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

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.

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.

scholarly journals Descriptive study of chest x-ray examination in mandatory annual health examinations at the workplace in Japan

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262404
Author(s):  
Yuya Watanabe ◽  
Toru Nakagawa ◽  
Kota Fukai ◽  
Toru Honda ◽  
Hiroyuki Furuya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Detection Rate ◽  
Low Dose ◽  
Care Center ◽  
Stage I ◽  
X Ray ◽  
Health Care Center ◽  
Chest X Ray

The utility of chest x-ray examination (CXR) in mandatory annual health examinations for occupational health is debatable in Japan. This study aimed to provide basic data to consider future policies for mandatory annual health examinations in the workplace. A nationwide descriptive survey was performed to determine the rate of detection of tuberculosis, lung cancer, and other diseases through CXR in organizations associated with National Federation of Industrial Health Association. The rate of finding on CXR conducted during annual health examinations in FY2016 was evaluated. Data regarding diagnosis based on follow-up examination findings were obtained and compared with the national statistics. In addition, CXR findings were compared with the results of low-dose lung computed tomography performed at the Hitachi Health Care Center. From 121 surveyed institutions, 88 institutions with 8,669,403 workers were included. For all ages, 1.0% of examinees required follow-up examination. Among 4,764,985 workers with diagnosis data, the tuberculosis detection rate was 1.8–5.3 per 100,000 persons. For Lung cancer, 3,688,396 workers were surveyed, and 334 positive cases were detected. The lung cancer detection rate using CXR was 9.1–24.4 per 100,000 persons. From 164 cases with information regarding the clinical stage, 72 (43.9%) had Stage I lung cancer. From 40,045 workers who underwent low-dose computed tomography multiple times, 31 lung cancer cases, all with Stage I disease, were detected (detection rate: 77.4 per 100,000 persons). Our findings suggest that CXR plays a little role in the detection of active tuberculosis. With regard to LC screening, the detection rate of LC by CXR was lower, approximately 50%, than the expected rate (41.0 per 100,000 persons) of LC morbidity based on the age–sex distribution of this study population. However, the role of CXR for LC screening cannot be mentioned based on this result, because assessment of mortality reduction is essential to evaluate the role.

Comparative effectiveness of lung cancer screening by computed tomography (CT) vs. chest x-ray (CXR) vs. no screening.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e18246-e18246
Author(s):  
John Paul Flores ◽  
Alejandro Moreno-Koehler ◽  
Matthew Finkelman ◽  
Jaime Caro ◽  
Gary M. Strauss
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Comparative Effectiveness ◽  
Lung Cancer Screening ◽  
X Ray ◽  
Chest X Ray

scholarly journals Computed tomography follow-up identifies radically treatable new primaries after resection for lung cancer

2019 ◽  
Author(s):  
Jenny Mitchell ◽  
Rachel Benamore ◽  
Fergus Gleeson ◽  
Elizabeth Belcher
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Early Stage ◽  
Primary Lung Cancer ◽  
Negative Likelihood Ratio ◽  
University Hospitals ◽  
Early Stage Lung Cancer ◽  
X Ray ◽  
Chest X Ray

Abstract OBJECTIVES The optimal imaging programme for the follow-up of patients who have undergone resection of primary lung cancer is yet to be determined. We investigated the incidence and patterns of new and recurrent malignancy after resection for early-stage lung cancer in patients enrolled into a computed tomography (CT) follow-up programme. METHODS We reviewed the outcomes of consecutive patients who underwent CT follow-up after resection of early-stage primary lung cancer at the Oxford University Hospitals NHS Foundation Trust, between 2013 and 2017. RESULTS Four hundred and sixty-six consecutive patients underwent resection of primary lung cancer between 1 January 2013 and 31 March 2017. Three hundred and thirty-one patients (71.0%) were enrolled in CT follow-up. The median follow-up was 98 weeks (range 26–262). Sixty patients (18.2%) were diagnosed with programme-detected malignancy. Recurrence was diagnosed in 36 patients (10.9%), new primary lung cancer in 16 patients (4.8%) and non-lung primary tumours in 8 patients (2.4%). A routine CT scan identified the majority of new primary lung cancers (84.2%) and those with disease recurrence (85.7%). The majority of programme-detected malignancies were radically treatable (55%). The median survival of programme-detected cancers was 92.4 versus 23.0 weeks for patients with clinically detected tumours (P < 0.0001). Utilizing the CT scout image as a surrogate for chest X-ray, the sensitivity of this modality was 16.95% (8.44–28.97%) and specificity was 89.83% (79.17–96.18%). Negative likelihood ratio was 0.92 (0.8–1.07). CONCLUSIONS CT follow-up of surgically treated primary lung cancer patients identifies malignancy at a stage where radical treatment is possible in the majority of patients. Chest X-ray follow-up may not be of benefit following lung cancer resection.

Screening for Lung Cancer With Low-Dose Helical Computed Tomography: Anti-Lung Cancer Association Project

2002 ◽  
Vol 20 (4) ◽  
pp. 911-920 ◽  
Author(s):  
Tomotaka Sobue ◽  
Noriyuki Moriyama ◽  
Masahiro Kaneko ◽  
Masahiko Kusumoto ◽  
Toshiaki Kobayashi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Low Dose ◽  
Helical Ct ◽  
Helical Computed Tomography ◽  
Tumor Diameter ◽  
Sputum Cytology ◽  
X Ray ◽  
Chest X Ray ◽  
Stage Ia

PURPOSE: Because efficacy of lung cancer screening using chest x-ray is controversial and insufficient, other screening modalities need to be developed. To provide data on screening performance of low-dose helical computed tomography (CT) scanning and its efficacy in terms of survival, a one-arm longitudinal screening project was conducted. PATIENTS AND METHODS: A total of 1,611 asymptomatic patients aged 40 to 79 years, 86% with smoking history, were screened by low-dose helical CT scan, chest x-ray, and 3-day pooled sputum cytology with a 6-month interval. RESULTS: At initial screening, the proportions of positive tests were 11.5%, 3.4%, and 0.8% with low-dose helical CT scan, chest x-ray, and sputum cytology, respectively. In 1,611 participants, 14 (0.87%) cases of lung cancer were detected, with 71% being stage IA disease and a mean tumor diameter of 19.8 mm. At repeated screening, the proportions of positive tests were 9.1%, 2.6%, and 0.7% with low-dose helical CT, chest x-ray, and sputum cytology, respectively. In 7,891 examinations, 22 (0.28%) cases of lung cancer were detected, with 82% being stage IA disease and a mean tumor diameter of 14.6 mm. The 5-year survival rate for screen-detected lung cancer was 76.2% and 64.9% for initial and repeated screening, respectively. CONCLUSION: Screening with low-dose helical CT has potential to improve screening efficacy in terms of reducing lung cancer mortality. An evaluation of efficacy using appropriate methods is urgently required.

scholarly journals Ensemble deep learning for tuberculosis detection

2020 ◽  
Vol 17 (2) ◽  
pp. 1014
Author(s):  
Mohd Hanafi Ahmad Hijazi ◽  
Leong Qi Yang ◽  
Rayner Alfred ◽  
Hairulnizam Mahdin ◽  
Razali Yaakob
Keyword(s):  
Infectious Disease ◽  
Machine Learning ◽  
Lung Cancer ◽  
Mycobacterium Tuberculosis ◽  
Deep Learning ◽  
Tubercle Bacillus ◽  
X Ray ◽  
Initial Stage ◽  
The World ◽  
Chest X Ray

Tuberculosis (TB) is one of the deadliest infectious disease in the world. TB is caused by a type of tubercle bacillus called Mycobacterium Tuberculosis. Early detection of TB is pivotal to decrease the morbidity and mortality. TB is diagnosed by using the chest x-ray and a sputum test. Challenges for radiologists are to avoid confused and misdiagnose TB and lung cancer because they mimic each other. Semi-automated TB detection using machine learning found in the literature requires identification of objects of interest. The similarity of tissues, veins and small nodules presenting the image at the initial stage may hamper the detection. In this paper, an approach to detect TB, that does not require segmentation of objects of interest, based on ensemble deep learning, is presented. Evaluation on publicly available datasets show that the proposed approach produced a model that recorded the best accuracy, sensitivity and specificity of 91.0%, 89.6% and 90.7% respectively.

scholarly journals Minimal-dose computed tomography is superior to chest x-ray for the follow-up and treatment of patients with resected lung cancer

2014 ◽  
Vol 147 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Waël C. Hanna ◽  
Narinder S. Paul ◽  
Gail E. Darling ◽  
Hadas Moshonov ◽  
Frances Allison ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
X Ray ◽  
Minimal Dose ◽  
Chest X Ray
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