Lung biopsy in diagnosis of causes of lung involvement in hemoblastosis
- Authors: Galstyan GM1, Glasko EN1, Gorodetsky VM1, Grzhimolovsky AV1, Danishyan KI1, Demidova IA1, Kaplanskaya IВ1, Keselman SA1, Klyasova GA1, Lyubimova LS1, Shulutko EM1, Savchenko VG1
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Affiliations:
- ГНЦ РАМН
- Issue: Vol 78, No 10 (2003)
- Pages: 57-64
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/29670
- ID: 29670
Cite item
Full Text
Abstract
Material and methods. The results of diagnostic biopsies of the lungs obtained from 22 HВ patients
are presented. Ten patients had no respiratory insufficiency (RI), twelve patients had RI. The biopsy
was transbronchial in 1 case, thoracoscopic in 10 and open in 11 cases.
Results. In Rl-free patients lung biopsy was informative in all the cases. The biopsy provided information which allowed therapy modification resulting in improvement of the patient condition. In RI patients biopsy was informative in 8 of 12 patients. Nonspecific changes in the lungs were identified histologically in 2 of 12 patients. In 2 RI patients lung biopsy confirmed the diagnosis made after examination of the bronchoalveolar lavage. Modification of therapy after the biopsy was conducted in 58.3%
HB patients with RI. Improvement was seen in 2 of them. 10 of 12 patients with RI died within 1-2
weeks after biopsy.
Conclusion. Lung biopsy in HB patients should be obtained only after examination with noninvasive
methods and before development of RI as prognosis after lung biopsy in the presence of RI is unfa-
vourable. The histological material should be examined for all expected pathogens.
About the authors
G M Galstyan
ГНЦ РАМНГНЦ РАМН
E N Glasko
ГНЦ РАМНГНЦ РАМН
V M Gorodetsky
ГНЦ РАМНГНЦ РАМН
A V Grzhimolovsky
ГНЦ РАМНГНЦ РАМН
K I Danishyan
ГНЦ РАМНГНЦ РАМН
I A Demidova
ГНЦ РАМНГНЦ РАМН
I В Kaplanskaya
ГНЦ РАМНГНЦ РАМН
S A Keselman
ГНЦ РАМНГНЦ РАМН
G A Klyasova
ГНЦ РАМНГНЦ РАМН
L S Lyubimova
ГНЦ РАМНГНЦ РАМН
E M Shulutko
ГНЦ РАМНГНЦ РАМН
V G Savchenko
ГНЦ РАМНГНЦ РАМН
References
- Price К. /. Thall P. F., Kish S. К. et al. Prognostic indicators for blood and morrow transplant patients admitted to an intensive care unit. Am. J. Respir. Crit. Care Med. 1998; 158: 876- 884.
- Gruson D., Hilbert G., Boiron J. M. et al. Severe respiratory failure requiring ICU admission in bone marrow transplants recipients. Eur. Respir. J. 1999; 13: 883-887.
- Иванова Л. Ф., Дмитриева Н. В., Багирова Н. С, ДурноеЛ. А. Профилактика и лечение фебрильных нейтропений у онкологических больных. Инфекции и антимикроб, тер. 2001; 3: 109-111.
- Каражас Н. В. Цитомегаловирусная инфекция - типичный представитель оппортунистических инфекций. Рос. мед. вести 1997; 2: 34-38.
- Ewig S., Clasmacher A., Ulrich В. et al. Pulmonary infiltrates in neutropenic patients with acute leukemia during chemotherapy. Outcome and prognosis. Chest 1998; 114: 444-451.
- Fernandez Aviles F.. Batlle M.. Ribera J. M. et al. Pneumonias in patients with hemopathies. Their etiology, response to treatment and prognostic factors in 69 patients (88 episodes). Med. Clin. (Bare) 1999; 112: 321-325.
- Cordonnier C, Bemaudin J. F., Bierling P. et al. Pulmonary complications occuring after bone marrow transplantation. A study of 130 consecutive transplanted patients. Cancer (Philad ) 1986, 58 1047-1054
- Wowa )h., ano A., himras 1. el al. Clivucal impact o! a prospective, sequential diagnostic approach for the study of pulmonary infiltrates in hematopoietic cell transplantation (HCT). Bone Marrow Transplant. 2001; 27 (suppl. 1): S47.
- Горелов В. Г. Эффективность искусственной вентиляции легких при острой дыхательной недостаточности у больных гемобластозами: Автореф. дис.канд. мед. наук. М.; 1994.
- Bodey G. P., Powell R. D., Hersh E. M. et al. Pulmonary complications of acute leukemia. Cancer (Philad.) 1996; 19: 781 - 793. „
- Галстян Г. M., Городецкий В. М., Гетман Л. Н. и соавт.. Поражение легких при острой дыхательной недостаточности у больных с депрессиями кроветворения. Тер. арх . 2002; 4: 25-35.
- RossiterS. J., Miller С. D., Churg A. M. et al. Open lung biopsy in immunosupressed patient: is it really beneficial? J. Thorac. Cardiovasc. Surg. 1979; 77: 338-345.
- Flabouris A., Myburgh J. The utility of open lung biopsy in patients requiring mechanical ventilation. Chest 1999; 115: 811 - О 1 П
- Kovalski R., Hansen-Flaschen J., Lodato R. F., Pietra G. G. Localized leukemic pulmonary infiltrates. Diagnosis by bronchoscopy and resolution with therapy. Ibid., 1990; 97: 674- 678.
- Flick M. R., Wasson K., Dunn L. J., Block J. Fatal pulmonary hemorrhage after transbronchial lung biopsy trough fiberoptic bronchoscope. Am. Rev. Respir. 1975; 111: 853-855.
- Matthay R. A., Farmer W. C, Odero D. Diagnostic Fiberoptic bronchoscopy in the immunocompromised host with pulmonary infiltrates. Thorax 1977; 32: 539-545.
- Cunningham J. H., Zavala D. C, Cony R. J., Keim L. W. Trephine air drill, bronchial brush and transbronchial lung biopsies in immunosuppressed patients. Am. J. Respir. Dis. 1977; 115:213-219.
- Kramer M. R., Berkman N.. Mintz B. et al. The role of open lung biopsy in management and outcome of patients with diffuse lung disease. Ann. Thorac. Surg. 1998; 65: 198-202.
- Whithe D. A., Wong P. W., Downey R. The utility of open lung biopsy in patients with hematological malignancies. Am. Respir. Crit. Care Med. 2000; 161: 723-729.
- Nishio J. N.. Lynch J. P. Fiberoptic bronchoscopy in the immunocompromised host: the significance of a "nonspecific" transbronchial biopsy. Amer. Rev. Respir. Dis. 1980; 121: 307-312
- Boutin C, Loddenkemper R., Astoul P. Diagnostic and thera- peutic thoracoscopy: techniques and indications in pulmonary medicine. Tubercle Lung Dis. 1993; 74: 225-239.
- Данишян К. И., Гржимоловский А. В., Демидова И. А. Малоинвазивная диагностика заболеваний легких у гематологических больных. Пробл. гематол. 2002; 1: 21.
- Stefanutti D., Morals L., Fournet J. С. et al. Value of open lung biopsy in immunocompromised children. J. Pediatr. 2000; 137: 165-171.
- Papazian L., Thomas P., Bregeon F. et al. Open lung biopsy in patients with acute respiratory distress syndrome. Anesthesiology 1998; 88: 934-944.
- Dunn J. C, West K. W., Rescoria F. J. et al. The utility of lung biopsy in recipients of stem cell transplantation. J. Pediatr. Surg. 2001; 36: 1302-1303.
- Dai M. S., Lee S. С, Но С L. et al. Impact of open lung biopsy for undiagnosed pulmonary infiltrates in patients with hematological malignancies. Ibid. 87-90.
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