scholarly journals Fungal pneumonia manifesting as cavitary lesions in a critically ill elderly patient

2019 ◽  
Vol 13 (12) ◽  
pp. 1170-1173 ◽  
Author(s):  
Wei Yang ◽  
Yixin Ma ◽  
Jieyu Wang ◽  
Yun Li ◽  
Yaxin Zhang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Lower Lobe ◽  
Multiple Organ ◽  
Middle Lobe ◽  
Fungal Treatment ◽  
Unsatisfactory Result ◽  
The Right ◽  
Systemic Infections ◽  
Anti Fungal ◽  
Fluid Levels

Elderly patients with fungal pneumonia experience higher mortality and are more likely to be misdiagnosed. The diagnosis and treatment of fungal pneumonia in elderly patients is challenging. We herein present a clinical case of pulmonary fungal infection (PFI) manifesting as cavitary lesions in an 85-year-old male with multiple organ failure. Broad-spectrum antibiotics showed unsatisfactory result in this case. Computed tomography (CT) of the chest showed multiple pulmonary cavities with gas-fluid levels in the right upper and middle lobe, and patchy blurred shadows in the lower lobe. The diagnosis of fungal pneumonia was made after ruling out other causes of fever. The patient showed good response to anti-fungal treatment. Physicians must consider the possibility of fungal pneumonia in elderly patients who do not respond to antibiotic treatment after exclusion of immune response, tumor, tuberculosis, and other systemic infections.

scholarly journals Pulmonary Tuberculosis mimicking a right Eventration on Radiography: The falsity of single view radiograph in the diagnosis of a precursor of pulmonary disease: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lower Lobe ◽  
Middle Lobe ◽  
The Body ◽  
Single View ◽  
Lymph Node Enlargement ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
High Index Of Suspicion

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.

Right Lower Lobectomy With Middle Lobe Preservation After Right Upper Lobectomy in Lung Cancer of the Right Lower Lobe

2013 ◽  
Vol 96 (6) ◽  
pp. 2227-2230 ◽  
Author(s):  
Naohiro Taira ◽  
Tsutomu Kawabata ◽  
Atsushi Gabe ◽  
Takaharu Ichi ◽  
Kazuaki Kushi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Lower Lobectomy ◽  
The Right ◽  
Middle Lobe Preservation ◽  
Right Lower Lobectomy

Morphometry of cat pulmonary venous tree

1983 ◽  
Vol 55 (1) ◽  
pp. 236-242 ◽  
Author(s):  
R. T. Yen ◽  
F. Y. Zhuang ◽  
Y. C. Fung ◽  
H. H. Ho ◽  
H. Tremer ◽  
...  
Keyword(s):  
Average Length ◽  
Pulmonary Veins ◽  
Branching Ratio ◽  
Lower Lobe ◽  
Average Diameter ◽  
Middle Lobe ◽  
Vascular Tree ◽  
Right Middle Lobe ◽  
The Right ◽  
Number Of Branches

Morphometric data of the pulmonary veins in the cat right lung are presented. Silicone elastomer casts of the right lungs of five cats were made, measured, counted, and analyzed. The Strahler system is used to describe the branching pattern of the vascular tree. These data are needed for the physicomathematical approach to pulmonary circulation. For all the pulmonary blood vessels lying between the left atrium and the capillary beds, there are a total of 10 orders of vessels in the right upper lobe, 9 orders of vessels in the right middle lobe, and 11 orders of vessels in the right lower lobe. The ratios of the diameters, lengths, and the number of branches in successive orders of vessels are called the diameter, length, and branching ratios, respectively. For the cat pulmonary venous tree, the average branching ratio is 3.521, the average diameter ratio is 1.727, and the average length ratio is 2.402 for vessels of orders 1-3 and 1.532 for vessels of orders 4-10.

Involvement of the #12u Lymph Nodes Around the Upper Lobe Bronchi in Patients with Lung Cancer of the Right Middle Lobe, Right Lower Lobe, or Left Lower Lobe

Surgery Today ◽  
1999 ◽  
Vol 29 (3) ◽  
pp. 238-242
Author(s):  
Masami Sato ◽  
Yasuki Saito ◽  
Hirokazu Aikawa ◽  
Akira Sakurada ◽  
Tatsuo Tanita ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Nodes ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Left Lower Lobe ◽  
Right Middle Lobe ◽  
The Right

Morphometry of Cat’s Pulmonary Arterial Tree

1984 ◽  
Vol 106 (2) ◽  
pp. 131-136 ◽  
Author(s):  
R. T. Yen ◽  
F. Y. Zhuang ◽  
Y. C. Fung ◽  
H. H. Ho ◽  
H. Tremer ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Average Length ◽  
Main Pulmonary Artery ◽  
Branching Ratio ◽  
Lower Lobe ◽  
Average Diameter ◽  
Middle Lobe ◽  
Arterial Tree ◽  
Pulmonary Arterial ◽  
The Right

Morphometic data of the pulmonary artery in the cat’s right lung are presented. Silicone elastomer casts of cat’s right lung were made, and measured, counted and analyzed. The Strahler system is used to describe the branching pattern of the arterial vascular tree. These data are needed for any quantitative approach to the study of the pulmonary circulation. For all the pulmonary blood vessels of the cat lying between the main pulmonary artery and the capillary beds, there are a total of 10 orders of vessels in the right upper lobe, 9 orders of vessels in the right middle lobe and 11 orders of vessels in the right lower lobe. The ratio of the number of branches in successive orders of vessels or the branching ratio, is 3.58. The corresponding average diameter ratio is 1.72, whereas the average length ratio is 1.81.

scholarly journals Tomographic findings in bronchial atresia

2021 ◽  
Vol 54 (1) ◽  
pp. 9-14
Author(s):  
Elazir Barbosa Mota Di Puglia ◽  
Rosana Souza Rodrigues ◽  
Pedro Augusto Daltro ◽  
Arthur Soares Souza Jr. ◽  
Marilene Monteiro Paschoal ◽  
...  
Keyword(s):  
Lower Lobe ◽  
Lung Parenchyma ◽  
Pulmonary Involvement ◽  
Middle Lobe ◽  
Pathological Examination ◽  
Surgical Specimen ◽  
Distal Lung ◽  
The Right ◽  
Ct Finding ◽  
Bronchial Atresia

Abstract Objective: To evaluate computed tomography (CT) findings in 23 patients with bronchial atresia. Materials and Methods: The CT images were reviewed by two radiologists who reached decisions by consensus. We included only patients who presented with abnormalities on CT and in whom the diagnosis had been confirmed by pathological examination of the surgical specimen (if the lesion was resected). The CT scans were assessed in order to identify the main findings and to map the distribution of the lesions (i.e., to determine whether the pulmonary involvement was unilateral or bilateral). Results: The main CT finding was the combination of bronchocele and hyperinflation of the distal lung. That combination was observed in all of the patients. The lesions were unilateral in all 23 cases, being seen predominantly in the left upper lobe, followed by the right lower lobe, right upper lobe, middle lobe, and left lower lobe. Conclusion: The diagnosis of bronchial atresia can be reliably made on the basis of a finding of bronchocele accompanied by hyperinflation of the adjacent lung parenchyma.

scholarly journals Evaluation of dynamic lung changes during coronavirus disease 2019 (COVID-19) by quantitative computed tomography

2020 ◽  
Vol 28 (5) ◽  
pp. 863-873
Author(s):  
Cong Shen ◽  
Nan Yu ◽  
Shubo Cai ◽  
Jie Zhou ◽  
Jiexin Sheng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Quantitative Computed Tomography ◽  
Lower Lobe ◽  
Ground Glass Opacity ◽  
Middle Lobe ◽  
Lesion Volume ◽  
Dynamic Changes ◽  
Initial Symptoms ◽  
Right Middle Lobe ◽  
The Right

OBJECTIVES: This study aims to trace the dynamic lung changes of coronavirus disease 2019 (COVID-19) using computed tomography (CT) images by a quantitative method. METHODS: In this retrospective study, 28 confirmed COVID-19 cases with 145 CT scans are collected. The lesions are detected automatically and the parameters including lesion volume (LeV/mL), lesion percentage to lung volume (LeV%), mean lesion density (MLeD/HU), low attenuation area lower than – 400HU (LAA-400%), and lesion weight (LM/mL*HU) are computed for quantification. The dynamic changes of lungs are traced from the day of initial symptoms to the day of discharge. The lesion distribution among the five lobes and the dynamic changes in each lobe are also analyzed. RESULTS: LeV%, MLeD, and LM reach peaks on days 9, 6 and 8, followed by a decrease trend in the next two weeks. LAA-400% (mostly the ground glass opacity) declines to the lowest on days 4–5, and then increases. The lesion is mostly seen in the bilateral lower lobes, followed by the left upper lobe, right upper lobe and right middle lobe (p < 0.05). The right middle lobe is the earliest one (on days 6–7), while the right lower lobe is the latest one (on days 9–10) that reaches to peak among the five lobes. CONCLUSIONS: Severity of COVID-19 increases from the day of initial symptoms, reaches to the peak around on day 8, and then decreases. Lesion is more commonly seen in the bilateral lower lobes.

scholarly journals Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan

2020 ◽  
Vol 26 ◽  
pp. 107602962093677 ◽  
Author(s):  
Jianpu Chen ◽  
Xiang Wang ◽  
Shutong Zhang ◽  
Bin Lin ◽  
Xiaoqing Wu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Laboratory Data ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Imaging Characteristics ◽  
Right Middle Lobe ◽  
The Right ◽  
D Dimer

The aim of this study was to describe clinical, imaging, and laboratory features of acute pulmonary embolism (APE) in patients with COVID-19 associated pneumonia. Patients with COVID-19 associated pneumonia who underwent a computed tomography pulmonary artery (CTPA) scan for suspected APE were retrospectively studied. Laboratory data and CTPA images were collected. Imaging characteristics were analyzed descriptively. Laboratory data were analyzed and compared between patients with and without APE. A series of 25 COVID-19 patients who underwent CTPA between January 2020 and February 2020 were enrolled. The median D-dimer level founded in these 25 patients was 6.06 μg/mL (interquartile range [IQR] 1.90-14.31 μg/mL). Ten (40%) patients with APE had a significantly higher level of D-dimer (median, 11.07 μg/mL; IQR, 7.12-21.66 vs median, 2.44 μg/mL; IQR, 1.68-8.34, respectively, P = .003), compared with the 15 (60%) patients without APE. No significant differences in other laboratory data were found between patients with and without APE. Among the 10 patients with APE, 6 (60%) had a bilateral pulmonary embolism, while 4 had a unilateral embolism. The thrombus-prone sites were the right lower lobe (70%), the left upper lobe (60%), both upper lobe (40%) and the right middle lobe (20%). The thrombus was partially or completely absorbed after anticoagulant therapy in 3 patients who underwent a follow-up CTPA. Patients with COVID-19 associated pneumonia have a risk of developing APE during the disease. When the D-dimer level abnormally increases in patients with COVID-19 pneumonia, CTPA should be performed to detect and assess the severity of APE.

scholarly journals An aberrant mediastinal medial basal segmental pulmonary artery (A7a) in a patient with lung cancer: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoshiaki Takase ◽  
Hiroyoshi Tsubochi ◽  
Ei Yamaki ◽  
Osamu Kawashima
Keyword(s):  
Lung Cancer ◽  
Colon Cancer ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Accurate Information ◽  
3D Ct ◽  
Lobe Bronchus ◽  
The Right

Abstract Background Mediastinal branching of the A7a from the right main pulmonary artery (PA) is extremely rare. Herein, we report a patient with an aberrant mediastinal A7a who underwent right basal segmentectomy for lung cancer. Case presentation A 73-year-old man was referred to our department for a right lower lobe nodule measuring 18 mm in diameter on computed tomography (CT). Three-dimensional (3D) CT revealed mediastinal A7a branching from the right main PA. As the patient had undergone colectomy for advanced ascending colon cancer, the nodule was suspected to be a metastasis from the colon primary, and thus, basal segmentectomy of the right lung was performed. Intraoperatively, the A7a was observed behind the V4+5 and middle lobe bronchus. The pathological diagnosis was combined small cell carcinoma with an adenocarcinoma component (p-T1cN0M0, stage IA3). The patient subsequently received adjuvant chemotherapy for colon cancer. At 1-year postoperative follow-up, there was no evidence of disease. Conclusion This is the first report describing an aberrant mediastinal A7a branching from the right main PA. It is important to obtain accurate information about variations of the PA using 3D-CT for safe anatomical pulmonary resection.

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