To examine any correlations between tumor maximum standard uptake values (SUVmax) in positron emission tomography-computed tomography (PET-CT) and homogeneous/heterogeneous tumor FDG uptake in ...PET-CT, and the diagnostic success of the procedure in thoracic ultrasonography (US)-guided transthoracic fine needle aspiration biopsy (TFNAB).
The files of patients who underwent thoracic US-guided TFNAB between 2013 and 2018 were examined. Patients who underwent thoracic US-guided TFNAB and were diagnosed as having primary lung cancer were considered as the US-TFNAB diagnostic group. Patients whose disease was diagnosed as primary lung cancer using a different diagnostic method (e.g. CT-guided biopsies, fiberoptic bronchoscopy) due to a lack of diagnosis despite undergoing thoracic US-guided TFNAB were allocated to the US-TFNAB non-diagnostic group. The clinical and radiologic characteristics and PET-CT parameters of the two groups were compared.
A total of 104 patients were included in the study; 79 (76%) patients whose disease was diagnosed using US-guided TFNAB, and 25 (24%) patients whose primary lung cancer could not be diagnosed with US-guided TFNAB. The mean SUVmax value of the US-TFNAB diagnostic group was 19.5 ± 10.1, whereas it was 15.1 ± 8.9 in the US-TFNAB non-diagnostic group (p = 0.016). Whether a lesion showed homogeneous or heterogeneous FDG uptake did not effect diagnostic success (p = 0.289). SUVmax value was the only effective independent factor in the diagnostic success of the procedure (p = 0.035).
High SUVmax values in PET-CT in lung cancers may increase the diagnostic success of US guided-TFNAB procedures.
Introduction: Fungus ball (aspergiloma) can be defined as spheric or ovoid conglomeration of fungal hypha, mucus and cellular debris with a fibrous wall located in cavities (mostly tuberculosis ...cavitiy) of the lung. A CT guided transthoracic FNA material showed fungal organisms, PNLs, hypha (45 degree angulation in some of them) which represents aspergilus (picture 2).
A retrospective analysis of 108 patients admitted to the hospital for hemoptysis in the year 2000 was performed. The aim of the study was to clarify the etiologic distribution of hemoptysis and the ...relation of etiology to the severity and recurrence of it. Of the cases, 79 were men and 29 were women, and the mean age was 51.74±17.51. In 77 of the cases it was the first attack, while in 31 it was recurrent. According to the severity of hemoptysis, it was classified as “mild” (<30 cm
3), “moderate” (30–100 cm
3), “severe” (100–600 cm
3) and “massive” (>600 cm
3). Lung cancer was the leading cause of hemoptysis (34.3%) followed by bronchiectasis (25.0%), tuberculosis (17.6%), pneumonia (10.2%) and pulmonary embolism (4.6%). Statistical analysis by chi-square test revealed that most of the lung cancer patients had mild hemoptysis (odds ratio 3.5;
P<0.05), and the most frequent etiology in recurrent hemoptysis was bronchiectasis (odds ratio 3.25;
P =0.01). Most of the lung cancer patients were male (
P=0.002). The two leading causes of hemoptysis in our study are similar to many previous reports. The high rate of tuberculosis in our study is probably due to the high prevalence of tuberculosis in our country.
To establish the diagnostic yield of transbronchial needle aspiration (TBNA) and its contribution to conventional diagnostic techniques (CDT) such as forceps biopsy, bronchial washing, and bronchial ...brushing in the diagnosis of malignant endobronchial lesions.
Retrospective clinical study.
One hundred fifteen lung cancer patients
We reviewed files of 115 lung carcinoma cases diagnosed in our clinic from 2001 to 2003 with endobronchial lesions sampled by CDT and TBNA. The lesions were classified into three groups: exophitic mass lesion (EML), submucosal disease, and peribronchial disease. The diagnostic yield of TBNA and CDT was compared to that of the combination of CDT and TBNA with respect to the type and location of the lesion and the histopathologic subgroups. Of the 115 cases, histology findings were confirmed by TBNA in 91 cases (79%), CDT in 75 cases (65%), and TBNA plus CDT in 105 cases (91%). The difference of the diagnostic yield of CDT vs TBNA plus CDT was statistically significant (p < 0.001). In peribronchial disease, the sensitivity of TBNA plus CDT was significantly better than CDT (87% vs 52%, p < 0.001). In EML and submucosal disease, addition of TBNA to CDT improved sensitivity from 85 to 100% and from 84 to 97%, respectively (p > 0.05). Regarding localization, the addition of TBNA to CDT increased sensitivity in the trachea and main bronchi, and in right upper and middle lobe lesions (p < 0.05). By the addition of TBNA to CDT, small cell lung cancer and non-small cell lung cancer cases demonstrated improvements in sensitivity from 74 to 100% and 61 to 87%, respectively. This significant difference (p < 0.05) was attributed to the peribronchial disease group.
In the case of peribronchial disease, the addition of TBNA to CDT improves the diagnostic yield of the bronchoscopic examination.
The secretory immunoglobulin A (IgA) system plays an important role in the protection of epithelial surfaces. The aim of this study was to evaluate whether the measurement of the primary airway Ig ...(sIgA) concentration in bronchial washings is clinically useful in patients with airway epithelial injury or inflammation. We measured serum IgA levels and sIgA concentrations in the bronchial lavages of patients with chronic bronchitis (n = 10), bronchiectasis (n = 15), lung cancer (n = 15) and in healthy control subjects (n = 10). Absolute sIgA levels of bronchial lavage fluids in the chronic bronchitis, bronchiectasis and lung cancer groups were higher than the controls, but there was no significant difference between the groups. sIgA/ml recovered bronchial fluid ratios were similar in the all groups. Standardisation of samples by means of albumin concentration ratios (sIgA/alb) showed that the bronchial lavages of the patients with lung cancer, chronic bronchitis and bronchiectasis were generally similar and demonstrated a significantly decreased sIgA/alb ratio compared to that of control subjects (p = 0.001, p < 0.05 and p < 0.05). sIgA/alb ratios in bronchial lavages recovered from involved lung of the patients with lung cancer and bronchiectasis were lower as compared to uninvolved lung (p < 0.001 and p < 0.05). There was no significant difference in serum IgA levels between all groups. As a result, although our findings seem partly to confirm the hypothesis that local bronchial IgA secretion is impaired in areas of bronchial epithelial injury or inflammation, we thought that sIgA would be useless as a marker of respiratory epithelial injury or inflammation in patients with chronic bronchitis, bronchiectasis and lung cancer.
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