Efficiency and safety of transbronchial cryobiopsy in the diagnosis of disseminated lung diseases in patients after unsuccessful transbronchial forceps lung biopsy

Disseminated lung diseases is a group of pathologies characterized by damage to the small airways, alveo-li, interstitium of the lungs united by a common symp-tom, dissemination in the lung tissue detected by X-ray. Pathologies included in the DLD group are numerous, and differential diagnosis between them is difficult, due to the similarity of symptoms and the absence of patho-gnomonic signs. Transbronchial cryobiopsy of the lungs is a relatively new technique, currently used in diagnos-tics, along with other methods of morphological verifi-cation in disseminated lung diseases. However, there are only sporadic publications on its use in Russia. The article describes the first experience of using transbronchial cry-obiopsy in patients with disseminated lung diseases after negative transbronchial biopsy. Objective. To obtain the first cli nical experience with the TBLC method. To assess the role and efficacy of TBLC in the diagnosis of DLDs. Ma-terials and methods. Patients with oncology in medical history or with previous tuberculosis were not included into the study; a total of 15 patients were included. The process was verified in 11 (73.33%) patients. Of these, sarcoidosis of the lungs was detected in 8 (72.73%) cases, pulmonary tuberculosis in 2 (18.18%), idiopathic intersti-tial pneumonia in 1 (9.09%). Complications were record-ed in 2 patients (13.33%): apical pneumothorax, which did not require pleural cavity drainage; and pulmonary hemorrhage requiring prolonged mechanical ventilation.Conclusions. Transbronchial cryobiopsy in patients with disseminated lung disease after unsuccessful transbron-chial lung biopsy appears to be a highly informative and relatively safe procedure. Cryobiopsy through a rigid bronchoscope tube appears to be safer. TBLC from the apex of the lungs, as well as in smokers, seems to be a more difficult task to verify, but this requires further studies

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A COMPLEX CASE OF DIFFERENTIAL DIAGNOSIS OF PULMONARY TUBERCULOSIS AND A NEUROENDOCRINE TUMOR

Journal of radiology and nuclear medicine ◽

10.20862/0042-4676-2018-99-5-259-263 ◽

2018 ◽

Vol 99 (5) ◽

pp. 259-263

Author(s):

N. L. Karpina ◽

L. N. Lepekha ◽

R. B. Amansakhedov ◽

O. M. Gordeeva ◽

A. V. Dudchenko ◽

...

Keyword(s):

Differential Diagnosis ◽

Pulmonary Tuberculosis ◽

Neuroendocrine Tumor ◽

Lung Diseases ◽

Clinical Symptoms ◽

Ct Scanning ◽

Young Female ◽

Complex Case ◽

Morphological Picture ◽

Neuroendocrine Lung Tumors

Pathomorphosis of tuberculosis and other lung diseases that have a similar clinical radiological and morphological picture leads to considerable difficulties and mistakes in the differential diagnosis of pulmonary processes. In particular, there are difficulties in the differential diagnosis of neuroendocrine lung tumors (NET) and pulmonary tuberculosis.A clinical case of timely diagnosis of a neuroendocrine tumor in a young female patient without clinical symptoms typical for NETs has been described. The main manifestations revealed by chest CT scanning were single focal consolidations. The diagnosis was confirmed by histological studies of surgery samples.

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New laboratory criterion for the differential diagnosis of sarcoidosis and pulmonary tuberculosis

10.21203/rs.3.rs-29266/v2 ◽

2020 ◽

Author(s):

Anna Starshinova ◽

Anna Malkova ◽

Yulia Zinchenko ◽

Natalia Basantsova ◽

Igor Kudryavtsev ◽

...

Keyword(s):

Differential Diagnosis ◽

Pulmonary Tuberculosis ◽

X Ray ◽

Healthy Donors ◽

Significant Difference ◽

Laboratory Features ◽

Citrullinated Vimentin ◽

Cell Subpopulations ◽

N 93 ◽

Granulomatous Diseases

Abstract In some cases there is a problem of differential diagnosis of sarcoidosis (SD) and tuberculosis (TB) because of the similarities in clinical, X-ray and laboratory features. The aim of this study was to search for new differential diagnostic criteria for sarcoidosis and tuberculosis by calculating the index, based on the level of autoantibodies to modified citrullinated vimentin (anti-MCV) and the level of B-cell subpopulations. These parameters were measured in patients with sarcoidosis (n = 93), tuberculosis (n = 28) and healthy donors (n = 40) using the ELISA and cytometry. The absence of a statistically significant difference when comparing the level of anti-MCV, the number of B-cells in SD and TB suggests that these changes may be characteristic of granulomatous diseases. The use of the formula Ds=([B-naïve%]\[B-memory%])*([B-CD38%]+[B-CD5%])/[anti-MCV] might allow to differentiate SD with an increase in the calculated index of more than 5 units with a sensitivity of 80.00% and specificity of 93.10% (AUC = 0.926).

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Treatment of hemorrhagic complications in patients with pulmonary tuberculosis

Kazan medical journal ◽

10.17816/kazmj62161 ◽

1985 ◽

Vol 66 (5) ◽

pp. 394-397

Author(s):

L. B. Khudzik

Keyword(s):

Pulmonary Tuberculosis ◽

Lung Diseases ◽

Pulmonary Hemorrhage ◽

Fatal Complication ◽

The Past ◽

Common Causes ◽

Hemorrhagic Complications ◽

Made In

Over the past decades, significant advances have been made in the treatment of tuberculosis, but pulmonary hemorrhage and hemoptysis still remain its formidable, often fatal complication, and among all lung diseases, tuberculosis is one of the most common causes of hemorrhagic syndrome.

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Disseminated lung disease in elderly patient with multimorbidity and HIV infection (clinical case)

Medical almanac ◽

10.21145/2499-9954-2019-3-53-55 ◽

2019 ◽

pp. 53-55

Author(s):

E. V. Yakovleva

Keyword(s):

Differential Diagnosis ◽

Hiv Infection ◽

Lung Diseases ◽

Clinical Case ◽

Immune Status ◽

Pneumocystis Pneumonia ◽

Interstitial Lung Diseases ◽

Hiv Screening ◽

X Ray ◽

Attending Physician

Disseminated lung diseases have similar non-specific manifestations in various etiologies, pathogenesis, and morphology. Pulmonary dissemination is the concept of X-ray, there are no pathognomonic symptoms on a radiograph that are inherent in a particular disease with pulmonary dissemination, therefore, in real clinical practice, differential diagnosis in pulmonary dissemination is the prerogative of the physician. Diseases that are manifested by pulmonary dissemination can be classified by dissemination of infectious causes (tuberculosis, HIV-associated dissemination, fungal lesions), malignant pulmonary lesions (carcinomatosis, cancer lymphangitis), cardiogenic dissemination and interstitial lung diseases. In recent years, the incidence of allergic interstitial lung diseases has increased. Infectious lesions of the lungs in patients with HIV infection and reduced immune status in many cases also have a disseminated form and cause difficulties in the differential diagnosis of tuberculosis. The article presents a clinical case of pneumocystis pneumonia in an HIV-infected patient with pulmonary dissemination syndrome on X-ray. The difficulties of the diagnostic search with low compliance of the patient and the physician are shown (a patient registered with HIV for 10 years hid this fact of his history from the attending physician and gave a written refusal to get tested for HIV fibrobronchoscopy). The possibility of introducing compulsory HIV screening for all patients admitted to the hospital with disseminated processes in the lungs has been considered.

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Pneumomediastinum after transbronchial cryobiopsy

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2018.909 ◽

2018 ◽

Vol 88 (2) ◽

Author(s):

Emanuela Barisione ◽

Rita Bianchi ◽

Roberto Fiocca ◽

Mario Salio

Keyword(s):

Systematic Reviews ◽

Lung Biopsy ◽

Transbronchial Biopsy ◽

Spontaneous Resolution ◽

Safe Procedure ◽

Surgical Lung Biopsy ◽

First Case

Pneumomediastinum is defined as the presence of air or gas within the mediastinum and it rarely complicates bronchoscopy. We report, to our best knowledge, the first case of pneumomediastinum following a transbronchial cryobiopsy (TBLC). TBLC is considered a safe procedure as compared with both transbronchial biopsy and surgical lung biopsy. Systematic reviews, metanalysis and a Pubmed research, revealed that in literature no pneumomediastinum has been mentioned after TBLC. We report this case for to make it known to interventional pulmonologists the possibility that a pneumomediastinum can follow a TBLC. In our case the spontaneous resolution in few days did not require any intervention.

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Lung gene expression signatures suggest pathogenic links and molecular markers for pulmonary tuberculosis, adenocarcinoma and sarcoidosis

Communications Biology ◽

10.1038/s42003-020-01318-0 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Qiyao Chai ◽

Zhe Lu ◽

Zhidong Liu ◽

Yanzhao Zhong ◽

Fuzhen Zhang ◽

...

Keyword(s):

Gene Expression ◽

Differential Diagnosis ◽

Molecular Markers ◽

Pulmonary Tuberculosis ◽

Lung Diseases ◽

Expression Patterns ◽

Migration And Invasion ◽

Molecular Signatures ◽

Tumor Cell Proliferation ◽

Pulmonary Tb

Abstract Previous reports have suggested a link between pulmonary tuberculosis (TB), which is caused by Mycobacterium tuberculosis (Mtb), and the development of lung adenocarcinoma (LUAD) and sarcoidosis. Furthermore, these lung diseases share certain clinical similarities that can challenge differential diagnosis in some cases. Here, through comparison of lung transcriptome-derived molecular signatures of TB, LUAD and sarcoidosis patients, we identify certain shared disease-related expression patterns. We also demonstrate that MKI67, an over-expressed gene shared by TB and LUAD, is a key mediator in Mtb-promoted tumor cell proliferation, migration, and invasion. Moreover, we reveal a distinct ossification-related TB lung signature, which may be associated with the activation of the BMP/SMAD/RUNX2 pathway in Mtb-infected macrophages that can restrain mycobacterial survival and promote osteogenic differentiation of mesenchymal stem cells. Taken together, these findings provide novel pathogenic links and potential molecular markers for better understanding and differential diagnosis of pulmonary TB, LUAD and sarcoidosis.

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Multiple Pulmonary Calssified Nodules and Cavitation Filled With the Dense Body on Chest X-Ray: A Case Report

International Journal of Medical Toxicology and Forensic Medicine ◽

10.32598/ijmtfm.v9i4.25106 ◽

2019 ◽

Vol 9 (4) ◽

pp. 255-260

Author(s):

Khosrow Agin ◽

Marymo Sadat Moin Azad Tehrani ◽

Bita Dadpour ◽

Maryam Vahabzadeh ◽

Babak Mostafazadeh

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Clinical Study ◽

Pulmonary Tuberculosis ◽

Clinical Assessment ◽

Dense Body ◽

Pulmonary Diseases ◽

X Ray ◽

Chest X Ray ◽

Initial Imaging

Imaging in the clinical study has a significant value in medical diagnosing and the following diseases. The characteristic signs of imaging are a clue in approach to differential diagnosis. A conventional chest x-ray radiography is a more prevalent image used in the initial clinical assessment of pulmonary diseases. Iran is one of the 9 countries with a 95% burden of tuberculosis in the Eastern Mediterranian region. Chest radiography is the initial imaging for the evaluation of pulmonary tuberculosis.

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Top Differential Diagnosis Should Be Microscopic Polyangiitis in ANCA-Positive Patient with Diffuse Pulmonary Hemorrhage and Hemosiderosis

Case Reports in Pathology ◽

10.1155/2014/286030 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Nicholas D. Ward ◽

Diane E. Cosner ◽

Colleen A. Lamb ◽

Wei Li ◽

Jacqueline K. Macknis ◽

...

Keyword(s):

Differential Diagnosis ◽

Renal Biopsy ◽

Lung Biopsy ◽

Crescentic Glomerulonephritis ◽

Microscopic Polyangiitis ◽

Pulmonary Hemorrhage ◽

Antineutrophil Cytoplasmic Antibody ◽

Giant Cells ◽

Positive Patient ◽

Neutrophil Aggregation

A rat model of antineutrophil cytoplasmic antibody (ANCA) associated vasculitides reveals crescentic glomerulonephritis as seen in human renal biopsies and diffuse lung hemorrhage that is not well documented in human lung biopsies. A 64-year-old male, with shortness of breath and mild elevation of serum creatinine, was found to have a positive serum test for ANCA, but negative antiglomerular basement membrane antibody. A renal biopsy showed pauci-immune type of crescentic glomerulonephritis and focal arteritis. The prior lung wedge biopsy was retrospectively reviewed to show diffuse hemorrhage and hemosiderosis with focal giant cells. In addition, small arteries revealed subtle neutrophil aggregation, and margination along vascular endothelium, but no definitive vasculitis. The pathology of ANCA associated vasculitides results from activated neutrophils by ANCA and subsequent activation of the alternative complement cascade with endothelial injury, neutrophil aggregation and margination. Our findings, after the correlation between lung biopsy and renal biopsy, imply that the top differential diagnosis in the lung biopsy should be microscopic polyangiitis when diffuse pulmonary hemorrhage and hemosiderosis are present in this ANCA-positive patient.

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