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Insights Into Imaging Oct 2021Congenital lung diseases in adults are rare diseases that can present with symptoms or be detected incidentally. Familiarity with the imaging features of different types... (Review)
Review
Congenital lung diseases in adults are rare diseases that can present with symptoms or be detected incidentally. Familiarity with the imaging features of different types of congenital lung diseases helps both in correct diagnosis and management of these diseases. Congenital lung diseases in adults are classified into three main categories as bronchopulmonary anomalies, vascular anomalies, and combined bronchopulmonary and vascular anomalies. Contrast-enhanced computed tomography, especially 3D reconstructions, CT, or MR angiography, can show vascular anomalies in detail. The tracheobronchial tree, parenchymal changes, and possible complications can also be defined on chest CT, and new applications such as quantitative 3D reconstruction CT images, dual-energy CT (DECT) can be helpful in imaging parenchymal changes. In addition to the morphological assessment of the lungs, novel MRI techniques such as ultra-short echo time (UTE), arterial spin labeling (ASL), and phase-resolved functional lung (PREFUL) can provide functional information. This pictorial review aims to comprehensively define the radiological characteristics of each congenital lung disease in adults and to highlight differential diagnoses and possible complications of these diseases.
PubMed: 34716817
DOI: 10.1186/s13244-021-01095-2 -
Lung India : Official Organ of Indian... 2021Mucoepidermoid carcinoma (MEC) is a primary salivary gland tumor also arising from nonsalivary gland organs of the body such as submucosal glands of tracheobronchial...
INTRODUCTION
Mucoepidermoid carcinoma (MEC) is a primary salivary gland tumor also arising from nonsalivary gland organs of the body such as submucosal glands of tracheobronchial tree. Surgical resection with negative margins is the treatment of choice. All efforts should be made to preserve as much lung parenchyma as possible, by various bronchoplastic procedures. We present our experience with mucoepidermoid tumors and review their management options including lung preservation techniques and outcome of surgery.
MATERIALS AND METHODS
This is a retrospective analysis of prospectively maintained data of 14 patients who underwent surgery for MEC. Their demographic data; clinical presentation; and preoperative, intraoperative, and postoperative details were recorded. All patients underwent contrast-enhanced computed tomography of chest and bronchoscopy as part of workup for diagnosis and to assess the location, size, and extent of tumor; extraluminal component; and status of distal lung parenchyma.
RESULTS
There were eight male and six female patients. The median age at the time of surgery was 28.36 years (range 22-45 years). The procedures performed included right upper lobectomy and right pneumonectomy in one patient each, left main bronchus sleeve resection in six patients, left upper sleeve lobectomy in three patients, and carinal resection and reconstruction of neo carina in three patients. Twelve (85.7%) of our patients underwent lung-preserving surgery. The median hospital stay and chest tube removal duration was 4 and 3 days, respectively. The median tumor size was 1.91 cm (range 1-8 cm). The median follow-up was 24 months (ranging from 6 to 78 months).
CONCLUSION
Radical surgery to achieve R "0" resection with aggressive emphasis on lung preservation is the mainstay of treatment of MEC. Greater awareness of these tumors is necessary to avoid misdiagnosis and to prevent delaying of potential complete resection of MEC.
PubMed: 33402633
DOI: 10.4103/lungindia.lungindia_511_20 -
Radiology Case Reports Sep 2021Tracheobronchial amyloidosis, manifested by amyloid deposits limited specifically to tracheal and bronchial tissue, is a rare manifestation with only a few hundred...
Tracheobronchial amyloidosis, manifested by amyloid deposits limited specifically to tracheal and bronchial tissue, is a rare manifestation with only a few hundred published cases. Patients classically present with symptoms related to fixed upper airway obstruction caused by tracheal stenosis. Clinical symptoms are non-specific and include hoarseness, dyspnea, cough, stridor, hemoptysis, and dysphagia, which are similar to those caused by more common airway disorders, often leading to incorrect, missed, and delayed diagnosis. The wide-spread use of computerized tomography (CT) imaging has the potential of dramatically advancing the early diagnosis of tracheobronchial amyloidosis. We present a case of a patient with chronic and progressive hoarseness, diagnosed with tracheobronchial amyloidosis, with a focus on unusually clear and precise CT soft tissue neck imaging. CT imaging demonstrated nodular circumferential raised mass-like thickening involving the long-segment posterior wall of the distal trachea. The wall thickening also extended into the proximal left main stem bronchi, but spared the distal bronchial tree. This resulted in moderate (approximately 50%) narrowing of the tracheal lumen, which explained the patient's hoarseness. Routine CT imaging of patients with chronic and progressive respiratory symptoms, including cough, hoarseness, and dyspnea, is recommended. Tracheobronchial amyloidosis is an uncommon disease, but it may become more commonly recognized with broader use of more effective CT imaging protocols.
PubMed: 34257768
DOI: 10.1016/j.radcr.2021.05.082 -
Hong Kong Medical Journal = Xianggang... Aug 2011Anastomotic leakage after oesophagectomy is a dreaded complication. It has a wide range of presentations ranging from the patient being totally asymptomatic to septic...
Anastomotic leakage after oesophagectomy is a dreaded complication. It has a wide range of presentations ranging from the patient being totally asymptomatic to septic with multi-organ failure. From the literature, in general, cervical anastomoses have a higher leakage rate than those that are intra-thoracic, but leaks from the latter confer greater morbidity. Cervical anastomotic leaks that are truly confined to the neck can be managed conservatively, but can extend into the mediastinum and result in more serious complications. Herein, we report on a patient with an oesophago-gastric anastomosis constructed in the neck but with extension into the mediastinum. Subsequently, the patient developed a fistulous erosion into the tracheobronchial tree, which was successfully managed endoscopically.
Topics: Aged; Anastomosis, Surgical; Bronchial Fistula; Esophageal Neoplasms; Esophagectomy; Humans; Male; Postoperative Complications
PubMed: 21813903
DOI: No ID Found -
Head and Neck Pathology Mar 2013Mucoepidermoid carcinoma (MEC), the most common salivary gland malignancy of the upper aerodigestive tract and tracheobronchial tree, is also known for its considerable... (Review)
Review
Mucoepidermoid carcinoma (MEC), the most common salivary gland malignancy of the upper aerodigestive tract and tracheobronchial tree, is also known for its considerable cellular heterogeneity including epidermoid, intermediate and mucin producing cells. Despite this structural and cellular heterogeneity, MEC is uniquely characterized by a specific translocation t(11; 19) (q12; p13), resulting in a fusion between the MECT1 and the MAML2 genes. Although the incidence of this fusion in MEC varies, it is generally accepted that more than 50 % of this entity manifest the MECT1-MAML2. Fusion-positive cases showed significantly better survival than fusion-negative cases, suggesting that MECT1-MAML2 represents a specific prognostic molecular marker in MEC. We contend that fusion in MEC represents a distinct mechanism in the development of this entity. In that context, fusion positive MEC, regardless of grade, manifest a more stable genome and better clinical behaviour, while fusion negative MEC represent a distinctly different pathway characterized by marked genomic instability and relatively aggressive tumors.
Topics: Carcinoma, Mucoepidermoid; Humans; Oncogene Proteins, Fusion; Salivary Gland Neoplasms
PubMed: 23459841
DOI: 10.1007/s12105-013-0432-5 -
Frontiers in Public Health 2023Tracheobronchial tuberculosis (TBTB) is a common form of extrapulmonary tuberculosis that affects the tracheobronchial tree. However, the mechanism has not been fully...
BACKGROUND
Tracheobronchial tuberculosis (TBTB) is a common form of extrapulmonary tuberculosis that affects the tracheobronchial tree. However, the mechanism has not been fully elucidated. Comparisons of clinical characteristics in various age groups can aid in the understanding of TBTB.
METHODS
This retrospective study was conducted at the Public Health Clinical Center of Chengdu between July 2017 and December 2021, including adults and children with TBTB. Clinical data were extracted from medical records. T/T' test, Mann-Whitney U test, Chi-square test, or Fisher's exact test were used in this study.
RESULTS
This study enrolled 347 patients with TBTB (175 adults and 172 children). Adult females were more susceptible to TBTB, whereas gender-based differences were not observed in children. Children had a higher occurrence of irritant dry cough and fever, and acute hematogenous disseminated PTB, and specific types of EPTB, but a shorter interval before diagnosis, and lower diagnostic yields compared to adults ( < 0.05). Adults presented more extensive lung lesions and cavitations as compared to children. Granulation hyperplasia and lymph fistula were more frequently observed in children, as well as airway stenosis, but less severe.
CONCLUSIONS
The study revealed important variations exist in multiple respects between adults and children with TBTB.
Topics: Female; Child; Humans; Adult; Retrospective Studies; Tuberculosis; China; Sex Factors; Tuberculosis, Extrapulmonary
PubMed: 37538277
DOI: 10.3389/fpubh.2023.1225267 -
Respiratory Research Nov 2023Airway tuft cells, formerly called brush cells have long been described only morphologically in human airways. More recent RNAseq studies described a chemosensory cell...
BACKGROUND
Airway tuft cells, formerly called brush cells have long been described only morphologically in human airways. More recent RNAseq studies described a chemosensory cell population, which includes tuft cells, by a distinct gene transcription signature. Yet, until which level in the tracheobronchial tree in native human airway epithelium tuft cells occur and if they function as regulators of innate immunity, e.g., by regulating mucociliary clearance, remained largely elusive.
METHODS
We performed immunohistochemistry, RT-PCR and immunoblotting analyses for various tuft cell markers to confirm the presence of this cell type in human tracheal samples. Immunohistochemistry was conducted to study the distribution of tuft cells along the intrapulmonary airways in humans. We assessed the influence of bitter substances and the taste transduction pathway on mucociliary clearance in mouse and human tracheal samples by measuring particle transport speed.
RESULTS
Tuft cells identified by the expression of their well-established marker POU class 2 homeobox 3 (POU2F3) were present from the trachea to the bronchioles. We identified choline acetyltransferase in POU2F3 expressing cells as well as the transient receptor potential melastatin 5 (TRPM5) channel in a small population of tracheal epithelial cells with morphological appearance of tuft cells. Application of bitter substances, such as denatonium, led to an increase in mucociliary clearance in human tracheal preparations. This was dependent on activation of the TRPM5 channel and involved cholinergic and nitric oxide signalling, indicating a functional role for human tuft cells in the regulation of mucociliary clearance.
CONCLUSIONS
We were able to detect tuft cells in the tracheobronchial tree down to the level of the bronchioles. Moreover, taste transduction and cholinergic signalling occur in the same cells and regulate mucociliary clearance. Thus, tuft cells are potentially involved in the regulation of innate immunity in human airways.
Topics: Humans; Mice; Animals; Mucociliary Clearance; Trachea; Signal Transduction; Taste; Cholinergic Agents
PubMed: 37925434
DOI: 10.1186/s12931-023-02570-8 -
Advances in Respiratory Medicine 2019Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases... (Review)
Review
Inhalation injury is a major cause of morbidity and mortality in patients with burns. Presence of airways injury adds to the need of fluid supplementation, increases risk of pulmonary complications. Due to many mechanisms involved in pathophysiology the treatment is complex. Among them the formation of fibrin casts inside airways constitutes a prominent element. The material residing in tracheobronchial tree causes ventilation-perfusion mismatch, complicates mechanical ventilation, provides a medium for bacterial growth. Many studies of animal models and single centre human studies investigated inhaled anticoagulation regimens employing heparin in management of inhalation injury. Simultaneously safety, especially in connection with possible bleeding risk, was the subject of research. The results suggest positive impact on treatment results, with low risk of side effects. This paper revise the available clinical data on inhaled heparin use in patients with burns.
Topics: Anticoagulants; Bronchial Diseases; Heparin; Humans; Smoke Inhalation Injury; Tracheal Diseases
PubMed: 31282560
DOI: 10.5603/ARM.2019.0029 -
Revista Portuguesa de Pneumologia 2012Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports...
INTRODUCTION
Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports of endobronchial myxoma.
CASE REPORT
We describe a case of endobronchial myxoma in a 40-year-old female patient with a history of asthma and repeated right-sided pneumonia. Thoracic computed tomography (CT) showed medium lobe atelectasis. Fiber optic bronchoscopy revealed a polypoid, well-circumscribed tumor, causing total obstruction of the medium lobe bronchus. Biopsy of the mass was non-diagnostic. Further study included a positron emission tomography (PET) which demonstrated low metabolic activity of the tumor and no evidence of neoplasia in other location. The patient was submitted to a medium lobectomy and microscopic examination of the tumor revealed myxoid stroma with lobulated pattern, elongated and stellate cells, compatible with myxoma.
CONCLUSION
Pulmonary myxoma is extraordinary rare and endobronchial location is very few reported in medical literature.
Topics: Adult; Bronchial Neoplasms; Female; Humans; Myxoma
PubMed: 22261261
DOI: 10.1016/j.rppneu.2011.12.004 -
World Journal of Radiology Dec 2015The tracheobronchial tree is a musculo-cartilagenous framework which acts as a conduit to aerate the lungs and consequently the entire body. A large spectrum of... (Review)
Review
The tracheobronchial tree is a musculo-cartilagenous framework which acts as a conduit to aerate the lungs and consequently the entire body. A large spectrum of pathological conditions can involve the trachea and bronchial airways. These may be congenital anomalies, infections, post-intubation airway injuries, foreign body aspiration or neoplasms involving the airway. Appropriate management of airway disease requires an early and accurate diagnosis. In this pictorial essay review, we will comprehensively describe the various airway pathologies and their imaging findings by multi-detector computed tomography.
PubMed: 26753061
DOI: 10.4329/wjr.v7.i12.459