Articles: pulmonary-fibrosis-etiology.
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Case Reports
Fibrobullous disease of the upper lobes: an extraskeletal manifestation of ankylosing spondylitis.
Fibrobullous disease of the upper lobes of the lungs is a rare extraskeletal manifestation of ankylosing spondylitis, occurring in 1.3% of patients with ankylosing spondylitis. We present a patient with this disease, and discuss this pulmonary manifestation. Because the radiographic appearance of the chest in this disease resembles that in tuberculosis, many patients are misdiagnosed and treated for tuberculosis despite negative bacteriology. Computed tomography is useful in delineating the extent of pleural thickening, bullous changes, volume loss, parenchymal fibrosis, and bronchiectasis, as well as identifying or excluding an intracavitary pulmonary mycetoma.
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A clinicopathological correlation of the lungs on 68 cases dying from burns was carried out. The patients were divided into two main groups. Those in which the burns were the main cause of death (30 cases) and the others that had other serious underlying pathology as well as burns (38 cases). ⋯ Interstitial fibrosis was present in only 8/30 cases where burns were the main cause of death, and in some of these there were other causes for the fibrosis. No correlation was found between the presence of hyaline membranes, interstitial fibrosis and the percentage or duration of oxygen therapy. These findings once again question the validity of the concept of oxygen toxicity in man.
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In a study of 1,251 persons with asbestos-related pleural and parenchymal changes, 16 had slowly progressive changes of the upper lobes, involving both pleura and parenchyma, with shrinkage of the lobes. In addition there were 41 cases with less advanced apical changes. Tuberculosis and other possible causes were excluded. It is hypothesized that the changes rate due to asbestos disease.