Comment on Adar et al, page 106 - 114 Calcifications in the aortic arch on chest x-ray - Incidental finding or valuable surrogate marker for cardiovascular risk?

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

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Typical Asthmatic Presentation of Congenital Vascular Ring Can Masquerade a General Physician

Case Reports in Vascular Medicine ◽

10.1155/2013/934790 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

Naveen Swami ◽

Georgey Koshy ◽

Maan Jamal ◽

Thair S. Abdulla ◽

Abdulaziz Alkhulaifi

Keyword(s):

Aortic Arch ◽

Vascular Ring ◽

Chest Ct ◽

General Physician ◽

Ligamentum Arteriosum ◽

Tracheal Compression ◽

X Ray ◽

Chest X Ray

A 24-year-old woman was referred to pulmonologist with worsening breathlessness and wheeze. During childhood, she was diagnosed with asthma and subsequent exacerbations were treated with bronchodilators for many years. The chest X-ray and a spirometry testing raised a doubt of extrinsic tracheal compression and a subsequent enhanced chest CT (computerized tomogram) scan confirmed a right-sided aortic arch and a vascular ring anomaly compressing the trachea. Standard surgical division of ligamentum arteriosum was able to relieve the trachea and so the symptoms.

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Novel use of the endobronchial ultrasound through esophagus (EUS-B): Diagnosis of thyroid lesions

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1275 ◽

2020 ◽

Vol 90 (2) ◽

Author(s):

Mario Tamburrini ◽

Parikshit Thakare ◽

Umberto Zuccon

Keyword(s):

Computed Tomography ◽

Thyroid Gland ◽

Incidental Finding ◽

Lung Nodule ◽

Endobronchial Ultrasound ◽

X Ray ◽

First Case ◽

Chest X Ray ◽

Thyroid Lesions

There is paucity in literature on the use of endobronchial ultrasound through esophagus (EUS-B) for the diagnosing thyroid gland lesions. We report the first case of colloid goiter diagnosed using EUS-B- FNA technique. A 77-year-old man presented with ophthalmic symptoms and an incidental finding of lung nodule on chest x-ray. The computed tomography of thorax revealed a left upper lobe nodule and an oval shaped left paratracheal lesion near left pole of thyroid gland. EUS-B- FNAC was performed which lead to the diagnosis of colloid goiter.

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Importance of pre-operative recognition of the nonrecurrent laryngeal nerve

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126957 ◽

1994 ◽

Vol 108 (5) ◽

pp. 417-419 ◽

Cited By ~ 19

Author(s):

Ikuo Nagayama ◽

Yozo Okabe ◽

Hideaki Katoh ◽

Mitsuru Furukawa

Keyword(s):

Aortic Arch ◽

Thyroid Surgery ◽

Decisive Role ◽

Laryngeal Nerve ◽

Barium Swallow ◽

X Ray ◽

Aortic Arch Anomaly ◽

Abnormal Shadow ◽

Chest X Ray ◽

Nonrecurrent Laryngeal Nerve

AbstractThe nonrecurrent laryngeal nerve is vulnerable during thyroid surgery. Pre-operative recognition of this nerve allows surgeons to avoid injuring the nerve. This anomaly depends upon the aortic arch anomaly and, therefore, in some cases, surgeons are able to predict the presence of this nerve pre-operatively by chest X-ray or barium swallow. Two patients with nonrecurrent laryngeal nerve are reported, one of whom, a 48-year-old man, had an abnormal shadow of the aortic arch, which led to confirmation of a right aberrant subclavian artery. Barium swallow plays a decisive role in the diagnosis of nonrecurrent laryngeal nerve, and this test is mandatory in patients who complain of difficulty in swallowing.

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Health and quality of life (QOL) issues in four groups of lung cancer patients: Low-dose computed tomography (LDCT) screened, chest x-ray detected, incidentally found, and routinely diagnosed.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1610 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1610-1610

Author(s):

Ping Yang ◽

Kathleen J. Yost ◽

Matthew M. Clark ◽

Mariza de Andrade ◽

Katherine M. Piderman ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Patients ◽

Low Dose ◽

Incidental Finding ◽

X Ray ◽

Lung Cancer Patients ◽

Patient Reported ◽

Chest X Ray ◽

Low Dose Computed Tomography

1610 Background: Low dose computed tomography (LDCT) scans have reduced lung cancer deaths by 20.3% in high risk populations, although there is an unknown balance between the benefits and harms of LDCT scans as a screening tool. Our purpose was to compare health-related QOL issues among lung cancer patients who were initially detected by LDCT scans; 4 comparison groups included: lung cancer diagnosed by a screening chest X-ray, as an incidental finding from procedures taken for other medical reasons, or based on symptoms indicative for lung cancer and routinely diagnosed, and individuals who were LDCT screened but found no lung cancer (controls who participated in Mayo’s lung cancer CT screening trial). Methods: A total of 1,658 lung cancer patients (cared at Mayo Clinic) in the 4 groups (37, 151, 389, and 1081 respectively) and 488 controls were compared on following patient-reported outcomes (collected via validated tools): overall QOL, four symptoms (cough, pain, dyspnea, fatigue), mental/ physical/ emotional/ social/ spiritual QOL, and other concerns (e.g., family/ friends/ financial/ legal). A clinically significant deficit was defined as at least 10-points in difference (or <50 points) on a 0-100 scale. The rates of deficits were compared via Fisher’s exact tests and average QOL values via Kruskal-Wallis tests. Results: Overall QOL and individual symptoms were significantly worse (p<0.05) in all lung cancer groups than in controls, except for pain. LDCT-screened patients reported the greatest deficit among the 4 lung cancer groups in physical (41%), emotional (24%), social (38%), and spiritual QOL (24%); whereas chest X-ray detected patients had the least deficit in overall QOL (22%) and pain (32%). All 4 lung cancer groups experienced much worse fatigue (52-64%) than the controls (32%). Conclusions: Our preliminary results suggest that LDCT-screening detected lung cancer patients reported a different QOL profile from other lung cancer patients and non-lung cancer controls. The clinical course, smoking behavior, and QOL related health issues associated with LDCT screening for lung cancer warrant thorough investigation.

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Rare case of double aortic arch suspected by preoperative chest X-ray in a healthy woman

British Journal of Anaesthesia ◽

10.1093/bja/aeu168 ◽

2014 ◽

Vol 112 (6) ◽

pp. 1117-1118 ◽

Cited By ~ 1

Author(s):

Y. Suzuki ◽

Y. Nishikawa ◽

D. Horiuchi ◽

K. Semba ◽

T. Fujii ◽

...

Keyword(s):

Aortic Arch ◽

Rare Case ◽

Healthy Woman ◽

Double Aortic Arch ◽

X Ray ◽

Chest X Ray ◽

Preoperative Chest

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Asymptomatic thoracic aortic aneurysm in a resource limited hospital in a 70-year-old man

Pyramid Journal of Medicine ◽

10.4081/pjm.2018.13 ◽

2018 ◽

Vol 1 (1) ◽

Author(s):

Mohammad A. Suwaid

Keyword(s):

Case Report ◽

Aortic Aneurysm ◽

Hypertensive Patient ◽

Congenital Syphilis ◽

Incidental Finding ◽

X Ray ◽

Medical Checkup ◽

Resource Limited ◽

Chest X Ray

Aortic aneurysm is a term used to describe more than 50% dilatation of a segment of the aorta (artery) from its original diameter. The etiological factors include hypertension, artherosclerosis, trauma, congenital syphilis, mycotic bacterial dissection, inflammation etc. A case of a 70-year-old man with well-controlled long-standing hypertension whose check chest X-ray showed aortic aneurysm as an incidental finding which latera ruptured was discussed. The case report discusses the importance of follow up imaging in a hypertensive patient even with regular medication as absence of routine medical checkup including X-ray may lead to missing important complication like aortic aneurysm that can rupture if untreated. This is what prompted this case report so as to underscore the importance of at least check chest radiograph in a hypertensive patient.

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Aortic Arch Calcification Predicts the Renal Function Progression in Patients with Stage 3 to 5 Chronic Kidney Disease

BioMed Research International ◽

10.1155/2015/131263 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Lung-Chih Li ◽

Yueh-Ting Lee ◽

Yi-Wei Lee ◽

Chia-An Chou ◽

Chien-Te Lee

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Kidney Disease ◽

Aortic Arch ◽

Estimated Glomerular Filtration Rate ◽

X Ray ◽

Chest X Ray ◽

Independent Determinant ◽

Egfr Decline ◽

Aortic Arch Calcification

Introduction. The presence of aortic arch calcification (AoAC) and cardiomegaly on chest radiography has been demonstrated as important risk factors for cardiovascular mortality in patients with chronic kidney disease (CKD). However, the interrelationship among AoAC, cardiomegaly, and renal function progression remains unclear. The aim of this study is to assess whether AoAC and cardiomegaly are independently associated with the renal function progression in patients with stages 3–5 CKD.Methods. We retrospectively determined AoAC and cardiomegaly by chest X-ray in 237 patients, followed up for at least three years without entering dialysis and classified into 4 groups according to the presence or absence of AoAC and cardiomegaly. The change in renal function was measured by the slope of estimated glomerular filtration rate (eGFR).Results. Of the 237 patients, the rate of eGFR decline was significantly higher in the group with coexistence of AoAC and cardiomegaly than any other groups. Baseline AoAC and proteinuria were independently associated with eGFR decline. AoAC were independently determined by age, eGFR slope, and cardiomegaly.Conclusions. The coexistence of AoAC and cardiomegaly is associated with faster eGFR decline. AoAC is an independent determinant of renal outcomes in patients with CKD stages 3–5.

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