ермин «организующая пневмония» активно используется в настоящее время патоморфологами и клиницистами. Несмотря на то, что данное заболевание содержит в своем названии указание на пневмонию, оно относится к группе интерстициальных заболеваний легких (интерстициальных пневмоний), а значит, имеет, отличные от обычного воспалительного процесса, подходы к лечению. В данном исследовании подробно разбирается эволюция понятия «организующая пневмония», рассматриваются современные подходы к классификации и терминологии. Кроме того, в приведенном обзоре подробно описана КТ-семиотика данной нозологии; проанализированы возможности компьютерной томографии в диагностике различных паттернов (форм) организующей пневмонии, представлены собственные верифицированные клинические наблюдения. Ключевые слова: организующая пневмония, организующаяся пневмония, криптогенная организующая пневмония, интерстициальная пневмония, компьютерная томография.
Compression stenosis of the celiac trunk (CSCT) is a syndrome based on the celiac trunk stenosis of varying degree, sometimes in combination with that of the superior mesenteric artery, caused by the compression of this vessel by the medial arched ligament of the diaphragm, as well as its internal legs and the neurofibrotic tissue of the celiac plexus. CSCT can cause chronic ischemia of the abdominal organs and chronic pain syndrome. The branches of the celiac trunk, supplying the stomach, liver, pancreas to the blood, are connected with the mesenteric arteries of the intestine in a common circle, therefore, with a lack of blood flow along one of the branches, the entire digestive tract suffers . The main clinical manifestation of CSCT is abdominal pain, observed in 97–100% patients. Angiography is the most invasive and, at the same time, the most informative method currently available to assess the extent and degree of the celiac trunk narrowing and to determine indications for surgical treatment. Ultrasound is a harmless, painless and at the same time informative diagnostic method for CSCT. A modern ultrasound technique is ultrasound with the use of echocontrast. Multi-detector CT angiography with multiplanar and 3D reconstruction is the optimal method of X-ray diagnostics of CSCT. MR angiography is successfully used both for preoperative preparation in patients with compression of the celiac trunk, and in the postoperative period. The methods of surgical treatment for abdominal ischemia are divided into palliative, decompressional and reconstructive. Modern diagnostic methods allow non-invasive methods to diagnose CSES in combination with clinical manifestations. The laparoscopic method is optimal for celiac trunk decompression, but the choice of the surgical treatment method should be considered individually.
Xanthogranulomatous pyelonephritis is a relatively rare form of chronic pyelonephritis. It is characterized by combination of destructive and proliferative processes with proliferation in the kidney of granulomatous tissue with a large number of lipid-containing macrophages, which are called xanthomous or "foamy" cells. Replacement kidney lipomatosis is also a rare disease that is characterized by proliferation of adipose tissue of the kidney sinus and perirenal adipose tissue with pronounced atrophy of the renal parenchyma. This is the result of renal atrophy, chronic inflammation, nephrolithiasis or long-term current hydronephrosis with the proliferation of adipose tissue in the renal sinus and paranephric fiber. The article presents a case of combining the above-mentioned pathological processes in a patient of the 93-ies. According to clinical manifestations and examination data, xanthogranulomatous pyelonephritis can occur under the guise of pionephrosis, carbuncle, abscess. Deservedly this disease is called "great imitator", because today there are no clear diagnostic criteria, and the diagnosis is established, as a rule, in the postoperative period.
Introduction. Congenital bronchopulmonary vascular malformations manifest a wide range of disorders in the three main components of the lungs: respiratory tract and lung parenchyma, arteries and veins. Malformations of all the main components of lung tissues, namely, arterial blood supply, venous outflow and respiratory tract - may be variants of a single primary complex of pulmonaryvascular anomalies.Observation. A described clinical case demonstrates an extremely interesting mixed bronchoarteriovenous malformation affecting the pulmonary respiratory tract, pulmonary artery and pulmonary vein. Various instrumental techniques were used for the diagnostics, the key of which was computed tomography with intravenous contrast.Conclusion. The article presents a wide range of pathological changes observed in this clinical case; it also analyzes the nature of each component and terminology.
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