Miliary pattern due to occupational lung disease in a patient with laryngeal cancer

Inhalation of metal dusts and fumes can induce a wide range of respiratory disorders, including granulomatosis, chemical pneumonitis and pulmonary interstitial disease. Laryngeal cancer is the most common cancer of the upper aerodigestive tract. We present a patient with occupational lung disease whose chest CT showed miliary nodular pattern, with concurrent laryngeal cancer who had been engaged in type printing for 22 years. Histology of the laryngeal lession showed squamous cell laryngeal cancer. Histology of the nodules showed a foreign body granulomatous response with several foreign body cells, most probably due to exposure to numerous inorganic (lanthanides, elements such us La, Ce, Nd, Sm, EU, Tb, Lu) and organic particles (such us acrylates, epoxy- and urethane-acrylates).

Cystic thymoma coexisting with vascular dysplasia

We report the case of a 23-year-old female patient, who was admitted to our hospital because of aggravating pain in the right shoulder, right chest and ear accompanied by cough and dyspnea. Imaging revealed a soft tissue mass in the mediastinum in close relation with an additional large mass extending in the right upper thorax, right axilla and neck. The tissue obtained during surgery showed the former mass to be a cystic thymoma, being in contact with an extensive vascular dysplasia. The characteristic clinical presentation, the contribution of imaging, the results of operation, and the follow-up are rather unique. The review of the literature did not reveal similar cases.

Nasopharyngeal adenoid cystic carcinoma: a rare nasopharyngeal tumor

Adenoid cystic carcinoma (ACC) is the most common histologic subtype of the salivary gland malignancies, but it is very rare in the nasopharynx with relatively few cases reported in the literature. We report a case of a 57 year-old woman with an ACC in the right Rosenmuller fossa of the nasopharynx, treated with combined radiotherapy and chemotherapy, without any recurrence or intracranial spread detected until the recent follow-up.

Non-invasive estimation of pulmonary arterial hypertension in chronic obstructive pulmonary disease

The feasibility and reliability of the combination of several noninvasive methods using a multivariate method of analysis to predict pulmonary artery hypertension (PAH) is evaluated in 20 patients with chronic obstructive pulmonary disease. These methods comprised arterial blood gases (Pao2, Paco2), pulmonary functional parameters (FEV1), echo-Doppler parameters (tricuspid regurgitation jets, acceleration time on pulmonary valve), computed tomography measurements (transhilar distance, hilar thoracic index, and measurement of the descending branch of the right pulmonary artery to the lower lobe). A multiple stepwise regression analysis (including one Doppler parameter, two parameters of arterial blood gases, and one functional parameter) revealed a coefficient of determination (R2) equal to 0.954 for mean pulmonary artery pressure (MPAP) with a standard error of estimate (S.E.E.) of 5.25 mmHg. A stepwise regression analysis including computed tomography and radiographic parameters revealed an R2 equal to 0.970 for PAP with a S.E.E. of 4.26 mmHg. Logistical regression analysis classified correctly 80% of patients with PAH using noninvasive methods such as the diameter of the main pulmonary artery and the diameter of the left pulmonary arterial branch calculated by computed tomography. Not only the presence of PAH but also the level of MPAP can be estimated by the combination of multiple stepwise and logistical regression analyses.