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[en] Ninety-six patients with inoperable carcinoma of the bronchus were entered into a prospective study of the effectiveness of palliative radiotherapy. The median survival of the group as a whole was 38 weeks. Major symptoms such as cough, dyspnoea and haemoptysis were well controlled at 3 months and 6 months follow-up. There were no significant effect on performance status. Dysphagia and tiredness occurred in 81% of patients, but were classed as mild in 41% and 47% respectively, lasting less than 4 weeks in 86%. There was no correlation between the radiotherapy dose received and symptom control. 14% of patients were dead within approximately 3 months of treatment and were unlikely to have benefited from therapy. Careful selection of patients for palliative radiotherapy is recommended. (author)
[en] Background: The incidence and findings of tuberculous invasion of the peripheral bronchus have not been fully investigated with MDCT. Purpose: To evaluate the prevalence and findings of MDCT abnormalities of small- and medium-sized bronchus (SMB) in active pulmonary tuberculosis (TB). Material and Methods: Using multiplanar reformation, 35 consecutive MDCT scans (follow-up exams available in 14 patients with a mean interval of 8.1 months) were assessed for following abnormalities of SMB: bronchial impaction (BI), wall thickening, dilatation, peribronchial cuff of soft tissue, and bronchocavitary fistula. It was also assessed whether tree-in-buds (TIB) have a tendency to distribute in the territories of diseased SMB, and whether SMB abnormalities are present in patients with relatively mild disease. Results: SMB abnormalities were observed in 23 (65.7%) patients with active TB. The most frequent finding was wall thickening (n=18, 51.4%), followed by BI (n=13, 37.1%; zigzag-shaped in four), dilatation (n =11, 31.4%), amputated appearance of air column (n=11, 31.4%), peribronchial cuff of soft tissue (n=10, 28.6%), and bronchocavitary fistula (n=8, 22.9%). TIB (n=29; absent in two patients with SMB) was mainly within (n=14) or close to (n=4) the territory of diseased SMB. Follow-up CT frequently showed improvement of wall thickening (11/12) and persistence of bronchial dilatation (11/13). SMB abnormality was present in all of six patients with mild disease. Conclusion: MDCT shows that tuberculous invasion of the peripheral bronchus may be more frequent than previously thought, of which findings include wall thickening, BI, dilatation, amputated appearance of air column, peribronchial cuff of soft tissue and bronchocavitary fistula
[en] A case of congenital multilocular intrapulmonary bronchogenic cyst which was undifferentiated radiographically from congenital lobar emphysema, large pneumatocele, or tension pneumothoax is reported. The cyst occupied about 4/5 of left lung fields and displaced the mediastinal structures to right moderately and compressed the remaining left lungs severely
[en] Objective: To report pulmonary squamous cell carcinomas presenting as localized, long, continuous, bronchial thickening on computed tomography (CT). Materials and methods: This study comprised five men (mean age, 66 years; range, 60–79 years) with pulmonary squamous cell carcinoma, including two (0.6%) selected from 310 consecutive patients with the diagnosis. Inclusion criteria were as follows: histological diagnosis obtained from thickened bronchi; continuous bronchial thickening > 5 cm in longitudinal extension on CT. CT scans were retrospectively reviewed, focusing on bronchial abnormalities. They were correlated with histopathological findings in four patients who underwent lobectomy. Results: On initial CT, bronchial thickening was continuous without skip area (n = 5), measured 56–114 mm in maximum longitudinal length, involved lobar (n = 3) or segmental and distal bronchi (n = 5) of the right upper (n = 4) or lower (n = 1) lobe, and was focally bulbous (n = 2). Follow-up CT before treatment, available in two, showed progression of bronchial thickening in its thickness and longitudinal length (n = 2) and a new bulbous portion (n = 1) and peribronchial nodules (n = 1) along the thickened bronchi. Cancer recurred after lobectomy in two, one of which manifested as continuous bronchial thickening extending from the bronchial stump on CT. On CT-histopathological correlation, bronchial thickening was mostly due to tumor spreading along the bronchus. A focal or short segmental tumor outgrowth from the thickened bronchi corresponded to a nodule or bulbous portion along thickened bronchi on CT, respectively. Conclusion: Pulmonary squamous cell carcinoma may present as localized, long, continuous, bronchial thickening on CT, simulating benign infectious or inflammatory diseases.
[en] Transcatheter embolization of bronchial arteries and non-bronchial systemic collaterals appears to be a well accepted means of accomplishing temporary or permanent hemostasis in the management of massive of chronic recurrent hemoptysis. We have performed 37 embolization procedures on 31 hemoptysis patients at our hospital through the period of July 1986 to December 1987 (18 months). The results were as follows: 1. The causes of hemoptysis were pulmonary tuberculosis (22 cases), bronchiectasis (7 cases), aspergillosis (1 case) and chronic bronchitis (1 case). 2. The embolized vessels responsible for hemoptysis were the bronchial arteries 39 (57.5%) and/or the non-bronchial systemic collaterals 30 (43.5%). 3. Rebleeding occurred in 6 out of 15 case of chronic recurrent hemoptysis, in 3 out of 5 cases of massive hemoptysis of over 600 ml per day, and occurred most often within 2 weeks after embolization. 4. A to fifteen month follow-up showed no further hemoptysis in 26 cases. The success rate of these embolization procedures was therefore 83.9%.
[en] The aim of this study was to evaluate differences in the prevalence of patterns of CT bronchus sign in malignant solitary pulmonary lesions (SPLs), according to their histologic cell types and with respect to size, location, and degree of cell differentiation. Computed tomography scans of 78 patients, in whom pathologically confirmed malignant SPLs with CT bronchus sign were present, were randomly selected and reviewed by two radiologists under consensus. All 78 were CT scans done using spiral technique with 10-mm collimation and 10-mm reconstruction intervals with enhancement, and 75 included additional high-resolution CT scans. Lesions were classified into four cell types as squamous cell carcinoma (n=24), small cell carcinoma (n=12), adenocarcinoma (n=23), bronchioloalveolar carcinoma (BAC; n=9), and others (n=12), into three degrees of differentiation, into three size groups, and according to location (central or peripheral). Patterns of CT bronchus sign were classified into abruptly obstructing (I), patent (II), displacing (III), or tapered narrowing (IV) types. The relationships between the patterns of CT bronchus sign and cell type and degree of cell differentiation were evaluated. Eighty patterns of CT bronchus sign were observed in 78 patients. According to cell type, squamous cell carcinoma showed most often type-I pattern (45.8%) but no type-II pattern, which was the most common pattern observed in BAC (77.8%) and adenocarcinoma (34.8%; p<0.01). Small cell carcinoma showed a varied distribution among the four patterns of CT bronchus sign. According to location, in central squamous cell carcinomas, type-I pattern was more common(55%; p<0.01). Bronchioloalveolar carcinoma showed more peripheral lesions and in both central and peripheral lesions, type-II pattern was significantly more common (100 and 66.7%; p<0.01). In SPLs with CT bronchus sign of obstructing pattern, especially if central location, squamous cell carcinoma should be suspected, whereas in SPLs with patent CT bronchus sign, regardless of the location, the strong possibility of BAC should be considered. (orig.)
[en] Classical fibrobrobronchoscopy is very important for diagnostics of the respiratory tract diseases. It is invasive method and need usually in children total narcosis. CT virtual bronchoscopy is new non-invasive technic for assessment mainly respiratory ways. Ingenious technic create realistic three-dimensional space of the superficial area of the tracheobronchial tree.This technic allows of the interactive movement through the respiratory ways, with visual identification behind obstructive lesion too. (author)