Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Jan 2022
Endosonographic predictors of malignancy in a left adrenal gland in lung cancer patients - a comparison of EUS-b, CT and PET-CT.
Patients with resectable lung cancer require invasive evaluation of the enlarged left adrenal gland (LAG). Few studies showed the utility of endoscopic ultrasound using ultrasound bronchoscope (EUS‑B) in LAG assessment. Moreover, little is known on the combination of computed tomography (CT), positron emission tomography-computed tomography (PET‑CT), and EUS‑B for predicting left adrenal metastasis. ⋯ Hypoechogenicity and loss of sea‑gull shape on EUS‑B are the most reliable predictors of left adrenal metastasis. The combination of CT, PET‑CT, and EUS‑B improves the noninvasive diagnosis of left adrenal metastases in lung cancer patients.
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While bronchiectasis is an old condition, it is only in the last decade that there have been major strides in our understanding of this disease and its treatment. Recent evidence has shown that the "vicious cycle" hypothesis remains valid. This, and the concept of "treatable traits," provide useful frameworks on which to base the management of this condition. ⋯ While airway clearance strategies remain the mainstay of therapy, other treatments including nebulized hypertonic saline and inhaled antibiotic treatment are discussed. Greater emphasis is being placed on immune‑modulatory therapies, not just long‑term macrolide therapy but other more innovative strategies. The role of surgical lung resection in the management of this condition is also discussed.