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Finger clubbing and COPD
Finger clubbing and COPD

This 73 year old patient with CPA in right upper lobe and COPD who was also a heavy smoker, showed evidence of finger clubbing ( A,B,C). He has been on long term itraconazole, in 1990 he had an oesophagectomy for cancer of the oesophagus. Finger clubbing is an uncommon symptom only seen in advanced or chronic disease. D, chest X ray there are background changes nof COPD with loss of volume in the right hemithorax and a right apical cavititating lesion.

Finger clubbing and COPD
Finger clubbing and COPD

This 73 year old patient with CPA in right upper lobe and COPD who was also a heavy smoker, showed evidence of finger clubbing ( A,B,C). He has been on long term itraconazole, in 1990 he had an oesophagectomy for cancer of the oesophagus. Finger clubbing is an uncommon symptom only seen in advanced or chronic disease. D, chest X ray there are background changes nof COPD with loss of volume in the right hemithorax and a right apical cavititating lesion.

Finger clubbing and COPD
Finger clubbing and COPD

This 73 year old patient with CPA in right upper lobe and COPD who was also a heavy smoker, showed evidence of finger clubbing ( A,B,C). He has been on long term itraconazole, in 1990 he had an oesophagectomy for cancer of the oesophagus. Finger clubbing is an uncommon symptom only seen in advanced or chronic disease. D, chest X ray there are background changes nof COPD with loss of volume in the right hemithorax and a right apical cavititating lesion.

Pt FW Chronic cavitary pulmonary aspergillosis with TB and emphysema A 43 year old with smoking related emphysema was admitted to hospital with two separate episodes of haemoptysis. He had been in good health up to 1989, when he was diagnosed as having bilateral pulmonary tuberculosis. At that time a CT scan revealed read more... Chest X Ray 22/12/00, Chest X Ray 27/02/01
Chest X Ray 22/12/00, Chest X Ray 27/02/01 Pt FW Chronic cavitary pulmonary aspergillosis with TB and emphysema A 43 year old with smoking related emphysema was admitted to hospital with two separate episodes of haemoptysis. He had been in good health up to 1989, when he was diagnosed as having bilateral pulmonary tuberculosis. At that time a CT scan revealed read more...
Pt AR Interval development of chronic cavitary pulmonary aspergillosis in the context of sarcoidosis This patient was diagnosed with sarcoid after developing a chronic cough with the attached chest X-ray. In February 2003 the X-ray demonstrated bilateral extensive changes consistent with fibrocystic sarcoidosis with a complex cavitary area in both read more...
Pt AR Interval development of chronic cavitary pulmonary aspergillosis in the context of sarcoidosis This patient was diagnosed with sarcoid after developing a chronic cough with the attached chest X-ray. In February 2003 the X-ray demonstrated bilateral extensive changes consistent with fibrocystic sarcoidosis with a complex cavitary area in both read more...
Pt MB Chronic Pulmonary Necrotising Aspergillosis with TB Further detailsImage B. Additional cavities are apparent inferior to this large cavity and are in communication both with the bronchi and the additional cavities. Some of the apparent cavities are probably dilated bronchi. The left lower lung is read more... Image A. This plain chest x-ray showed two large cavities, one smaller cavity in the completely opacified left hemithorax, which contains fibrotic tissue., Image B. Significant progression of the two cavities at the left apex, which have merged into one is apparent., Image C CT scan of thorax with a section at the carina.
Image A. This plain chest x-ray showed two large cavities, one smaller cavity in the completely opacified left hemithorax, which contains fibrotic tissue., Image B. Significant progression of the two cavities at the left apex, which have merged into one is apparent., Image C CT scan of thorax with a section at the carina. Pt MB Chronic Pulmonary Necrotising Aspergillosis with TB Further detailsImage B. Additional cavities are apparent inferior to this large cavity and are in communication both with the bronchi and the additional cavities. Some of the apparent cavities are probably dilated bronchi. The left lower lung is read more...
Patient DD subacute invasive (chronic necrotizing) pulmonary aspergillosis
PT MS Chronic necrotising pulmonary aspergillosis, with aspergilloma. Image A. 10/95, Image B. 12/96, Image C. 6/97 Note aspergilloma, Image D. 3/99 Note aspergilloma, Image E. 9/98, Image F. 3/2000
Image A. 10/95, Image B. 12/96, Image C. 6/97 Note aspergilloma, Image D. 3/99 Note aspergilloma, Image E. 9/98, Image F. 3/2000 PT MS Chronic necrotising pulmonary aspergillosis, with aspergilloma.

MS is a 59 year old diabetic patient requiring insulin. He had asthma since childhood, previous episodes of vasculitis, a retinopathy and renal dysfunction. In 1997 Mycobacterium avium intracellulare infection of the lung was diagnosed and successfully treated over a 12 month period. Shortly after this treatment was completed an aspergilloma was noted in the right upper lobe in September 1998. This was untreated for 2 years with progressive enlargement of the cavity most consistent with chronic necrotising pulmonary aspergillosis (CNPA), until the patient became unwell, when benefit from itraconazole was seen. Unfortunately the patient subsequently developed a squamous cell carcinoma and died. 

Kyphoscoliosis, left sided empyema The chest is distorted by a deformity of the back and ribs.
Kyphoscoliosis, left sided empyema The chest is distorted by a deformity of the back and ribs. This patient's X-ray is complex. The chest is distorted by a deformity of the back and ribs. Substantial metalwork following a spinal fusion is in place to support the vertebral column and part of this overlies the heart and part of it crosses the left lung. The patient also has a portacath device in-situ over the right lung, which allows i.v. antibiotics to be given. A needle is in-situ inside the portacath device. An external drainage tube is currently in-situ in a large air cavity and left upper thorax. This cavity contains mostly air but there is some fluid with the fluid level at its base. Underneath this large pyopneumothorax is a normal component of left lower lobe. The heart is very substantially moved to the right of the lung because of a previous right lower lobe resection. There is no evidence of aspergillosis on this x-ray as it stands.
Pt. MD. A.nidulans in AIDS, CT scan thorax. Transverse sections through the thorax of a patient with AIDS, hepatitis C and a left tempero-parietal cerebral lymphoma. His CD4 cell count was 45 x 106 / l. The lymphoma was proven by biopsy after a poor response to anti-toxoplasma therapy. He was read more... Image A., Image B., Image C., Image D.
Image A., Image B., Image C., Image D. Pt. MD. A.nidulans in AIDS, CT scan thorax. Transverse sections through the thorax of a patient with AIDS, hepatitis C and a left tempero-parietal cerebral lymphoma. His CD4 cell count was 45 x 106 / l. The lymphoma was proven by biopsy after a poor response to anti-toxoplasma therapy. He was read more...
Chronic Cavitary Pulmonary Aspergillosis and Aspergilloma with Atypical Tuberculosis and Emphysema Image A. June 1999 , Image B. July 2001, Image C. April 2002
Fever chart of Pt CA. who developed Invasive Pulmonary Aspergillosis Fever chart of Pt CA -heart transplant pt with candidemia on amphotericin therapy, who developed pulmonary aspergillosis. Fever chart of Pt CA.
Fever chart of Pt CA. Fever chart of Pt CA. who developed Invasive Pulmonary Aspergillosis Fever chart of Pt CA -heart transplant pt with candidemia on amphotericin therapy, who developed pulmonary aspergillosis.
Aspergillus amstelodami A Colonies on MEA + 20% sucrose after two weeks; B ascomata, x 40; C conidia and conidiophore, x 920; D ascospores and conidia x2330; E portion of ascoma with asci x920
Aspergillus amstelodami A Colonies on MEA + 20% sucrose after two weeks; B ascomata, x 40; C conidia and conidiophore, x 920; D ascospores and conidia x2330; E portion of ascoma with asci x920
Aspergillus versicolor A 66 yr old patient in good general health developed onychomycosis. Samples taken from the affected nail were grown by culture and examined by microscopy. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with read more...
Aspergillus versicolor A 66 yr old patient in good general health developed onychomycosis. Samples taken from the affected nail were grown by culture and examined by microscopy. Oral itraconazole pulse therapy was given to the patient (200 mg twice daily for 1 week, with read more...
Aspergillus versicolor A. versicolor by microscopy showing very long thin conidiophores.
Aspergillus versicolor A. versicolor by microscopy showing very long thin conidiophores.

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