• 文章类型: Case Reports
    产生粒细胞集落刺激因子(G-CSF)的肺肿瘤很少见,他们的成像特征和有效的治疗仍然难以捉摸。同样,间充质-上皮转化(MET)外显子14跳跃突变也不常见。在这里,我们报道一例产生G-CSF的肺腺癌MET第14外显子跳跃突变阳性,模仿肺脓肿。一名61岁男子出现咳嗽和高烧。对比增强胸部计算机断层扫描显示肿块有腔和内部液体积聚。患者最初接受肺脓肿的诊断治疗,但最终被诊断为MET外显子14跳跃突变阳性的肺腺癌。在替替尼治疗后,原发病变缩小,血清G-CSF水平下降,导致产生G-CSF的肺癌的诊断。产生G-CSF的肺肿瘤可以呈现模拟肺脓肿的影像学发现。Tepotinib治疗可能对MET外显子14跳跃突变的患者有效,包括那些产生G-CSF的肺癌。
    Granulocyte colony-stimulating factor (G-CSF)-producing lung tumours are rare, with their imaging features and effective treatments remaining elusive. Similarly, mesenchymal-epithelial transition (MET) exon 14 skipping mutations are also uncommon. Herein, we report a case of G-CSF-producing lung adenocarcinoma positive for a MET exon 14 skipping mutation, mimicking lung abscess. A 61-year-old man presented with cough and high fever. Contrast-enhanced chest computed tomography revealed a mass with a cavity and internal fluid accumulation. The patient initially underwent diagnostic treatment for a lung abscess but was ultimately diagnosed with lung adenocarcinoma positive for a MET exon 14 skipping mutation. Following tepotinib therapy, the primary lesion shrank, and serum G-CSF levels decreased, leading to a diagnosis of G-CSF-producing lung cancer. G-CSF-producing lung tumours can present imaging findings that mimic lung abscesses. Tepotinib therapy may be effective for patients with MET exon 14 skipping mutation, including those with G-CSF-producing lung cancer.
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  • 文章类型: Case Reports
    Congenital anomalies of respiratory system are quite diverse and not all of them are subject to surgical treatment. One example is accessory lobe of the azygos vein. This anomaly usually has no clinical manifestations and requires only follow-up, as well as attention in surgery on the right half of the chest for some other disease. This situation changes when complications occur, for example, purulent-inflammatory process. Therapy is not always effective, and lung tissue destruction requires surgical treatment. Progressive destruction complicates diagnosis and choosing surgical tactics. We present a rare case of severe purulent-inflammatory complication with abscess in accessory lobe of v. azygos. Anatomical abnormalities following this congenital pulmonary anomaly can cause difficulties in surgeries for other intra-thoracic diseases. The situation is especially relevant for thoracoscopic access. This report will be useful for radiologists, pulmonologists and thoracic surgeons.
    Врожденные аномалии развития органов дыхания достаточно разнообразны, и не все они подлежат хирургическому лечению. Одним из таких примеров считается добавочная доля непарной вены, которая в большинстве случаев не имеет клинических симптомов и требует лишь динамического наблюдения, а также учета при планировании операций на органах грудной клетки через правосторонний доступ. Ситуация кардинально меняется в случае возникновения осложнений. Как правило, это проявляется гнойно-воспалительным процессом вследствие прежде всего нарушения дренажной функции бронха. Не всегда воспаление может быть купировано консервативной терапией, что приводит к деструкции легочной ткани и требует уже хирургического вмешательства. Ситуации с прогрессирующим гнойно-деструктивным воспалением ввиду редкого возникновения данного осложнения могут вызвать трудности как при дифференциальной диагностике, так и при выборе хирургической тактики. Представлен редкий случай тяжелого гнойно-воспалительного осложнения с формированием абсцесса в добавочной доле непарной вены. Изменения топографической анатомии при данной врожденной аномалии могут вызвать затруднения и при выполнении операций по поводу других внутриторакальных хирургических болезней. Ситуация особенно актуальна при торакоскопическом доступе. Данная публикация будет полезной для врачей-рентгенологов, врачей-пульмонологов и врачей — торакальных хирургов.
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  • 文章类型: Case Reports
    该病例报告描述了一名最初接受肺炎和肺脓肿治疗的78岁男子,该男子对抗菌治疗具有耐药性,最终被诊断为纤毛腺癌。纤毛腺癌,罕见的非终末呼吸单位(TRU)型肺腺癌,由于其与肺炎和肺脓肿相似,因此提出了独特的诊断挑战。形态学上,这种情况下的纤毛腺癌似乎是非TRU型腺癌,部分粘液上皮,没有可见的细胞外粘液,甲状腺转录因子(TTF)-1阴性,和粘蛋白(MUC)5AC在免疫染色上的阳性。基于粘液上皮部分且细胞外粘液不突出的事实,该患者被认为患有纤毛腺癌。此病例强调了在未解决的肺部感染患者中考虑恶性肿瘤的重要性。
    This case report describes a 78-year-old man initially treated for pneumonia and lung abscess who was resistant to antimicrobial treatment and was eventually diagnosed with ciliated adenocarcinoma. Ciliated adenocarcinoma, a rare non-terminal respiratory unit (TRU)-type lung adenocarcinoma, presents a unique diagnostic challenge because of its similarity to pneumonia and lung abscesses. Morphologically, the ciliated adenocarcinoma in this case appeared to be a non-TRU type adenocarcinoma, with partial mucous epithelium, no visible extracellular mucus, thyroid transcription factor (TTF)-1 negativity, and mucin (MUC) 5AC positivity on immunostaining. The patient was considered to have ciliated adenocarcinoma based on the fact that the mucous epithelium was partial and extracellular mucus was not prominent. This case emphasizes the importance of considering malignancy in patients with non-resolving pulmonary infections.
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  • 文章类型: Case Reports
    腰大肌脓肿是一种相对罕见的疾病,可以表现出模糊的临床特征。患有这种疾病的患者通常以不同的方式出现在不同的专科,导致诊断和管理延迟。
    作者介绍了一名47岁的女性,主诉腹部模糊疼痛,发烧,接受CT检查的炎症标志物升高。在CT上,在右髂窝中发现了一个集合,该集合沿着右腹膜后延伸,穿过右肺基部的后外侧间隙,与具有空气-液体水平的空洞性肺病变连通。腰大肌脓肿被引流。
    我们的案例呈现了许多罕见和有趣的特征。值得注意的是,病人,有免疫能力的人,经历了原发性葡萄球菌感染,迅速发展为相当大的肺脓肿,在这样的宿主中不常见的现象。稀有性进一步延伸到感染源,起源于腹部,但通过腹膜后部位的连续扩散最终导致胸部并发症。尽管潜在的严重性,患者的结果非常积极。
    该病例强调了腰大肌脓肿肺部受累的潜在速度,强调在术前评估期间需要提高对呼吸体征的认识和考虑。
    UNASSIGNED: Psoas abscess is a relatively uncommon condition that can present with vague clinical features. Patients with this condition often present in different ways to different specialties leading to delays in diagnosis and management.
    UNASSIGNED: The authors present a 47-year-old woman with complaint of vague abdominal pain, fever, and raised inflammatory markers who underwent CT examination. On CT, a collection was noted in the right iliac fossa that extended along the right retroperitoneum through the retrocrural space in the right lung base communicating with a cavitary pulmonary lesion with air-fluid level. The psoas abscess was drained.
    UNASSIGNED: Our case presents a number of rare and intriguing features. Notably, the patient, who was immunocompetent, experienced a primary Staphylococcus infection that swiftly progressed to a sizable pulmonary abscess, a phenomenon uncommon in such hosts. The rarity further extends to the source of infection, originating abdominally but culminating in thoracic complications through contiguous spread from a retroperitoneal site. Despite the potential severity, the patient\'s outcome was remarkably positive.
    UNASSIGNED: This case underscores the potential rapidity of pulmonary involvement in psoas abscesses, emphasizing the need for heightened awareness and consideration of respiratory signs during preoperative assessments.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Case Reports
    牙源性感染可以扩散到呼吸道。尽管已知连翘膜作为牙周炎的主要病原体的作用,连翘衣原体感染与肺炎或肺脓肿风险之间的关联尚不清楚.在这份报告中,我们介绍一例由连翘衣原体感染引起的肺脓肿。通过宏基因组下一代测序(mNGS)在患者的支气管肺泡灌洗液中检测到病原体。讨论了感染的临床特征和可能的机制。连翘曲霉菌是一种条件性病原体,在存在辅助细菌和宿主免疫状态降低的情况下可引起肺脓肿。治疗过程应该是个性化的,可能超过3个月。
    Odontogenic infections can spread to the respiratory tract. Despite the known role of Tannerella forsythia as the primary pathogen in periodontitis, the association between T. forsythia infection and risk of pneumonia or lung abscess remains unknown. In this report, we present a case of lung abscess caused by T. forsythia infection. The pathogen was detected by metagenomic next-generation sequencing (mNGS) in the bronchoalveolar lavage fluid of the patient. The clinical characteristics and possible mechanisms of the infection are discussed. T. forsythia is a conditional pathogen that can cause lung abscess in the presence of helper bacteria and reduced host immune status. The course of treatment should be personalized and might be longer than 3 months.
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  • 文章类型: Case Reports
    肺放线菌病是一种罕见的感染性疾病,由于非特异性影像学异常以及需要通过CT引导的活检或支气管镜反复进行肺部采样,因此难以诊断。它可能会出现咯血,有或没有抗生素治疗,可能需要支气管动脉栓塞。我们在这里报告一例肺部放线菌病,胸部CT成像,数字减影血管造影,和病理标本。
    Pulmonary actinomycosis is a rare infectious disease that can be difficult to diagnose due to nonspecific imaging abnormalities and to a need for repeated lung sampling by CT-guided biopsy or bronchoscopy. It may present with hemoptysis, which can occur with or without antibiotic therapy and bronchial artery embolization may be required. We report here a case of pulmonary actinomycosis with imaging by thoracic CT, digital subtraction angiography, and pathological specimens.
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  • 文章类型: Case Reports
    肺脓肿和脓胸是社区获得性肺炎的重要并发症,特别是在患有肥胖症等合并症的患者中,哮喘,和vaping(这可能导致vaping相关的肺损伤)。虽然这些情况很少同时发生,它们共存显著增加了死亡率和发病率.管理策略通常涉及多学科方法,通过成像结合诊断评估,抗生素的管理,经常手术引流。虽然抗生素是治疗这两种疾病的基础,脓胸管理几乎总是需要手术干预。初始成像通常包括普通射线照片,尽管超声和肺部CT扫描提供了更高的灵敏度和流体特征。这里,我们介绍了一例24岁的病态肥胖患者,有支气管哮喘病史,最初表现为社区获得性肺炎,随后恶化为肺脓肿和脓胸,最终需要手术干预。
    Lung abscess and empyema represent significant complications of community-acquired pneumonia, particularly in patients with comorbidities such as obesity, asthma, and vaping (which can lead to vaping-associated lung injury). While these conditions rarely occur simultaneously, their coexistence significantly escalates both mortality and morbidity. Management strategies typically involve a multidisciplinary approach, incorporating diagnostic evaluation through imaging, administration of antibiotics, and often surgical drainage. While antibiotics are fundamental in treating both conditions, empyema management almost invariably necessitates surgical intervention. Initial imaging usually involves plain radiographs, although ultrasound and lung CT scans provide heightened sensitivity and fluid characterization. Here, we present the case of a 24-year-old morbidly obese patient with a history of bronchial asthma initially presenting with community-acquired pneumonia, which subsequently deteriorated into lung abscess and empyema, ultimately requiring surgical intervention.
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  • 文章类型: Case Reports
    阑尾炎是阑尾(位于盲肠底部附近)的炎症。肺脓肿是包含坏死的肺组织或感染的液体成分的空洞性病变。它主要是由于肺实质疾病而发生的。该患者是一名25岁的男性,首次出现发热咳嗽和低烧相关胸痛的1周病史。他被诊断为穿孔性盲肠阑尾炎的并发症,患有肺脓肿。我们报告这一点是为了减少这种罕见并发症的诊断延迟的挑战,特别是当患者的胸部X光检查类似脓胸时,避免受到虐待。此外,我们鼓励对这个主题进行进一步的研究。
    Appendicitis is an inflammation of the vermiform appendix (located near the base of the cecum). A lung abscess is a cavitary lesion containing necrotic lung tissue or an infected fluid component. It mainly occurs as a result of lung parenchymal disease. The patient was a 25-year-old male who first presented with a 1-week history of productive cough and chest pain associated with low-grade fever. He was diagnosed with a lung abscess as a complication of perforated retro cecal appendicitis. We report this in consideration of reducing the challenge of delay in diagnosis of this rare complication, and to avoid mistreatment specifically when the patient\'s chest x-ray resembles empyema. Additionally, we encourage doing further studies on this topic.
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  • 文章类型: Case Reports
    肺动脉假性动脉瘤(PAP)并不常见,然而,它们经常导致咯血,并与不良预后有关。我们报告一例87岁男性患者。最初,他住进了以前的医院,诊断为左下叶肺脓肿.在第二个住院日,他出现咯血.对比增强胸部计算机断层扫描(CT)确定了感染性肺动脉假性动脉瘤。第九个住院日,肺动脉弹簧圈栓塞术成功,显著改善患者的病情。
    Pulmonary artery pseudoaneurysms (PAPs) are uncommon, yet they frequently result in hemoptysis and are associated with a poor prognosis. We report a case of an 87-year-old male patient. Initially, he was admitted to a previous hospital, and diagnosed with a lung abscess in the left lower lobe. On the second hospital day, he developed hemoptysis. A contrast-enhanced chest computed tomography (CT) identified an infectious pulmonary artery pseudoaneurysm. On the ninth hospital day, pulmonary artery coil embolization was successfully performed, significantly improving the patient\'s condition.
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