Journal of thoracic imaging
-
In recent years interventional radiology has played an increasingly important role in the diagnosis and treatment of lung cancer. Useful interventional procedures include biopsy techniques, direct infusion of chemotherapeutic agents into neoplasms, and a number of palliative procedures. The article reviews the indications, contraindications, techniques, and complications of these procedures with emphasis on some of the newer procedures.
-
The epidemiology of lung cancer in industrialized nations during the 20th century is a fascinating phenomenon. It is predicted that 161,000 new cases of lung cancer will be diagnosed in the United States in 1991. Lung cancer will cause 143,000 deaths in the United States in 1991, and it has surpassed breast cancer as the leading cause of cancer-related deaths in women. ⋯ The current attack on lung cancer is aimed at earlier detection, better understanding of its biology, or effective therapy, and prevention, the last of which is the key to controlling this disease. Medical historians of the future will surely be both amused by and disappointed in our efforts of the past five decades. Despite our knowledge of the most important causative factor in the development of lung cancer, our efforts to control this deadly epidemic have been paltry at best.
-
Thoracic empyema usually results from pulmonary infection or thoracic surgery. Antibiotic therapy is an essential part of the treatment, but surgical techniques to drain the pleural fluid and obliterate the empyema space often are required. ⋯ Emphasis is placed on a thorough understanding of the pathophysiology and natural history of empyema for selection and timing of appropriate treatment. Thoracic imaging techniques play a substantial role in the evaluation and treatment of empyema and in assessing the outcome of surgical therapy.
-
Review Case Reports
Congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a report of 10 cases and review of the literature.
Mounier-Kuhn syndrome is a congenital abnormality of the trachea and main bronchi characterized by atrophy or absence of elastic fibers and thinning of muscle, which allows the trachea and main bronchi to become flaccid and markedly dilated on inspiration with narrowing or collapse on expiration or cough. The abnormal airway dynamics and pooling of secretions in broad outpouchings of redundant musculomembranous tissue between the cartilaginous rings predispose to the development of chronic pulmonary suppuration, bronchiectasis, emphysema, and pulmonary fibrosis. ⋯ In men it is diagnosed when the transverse and sagittal diameters of the trachea exceed 25 mm and 27 mm, respectively, and when the transverse diameters of the right and left main bronchi exceed 21.1 mm and 18.4 mm, respectively. The diagnosis can be confirmed easily by computed tomography.
-
Plain film signs of COPD, spirometric evidence of airflow obstruction, and smoking history were correlated in a group of 182 men aged 32 to 85 years (average, 57.5 years) who presented for evaluation of possible pulmonary disability. There were 148 current or past smokers (range, 0.66 to 150 pack-years; average, 31.89 pack-years) and 34 lifetime nonsmokers. A single observer, who had no knowledge of the other parameters, prospectively evaluated posteroanterior chest radiographs for 11 signs of COPD. ⋯ We found a statistically significant association between smoking and airflow obstruction on spirometry (P less than 0.001) and an equally significant association between smoking and radiographic signs of COPD on plain chest films (P less than 0.001). Both airflow obstruction and radiologic signs of COPD were generally absent in lifetime nonsmokers. The plain film signs of COPD were only of moderate value in predicting spirometric evidence of airflow obstruction in smokers; spirometric evidence is not the gold standard for the presence of COPD, however, and the strong association between smoking and these radiologic signs may indicate that in smokers the presence of plain film signs of COPD reflects morphologic abnormality in the lungs indicative of disease.(ABSTRACT TRUNCATED AT 250 WORDS)