scholarly journals PROBLEMS OF DIFFERENTIAL DIAGNOSIS OF BRONCHIOLOALVEOLAR CARCINOMA

2013 ◽  
Vol 4 (3) ◽  
pp. 61-72
Author(s):  
N Y Urazovsky ◽  
A V Averyanov ◽  
V N Lesnyak
Keyword(s):  
Differential Diagnosis ◽  
Primary Diagnosis ◽  
Bronchioloalveolar Carcinoma ◽  
Distinctive Features ◽  
X Ray ◽  
Modern View

The review presents the modern view on bronchioloalveolar carcinoma. The most attention is paid to the CT as one of the most important methods of primary diagnosis. Authors showed distinctive features of diseases that have similar X-ray picture.

Thoracic duct cysts: A rare differential diagnosis

2005 ◽  
Vol 132 (2) ◽  
pp. 330-333 ◽  
Author(s):  
Frank Gottwald ◽  
Heinrich Iro ◽  
Carsten Finke ◽  
Johannes Zenk
Keyword(s):  
Differential Diagnosis ◽  
Thoracic Duct ◽  
Jugular Vein ◽  
Primary Diagnosis ◽  
Imaging Method ◽  
Left Internal Jugular Vein ◽  
Duct Cyst ◽  
X Ray ◽  
Adjacent Structures ◽  
Rare Differential Diagnosis

OBJECTIVE: Cysts of the thoracic duct located in the supraclavicular region are uncommon. To date only 12 cases in this topographic area have been described in the literature. Between 1998 and 2002, 5 patients presented to our department with the primary symptom of a palpable soft left-supracavicular swelling that could be displaced relative to adjacent structures. SETTING: In each case, sonography showed a hypoechogenic, almost echo-free, distinctly outlined polycyclic structure with distal echo enhancement at the junction of the left internal jugular vein and the subclavian vein. All 5 patients underwent surgery, the cysts were extirpated, and the numerous communicating lymph vessels localized and meticulously ligated. Pathohistologic analysis of the milky, yellowish fluid obtained by intraoperative puncture confirmed the initial suspicion of a thoracic duct cyst in all patients. CONCLUSION: In the case of left supraclavicular masses, the rare differential diagnosis of a thoracic duct cyst must be considered as a possibility. Sonography as the imaging method of choice is sufficient for primary diagnosis. In addition, a thorax x-ray should be performed in order to exclude an intrathoracic involvement. Surgical extirpation marks the therapy of choice in treating such cysts.

scholarly journals A clinical case of pulmonary and hepatic echinococcosis

2017 ◽  
Vol 98 (2) ◽  
pp. 261-266
Author(s):  
M L Gorbunova ◽  
S N Volkova ◽  
G V Shestakova ◽  
E L Spiridonova
Keyword(s):  
Differential Diagnosis ◽  
Clinical Case ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Primary Diagnosis ◽  
Diagnostic Methods ◽  
X Ray ◽  
Chest X Ray ◽  
Pulmonary Echinococcosis ◽  
Hepatic Echinococcosis

The article presents а description of our personal case of pulmonary and hepatic echinococcosis in a 38-years-old patient. Literature data on clinical presentation, laboratory and instrumental diagnostic methods of the disease are presented. Different variants of clinical presentation of pulmonary echinococcosis and its possible complications are described. The problems of differential diagnosis, surgical and conventional methods of treatment are analyzed. The presented clinical case confirms the wide spread opinion that the diagnosis of pulmonary echinococcosis based on only the results of chest X-ray is extremely challenging. Frequent diagnostic mistakes are associated with the primary diagnosis of pneumonia based on chest X-ray. Use of high-pitch spiral computed tomography implemented recently into clinical practice provides early differential diagnosis of pulmonary lesions with parasitic diseases, in particular, with echinococcosis. The final diagnosis is confirmed by serologic methods of echinococcosis diagnosis with the use of enzyme immunoassays.

Differential diagnosis of hemoptysis

2021 ◽  
pp. 47-55
Author(s):  
Petr Arkadievich Ilyin
Keyword(s):  
Infectious Disease ◽  
Computed Tomography ◽  
Lung Cancer ◽  
Differential Diagnosis ◽  
Correct Interpretation ◽  
Diagnostic Investigation ◽  
Detailed History ◽  
X Ray ◽  
Chest X Ray ◽  
Upper Gastrointestinal

Blood expectoration or hemoptysis is the coughing up of sputum with blood from the larynx, bronchi or lungs. Hemoptysis is most often caused by diseases of the respiratory tract and lungs — bronchitis or pneumonia, as well as lung cancer, aspergilloma, tuberculosis, bronchiectasis, pulmonary embolism, etc. In the diagnostic investigation of the cause of hemoptysis, it is important to take a detailed history (in the case of an epidemiological history, a laboratory analysis of the secreted sputum for the detection of the causative agent of an infectious disease is necessary), to make the correct interpretation of the patient’s complaints and an assessment of the nature of the sputum (differential diagnosis with bleeding from the upper gastrointestinal tract). A chest X-ray is performed and, then, if indicated, computed tomography, bronchoscopy, and other studies are made. The article presents an algorithm for differential diagnostic investigation of hemoptysis in a patient

scholarly journals MP12: Acute asthma presentations to emergency departments in Alberta: an epidemiological analysis of presentations

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S69
Author(s):  
C. Alexiu ◽  
L. Krebs ◽  
C. Villa-Roel ◽  
B.R. Holroyd ◽  
M. Ospina ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Acute Asthma ◽  
Patient Flow ◽  
Primary Diagnosis ◽  
Secondary Diagnosis ◽  
Upper Respiratory Infection ◽  
X Ray ◽  
Icd 10 ◽  
Chest X Ray ◽  
Ionizing Radiation Exposure

Introduction: Asthma is a chronic condition and exacerbations are a common reason for emergency department (ED) presentations across Canada. The objective of this study was to characterize and describe acute asthma presentations over a five-year period. Methods: Administrative health data for Alberta from 2011-2015 was obtained from the National Ambulatory Care Reporting System (NACRS) for all adult (>17 years) acute asthma (ICD-10-CA: J45) ED presentations. All presentations to an Alberta ED with a primary or secondary diagnosis of acute asthma were eligible for inclusion. Presentations with a Canadian Triage and Acuity Scale (CTAS) score of 1 were excluded. Data from NACRS were linked with a provincial diagnostic imaging database. Data are reported as means and standard deviation (SD), medians and interquartile range (IQR) or proportions, as appropriate. Results: From 2011-2015, a total of 51,269 (~10,000/year) acute asthma presentations were made by 34,481 patients (~0.3 presentations per patient per year). The median age was 35 years (IQR: 25, 49 years) and more patients were female (57.2%). Few patients arrived to the ED by ambulance (6.5%) and the most frequent CTAS score was 3 (43.5%). The majority of these patients (77%) had a primary diagnosis of asthma in the ED. Differences were explored between those with a primary asthma diagnosis and those with a secondary diagnosis (e.g., ambulance arrival, length of stay, hospital admission, etc.). Although differences were statistically significant, no clinically relevant differences were identified. Patients with asthma most frequently had a co-diagnosis of acute upper respiratory infection (6.2%); other co-diagnoses included bronchitis (4.7%), pneumonia (3.7%), heart failure (0.18%), pulmonary embolism (0.15%), and pneumothorax (0.03%). For 39.3% of patients, ED management included chest x-ray. The majority of patients were discharged from the ED (92.2%) following a median length of stay of 2.2 hours (IQR: 1.2, 3.8 hours). Conclusion: Acute asthma remains an important ED presentation in Alberta and the absolute frequency of presentations has remained relatively stable over the past five years. Frequency of chest x-ray ordering is high and represents a target for future interventions to reduce ionizing radiation exposure, improve patient flow and reduce healthcare costs.

Serum Alpha Fetal Protein in a Three Year Old Child with Hepatoma

1976 ◽  
Vol 62 (4) ◽  
pp. 407-414 ◽  
Author(s):  
Yehuda Shoenfeld ◽  
Albert I. Pick ◽  
Sarah Schreibman ◽  
Helena Kessler ◽  
Moshe Dintzman
Keyword(s):  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Surgical Procedure ◽  
Tumor Recurrence ◽  
Clinical Laboratory ◽  
Sharp Decrease ◽  
Normal Serum ◽  
Primary Hepatocellular Carcinoma ◽  
X Ray

A 3 year old child with primary hepatocellular carcinoma and high AFP concentrations is described. Following hemihepatectomy, a sharp decrease and return to normal of serum AFP concentrations indicated the completeness of the surgical procedure. Repeat-normal serum AFP concentrations (less than 19 ng/ml), found during a three year follow-up, correlated well with the absence of clinical, laboratory and x-ray evidence of tumor recurrence. The differential diagnosis of abnormal AFP concentrations in childhood is discussed, and the importance of the AFP assay in the follow-up of post-hemihepatectomy patients for the assessment of the completeness of the surgical procedure, the prognosis, and the early detection of tumor recurrence is stressed.

Phosphorus L 2,3-edge XANES: overview of reference compounds

2009 ◽  
Vol 16 (2) ◽  
pp. 247-259 ◽  
Author(s):  
Jens Kruse ◽  
Peter Leinweber ◽  
Kai-Uwe Eckhardt ◽  
Frauke Godlinski ◽  
Yongfeng Hu ◽  
...  
Keyword(s):  
Spectral Features ◽  
Edge Structure ◽  
Complex Samples ◽  
Distinctive Features ◽  
X Ray ◽  
Wide Range ◽  
Element Speciation ◽  
Unknown Composition ◽  
Almost All ◽  
X Ray Absorption

Synchrotron-based X-ray absorption near-edge structure (XANES) spectroscopy is becoming an increasingly used tool for the element speciation in complex samples. For phosphorus (P) almost all XANES measurements have been carried out at the K-edge. The small number of distinctive features at the P K-edge makes in some cases the identification of different P forms difficult or impossible. As indicated by a few previous studies, the P L 2,3-edge spectra were richer in spectral features than those of the P K-edge. However, experimentally consistent spectra of a wide range of reference compounds have not been published so far. In this study a library of spectral features is presented for a number of mineral P, organic P and P-bearing minerals for fingerprinting identification. Furthermore, the effect of radiation damage is shown for three compounds and measures are proposed to reduce it. The spectra library provided lays a basis for the identification of individual P forms in samples of unknown composition for a variety of scientific areas.

scholarly journals P089: Does the use of ultrasound improve diagnosis during simulated trauma scenarios?

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S108
Author(s):  
D. McLean ◽  
L. Hewitson ◽  
D. Lewis ◽  
J. Fraser ◽  
J. Mekwan ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Performance ◽  
Statistical Tests ◽  
Correct Diagnosis ◽  
Primary Diagnosis ◽  
Point Of Care Ultrasound ◽  
Trauma Patients ◽  
Diagnostic Capabilities ◽  
Attending Physicians ◽  
The Impact

Introduction: Point of care ultrasound (US) is a key adjunct in the management of trauma patients, in the form of the extended focused assessment with sonography in trauma (E-FAST) scan. This study assessed the impact of adding an edus2 ultrasound simulator on the diagnostic capabilities of resident and attending physicians participating in simulated trauma scenarios. Methods: 12 residents and 20 attending physicians participated in 114 trauma simulations utilizing a Laerdal 3G mannequin. Participants generated a ranked differential diagnosis list after a standard assessment, and again after completing a simulated US scan for each scenario. We compared reports to determine if US improved diagnostic performance over a physical exam alone. Standard statistical tests (χ2 and Student t tests) were performed. The research team was independent of the edus2 designers. Results: Primary diagnosis improved significantly from 53 (46%) to 97 (85%) correct diagnoses with the addition of simulated US (χ2=37.7, 1df; p=<0.0001). Of the 61 scenarios where an incorrect top ranked diagnosis was given, 51 (84%) improved following US. Participants were assigned a score from 1 to 5 based on where the correct diagnosis was ranked, with a 5 indicating a correct primary diagnosis. Median scores significantly increased from 3.8 (IQR 3, 4.9) to 5 (IQR 4.7, 5; W=219, p<0.0001).Participants were significantly more confident in their diagnoses after using the US simulator, as shown by the increase in their mean confidence in the correct diagnosis from 53.1% (SD 22.8) to 83.5% (SD 19.1; t=9.0; p<0.0001)Additionally, participants significantly narrowed their differential diagnosis lists from an initial medium count of 3.5 (IQR 2.9, 4.4) possible diagnoses to 2.4 (IQR 1.9, 3; W=-378, p<0.0001) following US. The performance of residents was compared to that of attending physicians for each of the above analyses. No differences in performance were detected. Conclusion: This study showed that the addition of ultrasound to simulated trauma scenarios improved the diagnostic capabilities of resident and attending physicians. Specifically, participants improved in diagnostic accuracy, diagnostic confidence, and diagnostic precision. Additionally, we have shown that the edus2 simulator can be integrated into high fidelity simulation in a way that improves diagnostic performance.

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