Pulmonary Embolism, Pulmonary Hemorrhage and Pulmonary Infarction

Dalen, James E.; Haffajee, Charles I.; Alpert, Joseph S.; Howe, John P.; Paraskos, John A

doi:10.1056/nejm197706232962503

Cited by 200 publications

(84 citation statements)

References 11 publications

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“…Cavitary parenchymal nodules may be caused by septic occlusion of small peripheral PA branches [186]. Pulmonary infarction is uncommon when the emboli obstruct the central arteries but is frequent when distal arteries are occluded [187]. This may be explained by collateral flow from the bronchial arterial circulation that enters the PA distal to the site of an obstruction [186].…”

Section: Pathophysiologymentioning

confidence: 99%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

European Respiratory Journal

161

127

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Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes.The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than ''simple'' mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung.NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE.Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.

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Section: Pathophysiologymentioning

confidence: 99%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

European Respiratory Journal

161

127

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“…14). Initial wurde es bei der invasiven pulmonalen Aspergillose als Manifestation perifokaler Hämorrhagien beschrieben [21], es ist jedoch unspezifisch und kommt auch bei Hämorrhagien anderer Ursache [22] wobei die Basis der Pleura anliegt und die Spitze in Richtung des Hilus gerichtet ist [23,24]. Die radiologisch sichtbaren Verände-rungen entsprechen überwiegend pulmonalen Hämorrhagien infolge des Infarkts, eventuell auch einer Nekrose.…”

Section: Halozeichenunclassified

Glossar thoraxradiologischer Begriffe entsprechend der Terminologie der Fleischner Society

Wormanns

Hamer

2015

Fortschr Röntgenstr

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Zusammenfassung Die Fleischner Society hat seit 1985 mehrere Empfehlungen zur thoraxradiologischen Terminologie ver?ffentlicht, zuletzt im Jahre 2008. Eine deutsche ?bertragung dieser Begriffe wurde 1996 publiziert. Diese ?bersichtsarbeit stellt ein aktualisiertes deutschsprachiges Glossar thoraxradiologischer Begriffe vor. Es ist eng an die Terminologie der Fleischner Society angelehnt. An einigen Stellen waren ?berarbeitungen oder Anpassungen an den deutschen Sprachgebrauch erforderlich, au?erdem wurden einige Begriffe hinzugef?gt, die seit Erscheinen der englischen Version neu oder anders definiert wurden. Diese Abweichungen werden in einem Revisionsbericht dargestellt. Kernaussagen: ??Die Fleischner Society hat 2008 eine ?berarbeitung des Glossars thoraxradiologischer Begriffe publiziert. In diesem Artikel wird die deutsche ?bertragung dieses Glossars dargestellt. ??Einige Begriffe, die nicht in der englischen Version enthalten sind, wurden hinzugef?gt. ??Die generelle Verwendung der hier vorgestellten Terminologie in radiologischen Befunden ist zu empfehlen. Citation Format: ??Wormanns D., Hamer O. W., . Glossary of Terms for Thoracic Imaging ? German Version of the Fleischner Society Recommendations. Fortschr R?ntgenstr 2015; 187: 638???661

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“…At about 24 to 27 hours the natural evolution leads to surfactant loss and collapse of the alveoli consequently with the appearance and progression of lamellar atelectasis and to local edema with alveolar infiltrates that look like typical pneumonia. The reperfusion of the affected territory makes both processes to disappear after a few days (19).…”

Section: Acute Pementioning

confidence: 99%

Focus on pulmonary embolism imaging: where are we?

Dumitrescu¹,

Capsa²,

Lupescu³

2014

JTMR

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Purpose: This paper aims to realize an analysis of available radio-imaging methods for outlining various forms of pulmonary embolism (acute or chronic) with highlights on the semiology and adequate medical indications. Methods: There are several types of radiological examinations used in the evaluation of pulmonary embolism such as perfusion scintigraphy V/Q, digital subtraction angiography, computer tomography angiography, magnetic resonance angiography and cardio-pulmonary radiography. Results: Based on existing studies to date and the informations accumulated in our Department of Radiology and Medical Imaging, we have outlined an imaging pathway in pulmonary embolism assessment. Conclusions: Computer tomography angiography is actually considered the gold standard of diagnosis in suspected acute pulmonary embolism. Digital substraction angiography plays a primary adjuvant therapeutic role or a diagnostic role in case of inconclusive computer tomography angiography examinations. In case of chronic thrombembolic pulmonary hypertension, computer tomography angiography serves as a confirmation tool for the thromboembolic etiology and in conjunction with digital subtraction angiography is mapping the emboli vital for curative thrombendarterectomy. Computer tomography angiography proves its role in the diagnosis of unsuspected pulmonary embolism in oncological patients, discovery that has a negative impact on patient prognosis. In cases where computer tomography angiography refute the diagnosis of pulmonary, the examination may reveal other causes that may explain the patient's symptoms with medical impact. Digital subtraction angiography maintains especially a therapeutic role. Magnetic resonance angiography starts to become of interest in the evaluation and follow-up of subacute or chronic pulmonary embolism. Chest X-ray has not changed over time its place in pulmonary embolism assessment and continues to be of secondary importance.Key words: pulmonary embolism (PE), computer tomography angiography (CTA), angiography with digital substraction, magnetic resonance angiography (MRA), cardio-pulmonary radiography (chest X-ray) INTRODUCTION INTRODUCTIONPulmonary embolism (PE) is considered to be the third cause of death after myocardial infarction and cerebral vascular accident. Risk of death in acute massive PE is approximately 15% and is considered to be lethal in up to 5% of

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Pulmonary Embolism, Pulmonary Hemorrhage and Pulmonary Infarction

Cited by 200 publications

References 11 publications

Nonthrombotic pulmonary embolism

Nonthrombotic pulmonary embolism

Glossar thoraxradiologischer Begriffe entsprechend der Terminologie der Fleischner Society

Focus on pulmonary embolism imaging: where are we?

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