Thoracic Medicine

A 79-year-old woman was admitted to the emergency room with an ulcerated large wound in the lateral region of her neck. Computed tomography (CT) of the thorax revealed air bronchograms, nodular infiltration and areas of consolidation areas in both lungs. Multiple conglomerated lymph nodes, tending to coalesce with each other with areas of necrosis, were observed on the...
(Vol 13 p 52-56, Respiratory Medicine: 18 June 2013)
We report an interesting complex CFTR gene mutation in a patient with cystic fibrosis. It is an insertion combined with a deletion that spans an exonic splice site, causes a frameshift and could affect splicing. This rare mutation poses a challenge to provide correct nomenclature and to interpret its clinical significance.
(Vol 12 p 36-39, Pathology; Paediatrics; Respiratory Medicine: 10 August 2012)
This case report describes a young man in his early 20s who was found to have synchronous adenocarcinoma of the colon and abdominal tuberculosis. This is a rare finding and it is discussed whether a dampened immune response by the cancer allowed a latent tuberculosis infection to become active or vice versa.
(Vol 11 p 103-106, Colorectal surgery; General surgery; Infection and Immunity; Thoracic medicine: 9 December 2011)
The British Thoracic Society has issued recommendations on the management of cough in adults (September 2006). They confirm that chronic cough is common, and affects up to 16% of the population with a female predominance. Common causes are discussed and include smoking, asthma, rhinitis, and reflux with obesity and side effects of drugs. Their management/...
(Vol 7 p 26-28, Respiratory Medicine: 28 March 2007)
We report a case of spontaneous recurrent pneumothorax in a 32-year-old male with a family history of Birt–Hogg–Dube syndrome. Specific aspects of the surgical treatment for a pneumothorax within this particular setting are discussed as well as the potential underdiagnosis of this complex genodermatosis. The literature linking the syndrome to spontaneous pneumothorax is...
(Vol 7 p 18-20, Respiratory Medicine, Thoracic Surgery: 1 March 2007)
We report a case of persistent haemoptysis, initially investigated by chest physicians. An Ear, Nose and Throat (ENT) opinion was sought because no source for the bleeding could be found. On video-endoscopic examination of the trachea using a three chip digital camera system, a vascular lesion, possibly an arteriovenous malformation, was seen on the anterior tracheal wall...
(Vol 6 p 25-27, Radiology, Respiratory medicine: 21 September 2006)
We report a case of a 53-year-old man with a solitary nodular growth on the scalp in the right temporal region, noted during his hospital admission for bilateral knee replacement. A chest X-ray revealed a large circumscribed opacity in the left lung field. Bronchoscopy revealed a tumour at the carina. Histology of biopsies from the bronchoscopy and the scalp lesion showed...
(Vol 5 p 19-21, Respiratory medicine: April 2005)
A 67-year-old man with a lung mass developed a large painful chest wall swelling adjacent to a chest drainage tube site. The swelling occurred after a second chest drain was performed for a rapidly relapsing pleural effusion, and the biopsy showed that it was an adenocarcinoma. We conclude that chest wall tumour implantation was caused by the chest tube drainage of the...
(Vol 5 p 10-14, Respiratory medicine: March 2005)
A 44-year-old woman presented with poorly controlled asthma and nodular radiological changes. A VATS lung biopsy confirmed talc granulomatous disease possibly related to her previous work as a dental technician. A detailed occupational history is mandatory. Talc granulomatous disease is one important alternative diagnosis in poorly controlled asthma.
(Vol 5 p 1-3, Respiratory medicine; occupational medicine: January 2005)
The scientists William S. Tillett and Sol Sherry were responsible for the introduction of intrapleural fibrinolytics as therapeutic agents, thus supplementing antimicrobial therapy in the treatment of empyema. They were the first to suggest the possibility that the use of these drugs in empyema might obviate the need for radical surgical procedures. This article...
(Vol 4 p L4-L7, Landmark Case Report; Respiratory Medicine: April 2004)
We report the case of a woman from sub-Saharan Africa who presented with pyrexia, pulmonary lesions and a urinary tract infection (UTI). She was found to have multiple infections, i.e. Salmonella bovis bacteraemia, Escherichia coli UTI, and pulmonary nocardiosis. In the presence of lymphopaenia, a Human Immunodeficiency Virus (HIV) antibody test was performed and was...
(Vol 3 p 31-34, Infection and Immunity; Respiratory Medicine: February 2004)
ACC is an unusual pulmonary neoplasm, accounting for 0.09%–0.2% of all lung cancers. It is a low-grade tumour with unusual histological features and rarely metastasises outside the lungs. We describe a case with bilateral renal metastases. We discuss the clinical and histological features, and the implications for its treatment.
(Vol 2 p 40-42, Respiratory Medicine; Oncology: July 2002)
We report a case of pulmonary Mycobacterium avium-intracellulare (MAI) in a previously fit 48-year-old man who subsequently developed Crohn's disease. We discuss the potential predisposing factors for pulmonary MAI; the diagnostic uncertainties in this particular case; the relationship between pulmonary MAI and Crohn's disease; and the difficulties in management that are...
(Vol 2 p 24-28, Respiratory Medicine; Gastroenterology; Infection: May 2002)


Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK


Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

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