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  Most popular articles (Since August 28, 2020)

 
 
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CASE REPORTS
COVID-19 presenting as COVID - Clot obstructing vessels in deep
Monisha Anandhan, KM Aishwarya, Mohammed Shafi Abdulsalam, V Balaji, R Narasimhan
May-August 2020, 3(2):98-102
DOI:10.4103/WKMP-0215.309224  
Corona Virus Disease-2019 (COVID-19), a global health emergency shows a wide spectrum of clinical presentations and manifestations with dry cough, fever and shortness of breath being the most common symptoms. Available evidences shows that COVID-19 can be complicated by thrombotic manifestations. High index of clinical suspicion and early initiation of prophylactic or therapeutic dose of anti-coagulants is needed to prevent the occurrence of life-threatening thrombosis. We hereby present two cases of COVID-19 which had thrombosis at the time of initial presentation itself.
[ABSTRACT]   Full text not available  [PDF]
  24 2 -
OVERVIEW
Comprehensive Overview and Evidence Based Clinical Approach to Covid-19 - An Official Consensus Statement Endorsed By Association of Pulmonologist of Tamilnadu
R Narasimhan, B Rajagopalan, C Chandrasekhar, A Mahilmaran, R Sridhar, L Sundararajan, A Sundarajaperumal, R Sridhar, K Anupama murthy, PM Ramesh, A Manimaran, Meda. Sangeetha, OR Krishnarajasekhar, Arun Sampath, RP Ilangho, K Venugopal, AR Gayathri, V Senthil, Irfan Ismail Ayub, V Vinod Kumar, G Narendran, P Premananth, S Balamurugan, K Krishnamurthy, Aruna Shanmuganathan, R Velraj
August 2020, 3(3):1-64
DOI:10.4103/WKMP-0215.309207  
Background: The COVID-19 pandemic is the defining global health crisis of our time and the greatest challenge we have faced since World War Two. Since its emergence in China from December 2019, the virus has spread to every continent affecting more than 200 countries. The scientists and clinicians are in the continuous striving for determining the optimal standard of care. As Pulmonologists being active and prime specialists involved in diagnosis and management of COVID-19, it is imperative that we follow current evidence based clinical practice in the approach. Methods: A working group consisting of 26 senior respiratory physicians who are actively involved in management of COVID-19 was formed. A systematic search of the all major recent international / national guidelines for management of COVID-19, research articles and peer reviewed journals from December 2019 to July 2020 using key words “Novel Corona virus”, “SARS-CoV-2” and “COVID-19” was done. The consensus document was formed after thorough review of the evidence statement by the working group. Conclusion: This document provides the guidelines made by consensus of opinions among experts following discussion of systematic review of literature search pertaining to COVID-19. It is hoped that this document will help the clinician understand the accumulated evidence and help better diagnosis and management of COVID-19.
[ABSTRACT]   Full text not available  [PDF]
  8 15 -
CASE REPORTS
CT manifestations of novel coronavirus pneumonia: A case report and review of literature
Abdul Majeed Arshad, R Anand, Irfan Ismail Ayub, MV Jothikrishnan, A Kumaresh, T Dhanasekar, C Chandrasekar
May-August 2020, 3(2):88-92
DOI:10.4103/WKMP-0215.309222  
Background: Till November 17 2020, Novel Corona virus outbreak has affected over 200 countries and territories and in India the COVID-19 has Risen up to 8, 912, 9007 (Near by 9 Million cases) and leading to 1, 31,031 deaths Case Report: A Thirty three old male presented with complaints of fever for 3 days with myalgia and fatigue. Throat swab for RT PCR Positive. HRCT chest showed diffuse ill-defined ground glass opacities with coalescing consolidation noted in the bilateral lung fields with intralobular septal thickening suggestive of viral pneumonia - CORADS 6 - CTSS 20/25. The patient had severe Hypoxemia on Admission. The patient was started on HFNC and Steroids. The Patient’s Hypoxemia improved drastically throughout the course of treatment and was discharged with complete recovery from illness. Conclusion: Chest computed tomography offers fast and convenient evaluation of patients with suspected 2019-novel coronavirus pneumonia and negative RT PCR reports
[ABSTRACT]   Full text not available  [PDF]
  12 6 -
The Rubbish Rib Tickler - Successful Complete Surgical Removal of Large Symptomatic Rib Tumour
Ajay Narasimhan, Amal Johnson, R Narasimhan
September-December 2018, 1(2):78-82
Fibrous Dysplasia is a non inherited skeletal developmental abnormality, where normal bone is replaced by fibrous tissue and poorly formed area of immature bone. Monostotic lesions are 80% of the cases; and Polyostotic lesions are characteristic component of specific syndromes. It is usually detected in 1st and 2nd decade of life as an incidental finding and can cause occasionally dull aching pain2. The clinical course is variable and depends upon the extent and location of the lesion. Fibrous Dysplasia is the most common benign rib lesion3,4. In this case report, we describe a patient with large progressively increasing in size symptomatic rib tumour diagnosed as benign lesion with biopsy and underwent successful resection surgery.
[ABSTRACT]   Full text not available  [PDF]
  16 2 -
ORIGINAL ARTICLES
Correlation between CT severity score and clinical severity of COVID-19 pneumonia in hospitalised patients in a tertiary care hospital, Tamilnadu
Monisha Anandhan, KM Aishwarya, R Sridhar, Ajith , Balasubramaniam Ramakrishnan, R Narasimhan
May-August 2020, 3(2):67-75
DOI:10.4103/WKMP-0215.309219  
Aim: To study the correlation between CT severity score in COVID pneumonia patients with oxygen supplementation and diseases outcome. Background and Methods: Retrospective study was done on 56 hospitalied patients who were diagnosed with COVID-19 Pneumonia with gold standard RT PCR in Apollo Main Hospital, Greams road, Chennai. We retrospectively collected epidemiological data, clinical manifestation, co-morbidities, oxygen requirement as well as CT chest findings and CT severity score of all patients. Meticulous study of HRCT chest for pattern and distribution of the disease was done along with the calculation of CT severity score for all patients according to American journal of radiology recent guidelines. CT severity score was then compared with the clinical severity of the diseases as determined by the oxygen supplement and patient outcome. Results: The study was done on 56 hospitalized patients with mean age of 58.7 + 14.3 with age group of 40 to 59 years(48.21%) and above 60 years(46.43%). Male(71.4%) patients were more compared to female(28.6%) patients .Typical COVID-19 findings like peripheral GGO’s were present in all patients, crazy paving in 96.4% patients and consolidation in 16.1% patients. There is a significant difference in CT severity score between those who required (N=39) (19.2+7.2) and not required oxygen (N=17) (10.7 +5.7) (P value = 0.0001). Even though there was increasing trend in CT severity score across different modes of oxygen requirements but it was not statistically significant (0.183). Among 39 patients who needed Oxygen supplementation through different modes, nasal prongs(NP) (N=12) (30.8%),face mask (FM) (N=6)(15.4 %), Non rebreathing face mask(NRBM) (N=8) (20.5 %), High Flow Nasal Canula (HFNC) (N=2)( 5.1%),Non Invasive Ventilation (NIV)(N=6) (15.4%) intubated patients (12.8%) their respective mean CT severity were of 16.50+ 4.1, 16.67 + 5.5, 19.13+ 6.2,17+ 16, 23.7 + 8.8and 24+ 8.9 which was not statistically significant [P value (0.183)].There was increased CT severity score in those patients who died which was not statistically significant when compared to the patients who were alive (P value = 0.120). Mean duration of CT taken time and the onset of symptom was 3 days ( 1 to 6 days). The patients who delayed more than 2 days to take CT chest had an odds ratio of 3.2 higher chance of requiring oxygen which was statistically significant (P value = 0.046). Conclusions: Significant correlation between CT Severity Score and the comparable need for appropriate mode of oxygen delivery suggests the high predictive value of HRCT chest in the disease outcome. Hence, HRCT chest is one the best tools for early rapid identification as well as to predict the severity of disease. It also helps the physician in making important treatment modifications at crucial points during the progression and course of the disease.
[ABSTRACT]   Full text not available  [PDF]
  14 4 -
CASE REPORTS
Empyema necessitans presenting as chest wall abscess - Case series
M Natraj, Irfan Ismail Ayub, Deepika Ramachandran, Abdul Majeed Arshad, Dhanasekar , Rajagopalan , T Chandrasekar
June-August 2018, 1(1):25-28
Empyema Necessitans (EN) is a rare complication of untreated pleural infection. It burrows through the parietal pleura and extends to the extra pleural space. Tuberculosis is the most common cause of EN. It can be seen in both immunocompromised and immunocompetent patients. Diagnosis can be challenging due to long duration and indefinite symptoms. Missing the disease can have dreadful consequences on the patient’s health. Here we report two cases that presented with chest wall abscess later to be diagnosed as Empyema Necessitans.
[ABSTRACT]   Full text not available  [PDF]
  14 2 -
“Localised Bronchiectasis” - Time to Look Inside?
Mobeen Quadri, P Yugandhar
January-April 2020, 3(1):34-37
DOI:10.4103/WKMP-0215.309210  
Bronchiectasis is a well-known entity where the airways abnormally dilate, losing their natural function. The most common causes of non-cystic fibrosis bronchiectasis in the middle age group include secondary immunodeficiency, aspiration, and allergic bronchopulmonary aspergillosis (ABPA). An obstructive foreign body is an uncommon cause of Bronchiectasis and is often a missed diagnosis in localized disease. Foreign bodies can be missed making the diagnosis and treatment more challenging, and hence foreign body bronchiectasis should be considered in-patients presenting with focal disease. Here we describe a patient with a retained foreign body for a long duration of more than three decades. It was discovered through fiberoptic bronchoscopy with no significant aspiration history and nondiagnostic imaging of the chest.
[ABSTRACT]   Full text not available  [PDF]
  14 0 -
Adenocarcinoma Lung Presenting with Bilateral Chylothorax and SVC Thrombosis
S Aneeshkumar, R Narasimhan, C Srirajani
September-December 2018, 1(2):74-77
Chylothorax is a rare clinical entity characterized by a milky white fluid within the pleural space. It is a rare condition in which damage or obstruction of the thoracic duct results in chyle leakage into the pleural space. The most common causes are surgical or nonsurgical trauma, neoplasms, tuberculosis and venous trombosis. Lymphoma accounts for 70% of the neoplastic cause, while other malignant causes are very rare. Chylothorax occurs most commonly on the right side and B/L chylothorax is a very rare presentation. We present a case of B/L chylothorax secondary to adenocarcinoma of lung.
[ABSTRACT]   Full text not available  [PDF]
  12 1 -
ORIGINAL ARTICLES
Clinical profile and outcome of COVID 19 patients admitted in tertiary care hospital, Tamilnadu
Kirubanandam Arularasan, Ria Lawrence, R Sridhar, Balasubramaniam Ramakrishnan, R Ramanarasimhan, R Narasimhan
May-August 2020, 3(2):76-80
DOI:10.4103/WKMP-0215.309220  
Aim: to study the clinical, biochemical, radiological profile of symptomatic hospitalised COVID 19 patients at initial presentation and its outcome. Background and Methods: Retrospective study was done on 50 hospitalised patients who were diagnosed with COVID- 19 pneumonia with gold standard RT PCR in Apollo Main hospital, Greams road, Chennai. The clinical, laboratory, radiological characteristics and treatment and outcomes were collected from electronic medical records. The information recorded included medical history, contact history, co-morbidities, symptoms, signs, laboratory findings, radiological findings including chest X-ray and CT chest, treatment measures (antiviral, antibiotic, steroids, anticoagulant therapy and respiratory support), duration of hospital stay and outcomes of the patients. Results: The study was done on 50 hospitalised patients with mean age of 59.8 years. Male (66%) patients were more compared to female patients. Fever (N=44) (88%) was the most common symptom present in our patients followed by breathlessness (N=27) (54%) Most of the patients were under category B 2(N=16) (32%). Most common co-morbidity was Diabetes (N=25) (50%) followed by Hypertension (N=23) (46%). Only few patients had leucocytosis (N=16) (32%) but most of the patients had lymphocytopenia. LDH, PCT, and IL-6 were significantly elevated in majority of the patients. Chest x-ray of the patients demonstrated bilateral (N=26) (52%)involvement with predilection for peripheries(N=34) (68%). HRCT Chest of the patients demonstrated predilection for peripheral lung fields in the form of patchy ground glass opacities (100%). Most of the patients were treated with steroids(N=34%) (68%) and anticoagulants (N=46) (92%). 42 Patients were discharged (84%). Average length of stay in hospital is 8.92 days (2 to 42 days). Conclusion: This study shows the various range of COVID 19 presentation varying from mild to severe pneumonia. Lymphocytopenia and elevated biomarkers with peripheral opacities in CT chest will help to assess the prognosis. Old age and patients with multiple co-morbidities are associated with poor prognosis.
[ABSTRACT]   Full text not available  [PDF]
  8 5 -
CASE REPORTS
The maleficent nut in bronchus - Elusive foreign body retrieved with flexible bronchoscopy using cryoprobe and forceps
Amal Johnson, R Sridhar, R Narasimhan, Anand Murugesan
June-August 2018, 1(1):36-41
Foreign body aspiration (FBA) is relatively rare in adults. In non life threatening aspiration, patients seldom recall the history of aspiration and the clinical presentation is mostly subtle and inconsistent. Chest Xray directly identify foreign body in only a minority of patients. CT chest has better resolution in detection but it does entail limitations. Though rigid bronchoscopy remains the gold standard for retrieval of FB especially in children, now with new dedicated instruments Flexible bronchoscopy has become the most commonly used diagnostic and therapeutic modality in majority of patients. Herein, we describe a patient with a smooth, spherical FB impacted in a segmental bronchus retrieved with substantial difficulty using cryoprobe and forceps.
[ABSTRACT]   Full text not available  [PDF]
  10 2 -
Non resolving pneumonia - A rare differential
Monisha Anandhan, R Sridhar, Prabhu , R Narasimhan
January-April 2020, 3(1):42-46
DOI:10.4103/WKMP-0215.309212  
Multiple myeloma(MM) is a malignant systemic hematological disease that arises from monoclonal plasma cells. It usually affects older patients and is characterized by the presence of monoclonal immunoproteins in the serum. They are rarely found in extramedullar^ sites. We present a case of an elderly female who came to us with Respiratory symptoms, myalgia and loose stools for 2 weeks, not responding to standard antibiotic therapy raising an alarm of non resolving pneumonia of non-infectious etiology. Further radiological and laboratory evaluations showed diffuse parenchymal infiltrate and plasmacytosis. Thus the diagnosis of Multiple myeloma was made.
[ABSTRACT]   Full text not available  [PDF]
  10 2 -
PICTORIAL CME
Interesting chest skiagram
R Ravikumar, R Sridhar, R Narasimhan
June-August 2018, 1(1):42-43
Case: A 19 year old female came with complaints of haemoptysis and right side chest pain for 3 years with history of ATT intake twice and h/o VATS guided biopsy from right hilar mass which was inconclusive . Chest radiograph : Non-homogenous opacity on the right hilar region. Bronchoscopy : only two segments in right upper lobe. CT Chest Angiogram: suggestive of intralobar pulmonary sequestration which had arterial supply from internal mammary artery and venous drainage into the right pulmonary vein . Angiogram: shows multiple feeders from right internal mammary artery supplying the sequestrated segment of lung. Treatment: Embolisation of two major feeding branches from right internal mammary artery done. Patient became asymptomatic.
[ABSTRACT]   Full text not available  [PDF]
  8 3 -
REVIEW ARTICLE
Clinic-radiological features and diagnostics of mediastinal masses: A review article by Chennai thoracic associates
R Sridhar, Ajay Narasimhan, R Narasimhan
January-April 2020, 3(1):16-33
DOI:10.4103/WKMP-0215.309208  
The mediastinum is the site of infection, benign and malignant, primary and metastatic, many of which present as mediastinal masses and remains an interesting diagnostic challenge. Mediastinal masses affect patients of all ages and can be asymptomatic. Although clinical data, location in the mediastinum and radiological findings all aid in narrowing the differential diagnosis, tissue diagnosis is the gold standard for arriving the final diagnosis. The diagnosis of the mediastinal tumours requires a combination of clinical, radiological and pathological information. The purpose of this review study is to describe demographic, clinical features, radiology and pathological information of mediastinal masses which helps in organised diagnostic approach of mediastinal mass.
[ABSTRACT]   Full text not available  [PDF]
  8 3 -
REVIEW ARTICLES
Clinical and Inflammatory Phenotypes of Severe Asthma in Adults: A Comprehensive Review
Padmavathy Ramadoss
September-December 2018, 1(2):58-63
Evidence - based medicine is the norm of the day. Ever increasing recognition of marked phenotypic heterogeneity amongst patients with defined ‘severe asthma’ calls for precise, individualised patient-based treatment. Although international research has identified several clinical and inflammatory phenotypes of severe asthma, one of the innumerable hurdles that must be overcome in daily practice, is bridging of the knowledge gap between researchers and Physicians dealing with asthmatic patients in their daily clinical practice. While more enterprise is required to comprehend the relation between these phenotypes and their elemental disease mechanisms and pharmacological treatment responses, in-depth cognizance of these clinical and inflammatory phenotypes provide a good embarkation point for addressing disease heterogeneity in severe asthma in day to day practice. This review brings to the reader, comprehensive information on the clinical and inflammatory asthma phenotypes, their associations and related biomarkers and aims to emphasise the importance of recognition of these phenotypes in order to bring individualised patient management to the beside.
[ABSTRACT]   Full text not available  [PDF]
  8 3 -
CASE REPORTS
A strange cause of chylothorax- Dasatinib induced
M Natraj, Dhanasekar , Irfan Ismail Ayub, Abdul Majeed Arshad, Rajagopalan , T Chandrasekar
June-August 2018, 1(1):33-35
Dasatinib is a potent second-generation tyrosine kinase inhibitor for the treatment of chronic myeloid leukemia. Pulmonary side effects like pleural effusion due fluid retention are common. But dasatinib, causing chylothorax is very rarely reported. Exact mechanism along with clinical manifestations is very poorly understood. Here we report 35-year-old man presenting with chylothorax following with dasatinib use.
[ABSTRACT]   Full text not available  [PDF]
  8 2 -
ORIGINAL ARTICLES
A study on factors leading to treatment interruption among TB patients at GHTM
R Sridhar, V Vinodkumar, S Kumar
June-August 2018, 1(1):3-6
According to National drug resistance survey 2017, 36.82% of previously treated patients have resistance to at least one ATT drug. This observational study was undertaken to evaluate the reasons for treatment interruption among patients presenting with history of treatment interruption at GHTM. Most patients interrupting treatment were found in the productive age group (82.5%), smokers(72%), alcoholic (82%), 12% of patients were not aware of treatment duration and 16% had other co morbidities. Most of the treatment interruption was after 2 months of ATT. This study provides and insight into reasons for treatment interruption and serves as a guidance to focus on pretreatment counseling with goal of reducing the emergence of drug resistant TB.
[ABSTRACT]   Full text not available  [PDF]
  8 2 -
CT Guided Transthoracic Lung Biopsy - An Experience from a Tertiary Care Centre Hospital
S Aneeshkumar, R Narasimhan, K Sunder, L Sundararajan
September-December 2018, 1(2):49-52
Background: In 1883, Leyden described percutaneous lung biopsy, but it was not until 1970’s that image guided fine needle chest biopsy gained widespread acceptance. Haaga and Alfidi reported CT-guided thoracic biopsy in 1976. Currently, CT-guided core biopsy is playing an increasing role in the diagnosis of benign as well as malignant diseases, cellular differentiation, somatic mutation analysis, and molecular finger print analysis. Small tissue biopsy obtained through minimally invasive methods have become the primary diagnostic tools for the pathologic characterization and testing of lung masses Aim: To evaluate the diagnostic accuracy and complications of CT guided transthoracic lung (core) biopsy in radiologically visible lung lesions Materials and methods: One hundred and one patients who underwent CT guided transthoracic needle aspiration lung biopsy (TNAB) for radiologically visible lung lesions were studied. After obtaining informed consent, the patient was appropriately positioned depending on the site of the lesion. A coaxial 18G biopsy needle (by cook) was used for biopsy. An immediate CT screening was done post procedure to r/o complications. Results: Transthoracic needle aspiration biopsy was diagnostic in 88% (89/ 101) of patients. In case of malignancy even the histological type of tumor was known and adequate tissue was present for molecular sampling. The complication rate (pneumothorax) following CT guided biopsy was 5% (5/101)with 1%(1/101)requiring ICD insertion. One patient had minimal haemoptysis which subsided with conservative management. Conclusion: CT guided lung biopsy is a safe, cost effective and useful procedure for determination of different lung lesions with diagnostic challenge. The complication rates are very few in experienced hands.
[ABSTRACT]   Full text not available  [PDF]
  8 1 -
Role of Endobronchial Ultrasound Guided real time Transbronchial Needle Aspiration in Mediastinal Lymphadenopathy: A Case Series
Avinash Peddi, R Sridhar, R Narasimhan
September-December 2018, 1(2):53-57
Introduction: Mediastinal lymphadenopathy is expected to be the common mediastinal masses because this is caused by high prevalent diseases like tuberculosis, lung cancer metastasis, lymphoma and sarcoidosis etc. Mediastinal lymphadenopathies are difficult to biopsy since they are nearer to major vessels and airways and located commonly in the middle compartment. Hence mediastinal lymphadenopathy is under represented in many studies since unable to obtain tissue diagnosis. The newer techniques EBUS and EUS are made easier to approach the mass like lymphadenopthy in middle mediastinum with less complication. Objective: To know the effectiveness of real-time EBUS in the evaluation of mediastinal lymphadenopathy. Methodology: In our study 50 cases of mediastinal lymphadenopathy diagnosed by CT scan chest which were subjected to EBUS guided real time TBNA of mediastinal nodes. TBNA Specimens were sent for histopathological examinations and reports were collocated and analyzed. Results: Among 50 cases of mediastinal lymphadenopathy, arrived diagnosis in EBUS TBNA in 42 cases and inconclusive results in other 8 cases. Among 42 cases, tuberculosis in 17 cases [34%], malignancy in 16 cases [32%], sarcoidosis in 8 cases [16%], sub acute inflammation in 1 case [2%]. Conclusion: Before the advent of EBUS, Percutaneous transthoracic needle biopsy/FNAC (under CT or ultrasound guidance) or surgical procedures [VATS or Mediastinoscopy] were considered as the initial method of choice in evaluation of mediastinal lesions. EBUS techniques has demonstrated utility in the diagnosis of mediastinal lymphadenopathy secondary to malignancy, tuberculosis and sarcoidosis and easier and lesser complication than more invasive procedures like VATS or mediastinoscopy.
[ABSTRACT]   Full text not available  [PDF]
  8 1 -
CASE REPORTS
Pulmonary botryomycosis
C Govindasamy, C Selvi, R Narasimhan
June-August 2018, 1(1):29-32
Botryomycosis is a rare, chronic suppurative granulomatous bacterial infection of skin, soft tissue, and viscera with aggregates of nonbranching gram positive or negative bacteria. This is a very rare infection usually under diagnosed, mostly seen in immunocompromised state, so far only few case reports were reported worldwide. 59-year-old gentleman from Port Blair, with no comorbidities came with complaints of cough with expectoration for past six months who already received multiple treatments outside. On examination, he had basal crepitation’s in right infrascapular area. His chest X-ray showed right lower zone opacity. Blood investigation revealed leukocytosis with elevated ESR. HRCT Chest revealed right lower lobe consolidation. Bronchoscopy was done which showed mobile intrabronchial mass in RLL-CBS. Following removal, he improved. Histopathological examination of foreign body revealed vegetative material and showed gram negative bacteria with interspersed gram-positive bacteria surrounded by splendore-hoepplii phenomenon suggestive of botryomycosis. He was treated with antibiotics and he improved well.
[ABSTRACT]   Full text not available  [PDF]
  6 2 -
Melioidosis Presenting as Isolated Mediastinal Lymphadenopathy
R Gogulakrishnan, S Jayakumar, H Subramony, R Narasimhan
September-December 2018, 1(2):68-70
Melioidosis has varied clinical presentation involving different organs with pneumonia as common pulmonary presentation. Isolated mediastinal lymphadenopathy as presentation is rare. Herein, we describe a case of Melioidosis identified by endobronchial ultrasound guided transbronchial needle aspiration of subcarinal lymph node. This case stresses the need for clinical suspicion of melioidosis in patients from endemic areas and the role of endobronchial ultrasound in diagnosing it.
[ABSTRACT]   Full text not available  [PDF]
  6 2 -
Post-Partum Presentation of Ruptured Bronchogenic Cyst
Ajay Narasimhan, Jayagovardhanan Govindasamy Dayalu, Dinesh Shanmugasundaram, Arvind Venkatasamy
September-December 2018, 1(2):71-73
Mediastinal cysts account for 20% of all mediastinal masses. A 22-year-old pregnant female was admitted for delivery. She developed dyspnea on the 3rd day of delivery. Chest X-ray revealed a large right hydropneumothorax and tube thoracostomy was done. She was referred to us for further management. We decided to operate. At surgery, a ruptured cystic lesion was seen in the posterior mediastinum separate from all three lobes. It was communicating with the bronchus. The cyst was excised completely and bronchial communication was sutured. The lung expanded completely. Post operative period was uneventful. Histopathology revealed it to be a bronchogenic cyst.
[ABSTRACT]   Full text not available  [PDF]
  6 2 -
PICTORI CME
Radiology quiz
R Sivanthi Sapna, R Narasimhan
May-August 2020, 3(2):106-107
DOI:10.4103/WKMP-0215.309217  
Full text not available  [PDF]
  4 3 -
PICTORIAL CME
Pulmonary Agenesis - A Zebra Like Disorder for Pulmonologists
Monisha Anandhan, Amal Johnson, R Narasimhan
September-December 2018, 1(2):83-86
Pulmonary agenesis is an extremely rare congenital anomaly defined as a complete absence of the lung parenchyma, bronchus, and pulmonary vessels. In case of complete unilateral agenesis, no pleural cavity can be found on the affected side. More than 50% of children with lung aplasia die within five years of birth but some individuals live a normal life span with their deformity and may be asymptomatic throughout life. Respiratory tract infections are the greatest danger in these individuals. We report a case of left lung aplasia with bronchiectasis in a young-aged adult who was treated for tuberculosis and was referred to our institute for persistent cough.
[ABSTRACT]   Full text not available  [PDF]
  4 3 -
CASE REPORTS
A case report of extramedullary plasmacytoma - Presenting as a chest wall tumour
S Priya, Murugan , Mahilmaran
January-April 2020, 3(1):47-52
DOI:10.4103/WKMP-0215.309213  
Plasmacytoma refers to a malignant plasma cell tumor growing within soft tissue or within the axial skeleton. Plasmacytoma accounts for six percent of all primary chest wall tumours. A solitary extramedullary plasmacytoma is reported three percent of plasma cell disorders. A 65 year male patient presented with complaint of swelling in the back of right side of the chest noticed for one month, pain over the swelling and dry cough for two weeks. Physical examination revealed a diffuse, lobulated swelling in the back of right side of chest which is firm to hard in consistency. The chest radiograph showed a large extra-pulmonary opacity with well-defined medial margin and lateral margin merging with chest wall on right side and blunting of the right costophrenic angle. The histopathological examination of tru-cut biopsy section showed fragments of fibrocartilagenous stroma infiltrated by mononuclear cells with round to oval nucleus and eosinophilic cytoplasm and some foci showed plasmocytoid features with the intervening stroma shows proliferating capillaries thereby features suggestive of plasmacytoma. The specimen is positive for CD 138 by the immunohistochemistry analysis which is the hallmark for diagnosing plasmacytoma.
[ABSTRACT]   Full text not available  [PDF]
  6 0 -
EDITORIAL
Editorial

June-August 2018, 1(1):1-2
Full text not available  [PDF]
  2 4 -