Intrathoracic lymphangiomatosis mimicking lymphangioleiomyomatosis in a young woman.

In this report, we describe a case of lymphangiomatosis that mimicked lymphangioleiomyomatosis in a 20-year-old woman. Lung biopsy specimens showed proliferation of anastomosing lymphatic channels in the visceral pleura and dilated peribronchiolar and septal lymphatic channels. During 8 years of follow-up, this process behaved like lymphangioleiomyomatosis with reticulonodular infiltrates and worsening obstructive and restrictive changes evident on pulmonary function tests.

Silo-filler's disease.

Between 1955 and 1987, 17 patients were examined at the Mayo Clinic shortly after exposure to silo gas. All exposures had occurred in conventional top-unloading silos. Acute lung injury occurred in 11 patients, 1 of whom died; early diffuse alveolar damage with hyaline membranes and hemorrhagic pulmonary edema and acute edema of the airways were found at autopsy.

Long-term follow-up of persons attending a community-based smoking-cessation program.

The long-term effectiveness of a smoking-cessation program based on education, behavior modification, and group support was evaluated. Because of the availability of long-term follow-up data, the natural history of cessation of smoking in persons who had attended a smoking-cessation program could be studied. At 1 year, the permanent rate of cessation of smoking was 22%, and permanent cessation continued to occur at least through 6 years of follow-up.

Respiratory tract symptoms as a clue to giant cell arteritis.

Although many manifestations of giant cell arteries are increasingly recognized, little attention has been paid to respiratory symptoms associated with this disorder. We report the cases of 16 patients with giant cell arteritis who had prominent symptoms related to the respiratory tract including cough, sore throat, and hoarseness. These symptoms were the initial finding in 10 patients and obscured the diagnosis in some instances, but resolved quickly when corticosteroids were given.

Influence of height on the risk of spontaneous pneumothorax.

The risk of primary spontaneous pneumothorax was found to be greatest among persons 25 to 34 years old of each sex and greater for men than women, although a gradient of risk with increasing height was found which seemed to explain much of the male predominance in this condition. Minor physical anomalies were relatively common among these patients, but no specific clinical syndromes could be identified. For secondary spontaneous pneumothorax, the risk increased with age and was greater for men, although this may simply have reflected an increased frequency of underlying chronic pulmonary disease.

The outcome of patients with pleural effusion of indeterminate cause at thoracotomy.

In 51 patients, the cause for pleural effusion remained indeterminate immediately after thoracotomy. Thirty-one (60.8%) had no recurrence of the effusion, and no cause became apparent during a follow-up period of from 1 1/2 to 15 years.

Chronic obstructive pulmonary disease: a community-oriented program including professional education and screening by a voluntary health agency.

A community program for chronic obstructive pulmonary disease that included detection by screening, professional education, community involvement, and evaluation of results is described. Key figures in the success of this program were senior medical students. In the first community, in which no professional education was offered, 45.

Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974.

Between 1950 and 1974, 318 cases of initial pneumothorax were diagnosed among the residents of Olmsted County, Minn. Seventy-five cases were due to trauma, and 102 were iatrogenic. One hundred forty-one cases were spontaneous in onset, of which 77 were primary and 64 secondary to a specific underlying pulmonary disease.

Desmoid tumors of the chest wall.

Twenty-six cases of desmoid tumors of the wall of the chest were reviewed. These are rare lesions, which nonetheless should be considered in the differential diagnosis of all tumors of the chest wall. Although the lesion is most often palpable, several of the tumors were detectable only by means of an x-ray film of the thorax.

Pulmonary tumorlets associated with Cushing's syndrome.

Tumorlets of the lung generally have been considered benign nests of cells, usually found with bronchiectasis or fibrosis. We saw a patient with Cushing's syndrome whose tumorlets ultimately became roentgenographically visible as multiple small nodules throughout both lungs and metastasized to the mediastinum. The plasma corticotropin concentration was increased, as were the concentrations of corticotropin-like peptides in the tumor tissue.

Pleural fluid complement, complement conversion, and immune complexes in immunologic and nonimmunologic diseases.

Forty-four pleural fluids and 41 blood specimens from patients with various diseases were examined for concentration of whole complement, C4, C3, conversion products of C3 and C3PA, and immune complexes. C3 conversion was found in all eight pleural fluids from patients with rheumatoid arthritis, five of seven with lupus erythematosus, two of six with congestive heart failure, and nine of 23 with malignant diseases. Conversion of C3PA correlated closely with C3 conversion and both were significantly inversely related to whole complement, C4, and C3.

Host factors in chronic obstructive pulmonary disease in an upper Midwest rural community. Design, case selection, and clinical characteristics in a matched-pair study.

A series of 111 index subjects with chronic obstructive pulmonary disease (COPD) who had forced expiratory volume in 1 second (FEV1) of 70% or less of that predicted were matched on the basis of age, sex, occupation, and smoking history with control subjects who had an FEV1 of 85% or more of that predicted. Index and control subjects with seasonal or reversible airway disease were excluded. Men outnumbered women by a ratio of 4.