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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Imaging is unable reliably to distinguish carcinoid from bronchial carcinoma. At bronchoscopy, carcinoids appear as highly vascular (‘cherry-red’) tumours growing into the airway lumen. Lung biopsy may be required if not classical in appearance, but there is a significant risk of bleeding.
Paper 1
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Fibrosing alveolitis is a disease characterised by an increase in inflammatory cells and lung fibrosis. It can be associated with other connective tissue disorders, autoimmune thyroid disease and ulcerative colitis. Patients present with a dry cough, exertional dyspnoea, weight loss and malaise. Signs include clubbing and fine end-inspiratory crepitations (Velcro crepitations). Chest x-ray shows a honeycomb pattern as a late sign. Antinuclear antibodies and rheumatoid factor are present in 35% of patients. ESR is usually raised. Lung biopsy may be needed for diagnosis and staging. Immunosuppresion with steroids is the mainstay of treatment.
Unusual Inherited Pulmonary Diseases Which Provide Clues to Pulmonary Physiology and Function
Published in Stephen D. Litwin, Genetic Determinants of Pulmonary Disease, 2020
Thomas Κ. C. King, Robert A. Norum
In many instances, a lung biopsy is necessary to make the diagnosis. This is justifiable since the different disorders require different modes of treatment and there is evidence that early therapy can significantly alter the course of the disease.
Transbronchial Lung Cryobiopsy in children
Published in Expert Review of Respiratory Medicine, 2022
Generally, there are two main methods to obtain lung tissue biopsy, namely Surgical Open Lung Biopsy (SOLB) and Conventional Transbronchial Lung Biopsy (C-TBLB), using the biopsy forceps. For lung tissue diagnosis, a limited number of studies that had been previously performed reported that SOLB is considered to be a good alternative. The reason behind this is its substantial diagnostic yield, which might result in specifying an appropriate treatment for various types of chILD, but the outcomes have not been well studied [11]. Although sufficient tissue can be obtained via SOLB, patients have to be monitored more cautiously due to its invasive nature, especially if they have an unstable condition or a history of uneven recovery. Furthermore, a limited number of articles have stated that it is challenging to obtain lung tissue through the SOLB technique in children with chILD, making it a potentially dangerous method, especially for patients with respiratory failure [1,12].
Prospective nanoparticle treatments for lymphangioleiomyomatosis
Published in Expert Opinion on Drug Delivery, 2022
Emelie Landh, Roger Wang, Lyn M. Moir, Daniela Traini, Paul M. Young, Hui Xin Ong
Lymphangioleiomyomatosis (LAM) is a rare neoplastic lung disease that mainly manifests in women during their reproductive years, affecting 1 in 200,000 women [1]. The origin of LAM remains unknown, but in 1993, the gene that causes tuberous sclerosis was identified and located on chromosome 16 [2]. Later, evidence showed that mutations in the tuberous sclerosis complex 2 (TSC2) gene located on chromosome 16 was associated with LAM [3]. There are two types of LAM, S-LAM that occurs sporadically and TS-LAM that occurs in association with the disease tuberous sclerosis [3,4]. TS-LAM is caused by mutational inactivation of the tumor suppressor genes, TSC1 and 2, while S-LAM is caused by inactivation of TSC2 with both resulting in the constitutive activation of the mTOR pathway [3]. The activation of this pathway causes increased cell proliferation, migration, and autophagy (Figure 1) [4,5]. There is currently no cure for LAM, and the primary causes of mortality and morbidity are airway obstruction, decreased lung function, and collapsed lungs. While the disease course tends to vary greatly between individuals, it is estimated that mortality at 10 years is approximately 30% from the time that a lung biopsy is performed [6] and 10–20% from the onset of symptoms [6–8].
A woman and her breathtaking jewelry
Published in Acta Clinica Belgica, 2021
Dimitri Stylemans, Karolien Vekens, Stefanie Vincken, Shane Hanon, Eef Vanderhelst
HRCT scan alone is insufficient to diagnose the disease in most cases. Usually, a lung biopsy will be required to exclude other diagnoses [1]. The differential diagnosis of pulmonary siderosis consists of respiratory diseases with presence of a centrilobular reticulonodular pattern like hypersensitivity pneumonitis, infectious diseases (including endobronchial tuberculosis) as well as other pneumoconiosis (like coal workers pneumoconiosis) and sarcoidosis. Multidisciplinary consultation in the presence of pulmonologist and radiologist (specialized in occupational diseases) as well as pathologist is important to decide whether a biopsy is necessary. Pathological examination is characterized by Perls’ stain positive iron-loaded macrophages, localized in the perivascular and peribronchial area’s [3]. Benign forms of pneumoconiosis do, by definition, not cause fibrosis. However, if fibrosis is present in the lung biopsy of a suspected patient, this can be caused by concomitant inhalation of silica or asbestos (e.g. in welders and grinders) [3,4].