Clinics in chest medicine
-
Pulmonary involvement is a frequent manifestation of connective tissue disease (CTD)-related thoracic disease. It is important to characterize the underlying pattern when pulmonary involvement occurs in a patient with CTD, and to exclude other causes. ⋯ In complex cases, a multidisciplinary approach should be considered, potentially including the pulmonologist, rheumatologist, radiologist, pathologist, and sometimes the infectious disease specialist or oncologist. New techniques, such as quantitative computed tomography and MRI, are expected to be helpful for evaluation and management of CTD-associated thoracic disease.
-
Clinics in chest medicine · Jun 2015
ReviewLow-dose computed tomographic screening for lung cancer.
Low-dose computed tomographic (LDCT) screening is now moving from clinical trials to clinical practice, following the report from the National Lung Screening Trial that LDCT screening for lung cancer can reduce the number of deaths from lung cancer by 20% in current and former smokers, ages 55 to 74 years, with a 30 pack-year smoking history. This article reviews the current evidence for screening, key elements of a successful lung cancer screening clinic, and reporting and management guidelines for LDCT screening findings.
-
Diffuse cystic and nodular lung diseases have characteristic imaging findings. The most common causes of cystic lung disease are lymphangioleiomyomatosis and Langerhans cell histiocytosis. ⋯ Diffuse nodular lung disease are categorized as centrilobular, perilymphatic, and random types. In diffuse nodular lung disease, a specific diagnosis is achieved through a combination of history, physical examination, and imaging findings.
-
Clinics in chest medicine · Mar 2015
ReviewPathogenesis and risk factors for nontuberculous mycobacterial lung disease.
Nontuberculous mycobacteria (NTM) infections are broadly classified as skin and soft tissue infections, isolated lung disease, and visceral or disseminated disease. The degree of underlying immune abnormalities varies between each classification. ⋯ Visceral and disseminated NTM disease invariably occurs in individuals with more severe immunosuppression. Although the focus of this article is to discuss the pathogenesis of NTM lung disease, the risk factors of visceral/disseminated NTM disease are also summarized, as they provide insights into host-defense mechanisms against these organisms.
-
Clinics in chest medicine · Mar 2015
ReviewEpidemiology of human pulmonary infection with nontuberculous mycobacteria: a review.
Population-based data have documented a worldwide increase in the prevalence of human nontuberculous mycobacterial (NTM) infections since 2000. Mycobacterium avium complex is predominant in North America and East Asia, whereas in regions within Europe, M kansasii, M xenopi, and M malmoense are more common. ⋯ Clustering of disease within families suggests a heritable genetic predisposition to disease susceptibility. Warm, humid environments with high atmospheric vapor pressure contribute to population risk.