The unilateral destroyed lung is an important cause of morbidity and mortality. The commonest cause of destroyed lung is total post tuberculous sequelae. Primary lung tumors, mediastinal masses, vascular abnormalities, and some others are considered to be other causes of lung destruction. A study was undertaken at the National Institute of Diseases of the Chest and Hospital (NIDCH) on 600 cases from January 2016 to December 2020 to evaluate the etiopathogenesis of unilateral lung destruction and to evaluate hilar structures & the nature and extent of parenchymal damage. The study was performed on 600 patients with unilateral lung destruction, of whom 416(69.33%) had left lung destruction. Pulmonary tuberculosis was found to be the cause in 504(84%) patients. All patients had an X-ray chest and CT scan of the chest (contrast CT/ HRCT). However, 96(16%) non-tuberculous patients had their main bronchi occluded with extraluminal compression or by the intraluminal lesion. TAJ 2021; 34: No-1: 75-79
Coronavirus disease (COVID-19) pneumonia emerged in Wuhan, China, in December 2019. It is a highly contagious viral disease spreading worldwide, with a rapid increase in the number of cases & deaths. COVID-19 pneumonia is characterized by fever, fatigue, dry cough, and dyspnea with other systemic features such as diarrhea, altered sensorium, stroke & multi-organ failure. HRCT chest is one of the most sensitive modalities for early detection of COVID-19 pneumonia & monitor the outcome of these patients. It is an important complement to the reverse transcriptase polymerase chain reaction (RT-PCR) tests. HRCT shows high specificity & sensitivity in detection of COVID-19 pneumonia being 90.7% & 70.8% respectively. In this pandemic situation, proper diagnosis & management of COVID-19 positive cases largely depends on HRCT findings & severity scoring. TAJ 2021; 34: No-1: 109-114
Primary intramuscular hydatid cyst of thigh is a very rare parasitic disease caused by Echinococcus granulosus. We present an unusual case of primary hydatid cyst in a 21-year old male who presented with slowly growing painless lump in the anteromedial aspect of proximal right thigh. Ultrasonography of the mass revealed a multiloculated cyst in the medial compartment of right proximal thigh without detectable primary any other location. MRI clearly displayed the lesion showing cystic mass with multiple well defined daughter cysts and diagnosis of hydatid cyst was made. The patient was treated surgically and cyst was excised. Macroscopic and microscopic histopathological examination confirmed the diagnosis of muscular hydatid cyst. Primary muscular hydatidosis is kept in mind in the differential diagnosis of a cystic mass of a skeletal muscle especially in endemic areas.TAJ 2011; 24(2): 142-144
Bezoars are retained concretions of foreign materials or indigestible organic substances in the digestive tract resulting of their ingestion and accumulation, involving mainly the gastric lumen. The incidence of gastric bezoars is very low and they are of varied composition. We report a case of gastric trichobezoar in a 13- year old young girl who presented with intermittent pain in her epigastrium with dyspepsia. Her parents gave the history of intermittent ingestion of hairs since 06 years of age. The patient was relatively healthy with no history of psychiatric disorder or gastric surgery. She was investigated with ultrasound of abdomen, barium meal study and computed tomography followed by endoscopy which revealed gastric trichobezoar. The patient underwent gastrotomy which revealed a large trichobezoar confirming our radiological diagnosis. The mode of presentation and appearance on various imaging modalities like ultrasound, barium meal and computed tomography are discussed.TAJ 2012; 25: 77-80
DESCRIPTIONA 65-year-old man presented with left lower chest pain for 2 months and low grade intermittent fever for 1 month. Pain was dull aching, more marked during movement and partially subsided after taking non-steroidal anti-infl ammatory drugs. Examination revealed anaemia and tenderness in left fourth, fi fth ribs, intercostal space in the mid axillary line. All other clinical examinations were normal. Investigations revealed complete blood count: Hb-7.1 g/ dl, erythrocyte sedimentation rate (ESR) -140 mm in fi rst hour, peripheral blood fi lm -normocytic normochromic anaemia with marked rouleaux formation. Chest x-ray revealed a mass of the left chest wall with rib destruction suggestive of malignant pleural mesothelioma. A CT scan ( fi gures 1 -3 ) showed a spindle shaped 4×6 cm tumour, localised at the lateral angle of the fourth, fi fth rib and growing intrathoracic, with destruction of the fourth rib. The mass was relatively well demarcated and there were no cystic components. There was no evidence of lung or lymph node metastasis. CT-guided fi ne-needle aspiration of the chest wall mass showed an increasing number of plasma cells. With these clinical contests our next investigation of choice was bone marrow examination, which revealed marrow was infi ltrated with around 90% of both typical and atypical plasma cells including plasmablast. We therefore diagnosed this tumour as multiple myeloma (MM). Chest pain is a very unusual presentation of multiple myeloma. Isolated chest wall mass without any other skeletal involvement is even rarer. MM often produces gross sternal expansion, distortion and vertebral body
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