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Glasgow Medical Journal May 1866
PubMed: 30432623
DOI: No ID Found -
Molecular Imaging and Biology Feb 2023One of the novel advancements to enhance the visual aspects of lung cancer identification is intraoperative molecular imaging (IMI), which can reliably detect tumors...
BACKGROUND
One of the novel advancements to enhance the visual aspects of lung cancer identification is intraoperative molecular imaging (IMI), which can reliably detect tumors that would otherwise be missed by standard techniques such as tactile and visual feedback, particularly for sub-centimeter or ground-glass nodules. However, there remains a subset of patients who do not benefit from IMI due to excessive background fluorescence secondary to parenchymal light-absorbing carbon deposition. Our goal was to identify the effects of these carbonaceous materials on the quality of IMI-guided lung cancer resections.
STUDY DESIGN AND METHODS
Between July 2014 and May 2021, a total of 311 patients were included in the study. Patients underwent infusion of the study drug OTL38 or ICG up to 24 h prior to VATS for lung cancer. Several factors such as age, tumor subtype, PET SUV, smoking, demographics, chronic lung conditions, patient domicile, and anthracosis were analyzed with respect to lung fluorescence during IMI. P values < 0.05 were considered statistically significant.
RESULTS
Variables such as age, sex, and race had no statistical correlation to IMI success. However, smoking status and pack year had a statistically significant correlation with background parenchymal fluorescence and lung inflammation (p < 0.05). MFI of background (lung parenchyma) correlated with smoking history (p < 0.05) which led to decreased tumor-to-background ratio (TBR) measurements for all patients with proven malignancy (p < 0.05). Patients with chronic lung disease appear to have increased background parenchymal fluorescence regardless of smoking history (287 vs. 154, p < 0.01). City dwellers compared to other groups appear to be exposed to higher pollutant load and have higher rates of anthracosis, but living location's impact on fluorescence quantification appears to be not statistically significant.
CONCLUSION
Smokers with greater than 10 PPY and those with chronic lung disease appear to have decreased lesion-to-background discrimination, significant anthracosis, and reduced IMI efficacy secondary to light-absorbing carbon deposition.
Topics: Humans; Lung Neoplasms; Lung; Molecular Imaging; Anthracosis
PubMed: 35290565
DOI: 10.1007/s11307-021-01699-6 -
Glasgow Medical Journal Sep 1866
PubMed: 30432586
DOI: No ID Found -
Archives of Iranian Medicine Jun 2021Tracheobronchomalacia (TBM), presenting with the softening of the walls of trachea and bronchi, can cause respiration problems. Despite the importance of TBM, data on...
BACKGROUND
Tracheobronchomalacia (TBM), presenting with the softening of the walls of trachea and bronchi, can cause respiration problems. Despite the importance of TBM, data on its prevalence and related factors are limited. In the current study, the prevalence and predictive factors of this illness were investigated.
METHODS
This cross-sectional study was conducted on patients who were bronchoscopy candidates in the diagnostic department of pulmonary diseases in Afzalipour hospital in Kerman, Iran, from May 2017 to May 2018. First, all patients diagnosed with TBM were assessed based on their demographic variables, spirometry indices, anthracofibrosis and TBM severity. TBM was defined as a 50% or higher decrease in the diameter of the main tracheal and bronchial walls on expiration. These patients constituted the case group. Other patients for whom the bronchoscopy findings were not in concordance with TBM were selected through convenience sampling as control group to equal the number of patients in the case group. Data were analyzed using SPSS version 23.
RESULTS
In this study, 132 (9.38%, 95% CI: 8-11) of the total 1406 cases who underwent bronchoscopy had tracheomalacia. Also, 22 patients (16.66%) had bronchomalacia, at the same time. Based on the multivariable logistic test results, age ( = 0.03, 95% CI: 1.00-1.04, OR = 1.02) and having anthracofibrosis (<0.0001, 95% CI: 1.26-4.68, OR = 2.43) were identified as predictive factors for tracheomalacia.
CONCLUSION
The findings of the present study suggest that the presence of anthracotic plaques can be considered as a possible predictive factor for TBM.
Topics: Bronchi; Bronchoscopy; Cross-Sectional Studies; Humans; Retrospective Studies; Tracheobronchomalacia
PubMed: 34488309
DOI: 10.34172/aim.2021.67 -
Cureus Dec 2022Anthracosis is an environmental lung disease caused by carbon deposition and pigmentation in the airways. However, in rare instances, it can also have systemic...
Anthracosis is an environmental lung disease caused by carbon deposition and pigmentation in the airways. However, in rare instances, it can also have systemic involvement. We present a patient with B-symptoms and diffuse lymphadenopathy who was diagnosed with the infrequently described nodal anthracosis. A 64-year-old Vietnamese gentleman with a 50-pack-year smoking history who was recently diagnosed with prostate cancer post-radical prostatectomy and awaiting radiation therapy presented with generalized weakness, low-grade fever, night sweats, and unquantifiable weight loss for a month. He was hemodynamically stable, and examination revealed bilateral inguinal and axillary lymphadenopathy. Computed tomography (CT) showed diffuse lymphadenopathy involving the mediastinum, hilar, axillary, mesenteric, retroperitoneal, and bilateral iliac chains with multiple diffuse pulmonary nodules. Laboratories disclosed anemia, thrombocytopenia, elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), albumin-globulin (A-G) reversal, and sterile blood cultures. The disseminated intravascular coagulation panel was negative with normal fibrinogen and mildly elevated D-dimer. Autoimmune workup, including antinuclear antibody (ANA), was negative. Infectious workup included , , , Lyme serology, QuantiFERON-TB Gold, HIV, and hepatitis panel, and all were negative. He was managed with broad-spectrum antibiotics, which were discontinued after a negative infectious workup. He also complained of a new-onset holocranial headache with no features of meningitis; an MRI with contrast revealed focal occipital leptomeningeal involvement and cerebral edema with occipital lymphadenopathy. A lumbar puncture was planned but deferred at the patient's request. An excisional lymph node biopsy of the left axillary lymph node revealed reactive follicular hyperplasia with no evidence of malignancy, with flow cytometry negative for any evidence of B- or T-cell malignancies. He continued to have persistent low-grade fevers. A bone marrow biopsy showed 70% cellularity with paratrabecular interstitial lymphoid aggregates composed of both T and B cells, which was nonspecific, and flow cytometry could not be done due to dry tap. An F-18-fluorodeoxyglucose positron emission tomography (FDG PET) scan showed extensive hypermetabolic disease both above and below the diaphragm with bulky mediastinal adenopathy and splenomegaly. Subsequently, he underwent a mediastinoscopy and biopsy of the mediastinal lymph nodes, which demonstrated reactive hyperplasia and abundant anthracitic pigment on microscopic examination, consistent with the diagnosis of nodal anthracosis. He was managed conservatively, discharged, and found to have spontaneously resolved symptoms at a six-week follow-up. Nodal anthracosis with PET-positive mediastinal and hilar lymphadenopathy is a rare presentation of anthracosis that mimics infectious conditions, granulomatous diseases, and malignancies. The pigment deposition can cause persistent inflammatory activity and should be considered an infrequent but important explanation of lymphadenopathy in patients without known biomass exposure.
PubMed: 36654579
DOI: 10.7759/cureus.32495 -
Cureus May 2022Background Anthracosis may cause a positron emission tomography/computed tomography (PET/CT) false positivity in mediastinal and hilar lymph nodes. We aimed to evaluate...
Background Anthracosis may cause a positron emission tomography/computed tomography (PET/CT) false positivity in mediastinal and hilar lymph nodes. We aimed to evaluate the radiological features and the maximum standardized uptake values (SUVmax) of the mediastinal lymph nodes with anthracosis or squamous cell lung cancer metastasized. Methodology Patients diagnosed with anthracosis or squamous cell lung cancer with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) between January 1, 2015, and November 15, 2020, in a tertiary hospital were enrolled. The squamous cell subtype of lung cancer was selected due to its association with tobacco use, biomass, and air pollution. Anthracosis may occur due to the same etiologic reasons. Results A total of 190 patients met the study enrollment criteria, of which 86 were diagnosed with anthracosis and 33 with squamous cell lung cancer lymph metastasis. Median values for short axis, long axis, SUVmax, shape features, and presence of calcification were found significantly different between the groups. In receiver operating characteristic (ROC) analysis, the SUVmax cut-off value was calculated as 6.61. With this cutoff value, the negative predictive value (NPV) was 92.5% and the positive predictive value (PPV) was 54% for differentiating anthracosis and malignant lymph nodes metastasis. Conclusions We conclude that the evaluation of the shape and metabolic activities of the anthracotic lymph nodes detected by PET/CT together with EBUS-TBNA granted a more accurate staging of the patients and more cancer patients will benefit from surgical treatment.
PubMed: 35698679
DOI: 10.7759/cureus.24884 -
Tuberkuloz Ve Toraks Dec 2022Anthracosis is a kind of pneumoconiosis that may cause parenchymal and bronchiolar injury and mediastinal lymphadenopathy. In this study, we aimed to investigate F-18...
INTRODUCTION
Anthracosis is a kind of pneumoconiosis that may cause parenchymal and bronchiolar injury and mediastinal lymphadenopathy. In this study, we aimed to investigate F-18 fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) findings of patients who had anthracosis diagnosis with endobronchial ultrasonography (EBUS).
MATERIALS AND METHODS
The patients who underwent EBUS-transbronchial needle aspiration (TBNA) and were diagnosed with anthracosis in a five year period were included in the study. The diagnosis was confirmed by surgery/ radiological stability. Demographic characteristics such as age, sex, smoking status, and occupational and environmental exposures were recorded. The characteristics: diameter (short axis), shape, central hilar structure, necrosis sign, echogenicity, and margins measured by EBUS, and maximum standardized uptake value (SUV max value) by PET/CT of the lymph node stations were evaluated.
RESULT
One hundred thirty-three patients with 239 lymph node stations were investigated. Biomass exposure was detected in nearly half of the patients (n= 55, 41.4%) and occupational exposure was detected in 32 (24.1%) patients. Eighty-six (64.7%) patients had more than 20 packs/years of smoking history. Most of the lymph nodes (80.8%) have a higher PET/CT SUV max value than 2.5. The mean diameter of the lymph nodes measured by thorax CT (16.2 ± 6.5 mm) and EBUS (12.7 ± 5.6 mm) did not show any difference according to PET/CT SUV max value of ≥2.5 or not (p> 0.05). Subcarinal lymph nodes were significantly larger than the other lymph node stations. The lymph nodes with necrosis sign (p= 0.028), absence of central hilar structure (p= 0.013), and heterogeneous echogenicity (p= 0.008) were statistically significantly related to higher SUV max value.
CONCLUSIONS
Anthracosis should be considered as a cause of false-positive PET/CT results for mediastinal lymph nodes, especially in patients with a history of occupational and environmental exposure including biomass and smoking.
Topics: Humans; Positron Emission Tomography Computed Tomography; Fluorodeoxyglucose F18; Lymphadenopathy; Positron-Emission Tomography; Tomography, X-Ray Computed; Lymph Nodes; Anthracosis; Lung Neoplasms; Neoplasm Staging
PubMed: 36537087
DOI: 10.5578/tt.20229601 -
European Journal of Case Reports in... 2020Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology. Virtually any organ or system can be involved, resulting in a wide range of clinical...
UNLABELLED
Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology. Virtually any organ or system can be involved, resulting in a wide range of clinical presentation. Pleural sarcoidosis is rare. Pleural effusion can only be attributed to pleural sarcoidosis in the presence of pleural non-caseating epithelioid granulomas and after excluding other granulomatous diseases. Anthracosis is a pneumoconiosis associated with thoracic adenopathies and bronchial disease, and it is usually asymptomatic. The authors present a case of a middle-aged man hospitalized due to cough, right-sided pleuritic chest pain and trepopnoea.
LEARNING POINTS
To pursue a systematic and exhaustive investigation of pleuraleffusion until a definitive diagnosis is established.To recognize atypical presentations of sarcoidosis with a high degree of suspicion whenever the initial investigation is inconclusive.
PubMed: 32399439
DOI: 10.12890/2020_001479 -
Lung India : Official Organ of Indian... 2015Anthracosis is the black pigmentation of the mucosal lining of the tracheo-bronchial tree. The significance of this finding is not known and often ignored. The aim of...
BACKGROUND
Anthracosis is the black pigmentation of the mucosal lining of the tracheo-bronchial tree. The significance of this finding is not known and often ignored. The aim of the present study is to find the association of anthracosis with demographic variables, biomass fuel and occupational exposure, respiratory diseases, radiological pattern and functional morbidity.
MATERIALS AND METHODS
Enrolment of the subjects for the study was done at SMS hospital, Jaipur. Patients with anthracosis evident on bronchoscopy were included as the cases. Patients without anthracosis on bronchoscopy, matched according to age, gender and smoking habits, were included in the control group. Subjects in both the arms completed a questionnaire and also underwent computed tomography (CT) of the chest and six minute walk test (6MWT).
RESULTS
Thirty cases and 53 controls were included in the study. The patients with anthracosis presented with symptoms ranging from cough (76.65%), hemoptysis (46.6%), fever (26.6%), dyspnea (90%) and malaise (73.3%). Biomass fuel exposure for the cases was 35.13 ± 55.86 hours in a year and for the controls was 28.15 ± 40.09 hours in a year (P > 0.05). Stone mining was significantly associated with anthracosis (P < 0.05). CT chest revealed fibrosis (43.3%), consolidation (33.3%), cavitation (16.6%) and mass (46.6%) in the cases. Sixty percent of cases and 15% of controls were diagnosed to have either old or active pulmonary tuberculosis (P < 0.05).
CONCLUSIONS
Anthracosis is associated with pulmonary tuberculosis. Biomass exposure is not significantly associated with anthracosis. Post tubercular fibrosis is more common on CT chest of patients with anthracosis.
PubMed: 25814792
DOI: 10.4103/0970-2113.152614 -
Thoracic Research and Practice Jul 2023A rare case of a patient with chronic obstructive pulmonary disease who developed secondary anthracofibrosis to biomass exposure, fibrosing mediastinitis due to...
A rare case of a patient with chronic obstructive pulmonary disease who developed secondary anthracofibrosis to biomass exposure, fibrosing mediastinitis due to anthracotic enlarged lymph nodes in the mediastinum, and pulmonary hypertension because of compres- sion of the lymph nodes on the pulmonary arteries is presented. This is a case report of a 71-year-old female patient who has been followed up with chronic obstructive pulmonary disease for 10 years, has no history of smoking, and has been exposed to biomass for many years. The patient, who had been hospitalized in various centers for the last 3 years due to progressive shortness of breath and dry cough, applied to us with dry cough and dyspnea complaints. On echocardiography, systolic pulmonary arterial pressure was found to be 59 mmHg. For the etiology of pulmonary hypertension, dual-energy thoracic computed tomography was performed with the suspicion of chronic thromboembolic pulmonary hypertension. No filling defect compatible with thromboembolism was detected. In right heart catheterization, mean pulmonary artery pressure was 27 mmHg, pulmonary capillary tip pressure was 7 mmHg, and pulmonary vascular resistance was 3.71 woods units. Endobronchial ultrasound was applied to the patient with the preliminary diagnoses of lymphoma, anthracosis, fibrosing mediastinitis, and infection. Widespread anthracosis was observed in all lobes and segments macroscopically. The lymph node in the subcarinal area was interpreted as anthracotic lymph node. Anthracosis is defined as black pigmentation involving the mucosal, and submucosal layers of the tracheobronchial tree and the lung parenchyma. If anthracosis is associated with luminal obliteration and/or mucosal proliferation causing obstruction, it is considered anthracofibrosis. In this case, we saw that secondary anthracofibrosis, fibrosing mediastinitis due to anthracotic enlarged lymph nodes in the mediastinum, and pulmonary hypertension may develop because of compression of the lymph nodes on the pulmonary arteries, and we wanted to draw attention to it was a rare case.
PubMed: 37485714
DOI: 10.5152/ThoracResPract.2023.22110