The role of autofluorescence bronchoscopy in monitoring a tumorous lesion in the bronchial mucosa: a case report

INTRODUCTION

Autofluorescence bronchoscopy (AFB) is a diagnostic procedure that is included in all diagnostic algorithms discovering precancerous lesions in the large airways.

CASE REPORT

We presented a 71-year-old patient submitted to exploration due to prolonged cough. Both noninvasive and invasive pulmonary diagnostic management was carried out. On bronchoscopy, an endobronchial mass was detected in the apical bronchus. A positive endoscopy finding indicated AFB which disclosed a fluorescence alteration of the tumor mucosa and the former bronchoscopy site. Histopathological analysis of the catheter biopsy obtained samples from the right upper lobe confirmed fibrinous purulent pneumonia in organization. The applied treatment resulted in regression of both symptoms and the lesion in the right upper lobe. Due to a positive AFB finding, the patient was regularly observed over the following three years, having had three control AFB to monitor the initial finding.

CONCLUSION

AFB may be utilized in the routine of everyday practice to assess the spread of the disease, as well as in the postsurgical and long-term follow-up of operated patients. The procedure may also be applied to enable an easier and more reliable observation of patients with suspicious endobronchial lesions, smokers with altered fluorescence of the bronchial mucosa, and chronic patients.

Chronic necrotizing pulmonary aspergillosis

INTRODUCTION

Chronic necrotizing pulmonary aspergillosis (CNPA) is a cavitary, infectious process of lung parenchyma with slow progressive course. Vascular invasion and dissemination to other organs are unusual.

CASE REPORT

We presented a 25-year old man with bilineal acute leukaemia who developed pulmonary and systemic symptoms. Chest CT showed nodular consolidations and cavitary lesions in both lungs. Bronchial biopsy revealed necrotic hyphae but it was negative for Aspergillus by culture. Serum was positive for antibodies to Aspergillus, but it was negative for antigens. A thoracoscopic lung biopsy of the upper left lobe revealed necrosis of lung tissue, with acute and chronic inflammation of the cavity wall and the presence of hyphae consistent with Aspergillus species.

CONCLUSION

Although confirmation of the diagnosis is difficult, a combination of characteristic clinical, radiological and histological findings and either serological results positive for Aspergillus or the isolation of Aspergillus from respiratory samples are highly indicative of CNPA.

Adult human case of toxocariasis with pulmonary migratory infiltrate and eosinophilia

INTRODUCTION

Toxocariasis is a zoonosis which is in Serbia characterized with a very high infection rate of dogs and excessive contamination of the soil with the eggs of Toxocara canis, the agent of the disease. Toxocara-induced infections have in recent years been established in a few hundreds of children, but toxocariasis has rather rarely been diagnosed in adults.

CASE REPORT

We reported toxocariasis (visceral larva migrans) in an adult, manifested by migratory pulmonary infiltrates and positive serological test finding to Toxocara.

CONCLUSION

Human toxocariasis is a rare disease in adults, therefore it should be considered in adult patients presented with eosinophilia and migratory pulmonary infiltrates.

[Electrocardiography and echocardiography in the diagnosis of chronic cor pulmonale]

The study was aimed at evaluating the possibilities of electrocardiography (ECG) and echocardiography in establishing the diagnosis of chronic pulmonary heart disease (CPHD). Sixty patients with a chronic obstructive pulmonary disease (COPD) and clinical symptoms of cardiac decompensation were observed. The examined patients ranged from 26 to 74 years of age, the mean age being 59.25 years. The diagnosis of CPHD was established by electrocardiography in 43 patients (78.18%) while in 57 patients (95%) it was done by ultrasound cardiography. Morphologic changes of the right ventricle (RV) were quantified, i.e. the diagnosis of chronic pulmonary heart disease was confirmed by echocardiography parameters such as right ventricle free wall thickness--RVFWT (0.82 +/- 0.09 cm), enddiastolic right ventricle dimension--ERVD (3.78 +/- 0.73 cm) and tricuspid regurgitation--TR (2.9 +/- 0.59, i.e. 2.58 +/- 0.55 after therapy). The information on the right ventricle function was provided by the values of echocardiography parameters, right ventricle ejection fraction--RVEF (30.98 +/- 5.88%, i.e. 34.1 +/- 5.64 after therapy) and right ventricle systolic pressure--RVSP (60.41 +/- 16.98 mmHG, i.e. 51.50 +/- 12.76 after therapy). Monitoring of these values after therapy, as well as of the RTO changes gave a good insight into the therapy effects. Echocardiography has been concluded to be of better sensitivity than ECG in diagnosing CPHD and both methods, noninvasive and easily applicable, have an important role in examining cardiac changes in patients with COPD.

[Primary pulmonary cancer in women the the Doboj Region]

The aim of this work is primary lung cancer in female population of the Doboj district in the period 1975-88. incidence research as well as age structure, localisation, histological types, stage and diseases associated with lung cancer. A group of 114 female patients was investigated and as comparative group male patients with lung cancer in the same period was used. The results show that incidence rate increase is significant and in the future that trend will be continued. Especially serious is often microcellular and adenocarcinoma appearance as well as female non-smoking patients (42%) and patients with diabetes mellitus (18%) in the investigated group high percentage. These phenomena lead to conclusion that risk factors are partly different and they should be better investigated. Females with diabetes mellitus require special treatment and further research should be focused on diabetes--lung cancer relationship.

[Pulmonary tuberculosis in patients with primary bronchial carcinoma]

The aim of this study was to determine the percentage of patients with lung cancer associated with pulmonary tuberculosis, and difference between those who only suffered from lung cancer and those who had lung cancer associated with any kind of pulmonary tuberculosis. In that sense two groups of patients: first one--110 lung cancer cases with different forms of pulmonary tuberculosis (investigated group), and second one--686 patients without any signs of pulmonary tuberculosis (control group) were studied and compared. Three scare cancers were squamous, three were adenocarcinoma and one undifferentiated cell type.