Advances in respiratory medicine
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Review
IPF and CPFE - the two different entities or two different presentations of the same disease?
In this article the co-existence of pulmonary emphysema with lung fibrosis of typical pattern and distribution for usual interstitial pneumonia (UIP) was compared with idiopathic pulmonary fibrosis (IPF) alone. Author discusses the etiopathogenesis of these diseases, differences in signaling pathways and the role of senescent cells. Moreover, clinical course, pulmonary function tests as well as main complications are reviewed. However, the lack of well-established diagnostic criteria for CPFE along with mainly retrospective character of the studies make current knowledge about this entity rather deficient.
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Inflammatory myofibroblastic tumors (IMT) of the lung, first reported in 1939, are considered a subset of inflammatory pseudo -tumors. They are a distinctive lesions composed of myofibroblastic spindle cells accompanied by an inflammatory infiltrate of plasma cells, lymphocytes, and eosinophils. IMTs may be benign, invade surrounding structures, undergo malignant transformation, recur or may even metastasize. ⋯ Patients may be asymptomatic, or present with cough, hemoptysis, dyspnea, pleuritic pain, constitutional symptoms or pneumonia. In this article we review the pathophysiology, genetics, clinical presentation, imaging findings of IMT of the lung. We also discuss the various surgical and non-surgical treatment options and the prognosis associated with this disease.
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Castleman's disease is a rare benign lymphoproliferative disorder of unknown etiology. The disease occurs in two clinical forms with different prognoses, treatments and symptoms: a unicentric form (UCD), which is solitary, localized, and a multicentric form characterized by generalized lymphadenopathy and systemic symptoms. This article aims to review the current literature to consolidate the evidence surrounding the curative potential of surgical treatment to the unicentric type. ⋯ We conclude that surgical resection appears to be the most effective treatment for Unicentric Castleman's Disease of the thoracic cavity. Radiotherapy can also achieve clinical response and cure in selected patients.
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Chest X-ray (CXR) has been used since long as an aid in the diagnosis of pulmonary tuberculosis (PTB) and also to determine the extent of the disease. The present study was conducted to evaluate the correlation of disease extent on CXR basing on the Timika CXR score with clinical and microbiological parameters at baseline, in sputum positive cases of pulmonary tuberculosis. ⋯ Cavitary disease on CXR is associated with a higher mycobacterial load at baseline. The Timika CXR score is a simple, standard scoring system which can be used by a chest physician in a clinical setting. The CXR score significantly correlates with a broad range of clinical and microbiological measures of disease severity in PTB patients. Thus, it has a role in risk stratification, especially in patients not producing sputum or sputum negative PTB at diagnosis.
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Transthoracic ultrasound has lately emerged as a useful diagnostic tool for respiratory physicians in the diagnosis of diverse pulmonary diseases, usually including pleural effusion and pneumothorax. However, the use of chest ultrasound may be also critical in the evaluation of chest wall diseases. Therefore, we present an interesting case of a patient with metastases of lung cancer to the rib, detected during the chest wall ultrasound examination. By representing a non-invasive, surface-imaging technique with several advantages, chest ultrasound may evolve to a valid, bed-side diagnostic tool for the diagnosis and follow up of lung cancer with metastases in the chest wall.