that although pulmonary embolism and splenic infarction are relatively rare in patients with polycythemia vera, the possibility of polycythemia vera should be considered in clinical practice.
Topics: Angiography; Humans; Male; Polycythemia Vera; Pulmonary Embolism; Splenic Infarction; Tomography, X-Ray Computed
PubMed: 35023386
DOI: 10.1177/03000605211072801 -
Current Opinion in Critical Care Oct 2014We aim to help clinicians to use and interpret high-sensitivity cardiac troponins (cTns) in different acute care settings. This guidance is timely and relevant as... (Review)
Review
PURPOSE OF REVIEW
We aim to help clinicians to use and interpret high-sensitivity cardiac troponins (cTns) in different acute care settings. This guidance is timely and relevant as high-sensitivity cTns are currently replacing conventional cTn assays in most parts of the world.
RECENT FINDINGS
cTn I and T are structural proteins unique to the heart. Detection of cTn in peripheral blood indicates cardiomyocyte injury. Although acute myocardial infarction is a very common, dangerous, but treatable and therefore clinically important cause of cardiomyocyte injury, multiple other acute conditions are associated with substantial amounts of cardiomyocyte injury and corresponding elevations in cTn. These include acute heart failure, tachyarrhythmias, pulmonary embolism, sepsis, shock, and noncardiac surgery. Recent advances in assay technology have led to more sensitive and precise cTn assays that now allow the detection and exact quantification of cardiomyocyte injury also in many predominately noncardiac acute conditions.
SUMMARY
In all of these, elevated levels of high-sensitivity cTn are associated with increased mortality risk. In some of these, concepts are evolving as to how the pathophysiological signal of cardiomyocyte injury could be used to alter patient management and potentially improve outcomes.
Topics: Acute Disease; Biomarkers; Diagnosis, Differential; Early Diagnosis; Heart Failure; Humans; Myocardial Infarction; Myocytes, Cardiac; Pulmonary Embolism; Risk Assessment; Sensitivity and Specificity; Troponin I; Troponin T
PubMed: 25159476
DOI: 10.1097/MCC.0000000000000132 -
The Clinical Respiratory Journal Jun 2021Pulmonary infarction (PI) shares similar symptoms and imaging presentations with community-acquired pneumonia (CAP), which might delay diagnosis and lead to devastating...
INTRODUCTION AND OBJECTIVES
Pulmonary infarction (PI) shares similar symptoms and imaging presentations with community-acquired pneumonia (CAP), which might delay diagnosis and lead to devastating consequences. Noncontrast computed tomography (CT) is the first-line examination for the patients with the respiratory symptoms. This study aimed to investigate a radiomics method to differentiate PI from CAP using noncontrast-enhanced CT.
METHODS
Noncontrast-enhanced CT images of 54 patients with PI and 64 patients with CAP were retrospectively selected. All patients were confirmed using computed tomography pulmonary angiography (CTPA). A radiomics model was built with 18 texture features that showed significant differences between PI and CAP patients. For comparison, a clinical model using clinical biomarkers and an integrated model combining the radiomics and clinical biomarkers were also generated. An experienced radiologist performed diagnoses using the noncontrast-enhanced CT images. The parameters of the models were generated using a training dataset of 61 patients, whereas the performance of the models was evaluated using receiver operating characteristic (ROC) analysis and Harrell's concordance index (C-index) applied to a separate validation dataset of 57 patients.
RESULTS
The integrated model achieved the best performance (C-index 0.760, sensitivity 0.703, specificity 0.867, positive predictive value [PPV] 0.826, and negative predictive value [NPV] 0.765). The radiomics model was better than both the clinical model and the radiologist's interpretations (C-index 0.721, 0.707, 0.665, respectively; sensitivity 0.667, 0.630, 0.593; specificity 0.800, 0.785, 0.733; PPV 0.750, 0.739, 0.667; and NPV 0.727, 0.706, 0.667).
CONCLUSIONS
Radiomics features generated from noncontrast-enhanced CT images allow PI to be differentiated from CAP with considerable accuracy. The radiomics-based method could provide useful information in clinical practice.
Topics: Humans; Pneumonia; Pulmonary Infarction; ROC Curve; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 33686798
DOI: 10.1111/crj.13341 -
The Lancet. Respiratory Medicine May 2024
Topics: Humans; Pulmonary Disease, Chronic Obstructive; Myocardial Infarction; Risk Factors
PubMed: 38437859
DOI: 10.1016/S2213-2600(24)00038-9 -
Heart, Lung & Circulation Apr 2019
Topics: Aged; Female; Humans; Non-ST Elevated Myocardial Infarction; Pulmonary Embolism; Syncope; Tomography, X-Ray Computed
PubMed: 30389365
DOI: 10.1016/j.hlc.2018.10.008 -
Seminars in Thrombosis and Hemostasis Feb 2016Allergic diseases are very frequent conditions worldwide. The pathogenesis of allergic reactions and venous thromboembolism (VTE) shares several risk factors and... (Review)
Review
Allergic diseases are very frequent conditions worldwide. The pathogenesis of allergic reactions and venous thromboembolism (VTE) shares several risk factors and predisposing conditions. In particular, the concentration of immunoglobulin E (IgE) is considerably increased in patients with allergic diseases, and this immunoglobulin exert many prothrombotic and antifibrinolytic activities, especially through interaction with mast cells. Therefore, this narrative review is aimed to provide an overview of the current scientific evidence supporting a potential relationship between allergy and the risk of VTE. Although no prospective studies have been published so far, the evidence provided by six large cross-sectional studies and several case reports support the existence of an unquestionable epidemiological association between different allergic diseases (especially atopy, asthma, and celiac disease) and venous thrombosis. Two additional investigations reported that the concentration of IgE might predict the onset of severe complications of pulmonary embolism such as pulmonary infarction and pleural fluid accumulation. Therefore, the existence of a convincing epidemiologic link between allergy and VTE paves the way to future investigations aimed to establish whether the prevention or treatment of allergic diseases might be regarded as an effective measure to lower the risk of VTE.
Topics: Cross-Sectional Studies; Female; Humans; Hypersensitivity; Immunoglobulin E; Male; Mast Cells; Pulmonary Infarction; Venous Thromboembolism
PubMed: 26716499
DOI: 10.1055/s-0035-1568876 -
Diagnostic and Interventional Imaging Jan 2017The complications following surgery for lung cancer vary depending upon the comorbidities and the type of surgery. Hemorrhage, infections and pulmonary edemas are not... (Review)
Review
The complications following surgery for lung cancer vary depending upon the comorbidities and the type of surgery. Hemorrhage, infections and pulmonary edemas are not specific to the type of resection but frequently occur following pneumonectomies. Morbidity following pneumonectomies is related to the significant changes in the contents of the intrathoracic space. Pulmonary infarction and torsion are emergency situations that develop following lobectomy. CT shows features of localized congestion and stenosis or occlusion of a vein or bronchus. Rapid identification of severe events, in particular by systematic CT is essential for appropriate management of a postoperative or delayed complication of lung cancer surgery.
Topics: Arterial Occlusive Diseases; Chylothorax; Diaphragm; Empyema, Pleural; Foreign Bodies; Heart Diseases; Hernia; Humans; Lung Neoplasms; Mononeuropathies; Neoplasm Recurrence, Local; Phrenic Nerve; Pneumonectomy; Postoperative Complications; Pulmonary Edema; Pulmonary Embolism; Pulmonary Infarction; Torsion Abnormality
PubMed: 26342532
DOI: 10.1016/j.diii.2015.06.022