S. Indhu, S. Mohanraj, Vishnu Chaitanya, B. M. S. Patrudu
Although pleural fluid adenosine deaminase (ADA) level >70 U/L suggestive tuberculous pleural effusion (TPE). High ADA levels can also be seen in pneumonia, empyema, lymphoma, malignancy, and rheumatoid pleuritis. Elevated pleural fluid lactate dehydrogenase (LDH) is seen in tubercular pleural effusion (TPE), parapneumonic pleural effusion (PPE), and malignant pleural effusion (MPE). Therefore, it is challenging distinguish between TPE, PPE, and MPE based on elevated pleural fluid ADA and LDH levels. In this study, we evaluated the use of pleural fluid LDH/ADA ratio as a new parameter for etiological differentiation of exudative pleural effusions. A retrospective hospital-based observational study conducted in GHCCD, Visakhapatnam. A total of 52 patients (TPE – 19, PPE – 16, and MPE – 17) with exudative pleural effusion who fulfilled inclusion criteria were taken into study. Qualitative variables have been described in the form of frequency and percentages. Median and interquartile ranges were used for nonnormal distribution values. Receiver operating curve (ROC) curves with area under the curve (AUC) were calculated. P ≤ 0.05 was considered statistically significant. The mean ADA value for TPE was 75.4 U/L (25–195 U/L), PPE was 59.1 U/L (13–180 U/L), and for MPE was 35.52 U/L (10–75 U/L). The mean LDH value for TPE was 887.8 U/L (139–2213 U/L), PPE was 1128 U/L (334–3110 U/L), and for MPE was 1470 U/L (234–4285 U/L). On ROC analysis, pleural LDH/ADA ratio ≤20.81 diagnose TPE with (sensitivity – 84.2%, specificity – 63.6%) with AUC of 0.758 (95% confidence interval [CI]: 0.619–0.866) (P = 0.0001) whereas LDH/ADA ratio in the diagnosis of PPE was found to be >23.39 (sensitivity – 50%, specificity – 66.7%) with AUC of 0.535 (95% CI: 0.391–0.674) (P = 0.689) and the cutoff LDH/ADA ratio in the diagnosis of MPE was found to be >20.86 (sensitivity – 70.6%, specificity – 68.6%) with AUC of 0.724 (95% CI: 0.583–0.839) (P = 0.007). The cutoff value of the LDH/ADA ratio in PPE does not reach the statistical significant value. Pleural fluid LDH/ADA ratio ≤20.81 U/L is predictive of TPE, and >20.86 U/L is predictive of MPE and the cutoff value of 20.8 U/L can be used for etiological differentiation of pleural effusion.
{"title":"Role of Pleural Fluid Lactate Dehydrogenase to Adenosine Deaminase Ratio in the Etiological Differentiation of Exudative Pleural Effusion","authors":"S. Indhu, S. Mohanraj, Vishnu Chaitanya, B. M. S. Patrudu","doi":"10.4103/japt.japt_8_24","DOIUrl":"https://doi.org/10.4103/japt.japt_8_24","url":null,"abstract":"\u0000 \u0000 \u0000 Although pleural fluid adenosine deaminase (ADA) level >70 U/L suggestive tuberculous pleural effusion (TPE). High ADA levels can also be seen in pneumonia, empyema, lymphoma, malignancy, and rheumatoid pleuritis. Elevated pleural fluid lactate dehydrogenase (LDH) is seen in tubercular pleural effusion (TPE), parapneumonic pleural effusion (PPE), and malignant pleural effusion (MPE). Therefore, it is challenging distinguish between TPE, PPE, and MPE based on elevated pleural fluid ADA and LDH levels. In this study, we evaluated the use of pleural fluid LDH/ADA ratio as a new parameter for etiological differentiation of exudative pleural effusions.\u0000 \u0000 \u0000 \u0000 A retrospective hospital-based observational study conducted in GHCCD, Visakhapatnam. A total of 52 patients (TPE – 19, PPE – 16, and MPE – 17) with exudative pleural effusion who fulfilled inclusion criteria were taken into study. Qualitative variables have been described in the form of frequency and percentages. Median and interquartile ranges were used for nonnormal distribution values. Receiver operating curve (ROC) curves with area under the curve (AUC) were calculated. P ≤ 0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 The mean ADA value for TPE was 75.4 U/L (25–195 U/L), PPE was 59.1 U/L (13–180 U/L), and for MPE was 35.52 U/L (10–75 U/L). The mean LDH value for TPE was 887.8 U/L (139–2213 U/L), PPE was 1128 U/L (334–3110 U/L), and for MPE was 1470 U/L (234–4285 U/L). On ROC analysis, pleural LDH/ADA ratio ≤20.81 diagnose TPE with (sensitivity – 84.2%, specificity – 63.6%) with AUC of 0.758 (95% confidence interval [CI]: 0.619–0.866) (P = 0.0001) whereas LDH/ADA ratio in the diagnosis of PPE was found to be >23.39 (sensitivity – 50%, specificity – 66.7%) with AUC of 0.535 (95% CI: 0.391–0.674) (P = 0.689) and the cutoff LDH/ADA ratio in the diagnosis of MPE was found to be >20.86 (sensitivity – 70.6%, specificity – 68.6%) with AUC of 0.724 (95% CI: 0.583–0.839) (P = 0.007). The cutoff value of the LDH/ADA ratio in PPE does not reach the statistical significant value.\u0000 \u0000 \u0000 \u0000 Pleural fluid LDH/ADA ratio ≤20.81 U/L is predictive of TPE, and >20.86 U/L is predictive of MPE and the cutoff value of 20.8 U/L can be used for etiological differentiation of pleural effusion.\u0000","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"49 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Developing countries face a huge challenge in managing obstructive lung disorders due to frequency, severity, management, and economic impact. Spirometry has been the popular choice to assess the severity and reversibility of airflow obstruction, but the success of evaluation depends on the practitioner’s skills and the patient’s cooperation. Impulse oscillometry (IOS), a variant of forced oscillation technique is preferred over spirometry since it can be performed without forced respiratory maneuvers. The objective of this review is to evaluate IOS techniques and weigh its benefits against spirometry. Publications from international electronic databases such as PubMed, Scopus, and Web of Science were searched using relevant keywords for 5 years (2018–2023). A total of 416 articles were filtered, and of these, 70 were selected which specifically discussed the principles, procedures, parameters, and interpretations of spirometry and oscillometry. From the full-text articles included, we have reflected on the history, defined, explained, compared, and contrasted spirometry and oscillometry methods to establish the versatility of oscillometry technique to identify small airway functions and its application in special clinical conditions. This review presents an easily comprehensible synthesis of oscillometry and spirometry bringing out the principles, advantages, and limitations that are suitable for a larger spectrum of healthcare and research community.
由于阻塞性肺部疾病的频率、严重程度、管理和经济影响，发展中国家在管理阻塞性肺部疾病方面面临着巨大的挑战。肺活量测定一直是评估气流阻塞严重程度和可逆性的常用方法，但评估的成功与否取决于医生的技术和患者的配合。脉冲振荡测量法（IOS）是强迫振荡技术的一种变体，与肺活量测量法相比更受青睐，因为它可以在不进行强迫呼吸操作的情况下进行。本综述旨在评估 IOS 技术，并权衡其与肺活量测定法的优势。使用相关关键词检索了PubMed、Scopus和Web of Science等国际电子数据库中5年内（2018-2023年）的出版物。共筛选出 416 篇文章，并从中挑选出 70 篇专门讨论肺活量测定法和振荡测定法的原理、程序、参数和解释的文章。从收录的全文文章中，我们回顾了肺活量测定法和振荡测定法的历史，对其进行了定义、解释、比较和对比，从而确定了振荡测定法在确定小气道功能方面的多功能性及其在特殊临床条件下的应用。这篇综述对振荡测定法和肺活量测定法的原理、优势和局限性进行了简单易懂的综述，适用于更广泛的医疗保健和研究领域。
{"title":"Can Oscillometry Replace Spirometry as a Major Tool for Lung Function Testing? – An Overview","authors":"Jaymohan Unnithan, Srikanth Krishnamurthy, Nandagopal Velayuthaswamy, Nagarajan Srinivasan","doi":"10.4103/japt.japt_1_24","DOIUrl":"https://doi.org/10.4103/japt.japt_1_24","url":null,"abstract":"\u0000 Developing countries face a huge challenge in managing obstructive lung disorders due to frequency, severity, management, and economic impact. Spirometry has been the popular choice to assess the severity and reversibility of airflow obstruction, but the success of evaluation depends on the practitioner’s skills and the patient’s cooperation. Impulse oscillometry (IOS), a variant of forced oscillation technique is preferred over spirometry since it can be performed without forced respiratory maneuvers. The objective of this review is to evaluate IOS techniques and weigh its benefits against spirometry. Publications from international electronic databases such as PubMed, Scopus, and Web of Science were searched using relevant keywords for 5 years (2018–2023). A total of 416 articles were filtered, and of these, 70 were selected which specifically discussed the principles, procedures, parameters, and interpretations of spirometry and oscillometry. From the full-text articles included, we have reflected on the history, defined, explained, compared, and contrasted spirometry and oscillometry methods to establish the versatility of oscillometry technique to identify small airway functions and its application in special clinical conditions. This review presents an easily comprehensible synthesis of oscillometry and spirometry bringing out the principles, advantages, and limitations that are suitable for a larger spectrum of healthcare and research community.","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"89 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141133754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
36 Years old male, farmer by profession from rural Tamil Nadu presented with complaints of unilateral painful leg swelling for 1 month and cough with hemoptysis for 3 weeks. Chest skiagram revealed Hampton’s hump and ultrasound venous Doppler revealed deep vein thrombosis of the left leg. His computed tomography pulmonary angiogram revealed pulmonary embolism. Due to unusual presentation work up was done and we found positive anti cardiolipin antibody, lupus anticoagulant and anti β 2 glycoprotein antibody. Patient was diagnosed as APLA and was started on oral anticoagulant.
{"title":"Hemoptysis and Deep Vein Thrombosis in a middle aged male due to Anti Phospholipid Antibody (APLA) Syndrome’’ - A Case Report","authors":"P. J. Paul, Suresh Kumar","doi":"10.4103/japt.japt_42_23","DOIUrl":"https://doi.org/10.4103/japt.japt_42_23","url":null,"abstract":"\u0000 36 Years old male, farmer by profession from rural Tamil Nadu presented with complaints of unilateral painful leg swelling for 1 month and cough with hemoptysis for 3 weeks. Chest skiagram revealed Hampton’s hump and ultrasound venous Doppler revealed deep vein thrombosis of the left leg. His computed tomography pulmonary angiogram revealed pulmonary embolism. Due to unusual presentation work up was done and we found positive anti cardiolipin antibody, lupus anticoagulant and anti β 2 glycoprotein antibody. Patient was diagnosed as APLA and was started on oral anticoagulant.","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":" 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pseudo-pneumomediastinum: A Diagnostic Puzzle","authors":"G. Thilagavathy, V. Vishnu, S. Prabhu","doi":"10.4103/japt.japt_2_24","DOIUrl":"https://doi.org/10.4103/japt.japt_2_24","url":null,"abstract":"","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"41 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Excessive Dynamic Airway Collapse","authors":"R. Narasimhan","doi":"10.4103/japt.japt_13_24","DOIUrl":"https://doi.org/10.4103/japt.japt_13_24","url":null,"abstract":"","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141135969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Churg–Strauss syndrome, also known as eosinophilic granulomatosis, is one of the antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis associated with asthma and peripheral eosinophilia. Here, we present a case of a 50-year-old male, known asthmatic presenting with cough, dyspnea, fever, and lower limb purpura. On evaluation found to have perinuclear ANCA positivity; a nerve conduction study showed mononeuritis multiplex, and he was diagnosed with Churg–Straus syndrome.
Churg-Strauss 综合征又称嗜酸性粒细胞肉芽肿病，是一种与哮喘和外周嗜酸性粒细胞增多相关的抗中性粒细胞胞浆抗体（ANCA）相关性血管炎。在此，我们介绍了一例 50 岁男性患者的病例，他是已知的哮喘患者，表现为咳嗽、呼吸困难、发热和下肢紫癜。评估发现他的核周 ANCA 阳性；神经传导研究显示他患有单神经炎，并被诊断为 Churg-Straus 综合征。
{"title":"Unmasking of Churg–Strauss Syndrome in an Asthmatic","authors":"K K Navya, G. Ramakrishnan","doi":"10.4103/japt.japt_50_23","DOIUrl":"https://doi.org/10.4103/japt.japt_50_23","url":null,"abstract":"\u0000 Churg–Strauss syndrome, also known as eosinophilic granulomatosis, is one of the antineutrophilic cytoplasmic antibody (ANCA)-associated vasculitis associated with asthma and peripheral eosinophilia. Here, we present a case of a 50-year-old male, known asthmatic presenting with cough, dyspnea, fever, and lower limb purpura. On evaluation found to have perinuclear ANCA positivity; a nerve conduction study showed mononeuritis multiplex, and he was diagnosed with Churg–Straus syndrome.","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"222 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rohit Amuje, S. Davalagi, Nukala V. S. R. R. Phani Krishna
Airborne transmission of tuberculosis (TB) is a major route of spread. Household contacts of TB patients are at high risk of infection. However, there is limited evidence on airborne infection control knowledge and practices among TB patients in India. This study was done to assess the knowledge and practices related to airborne infection control among pulmonary TB (PTB) patients at the household level and determine associated factors. A cross-sectional study was conducted among 157 smear-positive PTB patients at a tertiary care hospital in Karnataka, India, using a pretested questionnaire. Knowledge and self-reported practices regarding airborne precautions were assessed. Bivariate analysis was done to determine associated factors. P <0.005 was considered significant. Major gaps were found in knowledge about ventilation (50.3%), avoiding visitors (39.5%), and sputum disposal (33.8%). Suboptimal practices were reported for using tissues (19%), handwashing (25%), ventilation (66%), sputum handling (54%), and waste disposal (30%). Good knowledge was associated with younger age, higher education, Hindu religion, family history of TB, intensive phase treatment, and presence of symptoms (P < 0.05). Participants with good knowledge had significantly better preventive practices (P < 0.00001). Tailored education on airborne precautions focusing on identified knowledge gaps and risky practices can help improve the adoption of infection control measures among TB patients at the household level. A multifaceted approach is required to translate improved awareness into optimal preventive behaviors.
{"title":"Knowledge and Practices of Airborne Infection Control at the Household Level among Pulmonary Tuberculosis Patients Attending a Tertiary Care Teaching Hospital in Central Karnataka, India","authors":"Rohit Amuje, S. Davalagi, Nukala V. S. R. R. Phani Krishna","doi":"10.4103/japt.japt_5_24","DOIUrl":"https://doi.org/10.4103/japt.japt_5_24","url":null,"abstract":"\u0000 \u0000 \u0000 Airborne transmission of tuberculosis (TB) is a major route of spread. Household contacts of TB patients are at high risk of infection. However, there is limited evidence on airborne infection control knowledge and practices among TB patients in India. This study was done to assess the knowledge and practices related to airborne infection control among pulmonary TB (PTB) patients at the household level and determine associated factors.\u0000 \u0000 \u0000 \u0000 A cross-sectional study was conducted among 157 smear-positive PTB patients at a tertiary care hospital in Karnataka, India, using a pretested questionnaire. Knowledge and self-reported practices regarding airborne precautions were assessed. Bivariate analysis was done to determine associated factors. P <0.005 was considered significant.\u0000 \u0000 \u0000 \u0000 Major gaps were found in knowledge about ventilation (50.3%), avoiding visitors (39.5%), and sputum disposal (33.8%). Suboptimal practices were reported for using tissues (19%), handwashing (25%), ventilation (66%), sputum handling (54%), and waste disposal (30%). Good knowledge was associated with younger age, higher education, Hindu religion, family history of TB, intensive phase treatment, and presence of symptoms (P < 0.05). Participants with good knowledge had significantly better preventive practices (P < 0.00001).\u0000 \u0000 \u0000 \u0000 Tailored education on airborne precautions focusing on identified knowledge gaps and risky practices can help improve the adoption of infection control measures among TB patients at the household level. A multifaceted approach is required to translate improved awareness into optimal preventive behaviors.\u0000","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Empyema necessitans (EN) is a rare complication of untreated pleural infection. Tuberculosis is the most common cause. It can be found in both immunocompromised and immunocompetent patients, especially in endemic areas. Diagnosis can be challenging due to long duration and indefinite symptoms. Here, we present a case series of three patients with EN.
必然性肺水肿（EN）是胸膜感染未经治疗的一种罕见并发症。肺结核是最常见的病因。免疫力低下和免疫力正常的患者均可发病，尤其是在疾病流行地区。由于病程长、症状不明确，诊断具有挑战性。在此，我们介绍了三例 EN 患者的系列病例。
{"title":"Tuberculous Empyema Necessitans – Case Series","authors":"M. Natraj, Nisha Parveen, S. Vignesh","doi":"10.4103/japt.japt_3_24","DOIUrl":"https://doi.org/10.4103/japt.japt_3_24","url":null,"abstract":"\u0000 Empyema necessitans (EN) is a rare complication of untreated pleural infection. Tuberculosis is the most common cause. It can be found in both immunocompromised and immunocompetent patients, especially in endemic areas. Diagnosis can be challenging due to long duration and indefinite symptoms. Here, we present a case series of three patients with EN.","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vyshnavi Rajeev, Riha Mehrin, Ria Lawrence, A. Narasimhan
Patients with chest wall tumors present diagnostic and therapeutic challenges. The differential diagnosis of these tumors is broad because they can present a heterogeneous spectrum of diseases such as primary benign or malignant tumors, metastasis, local extension of adjacent tumors, and infectious or inflammatory conditions. Among that, primary chest wall tumors are rare.
{"title":"Anterior Chest Wall Sarcoma: An Aggressive Tumor","authors":"Vyshnavi Rajeev, Riha Mehrin, Ria Lawrence, A. Narasimhan","doi":"10.4103/japt.japt_41_23","DOIUrl":"https://doi.org/10.4103/japt.japt_41_23","url":null,"abstract":"\u0000 Patients with chest wall tumors present diagnostic and therapeutic challenges. The differential diagnosis of these tumors is broad because they can present a heterogeneous spectrum of diseases such as primary benign or malignant tumors, metastasis, local extension of adjacent tumors, and infectious or inflammatory conditions. Among that, primary chest wall tumors are rare.","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"4 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The knowledge of the tracheobronchial tree is fundamental for a bronchoscopist, especially for diagnostic, therapeutic, and surgical options that are under consideration. Among all lobes, the right upper lobe (RUL) has a relatively high incidence of tumor and airspace diseases. Most bronchial anomalies are on the right side. Bifurcation is the most common anatomical variation. Quadrification has a very low prevalence. We report the case of a 54-year-old male who came with complaints of hemoptysis and showed a quadrivial type of bronchial division of RUL during a bronchoscopic examination after which three-dimensional computed tomography bronchography showed a supernumerary lateral or axillary segment bronchus. Awareness of this variant may explain otherwise confusing findings and its clinical implication is important for every pulmonologist.
{"title":"A Case of Quadrivial Pattern of Right Upper Lobe Bronchus","authors":"Mohanakrishnan Deivasigamani, Chandrasekar Chockalingam, Balamurugan Santhalingam, Manikandan Nagesh","doi":"10.4103/japt.japt_55_23","DOIUrl":"https://doi.org/10.4103/japt.japt_55_23","url":null,"abstract":"\u0000 The knowledge of the tracheobronchial tree is fundamental for a bronchoscopist, especially for diagnostic, therapeutic, and surgical options that are under consideration. Among all lobes, the right upper lobe (RUL) has a relatively high incidence of tumor and airspace diseases. Most bronchial anomalies are on the right side. Bifurcation is the most common anatomical variation. Quadrification has a very low prevalence. We report the case of a 54-year-old male who came with complaints of hemoptysis and showed a quadrivial type of bronchial division of RUL during a bronchoscopic examination after which three-dimensional computed tomography bronchography showed a supernumerary lateral or axillary segment bronchus. Awareness of this variant may explain otherwise confusing findings and its clinical implication is important for every pulmonologist.","PeriodicalId":348236,"journal":{"name":"Journal of Association of Pulmonologist of Tamil Nadu","volume":"222 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141145027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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