杏林大学呼吸器内科 『あんずの呼吸 part2』

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Black Pleural Effusion

2013年04月24日 | 医局のソファー
胸水のLightの基準のLight先生との共著です

Black Pleural Effusion

Am J Med 2013 in press

Takeshi Saraya,
Richard W. Light,
Hajime Takizawa,
Hajime Goto,


Background
Black pleural effusions are extremely rare and have been reported in patients with infection, malignancy, and hemorrhage. However, no review articles appear to have focused on this rare clinical presentation.

Purpose
To classify and characterize diseases causing “black pleural effusion” based on the pathophysiological mechanisms involved.

Methods
We searched the medical literature to find reports of “black pleural effusion” using the PubMed database.

Results
We identified 8 cases and classified the underlying diseases into the following 4 entities based on pathophysiological conditions: 1) infection (Aspergillus niger and Rhizopus oryzae); 2) malignant melanoma, in which cells contain melanin pigment; 3) hemorrhage and hemolysis associated with non-small cell lung cancer or rupture of a pancreatic pseudocyst; and 4) other causes (charcoal-containing empyema). Discrimination between biliopleural fistula and pancreatico-pleural fistula, which also mimicking in color, was easily achieved by focusing on pleural amylase levels, elevation of pleural indirect bilirubin, presence of pleural glycoholic acid, and the predominant site of pleural effusion.

Conclusion
Black pleural effusions can be divided into 4 major categories based on the underlying pathophysiological conditions


Prognostic Factors in 194 Patients with Chronic Necrotizing Pulmonary Aspergillosis

2013年04月10日 | 医局のソファー
Prognostic Factors in 194 Patients with Chronic Necrotizing Pulmonary Aspergillosis

杏林から埼玉循環器呼吸器病センターに勉強に行っていた埼玉でのお仕事。中本先生らの報告。

Nakamoto K, Takayanagi N, Kanauchi T, Ishiguro T, Yanagisawa T, Sugita Y.
Source
Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Japan.