scholarly journals Chronic Aspergillosis in the Guise of Peripheral Lung Neoplasia

2021 ◽  
Vol 102 (1) ◽  
pp. 47-56
Author(s):  
N. G. Nikolaeva ◽  
T. A. Golimbievskaya ◽  
O. V. Shadrivova ◽  
E. A. Desyatik ◽  
I. A. Bekhtereva ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Laboratory Tests ◽  
Decisive Role ◽  
Antifungal Drugs ◽  
Malignant Neoplasms ◽  
Pulmonary Aspergillosis ◽  
Peripheral Lung ◽  
Postoperative Diagnosis ◽  
Chronic Pulmonary Aspergillosis

Two cases of postoperative diagnosis of chronic pulmonary aspergillosis are presented, which were previously regarded as malignant neoplasms. A decisive role in the detection of chronic pulmonary aspergillosis is played by computed tomography, but the diagnosis should be confirmed by laboratory tests. The importance of early diagnosis of chronic pulmonary aspergillosis is associated with high risk of complications during surgery without the use of antifungal drugs.

scholarly journals Chronic Pulmonary Aspergillosis: Literature Review and Demonstration of Own Observations

2021 ◽  
Vol 102 (5) ◽  
pp. 317-328
Author(s):  
N. G. Nikolaeva ◽  
O. V. Shadrivova ◽  
I. E. Itskovich ◽  
N. N. Klimko
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Literature Review ◽  
Web Of Science ◽  
Severe Disease ◽  
Instrumental Method ◽  
Immune Disorders ◽  
Pulmonary Aspergillosis ◽  
Treatment Policy ◽  
Chronic Pulmonary Aspergillosis

Chronic pulmonary aspergillosis (CPA) is a severe disease that develops mainly in patients without obvious immune disorders. Computed tomography is the main instrumental method in the diagnosis of CPA, which is necessary to determine the form of the disease, to choose treatment policy, to combat complications, and to monitor therapy. This makes it important for a radiologist to understand the main aspects of timely and differential diagnosis. There are insufficient Russian studies on this problem. This paper analyzes the 2014–2020 Russian and foreign publications available in PubMed, Web of Science, Elsevier, and eLibrary electronic databases. When searching for information, the following keywords were used: “computed tomography”, “chronic pulmonary aspergillosis”, “aspergilloma”, “air-crescent symptom”, “differential diagnosis”.

Computed tomography assessment of response to treatment in chronic pulmonary aspergillosis

2015 ◽  
Author(s):  
Cendrine Godet ◽  
François Laurent ◽  
Anne Bergeron ◽  
Catherine Begeilman ◽  
Christophe Pison ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Response To Treatment ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

scholarly journals Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis

2016 ◽  
Vol 69 (2) ◽  
pp. 118-126 ◽  
Author(s):  
Tsunehiro Ando ◽  
Naobumi Tochigi ◽  
Kyoko Gocho ◽  
Atsuko Moriya ◽  
Soichiro Ikushima ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Aspergillosis ◽  
Computed Tomography Images ◽  
Chronic Pulmonary Aspergillosis

High detection rate of azole-resistant Aspergillus fumigatus after treatment with azole antifungal drugs among patients with chronic pulmonary aspergillosis in a single hospital setting with low azole resistance

2020 ◽  
Author(s):  
Keita Takeda ◽  
Junko Suzuki ◽  
Akira Watanabe ◽  
Teppei Arai ◽  
Tomohiro Koiwa ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Antifungal Therapy ◽  
Detection Rate ◽  
Hospital Setting ◽  
Antifungal Drugs ◽  
High Rate ◽  
Therapy Failure ◽  
National Hospital ◽  
Pulmonary Aspergillosis ◽  
Chronic Pulmonary Aspergillosis

Abstract The prevalence of azole-resistant Aspergillus fumigatus (ARAF) among chronic pulmonary aspergillosis (CPA) patients treated with azoles in Japan is unknown. The aim of this study was to determine the detection rate of ARAF in isolates from CPA patients who were treated with azoles for varying durations. The potential mechanism of acquiring resistance was examined by sequencing cyp51A and hmg1, two genes associated with ARAF. A. fumigatus isolates (n = 120) were collected from CPA patients (n = 104) between February 2012 and February 2019, at National Hospital Organization Tokyo National Hospital. The isolates were tested for susceptibility to the azole drugs itraconazole (ITCZ) and voriconazole (VRCZ). The detection rate of ARAF among all isolates was 8.3% (n = 10). Of the 10 resistant isolates, eight were ITCZ-resistant and five were VRCZ-resistant. Among 47 isolates obtained from 36 CPA patients who were treated with ITCZ (for an average of 256 days) and/or VRCZ (for an average of 29 days), the resistance rates were 17.0% and 10.6%, respectively. In addition, 46.2% of 13 isolates obtained from CPA patients with ongoing azole treatment at the time of antifungal therapy failure were resistant to azoles. Among the 10 ARAF isolates, a point mutation was detected in cyp51A in seven isolates and in hmg1 in two isolates. ARAF was detected at a high rate in CPA patients, particularly in those with ongoing long-term azole treatment, at the time of azole antifungal therapy failure.

scholarly journals Pre-symptomatic (Baseline) computed tomography predicts invasive pulmonary aspergillosis in high-risk adult haemato-oncology patients

2017 ◽  
Vol 182 (5) ◽  
pp. 723-727 ◽  
Author(s):  
M. Mansour Ceesay ◽  
Sujal R. Desai ◽  
Joanna Cleverley ◽  
Lisa Berry ◽  
Melvyn Smith ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Oncology Patients

LOW-DOSE COMPUTED TOMOGRAPHY IN MOSCOW FOR LUNG CANCER SCREENING (LDCT-MLCS): BASELINE RESULTS

2019 ◽  
Vol 65 (2) ◽  
pp. 224-233
Author(s):  
Sergey Morozov ◽  
Viktor Gombolevskiy ◽  
Anton Vladzimirskiy ◽  
Albina Laypan ◽  
Pavel Kononets ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Low Dose ◽  
Early Stage ◽  
Lung Cancer Screening ◽  
Stage I ◽  
Malignant Neoplasms ◽  
Number Needed To Screen ◽  
Low Dose Computed Tomography

Study aim. To justify selective lung cancer screening via low-dose computed tomography and evaluate its effectiveness. Materials and methods. In 2017 we have concluded the baseline stage of “Lowdose computed tomography in Moscow for lung cancer screening (LDCT-MLCS)” trial. The trial included 10 outpatient clinics with 64-detector CT units (Toshiba Aquilion 64 and Toshiba CLX). Special low-dose protocols have been developed for each unit with maximum effective dose of 1 mSv (in accordance with the requirements of paragraph 2.2.1, Sanitary Regulations 2.6.1.1192-03). The study involved 5,310 patients (53% men, 47% women) aged 18-92 years (mean age 62 years). Diagnosis verification was carried out in the specialized medical organizations via consultations, additional instrumental, laboratory as well as pathohistological studies. The results were then entered into the “National Cancer Registry”. Results. 5310 patients (53% men, 47% women) aged 18 to 92 years (an average of 62 years) participated in the LDCT-MLCS. The final cohort was comprised of 4762 (89.6%) patients. We have detected 291 (6.1%) Lung-RADS 3 lesions, 228 (4.8%) Lung- RADS 4A lesions and 196 (4.1%) Lung-RADS 4B/4X lesions. All 4B and 4X lesions were routed in accordance with the project's methodology and legislative documents. Malignant neoplasms were verified in 84 cases (1.76% of the cohort). Stage I-II lung cancer was actively detected in 40.3% of these individuals. For the first time in the Russian Federation we have calculated the number needed to screen (NNS) to identify one lung cancer (NNS=57) and to detect one Stage I lung cancer (NNS=207). Conclusions. Based on the global experience and our own practices, we argue that selective LDCT is the most systematic solution to the problem of early-stage lung cancer screening.

scholarly journals Misdiagnosis of chronic pulmonary aspergillosis as pulmonary tuberculosis at a tertiary care center in Uganda: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Richard Kwizera ◽  
Andrew Katende ◽  
Felix Bongomin ◽  
Lydia Nakiyingi ◽  
Bruce J. Kirenga
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Diagnostic Criteria ◽  
Tertiary Care ◽  
Chest Imaging ◽  
Resource Limited Settings ◽  
Pulmonary Aspergillosis ◽  
Resource Limited ◽  
Chronic Pulmonary Aspergillosis ◽  
Hiv Negative

Abstract Background Diagnosis of chronic pulmonary aspergillosis (CPA) is based on a combination of clinical symptomatology, compatible chest imaging findings, evidence of Aspergillus infection and exclusion of alternative diagnosis, all occurring for more than 3 months. Recently, a rapid, highly sensitive and specific point-of-care lateral flow device (LFD) has been introduced for the detection of Aspergillus-specific immunoglobulin (Ig)G, especially in resource-limited settings where CPA is underdiagnosed and often misdiagnosed as smear-negative pulmonary tuberculosis (PTB). Therefore, in our setting, where tuberculosis (TB) is endemic, exclusion of PTB is an important first step to the diagnosis of CPA. We used the recently published CPA diagnostic criteria for resource-limited settings to identify patients with CPA in our center. Case presentation Three Ugandan women (45/human immunodeficiency virus (HIV) negative, 53/HIV infected and 18/HIV negative), with a longstanding history of cough, chest pain, weight loss and constitutional symptoms, were clinically and radiologically diagnosed with PTB and empirically treated with an anti-tuberculous regimen despite negative microbiological tests. Repeat sputum Mycobacteria GeneXpert assays were negative for all three patients. On further evaluation, all three patients met the CPA diagnostic criteria with demonstrable thick-walled cavities and fungal balls (aspergilomas) on chest imaging and positive Aspergillus-specific IgG/IgM antibody tests. After CPA diagnosis, anti-TB drugs were safely discontinued for all patients, and they were initiated on capsules of itraconazole 200 mg twice daily with good treatment outcomes. Conclusions The availability of simple clinical diagnostic criteria for CPA and a LFD have the potential to reduce misdiagnosis of CPA and in turn improve treatment outcomes in resource-limited settings.

scholarly journals Clinical Relevance of Coronary Computed Tomography Angiography Beyond Coronary Artery Stenosis

2021 ◽  
Author(s):  
Mohammed Nooruddin Meah ◽  
Michelle C. Williams
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
High Risk ◽  
Atherosclerotic Plaque ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Calcium Score ◽  
Coronary Plaque ◽  
Coronary Computed Tomography ◽  
Low Attenuation Plaque

Background The capabilities of coronary computed tomography angiography (CCTA) have advanced significantly in the past decade. Its capacity to detect stenotic coronary arteries safely and consistently has led to a marked decline in invasive diagnostic angiography. However, CCTA can do much more than identify coronary artery stenoses. Method This review discusses applications of CCTA beyond coronary stenosis assessment, focusing in particular on the visual and quantitative analysis of atherosclerotic plaque. Results Established signs of visually assessed high-risk plaque on CT include positive remodeling, low-attenuation plaque, spotty calcification, and the napkin-ring sign, which correlate with the histological thin-cap fibroatheroma. Recently, quantification of plaque subtypes has further improved the assessment of coronary plaque on CT. Quantitatively assessed low-attenuation plaque, which correlates with the necrotic core of the thin-cap fibroatheroma, has demonstrated superiority over stenosis severity and coronary calcium score in predicting subsequent myocardial infarction. Current research aims to use radiomic and machine learning methods to further improve our understanding of high-risk atherosclerotic plaque subtypes identified on CCTA. Conclusion Despite rapid technological advances in the field of coronary computed tomography angiography, there remains a significant lag in routine clinical practice where use is often limited to lumenography. We summarize some of the most promising techniques that significantly improve the diagnostic and prognostic potential of CCTA. Key Points:  Citation Format

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