Article Abstract:
A 38-year-old Haitian woman had taken ill about four or five weeks prior to hospitalization. Upon physical examination, she appeared to be acutely ill and her primary symptoms were cough, fever, and a right paratracheal tissue mass near the windpipe. Extensive blood chemistry tests were performed and in the meantime no improvement was observed in the patient. Intermittent fever persisted along with the development of a sore throat. Several possible diagnoses were considered, including Hodgkin's disease, non-Hodgkin's lymphoma and chronic Epstein-Barr infection. Diagnosis was tentatively narrowed down to lymphoma or tuberculosis. Additional tests included a mediastinoscopic examination, which involves an incision into the tissues and organs which separate the lungs, and biopsy of the tracheal mass. When tissue cultures were analyzed, Mycobacterium tuberculosis was found to be present. Tuberculosis was confirmed and a nine-month treatment of antitubercular therapy was begun. A test for human immunodeficiency virus (HIV) was positive, suggesting that the tuberculosis may have been an opportunistic infection, able to take advantage of the depressed immunity associated with AIDS-related complex (ARC). A high incidence of HIV-infection in Haitians, as well as the fact that this women had had a boyfriend who had most likely died of AIDS seven years before, made AIDS-related complex very likely. Tuberculosis is also common in Haitians, but atypical tuberculosis of the type observed in this patient indicated a very high risk for development of AIDS. Subsequent anatomical diagnosis confirmed tuberculosis of mediastinal lymph nodes and lungs with HIV-infection-related lymph node irregularities.
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Article Abstract:
A 42-year-old women with progressive difficulty breathing was diagnosed with pulmonary alveolar proteinosis. This lung disease is caused by an accumulation of protein in the small air spaces inside the lungs.
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Article Abstract:
A case of 56-year-old woman, evaluated in the thoracic oncology clinic for treatment of non-small-cell lung cancer is described. The diagnosis, management and treatment of the disease are stated.
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