BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two disea...BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two diseases.AIM To improve the diagnosis of lymphatic PB or primary chylothorax,a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.METHODS The clinical and CTL data of 71 patients(20 with lymphatic PB,41 with primary chylothorax,and 10 with lymphatic PB with primary chylothorax)were collected retrospectively.CTL was performed in all patients.The clinical manifestations,CTL findings,and conventional chest CT findings of the three groups of patients were compared.The chi-square test or Fisher's exact test was used to compare the differences among the three groups.A difference was considered to be statistically significant when P<0.05.RESULTS(1)The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows:Thoracic duct outlet in 14(70.0%),33(80.5%)and 8(80.0%)patients;peritracheal region in 18(90.0%),15(36.6%)and 8(80.0%)patients;pleura in 6(30.0%),33(80.5%)and 9(90.0%)patients;pericardium in 6(30.0%),6(14.6%)and 4(40.0%)patients;and hilum in 16(80.0%),11(26.8%)and 7(70.0%)patients;and(2)the abnormalities on conven-tional chest CT in the three groups were as follows:Ground-glass opacity in 19(95.0%),18(43.9%)and 8(80.0%)patients;atelectasis in 4(20.0%),26(63.4%)and 7(70.0%)patients;interlobular septal thickening in 12(60.0%),11(26.8%)and 3(30.0%)patients;bronchovascular bundle thickening in 14(70.0%),6(14.6%)and 4(40.0%)patients;localized mediastinal changes in 14(70.0%),14(34.1%),and 7(70.0%)patients;diffuse mediastinal changes in 6(30.0%),5(12.2%),and 3(30.0%)patients;cystic lesions in the axilla in 2(10.0%),6(14.6%),and 2(20.0%)patients;and cystic lesions in the chest wall in 0(0%),2(4.9%),and 2(4.9%)patients.CONCLUSION CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax.This method is an excellent tool for diagnosing these two diseases.展开更多
Presentation of case Dr.Cheng:an eight-year-old boy with a two-month history of productive cough was admitted to our hospital in July 2020.Prior to admission,the patient had been hospitalized twice at a local hospital...Presentation of case Dr.Cheng:an eight-year-old boy with a two-month history of productive cough was admitted to our hospital in July 2020.Prior to admission,the patient had been hospitalized twice at a local hospital because of gelatinous sputum accompanied by expiratory wheezing and chest tightness.He had received intravenous therapies and nebulization therapy.The patient continued to persistently cough up sputum,accompanied by intermittent wheezing and chest tightness.展开更多
Acute respiratory infections(ARIs)are the main cause of morbidity and mortality worldwide,especially among children.The human bocavirus(HBoV)is a nonenveloped DNA virus that was recently identified as a respiratory pa...Acute respiratory infections(ARIs)are the main cause of morbidity and mortality worldwide,especially among children.The human bocavirus(HBoV)is a nonenveloped DNA virus that was recently identified as a respiratory pathogen associated with respiratory tract infections(RTIs),predominantly in infants and young children.It is also detected from the gastrointestinal tract in children.The prevalence of HBoV1 acute respiratory tract infection varies across age groups,ranging from 10.3%to 12.51%in individuals under 3 years of age.The spectrum of clinical presentation includes mild upper RTIs,acute exacerbation of asthma,bronchitis,bronchiolitis,pneumonia,and multi-organ failure.Although HBoV is often detected in patients with ARIs who have other respiratory viruses(17%-85%),recent studies have identified it as the sole aetiology for mild to severe ARIs.Children with pre-existing medical conditions infected with HBoV often have a risk of severe illness.HBoV infection is diagnosed primarily by detecting viral DNA in respiratory samples using molecular methods.Currently,there is no specific antiviral treatment for HBoV infections and the cases are managed symptomatically.General preventive measures used for the prevention of viral RTIs are applicable,as there is no effective vaccine against this virus.The HBoV has been implicated in RTIs,particularly in children,and has also been detected in cases of gastroenteritis.Despite its global prevalence,the exact pathogenic role of HBoV remains unclear due to frequent co-infections with other viruses.This minireview discusses the virology,epidemiology,clinical manifestations,diagnosis,and potential treatment approaches related to HBoV infections.展开更多
In this editorial,we discuss the clinical implications of the article“Lymphatic plastic bronchitis and primary chylothorax:A study based on computed tomography lymphangiography”published by Li et al.Pulmonary lympha...In this editorial,we discuss the clinical implications of the article“Lymphatic plastic bronchitis and primary chylothorax:A study based on computed tomography lymphangiography”published by Li et al.Pulmonary lymphatic disorders involve abnormalities in the lymphatic tissues within the thoracic cavity.Specifically,pulmonary lymphatic perfusion syndrome describes a condition where the flow of lymphatic fluid in the lungs is redirected towards abnormally widened lymphatic vessels.Clinically,individuals with this syn-drome may experience symptoms such as chyloptysis,plastic bronchitis(PB),chylothorax,chylopericardium,and interstitial lung disease.These disorders can be caused by various factors,including PB,chylothorax,and complex lymphatic malformations.Advancements in lymphatic imaging techniques,such as in-tranodal lymphangiography,computed tomography lymphangiography,and dynamic contrast-enhanced magnetic resonance lymphangiography,have enabled the detection of abnormal lymphatic flow.This has enhanced our understanding of the pathophysiology of these conditions.Additionally,innovative minimally invasive treatments,such as thoracic duct embolization,selective embolization of lymphatic channels,and surgical procedures aim to improve clinical condition of patients and address their dietary needs.展开更多
文摘BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two diseases.AIM To improve the diagnosis of lymphatic PB or primary chylothorax,a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.METHODS The clinical and CTL data of 71 patients(20 with lymphatic PB,41 with primary chylothorax,and 10 with lymphatic PB with primary chylothorax)were collected retrospectively.CTL was performed in all patients.The clinical manifestations,CTL findings,and conventional chest CT findings of the three groups of patients were compared.The chi-square test or Fisher's exact test was used to compare the differences among the three groups.A difference was considered to be statistically significant when P<0.05.RESULTS(1)The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows:Thoracic duct outlet in 14(70.0%),33(80.5%)and 8(80.0%)patients;peritracheal region in 18(90.0%),15(36.6%)and 8(80.0%)patients;pleura in 6(30.0%),33(80.5%)and 9(90.0%)patients;pericardium in 6(30.0%),6(14.6%)and 4(40.0%)patients;and hilum in 16(80.0%),11(26.8%)and 7(70.0%)patients;and(2)the abnormalities on conven-tional chest CT in the three groups were as follows:Ground-glass opacity in 19(95.0%),18(43.9%)and 8(80.0%)patients;atelectasis in 4(20.0%),26(63.4%)and 7(70.0%)patients;interlobular septal thickening in 12(60.0%),11(26.8%)and 3(30.0%)patients;bronchovascular bundle thickening in 14(70.0%),6(14.6%)and 4(40.0%)patients;localized mediastinal changes in 14(70.0%),14(34.1%),and 7(70.0%)patients;diffuse mediastinal changes in 6(30.0%),5(12.2%),and 3(30.0%)patients;cystic lesions in the axilla in 2(10.0%),6(14.6%),and 2(20.0%)patients;and cystic lesions in the chest wall in 0(0%),2(4.9%),and 2(4.9%)patients.CONCLUSION CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax.This method is an excellent tool for diagnosing these two diseases.
基金supported by the Pioneer R&D Program of Zhejiang(Grant Number:2023C03009).
文摘Presentation of case Dr.Cheng:an eight-year-old boy with a two-month history of productive cough was admitted to our hospital in July 2020.Prior to admission,the patient had been hospitalized twice at a local hospital because of gelatinous sputum accompanied by expiratory wheezing and chest tightness.He had received intravenous therapies and nebulization therapy.The patient continued to persistently cough up sputum,accompanied by intermittent wheezing and chest tightness.
文摘Acute respiratory infections(ARIs)are the main cause of morbidity and mortality worldwide,especially among children.The human bocavirus(HBoV)is a nonenveloped DNA virus that was recently identified as a respiratory pathogen associated with respiratory tract infections(RTIs),predominantly in infants and young children.It is also detected from the gastrointestinal tract in children.The prevalence of HBoV1 acute respiratory tract infection varies across age groups,ranging from 10.3%to 12.51%in individuals under 3 years of age.The spectrum of clinical presentation includes mild upper RTIs,acute exacerbation of asthma,bronchitis,bronchiolitis,pneumonia,and multi-organ failure.Although HBoV is often detected in patients with ARIs who have other respiratory viruses(17%-85%),recent studies have identified it as the sole aetiology for mild to severe ARIs.Children with pre-existing medical conditions infected with HBoV often have a risk of severe illness.HBoV infection is diagnosed primarily by detecting viral DNA in respiratory samples using molecular methods.Currently,there is no specific antiviral treatment for HBoV infections and the cases are managed symptomatically.General preventive measures used for the prevention of viral RTIs are applicable,as there is no effective vaccine against this virus.The HBoV has been implicated in RTIs,particularly in children,and has also been detected in cases of gastroenteritis.Despite its global prevalence,the exact pathogenic role of HBoV remains unclear due to frequent co-infections with other viruses.This minireview discusses the virology,epidemiology,clinical manifestations,diagnosis,and potential treatment approaches related to HBoV infections.
文摘In this editorial,we discuss the clinical implications of the article“Lymphatic plastic bronchitis and primary chylothorax:A study based on computed tomography lymphangiography”published by Li et al.Pulmonary lymphatic disorders involve abnormalities in the lymphatic tissues within the thoracic cavity.Specifically,pulmonary lymphatic perfusion syndrome describes a condition where the flow of lymphatic fluid in the lungs is redirected towards abnormally widened lymphatic vessels.Clinically,individuals with this syn-drome may experience symptoms such as chyloptysis,plastic bronchitis(PB),chylothorax,chylopericardium,and interstitial lung disease.These disorders can be caused by various factors,including PB,chylothorax,and complex lymphatic malformations.Advancements in lymphatic imaging techniques,such as in-tranodal lymphangiography,computed tomography lymphangiography,and dynamic contrast-enhanced magnetic resonance lymphangiography,have enabled the detection of abnormal lymphatic flow.This has enhanced our understanding of the pathophysiology of these conditions.Additionally,innovative minimally invasive treatments,such as thoracic duct embolization,selective embolization of lymphatic channels,and surgical procedures aim to improve clinical condition of patients and address their dietary needs.
