A 75-year-old male presented with a large pleural effusion and significant hypoxaemia. The hypoxaemia persisted after large-volume drainage, this prompted further investigations. CT scan yielded malignancy pulmonary embolus, which was responsible for the We revisit mechanisms behind dyspnoea in effusions, underly need to investigate should persist adequate drainage.

Twenty-five patients with a clinically suggestive diagnosis of pulmonary embolism were referred directly from the accident and emergency department for a ventilation and perfusion isotope scan. On the basis of a negative scan, the authors were able to discharge 19 patients. The advantages of having direct access to isotope imaging are described.

OBJECTIVE To identify factors that predict a positive duplex scan examination result in patients with suspected deep vein thrombosis of the lower extremity. DESIGN Retrospective study. SETTING Vascular laboratory in a university teaching hospital. PATIENTS AND METHODS The results of 345 lower extremity duplex venous scans performed between August 1994 and November 1998 were reviewed. All ...

Story From the Front Lines A70-year-oldmansawhisprimary care clinicianandexpressed concern about his lung cancer risk after learning a friend had recently died of it. The patient had had an 80-pack-year history, and had quit 7 years previously. His physician ordered a screening chest computed tomographic (CT) scan, which demonstrated a spiculated 12-mm lungnodule thatwasnewwhencomparedwithscans...

Pulmonary artery aneurysm (PAA) is a rare disorder with difficult diagnosis and debated management in literature due to the limited number of cases. Even if definitive treatment PAA surgery, consistent guidelines still need be developed help surgeons determine when intervention appropriate. We report case 77-year-old female diagnosed central measuring 61 mm at contrast-enhanced computerized tom...

Invasive tracheobronchial aspergillosis that is entirely limited or predominantly confined to tracheobronchial lesions is a relatively rare form of invasive pulmonary aspergillosis. Extended parenchymal opacities that are radiological manifestations of invasive aspergillosis sometimes occur following invasive tracheobronchial aspergillosis. However, it remains unclear whether or not invasive tr...

BACKGROUND The diagnosis of pulmonary embolism demands flexible decision models, both for the presence of clinical confounders and for the variability of local diagnostic resources. As Bayesian networks fully meet this requirement, Bayes Pulmonary embolism Assisted Diagnosis (BayPAD), a probabilistic expert systems focused on pulmonary embolism, was developed. METHODS To quantitatively valida...

A 48-year-old male patient presented with dialysis dependent renal failure biopsy showing crescentic glomerulonephritis and Positron emission tomography–computed tomography (PET-CT scan) revealing features of pericardial, pulmonary tuberculosis positive urinary GeneXpert test for bacilli. Clinicians should keep in mind the atypical presentations while managing rapidly progressive especially tro...

Thorax Editorials Continuous volume computed tomography in pulmonary embolism: the answer, or just another test? Few exercises in clinical medicine are more troublesome than securing a diagnosis of pulmonary embolism. Because of the protean clinical features of pulmonary embolism, much reliance has been placed on the direct and indirect imaging of clot within the pulmonary arteries and/or perip...

The high-probability ventilation-perfusion lung scan is accepted as supportive of pulmonary embolism and often negates further diagnostic evaluation; however, there are processes that mimic the clinical presentation and radiographic findings of pulmonary emboli, including a unilateral segmental or greater perfusion defect. We present the findings in a patient whose presentation and ventilation-...