Do we really care about incidental lung nodules?—Review of atypical lung carcinoid and a proposal for systematic patient follow up

Motiwala, Henal; Bansal, Itisha; Goyal, Pradeep; Dorokhova, Olena; Kumar, Yogesh; Olsavsky, Thomas; DiMeo, Albert; Gupta, Nishant

doi:10.21037/tlcr.2017.05.05

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…This anomalous structure did not present with any clinical symptoms. On imaging studies, the azygos lobe may mimic an enlarged thymus, a substernal goiter, a localised pneumothorax, bulla, lung abscess, or neoplasm [ 2 , 6 - 7 ]. Diagnosing the azygos lobe may be further complicated by physiological changes in the size of the azygos vein or morphological variants of the fissure [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of an Azygos Lobe in the Right Lung of a 40-year-old Male

Kotov

Dimitrova

Iliev

et al. 2018

Cureus

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The azygos lobe is a rare anatomical variant, most often encountered in the right lung. Its etiology is related to a defect of the migration of the azygos vein during the embryonic development. Here, we describe a rare case of an azygos lobe of the right lung, diagnosed incidentally on a computed tomography (CT) scan in a 40-year-old male patient who presented with chest pain, shortness of breath, and fever. The initial differential diagnosis included acute myocardial infarction, aortic dissection, and myocarditis. Chest CT with contrast matter demonstrated a peculiar finding in the right lung which was recognized as an azygos vein passing through the upper lobe and separating an azygos lobe with its mesoazygos. The azygos lobe may be rarely associated with neoplastic processes or spontaneous pneumothorax and its differential diagnosis on imaging studies includes various conditions. Knowledge of this variation is important to avoid misdiagnosis or complications during thoracic surgery.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of an Azygos Lobe in the Right Lung of a 40-year-old Male

Kotov

Dimitrova

Iliev

et al. 2018

Cureus

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“…Diagnosis of NNs is challenging. CT images and immunohistochemistry are used to aid in the diagnosis [ 2 ]. 68 Ga was produced from the generator and yielded similar accuracy compared to FDG [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The main method for follow-up of smaller noncalcified lung nodules is by the computed tomography (CT) scan using Fleischner’s criteria. Moreover, the timely follow up by the Radiology Department itself can provide valuable information about lung cancer patients to their consultants [ 2 ]. So far, 18 fluoro-fluorodeoxyglucose (FDG)- based positron-emission computed tomography (PET) has been established as a commonly used method for diagnosis of cancer and noncalcified nodules (NNs) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Computed Tomographic Studies of Noncalcified Nodules Related to Neuroendocrine Lung Tumor Using 68Gallium-Tagged Somatostatin Variant for Improvement in Diagnosis: A Non-Experimental, Non-Randomized, Cross-Sectional Study

Shen

Geng

et al. 2018

Med Sci Monit

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Background18Fluoro-fluorodeoxyglucose (FDG)- based positron-emission computed tomography (PET) has less specificity for noncalcified nodules (NNs). Somatostatin receptors affect the expression of normal and malignant cells. The purpose of the study was to compare the sensitivity, specificity, and accuracy of 68Gallium-tagged DOTA-octreotate (Ga-tDO) with that of FDG PET for diagnosis of newly detected and/or untreated NNs in lung cancer patients.Material/MethodsA total of 45 patients with lung cancer were included in the cross-sectional study and underwent Ga-tDO and FDG PET. We further confirmed observed outcomes by testing immune histochemical staining for subtype 2A of somatostatin receptor in a granuloma tissue array. The chi-square test was performed for sensitivity and specificity of predictive values among the 3 diagnostic modalities. McNemar’s test was performed to compare accuracy between Ga-tDO and FDG PET. Results were considered significant at 95% confidence level.ResultsGa-tDO had less sensitivity (69% vs. 89%) but more specificity (91% vs. 78%) than FDG PET. Ga-tDO and FDG PET were characterized as 36 and 6 and in 36 and 3 lesions as accurate and inaccurate, respectively. There was an insignificant difference between Ga-tDO and FDG PET regarding diagnostic accuracy (p=0.7). Dosimetry results showed that the lungs were one of the least critically affected organs.ConclusionsGa-tDO was more specific but less sensitive than FDG PET scanning and imaging.

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“…The diagnosis of PAVMs can be performed with various modalities like pulmonary function tests (PFT), CXR, transthoracic contrast echocardiography (TTCE), radionucleotide lung perfusion scanning, CT scan and 3D MR angiography. The CXR is the initial primary modality in evaluating PAVMs and 98% of patients show some abnormality, classically a lobulated well demarcated mass, mostly in lower lobes (11,12). In PFT, reduction in oxygen saturation has been observed in patients with PAVMs.…”

Section: A B Cmentioning

confidence: 99%

A case of pulmonary arteriovenous malformation: role of interventional radiology in diagnosis and treatment

et al. 2017

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Pulmonary arterio-venous malformations (PAVMs) are abnormal pulmonary arteries and pulmonary veins communicating directly without interposition of a capillary bed and about 80-90% of patients with PAVMs eventually may present with hereditary hemorrhagic telangiectasia (HHT), remaining ones are sporadic cases. On the other hand, about 15-35% of HHT patients may present with PAVMs. The PAVMs have a tendency to grow and increase in size over time and various factors like puberty, pregnancy and pulmonary arterial hypertension (PAH) affect growth. This condition needs early diagnosis, aggressive management and vigilant follow up. Our article aims to review pulmonary AVMs as a rare cause of strokes in young patients. We will discuss the clinical presentation, diagnosis, complications, the therapeutic options and the follow up.

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Do we really care about incidental lung nodules?—Review of atypical lung carcinoid and a proposal for systematic patient follow up

Cited by 7 publications

References 14 publications

A Rare Case of an Azygos Lobe in the Right Lung of a 40-year-old Male

A Rare Case of an Azygos Lobe in the Right Lung of a 40-year-old Male

Computed Tomographic Studies of Noncalcified Nodules Related to Neuroendocrine Lung Tumor Using 68Gallium-Tagged Somatostatin Variant for Improvement in Diagnosis: A Non-Experimental, Non-Randomized, Cross-Sectional Study

A case of pulmonary arteriovenous malformation: role of interventional radiology in diagnosis and treatment

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