Clinical Image
Twin Cavities: An Unusual Radiological Finding in Pulmonary Tuberculosis
Cavernas gemelas, una curiosa imagen radiográfica en tuberculosis pulmonar
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The nonsolid nodule that was biopsied is indicated within the red circle. Microscopic images (250×) of the lung biopsy (B and C), showing interstitial infiltration by the cancer cells on hematoxylin–eosin staining (B). S100 protein positivity indicates melanocytic differentiation (C).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ivan Vollmer, José Ramírez, Marcelo Sánchez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ivan" "apellidos" => "Vollmer" ] 1 => array:2 [ "nombre" => "José" "apellidos" => "Ramírez" ] 2 => array:2 [ "nombre" => "Marcelo" "apellidos" => "Sánchez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S030028961500304X" "doi" => "10.1016/j.arbres.2015.06.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961500304X?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916301069?idApp=UINPBA00003Z" "url" => "/15792129/0000005200000008/v1_201607230336/S1579212916301069/v1_201607230336/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212916301306" "issn" => "15792129" "doi" => "10.1016/j.arbr.2016.06.026" "estado" => "S300" "fechaPublicacion" => "2016-08-01" "aid" => "1373" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "ssu" "cita" => "Arch Bronconeumol. 2016;52:425-31" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3781 "formatos" => array:3 [ "EPUB" => 194 "HTML" => 2806 "PDF" => 781 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Is Chronic Obstructive Pulmonary Disease Caused by Wood Smoke a Different Phenotype or a Different Entity?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "425" "paginaFinal" => "431" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad pulmonar obstructiva crónica por humo de leña: ¿un fenotipo diferente o una entidad distinta?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1335 "Ancho" => 2311 "Tamanyo" => 123488 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">(A) DL<span class="elsevierStyleInf">CO</span> (%) by exposure and degree of obstruction.<a class="elsevierStyleCrossRef" href="#bib0615"><span class="elsevierStyleSup">49</span></a> (B) DL<span class="elsevierStyleInf">CO</span>/VA (%) by exposure and degree of obstruction.<a class="elsevierStyleCrossRef" href="#bib0615"><span class="elsevierStyleSup">49</span></a> In T-COPD, DL<span class="elsevierStyleInf">CO</span> and DL<span class="elsevierStyleInf">CO</span>/VA are more heavily compromised. DL<span class="elsevierStyleInf">CO</span>/VA is normal in W-COPD at all levels of severity. DL<span class="elsevierStyleInf">CO</span>: carbon monoxide diffusing capacity; VA: alveolar volume.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos A. Torres-Duque, María Carmen García-Rodriguez, Mauricio González-García" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Carlos A." 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She presented with a 3-month history of purulent expectoration which did not resolve after various courses of antibiotics. She had no other associated symptoms. She reported work-related contact in London, 20 months previously, with an individual infected with tuberculosis (TB), and also sporadic contact with a friend with a diagnosis of TB. No contact tracing was performed in either case. In view of the persistent symptoms, a chest radiograph was requested, which revealed 2 practically symmetric and well-defined cavitating lesions in both upper lobes (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Auramine staining was positive and <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> was isolated from the culture. Serology was negative for hepatotropic viruses and human immunodeficiency virus.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">There is no specific diagnostic sign or radiographic pattern for TB. The radiological spectrum is wide, but it is clear that some very suggestive patterns can be recognized, for example, cavities in the upper lobes. In most cases, these cavities are multifocal, with thick irregular walls.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> In contrast, our case presented with 2 isolated, bilateral, well-defined cavities, a most curious presentation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Jodra Sánchez S, Barrueco Ferrero M, González Ruíz JM. Cavernas gemelas, una curiosa imagen radiográfica en tuberculosis pulmonar. Arch Bronconeumol. 2016;52:432.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 926 "Ancho" => 993 "Tamanyo" => 77383 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Radiographs showing tuberculous cavities in both upper fields.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculosis: a radiologic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Burril" 1 => "C.J. Williams" 2 => "G. Bain" 3 => "G. Conder" 4 => "A.L. Hine" 5 => "R.R. Misra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.275065176" "Revista" => array:6 [ "tituloSerie" => "RadioGraphics" "fecha" => "2007" "volumen" => "27" "paginaInicial" => "1255" "paginaFinal" => "1273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17848689" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualización en tuberculosis pulmonar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Rosado" 1 => "S. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Avances en diagnóstico por imágenes" "paginaInicial" => "29" "edicion" => "1.a ed." "serieFecha" => "2009" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005200000008/v1_201607230336/S1579212916301070/v1_201607230336/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005200000008/v1_201607230336/S1579212916301070/v1_201607230336/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916301070?idApp=UINPBA00003Z" ]
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