lung

摘要： BACKGROUND It now seems that all pulmonary hamartomas(PHs)are large cystic-solid lesions that are difficult to diagnose.However,few cases of large cystic-solid PHs have been reported.The present case report presents a large cystic-solid PH and provides a literature review of the imaging features,formation mechanism and histopathological basis of PHs.CASE SUMMARY A 53-year-old woman with no clinical symptoms underwent a chest computed tomography(CT)examination at our hospital.Nonenhanced CT images revealed a large,flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor;the solid part of the tumor showed abundant fat and lamellar soft tissue components.Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images.Given the large size of the lesion,the patient elected to undergo surgery.Histological examination revealed PH.A detailed review of the patient’s CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe,which was a clue to its lung tissue histological origin.According to immunohistochemical staining,the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium.CONCLUSION This case shows the imaging manifestations of a large PH.Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.

摘要： Dear editor,Shrinking lung syndrome(SLS),a rare complication of autoimmune inflammatory diseases,is mainly associated with systemic lupus erythematosus(SLE),with an occurrence in 1%-2%of cases.^([1])It is characterized by restrictive defects on pulmonary function tests(PFTs)associated with reduced lung volume.SLS has also been reported in cases of primary Sjogren syndrome(pSS),^([2,3])scleroderma,^([4])rheumatoid arthritis,^([5])mixed connective tissue disease,⑹and undifferentiated connective tissue disease.Herein,we present three case reports of SLS,including two patients with SLE and one patient with adultonset StilFs disease(AOSD)(Table 1).

摘要： Langerhans cell histiocytosis(LCH)is a rare proliferative histiocyte disorder.It can affect any organ or system,especially the bone,skin,lung,and central nervous system(CNS).In the CNS,the hypothalamic-pituitary is predominantly affected,whereas the brain parenchyma is rarely affected.LCH occurring in the brain parenchyma can be easily confused with glioblastoma or brain metastases.Thus,multimodal imaging is useful for the differential diagnosis of these intracerebral lesions and detection of lesions in the other organs.CASE SUMMARY A 47-year-old man presented with a headache for one week and sudden syncope.Brain computed tomography(CT)and magnetic resonance imaging showed an irregularly shaped nodule with heterogeneous enhancement.On^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/CT,a nodule with^(18)F-FDG uptake and multiple cysts in the upper lobes of both lungs were noted,which was also confirmed by high-resolution CT.Thus,the patient underwent surgical resection of the brain lesion for further examination.Postoperative pathology confirmed LCH.The patient received chemotherapy after surgery.No recurrence was observed in the brain at the 12-mo follow-up.CONCLUSION Multimodal imaging is useful for evaluating the systemic condition of LCH,developing treatment plans,and designing post-treatment strategies.

摘要： BACKGROUND Papillary thyroid carcinoma(PTC)is the most common endocrine malignancy.Papillary thyroid microcarcinoma(PTMC)accounts for the majority of PTC cases.However,concurrent pulmonary and hepatic metastases of PTMC are rarely seen.Here,we present a patient with coexisting liver and lung metastases from PTMC.CASE SUMMARY We describe a 26-year-old woman with PTMC with multiple concurrent metastases.After 3 d of unexplained fever,she was admitted to our hospital.Her thyroid functional tests were abnormal.Her positron emission tomography(PET)/magnetic resonance imaging(MRI)examination showed increased fluorodeoxyglucose(FDG)metabolism and space-occupying lesions in the left lobe of the thyroid.Additionally,PET/MRI images revealed multiple nodules in the lung and liver with increased FDG metabolism.Chest computer tomography(CT)showed multiple pulmonary metastases.Abdominal ultrasound and liver MRI showed multiple space-occupying lesions in the liver.The patient underwent total thyroidectomy and central lymph node dissection.Postoperative pathological analysis showed a papillary microcarcinoma multiplex in the left lobe of the thyroid.A diagnosis of hepatopulmonary metastases from papillary thyroid microcarcinoma was made.The patient was given iodine-131 treatment one year after the surgery.She recovered well after the operation,and the incision healed well.After discharge,she was treated with oral levothyroxine sodium tablets,and symptomatic and supportive treatments were also given to promote radioactive excretion and prevent bone marrow suppression by iodine-131 treatment.CONCLUSION Since patients with thyroid cancer concurrent with hepatopulmonary metastases have rarely been reported,our case will highlight the clinical and pathological profiles of these patients.

摘要： Introduction: Mycobacteria pulmonary diseases are chronic illnesses with various impacts on patients’ health status, and wellbeing. These diseases currently represent a global health issue due to increasing burdens and the lack of new development on therapeutic options. Policies based on the quality of life may help to improve the management of this chronic respiratory disease;this study was designed to assess the quality of life of patients treated for the pulmonary mycobacterial disease. Materials and Methods: Participants diagnosed with a mycobacterial pulmonary disease were selected from the University Clinical Research Centers’ (UCRC) 2019 mycobacterial cohort database. A telephone interview was conducted using the Medical Outcome Study Short Form (SF-36) which has 36 items evaluating physical and mental wellbeing. Scores range from 0 - 100, with higher scores indicating greater Health-related quality of life (HRQOL). Statistical analysis was performed with SPSS 23.0 and the Fisher test was used to compare percentages. A p-value less than 0.05 was considered significant. Results: A total of 26 participants were reached and interviewed by phone. The mean age was 42 ± 10.6 years, and 76.9% (20/26) were male. The most common cause of the mycobacterial pulmonary disease was Mycobacterium tuberculosis, with 84.6% (22/26). Four cases of Non-Tuberculous Mycobacteria (NTM) were diagnosed including one Mycobacterium avium complex strain (MAC). HIV-positive cases were 46.2% (12/26), and the main respiratory sign was cough for all the participants (100%), followed by dyspnea 46.2% (12/26), chest pain 38.5% (10/26). The mean BMI was 19.7 ± 6.9 kg/m2, the mean respiratory rate was 24.7 ± 8.6, and the mean hemoglobin was 11.8 ± 2.2 g/dl. The mean SF-36 score was 75.1 ± 16.6, and impairment was mainly related to mental problems in 59.6%. The mean total score was significantly lower with age more than 42 years than age less than 42 years. But HIV positive and BMI less than 18.5 do not lead to a significant change of mean total score. Conclusion: Patients with mycobacterial pulmonary diseases have more psychological problems than physical ones. Hence the importance of psychological support in their management to improve their quality of life. A large sample size with a deep interview component would be necessary to address limitations in this design.

摘要： Hepatoid adenocarcinoma of the lung is a rare tumor with a poor prognosis. There are no specific treatment-recommendations for this cancer. We report a 59-year-old man, a former smoker, with this condition. He presented with a cough and computed tomography revealed a pulmonary nodule (50 × 47 × 48 mm) with a right pleural effusion, together with a cerebral right temporal-lobe lesion and a right adrenal lesion. The serum alpha-fetoprotein value was normal. Histological examination via bronchoscopic biopsy revealed an adenocarcinoma. Positive CK7, AE1/AE2, and TTF1 with granular cytoplasmic staining on immunohistochemical study confirmed the diagnosis of hepatoid adenocarcinoma of the lung, stage IV-B. The patient had received chemotherapies (carboplatin-pemetrexed, gemcitabine) and cerebral radiotherapy, but he died at eight months of the treatment as a result of tumor progression.

摘要： Artificial intelligence(AI)is a branch of computer science where machines are trained to imitate human-level intelligence and perform well-defined tasks.AI can provide accurate results as well as analyze vast amounts of data that cannot be analyzed via conventional statistical methods.AI has been utilized in pulmonary medicine for almost two decades and its utilization continues to expand.AI can help in making diagnoses and predicting outcomes in pulmonary diseases based on clinical data,chest imaging,lung pathology,and pulmonary function testing.AI-based applications enable physicians to use enormous amounts of data and improve their precision in the treatment of pulmonary diseases.Given the growing role of AI in pulmonary medicine,it is important for practitioners caring for patients with pulmonary diseases to understand how AI can work in order to implement it into clinical practices and improve patient care.The goal of this mini-review is to discuss the use of AI in pulmonary medicine and imaging in cases of obstructive lung disease,interstitial lung disease,infections,nodules,and lung cancer.

摘要： "Tihujiegai method"(lifting a kettle and removing its lid figuratively refers to a method of lifting the'Lung Qi'(It refers to the functional activity of the lungs and also includes breathing gases.)to promote urination.),created by Zhu Danxi(1281-1358),who ranked among the era’s best doctors,is a metaphor for using"Xuanfei method"(A method of promoting the dispersing function of the lung)or"Tiqi method"(A method for treating Qi activity depression),which has been widely used later.The author consulted a large number of relevant essays and found that the"Tihujiegai method"of amenorrhea was also effective.This study mainly discusses the treatment of amenorrhea method theoretically,and opens up ideas for clinical application.

摘要： Dear Editor,With the development of video-assisted thoracoscopic surgery(VATS),one-lung ventilation(OLV)technique has become a fundamental component of thoracic anesthesia as it facilitates surgical field exposure.Bronchial blocker(BB)functions as one of the frequently used equipment for OLV.It tends to bring less stress response and less postoperative airway complications than a traditional double-lumen endotracheal tube[1].But to anesthesiologists and surgeons,it takes more time to collapse the in-dependent lung.The anesthesiologists often open the suction port of BB to accelerate non-ventilated lung collapse during OLV[1].Our two cases here may challenge the feasibility of opening the suction port of BB during OLV.

摘要： Contents 1.Overview 2.Screening and diagnosis 2.1 Risk factors for lung cancer 2.1.1 Smoking and involuntary smoking 2.1.2 History of chronic obstructive pulmonary disease(COPD)2.1.3 Occupational exposures 2.1.4 Family history of lung cancer and genetic susceptibility 2.1.5 Other factors 2.2 Screening for high-risk population。