Essentials of Clinical Pulmonology

Cover
Half Title
Title Page
Copyright Page
Contents
Preface
Editors
Contributors
Part 1:Basic sciences
Chapter 1:Lung anatomy and development
	Lungs
		Introduction: Lobes and pleura
		Bronchopulmonary segments
	Airways
		Trachea
		Left and right mainstem bronchus
		Airway divisions
	Alveolar–capillary unit
	Pulmonary circulation
	Lymphatics of the pulmonary system
	Lung innervation
	Lung development
		Stages of lung development
			Embryonic stage
			Pseudoglandular stage
			Canalicular stage
			Saccular stage
			Alveolar stage
		Factors involved in lung growth
		Consequences of preterm birth
	Questions
	Further reading
Chapter 2:Pathology
	Cell biology and immune defense mechanisms
		Lung cells and airway cellular organization
		Lung cell injury
		Pulmonary defense and inflammation
			Epithelial cells
			Neutrophils
			Macrophages
			Lymphocytes
			Innate lymphoid cells
			Natural killer cells
		Cellular mechanisms of lung diseases
			Chronic obstructive pulmonary disease
			Idiopathic pulmonary fibrosis
			Asthma
	Interstitial lung disease pathology
		Normal lung histology
		Multidisciplinary approach for diagnosis of idiopathic interstitial pneumonia
		Idiopathic interstitial pneumonia
			IPF/USUAL interstitial pneumonia
			Nonspecific interstitial pneumonia
			Cryptogenic organizing pneumonia
			Diffuse alveolar damage/acute interstitial pneumonia
		Smoking-related interstitial lung disease
			Respiratory bronchiolitis-interstitial lung disease
			Desquamative interstitial pneumonia
		Important differential diagnoses for IIP
			Hypersensitivity pneumonia
			Sarcoidosis
			Lymphangioleiomyomatosis (LAM)
	Obstructive lung disease pathology
		Chronic obstructive pulmonary disease
			Emphysema
			Chronic bronchitis
		Asthma
		Bronchiectasis
	Questions
	Further reading
Chapter 3:Genetics of lung diseases
	Human genetic variation
	Allele frequency and effect size in population genetics
	Approaches to identifying genetic risk factors for pulmonary disease
		Study designs
		Methodological design
		Assay designs
	Genetic associations with spirometric lung function and pulmonary diseases
	Clinical applications of genetic studies
	Questions
	Further reading
	References
Part 2:Clinical evaluation
Chapter 4:History
	Introduction
	Presenting complaint
		Breathlessness
		Cough
		Hemoptysis
		Chest pain
	Medical history
	Medication history
	Family history
	Social history
	Systemic enquiry
Chapter 5:Clinical examination
	Inspection
		General observations
		Breathing pattern
		Peripheral stigmata
		Closer inspection of the neck, face, and chest
	Palpation
		Expansion
		Vocal fremitus
	Percussion
	Auscultation
		Sounds heard during respiration
		Pleural sounds
		Vocal sounds
	Cardiac signs in respiratory disease
Chapter 6:Imaging techniques
	Chest radiography
		Types of radiographic projections
			Frontal projections
			Other projections
		Technical considerations
			Film–screen radiography
			Digital radiography
			Portable CXR
			Novel radiographic techniques
		Systematic evaluation of the CXR
			Initial steps
			Iatrogenic objects
			Soft tissues and subdiaphragmatic region
			Airways, mediastinum, and hila
			Bones
			Lungs and review areas
	Computed tomography
		Technological aspects
			Basic principles
			From spiral to multidetector and dual-source CT
		Thoracic CT protocols and techniques
			Volumetric, noncontiguous, and high-resolution CT
			Unenhanced versus contrast-enhanced CT
			Timing of contrast-enhanced CT
			Conventional-dose versus low-dose CT
			Additional acquisitions
			Cardiac or respiratory gating
			Postprocessing techniques
		Novel CT techniques
			Dynamic perfusion CT
			Dual-energy CT
	Interpreting the CXR and thoracic CT
		Systematic evaluation of thoracic CT
			Initial steps
			Iatrogenic objects
			Airways
			Lungs
			Mediastinum and hila
			Vasculature and heart
			Pleura and pericardium
			Diaphragm, subdiaphragmatic regions, soft tissues, and bones
	Ultrasound
		Technique
		Indications for US
			Pleural collections
			Peripheral and mediastinal lesions
			Pneumothorax
			Diaphragmatic function
	Magnetic resonance imaging
	Further reading
Chapter 7:Non-oncological pulmonary nuclear medicine
	Introduction
	Radiopharmaceuticals
	VP (ventilation perfusion) imaging
		Ventilation imaging
		Perfusion imaging
		VP SPECT–CT
	Pulmonary embolism
		VP scan versus CTPA
	Radiation safety
	Can a test be too good?
	Pregnancy
	Chronic PE
	Other uses of VP scintingraphy
		Emphysema and lung reduction surgery
		Lung reduction surgery
		Pediatric lung and congenital heart disease scintigraphy
		Right-to-left shunt evaluation
		Nuclear medicine imaging in inflammatory and infectious conditions
	Special consideration: cardiac sarcoid
	Infection
	Pyrexia of unknown origin
	PET–CT in interstitial lung disease and future developments for pulmonary nuclear medicine
	Dynamic techniques
	Summary
	Acknowledgments
	Further reading
Chapter 8:PET–CT in oncological pulmonary nuclear medicine
	Introduction
	PET–CT
		Performing PET–CT
	Non-small cell lung cancer
		Thoracic staging
		Extrathoracic staging
		Recurrence and prognostication
	Small cell lung cancer
	Solitary pulmonary nodule
	Pleural mesothelioma
	Radiotherapy planning
	Bone scan
	Future developments
	Conclusion
	Key learning points
	Questions
	Acknowledgments
	Further reading
Chapter 9:Pulmonary function and exercise testing
	Introduction
	Quality control and assurance
	Pulmonary function testing
		Routine lung function testing
			Spirometry
			Gas transfer
			Lung volume measurement
			Approach to interpretation of lung function
		Specialist lung function testing
			Bronchoprovocation testing
			Respiratory muscle strength testing
			Lung compliance measurement
			Hypoxic inhalation challenge tests (HIT)
	Exercise testing
		Introduction
		Cardiopulmonary exercise testing
	Questions
	Reading list
Part 3:Clinical procedures
Chapter 10:Bronchoscopy
	Introduction
	Types of bronchoscopy
		Flexible bronchoscopy
		Rigid bronchoscopy
		Virtual bronchoscopy
	Disinfection
	Indications
	Contraindications
	Patient preparation, sedation, and anesthesia
	Basic airway anatomy for the bronchoscopist
	Nodal stations accessible endobronchially and their vascular relationships
	Basic bronchoscopic diagnostic sampling techniques
		Bronchial washings
		Bronchoalveolar lavage
		Endobronchial biopsies
		Transbronchial biopsies
		Bronchial brushings
		Needle aspiration
	Advanced diagnostic bronchoscopy
		AFB and narrow band imaging
	Therapeutic bronchoscopy
		Laser therapy
		Electrocautery and APC
		Cryotherapy
		Stent implantation
		Photodynamic therapy
		Brachytherapy
		Endoscopic lung volume reduction
		Bronchial thermoplasty
	Further reading
Chapter 11:Endosonography for pulmonary diseases: Endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)
	Introduction
	Endosonography equipment
		EBUS–transbronchial needle aspiration (TBNA) (linear)
		EUS-FNA (linear)
		EBUS miniprobe (radial)
		Endosonography needles
	EBUS and EUS (B) procedure
		General
		Mediastinal endosonography anatomy
			EBUS
			EUS
	Endosonography indications in chest medicine
		EBUS and EUS(-B) for diagnosing and staging of lung cancer
		Combining EBUS and EUS(-B) for complete mediastinal staging
		Endosonography for sarcoidosis
		EBUS and EUS(-B) for diagnosing intrapulmonary lung tumors
		EUS(-B) procedures for distant metastases in lung cancer
	Complications of EBUS and EUS(-B)
	Training
	References
Chapter 12:Pleural procedures
	Introduction
	Ultrasound guidance
	Thoracentesis
	Chest tubes
		Management of chest tubes after insertion: Monitoring, suction, and removal
	Tunneled pleural catheter
	Pleural biopsy methods
		Closed pleural biopsy
		Image-guided pleural biopsy
		Thoracoscopy and surgical intervention
	Conclusion
	Practice points
	Questions
	Videos
	Further reading
Chapter 13:Medical thoracoscopy
	Introduction
	Indications
		Recurrent pleural effusion
		Malignant pleural effusion
		Empyema
		Spontaneous pneumothorax
	Equipment
		Rigid thoracoscopy
		Semirigid thoracoscopy
		Equipment choice
	Technique
		Chest wall anatomy
		Anesthesia
		Procedure
	Complications
	Conclusion
	References
Chapter 14:Essentials of clinical pulmonology: Interventional radiology
	Introduction
	Nonvascular procedures
		Transthoracic lung biopsy
			IndicationS
			Contraindications
			Biopsy technique
			Complications
			Management of complications
		Pleural space thoracocentesis
		Ablation of lung tumors
			Radiofrequency ablation
			Microwave ablation
			Cryogenic ablation (CRYO)
			Irreversible electroporation
			Complications
			Postablation imaging
		Fiducial markers
	Vascular procedures
		Bronchial arterial embolization
		Thrombectomy for pulmonary embolism
		Superior vena cava stents
		Central venous catheters
	Further reading
Part 4:Clinical assessment and safety
Chapter 15:Fitness for general anesthesia
	Risk classification systems
	Perioperative pulmonary risk evaluation
	Assessment of the risk of PPCs
	Summary
	Further reading
Chapter 16:Fitness to fly
	Introduction
	Asthma
		Passenger travel
	Sarcoidosis
	Pneumothorax
	Traumatic pneumothorax
	Obstructive sleep apnea
	Chronic obstructive pulmonary disease
	Pulmonary tuberculosis
	Interstitial lung disease
	Pulmonary thromboembolic disease
	Chapter summary
	References
Chapter 17:Guidelines for driving and drowsiness
	Introduction
	Effects of drowsiness on driving
	Risk groups for drowsy driving
	Sleep apnea and driving
	Approach to evaluating driving-related risk due to drowsiness
	Specific scenarios of OSA and self-reported drowsiness
	Strategies for preventing and reducing drowsy driving and associated MVAs
	Licensing and legal considerations
		Roles and responsibilities
			Specialist responsibilities
			Patient responsibilities
	Summary
	Further reading
Part 5:Therapies
Chapter 18:Pulmonary rehabilitation
	Definition and concept of pulmonary rehabilitation
	Selection criteria for pulmonary rehabilitation
	Multidisciplinary pulmonary rehabilitation team
	Pulmonary rehabilitation settings and timing
		Settings
		Timing
	Process of pulmonary rehabilitation
		Initial assessment
		Exercise training
		Self-management education and behavior change
		Other components of pulmonary rehabilitation
	Pulmonary rehabilitation outcomes
	Current issues in pulmonary rehabilitation
	References
Chapter 19:Non-invasive ventilation
	Introduction
	History
	Respiratory failure
	Noninvasive positive pressure ventilation
	Noninvasive external negative pressure ventilation
	Continuous positive airway pressure
	Bilevel positive airway pressure
	Use of NIV in the setting of acute respiratory failure
		Patient selection for use of NIV in acute setting
		Absolute contraindications
		Relative contraindications
		Clinician experience and setting
		Patient selection criteria
	Hypoxemic respiratory failure
	Predictors of NIV failure
	Pneumonia
	Asthma
	COPD exacerbation and acute hypercapnic respiratory failure
	COPD exacerbation: important points
	Practical points for administering NIV
	Pulmonary edema
	Immunocompromised
	Postoperative respiratory failure
	Use of NIV in the setting of CRF
		COPD
		Restrictive and neuromuscular lung disease
	NIV complications
		Pneumonia
		Barotrauma
		Hemodynamic effects
		Carbon dioxide rebreathing
		Claustrophobia
		Discomfort
		Facial skin lesions
Part 6:Upper respiratory disease
Chapter 20:The upper respiratory tract—Allergic rhinitis and rhinosinusitis with/without nasal polyps
	Allergic rhinitis
		Epidemiology
		Etiology
		Pathogenesis
		Diagnosis
		Differential diagnosis
		Management of allergic rhinitis
			Allergen avoidance
			Anti-allergic drugs
			Allergen immunotherapy
	Rhinosinusitis
		Introduction
		Acute rhinosinusitis
		Chronic rhinosinusitis
			Epidemiology
			Etiology
			Pathology
			Clinical presentation and diagnosis
			Complications
		Pediatric CRS
		Fungal rhinosinusitis
		CRS and the lower airway
			Management
				CRSsNP
				CRSwNP
				Other treatments
	Recommended reading
Chapter 21:Sleep apnea and sleep disordered breathing
	Obstructive sleep apnea
		Definition
		Clinical features
		Prevalence
		Pathogenesis
		Diagnosis
		Treatment of OSA
	Other forms of sleep disordered breathing
		Obesity hypoventilation syndrome
		Central sleep apnea
		Sleep-induced hypoxemia
	Conclusion
	References
Part 7:Airway disease
Chapter 22:Asthma
	Epidemiology
		Epidemiologic variability
	Clinical features
	Investigation
		Spirometry
		Peak flow
		Bronchoprovocation
	Pathophysiology
	Mechanisms of airway inflammation
	Factors contributing to the development of asthma
	Environmental factors
	Asthma phenotypes
		Early-onset allergic
		Late-onset eosinophilic
		Alternative histologic phenotypes
		Obesity phenotype
	Assessment
		Disease severity
		Modifiable risk factors
		Comorbidities
	Nonpharmacologic treatment
		Asthma action plan
		Sputum eosinophils
		FeNO
	Asthma control
	Responsiveness
	Step therapy
	Pharmacologic therapy
		Intermittent asthma
			SABA
			Other short-acting agents
		Mild persistent asthma
			Inhaled steroid therapy
		Moderate persistent asthma
			Long-acting beta agonists
			Leukotriene modifiers
			Theophylline
		Severe persistent asthma
		Acute severe asthma
		Allergic bronchopulmonary aspergillosis
		Childhood asthma
		Occupational asthma
Chapter 23:Chronic obstructive pulmonary disease
	Introduction
	Epidemiology
	Risk factors
		Developmental risk factors
			Genetic factors
			neonatal and childhood development
			Gender and age
			Asthma and bronchial hyperresponsiveness
		Environmental risk factors
			Smoke exposure
			Biomass fuel and occupational exposures
			Infectious
	Pathophysiology
		Pathology
			Emphysema
				Centrilobular emphysema
				Panlobular emphysema
				Paraseptal emphysema
				Irregular emphysema
			Chronic bronchitis
		Pathogenesis
			Inflammatory cells
			Oxidative stress
			Protease–antiprotease imbalance
		Physiology
	Clinical features
		History
		Physical examination
		Exacerbations
		Comorbidities
			Cardiovascular disease and metabolic syndromes
			Gastroesophageal reflux disease
			Obstructive sleep apnea
			Anxiety and depression
			Osteoporosis
			Lung cancer
	Diagnosis
		History
		Spirometry
		Assessment of symptoms
		Pulmonary function testing
		Exercise testing
		Imaging
	Therapeutics
		Smoking cessation
		Vaccines
		Pulmonary rehabilitation
		Pharmacologic therapies
			Bronchodilators
				Beta-agonists
				Antimuscarinic
				Corticosteroids
				Combination therapies
			Oral medications
				Macrolides
				Phosphodiesterase-4 inhibitors
				Corticosteroids
		Long-term oxygen therapy
		Acute exacerbations
			Bronchodilators
			Corticosteroids
			Antibiotics
			Ventilatory and oxygen support
		Surgery, bronchoscopic lung volume reduction, and transplantation
			Surgery
			Bronchoscopic lung volume reduction
			Transplantation
		Palliative care
	AAT deficiency
		Epidemiology
		Pathophysiology
			Genetics
			Physiology
			Pathophysiology
		Clinical features
			Pulmonary
			Extrapulmonary
		Diagnosis
		Treatment
			Clinical care
			Augmentation therapy
	References
Chapter 24:Bronchiectasis
	Introduction
	Epidemiology
	Pathogenesis
		Pathology and pathogenesis
	Clinical features and presentation
	Diagnosis
	Imaging in bronchiectasis
		Chest radiograph
		Computerized tomogram
	Laboratory tests
		Sputum
		Bronchoscopy
		Pulmonary function testing
	Specific diseases or conditions associated with bronchiectasis
		Allergic bronchopulmonary aspergillosis
		Alpha-1-antitrypsin deficiency
		Cystic fibrosis
		HIV
		Nontuberculous mycobacteria (e.g., MAC)
		Primary ciliary dyskinesia
		Immunodeficiency disorders
		Rheumatoid arthritis
		Sarcoidosis
		Inflammatory bowel disease
		Young’s syndrome
		Middle lobe syndrome
	Management
		Acute exacerbation
		Suppressive strategies
	Treatment of exacerbations
	Surgery
	References
Chapter 25:Cystic fibrosis
	Epidemiology
		Survival into adulthood
		CF: An aging population
	Pathophysiology
		CFTR: The basic defect
		Microbiology
			Bacterial pathogens
			Biofilm formation
			CF airway microbiota
			Routine identification of recognized CF bacterial pathogens
			Fungal infection
	Diagnosis
		Sweat chloride
		Mutation analysis
		NPD and other measures of CFTR function
		Neonatal screening
	Respiratory tract disease: Complications and management
		Lower airways disease
			Antibiotic treatment
				Prophylactic treatment of initial infection
				Treatment of initial or new bacterial infection
				Chronic antibiotic therapy
				Treatment of exacerbations
			Maintenance treatments
				Airway clearance therapy
				Mucolytics
				Hydrator (or osmotic) therapy
				Anti-inflammatory agents
		ABPA
		Pneumothorax
		Hemoptysis
		Advanced lung disease
		Transplantation
		End-of-life care
	Extrapulmonary disease: Complications and management
		Upper airway disease
		Pancreatic function and nutrition
		Hepatobiliary disease
		Luminal GI disease
		Endocrine and metabolic disease
			Salt and water deprivation
			CF-related diabetes
			Metabolic bone disease of CF
		Fertility and reproduction
		Renal disease
	Psychological aspects of CF
		Quality of life
		Mental health
		Adherence
	New therapies
		CFTR gating/conductance mutations
		CFTR folding/maturation mutations
		Nonsense mutations
		Gene therapy
	Delivery of CF care
		CF data registries
		Standards of care
		Benchmarking
		Peer review
		Monitoring disease status
		Multidisciplinary care
		Transition of care
	Future perspectives
	Further reading
Part 8:Neoplasms
Chapter 26:Lung cancer
	Epidemiology
	Etiology
	Pathogenesis
		Molecular epidemiology of lung cancer
		Genetic susceptibility to lung cancer
	Pathology
		Squamous cell carcinoma
		Adenocarcinoma
		Small cell carcinoma
	Natural History
	Clinical presentation
		Local Disease
		Metastatic Disease
		Paraneoplastic Syndromes
	Diagnosis
		Staging
			Tumor: T Staging
			Nodal: N Staging
			Metastases: M Staging
		Approach to staging and diagnosis
			Endobronchial ultrasound
			CT-guided biopsy
			Other bronchoscopic techniques
			Ultrasound-guided tissue biopsy
			Endoscopic ultrasound
			Mediastinoscopy
	Treatment of NSCLC
		Multidisciplinary treatment of lung cancer
		Surgery
		Radiotherapy
			Adjuvant radiotherapy
		Chemotherapy
			Neoadjuvant chemotherapy
			Adjuvant chemotherapy
			Palliative chemotherapy
		Molecular targets
		Immunotherapy
		Multimodality therapy
			Palliative therapy
			Endobronchial therapy
	Treatment of SCLC
		Chemotherapy
		Radiotherapy
		Surgery
		Targeted therapy and immunotherapy
	Prognosis
		Screening for lung cancer
Chapter 27:Rare lung tumors and metastatic disease to the lungs
	Introduction
	Carcinoid tumor
	Salivary gland-type carcinomas
	Pulmonary sarcomas
	Pulmonary blastoma
	Primary lung lymphoma
	Hamartoma
	Metastatic disease to the lung
	Conclusion
	References
Chapter 28:Mediastinal tumors
	Introduction
		Anatomy of the mediastinum
		Clinical presentation
		Clinical management
	Thymoma and thymic carcinoma
		Epidemiology
		Pathogenesis
		Pathology
		Clinical features
		Diagnosis
		Treatment
		Prognosis
	Mediastinal germ cell tumors
		Introduction
		Mediastinal teratomas
		Mediastinal seminomas
		Mediastinal nonseminomatous germ cell tumors
	Neurogenic tumors of the mediastinum
		Introduction
		Benign mediastinal peripheral nerve sheath tumors
			Epidemiology
			Pathology
			Clinical features
			Diagnosis
			Treatment
		Malignant mediastinal peripheral nerve sheath tumors
			Epidemiology
			Pathology
			Clinical features
			Diagnosis
			Treatment
			Prognosis
		Mediastinal neuroblastoma
			Epidemiology
			Etiology
			Pathology
			Natural history
			Clinical features
			Treatment
			Prognosis
	Mediastinal lymphoma
		Mediastinal Hodgkin lymphoma
		Mediastinal non-Hodgkin lymphomas
			Lymphoblastic lymphoma
			Primary mediastinal large B-cell lymphoma
	Cases
Part 9:Infection
Chapter 29:Bacterial lung infection
	Introduction
		Epidemiology
		Etiology
	Pathophysiology of bacterial lung infection
	Presentation
	Investigations
		Imaging
		Blood tests
		Microbiological investigations
		Severity scoring
	Treatment of bacterial lung infections
		Antibiotic treatment
		Respiratory failure
	Future aspects
	Acknowledgments
Chapter 30:Tuberculosis
	Epidemiology
	Natural history
	Primary disease
	Latent disease
		Diagnosing latent TB
	Reactivation/active disease
	Diagnosing TB
		Microbiology
		Sputum sampling
		Sputum induction/bronchoscopy/gastric lavage
		Radiology in active TB
		Chest radiograph
		Computed tomography
		Positron emission tomography
		Pleural investigations
		Lymph node sampling
	Treatment of TB
		Treatment of latent TB
		Treatment of active TB
		Treatment of extrapulmonary TB
		Treatment initiation
		Treatment of people living with HIV
	Treatment monitoring
		Hepatotoxicity
		Treatment response
		Infection control
		Contact tracing
	Drug resistance
		Diagnosing resistance
	Treatment for drug-resistant TB
		Treatment for MDR-TB
		New treatments
	References
Chapter 31:Respiratory fungal infection
	Introduction
	Epidemiology
	Antifungal therapy
	Aspergillosis
		Invasive and semi-invasive aspergillosis
		Chronic pulmonary aspergillosis
	Invasive candidiasis
		Non-aspergillus mold and emerging fungal infections
			Mucormycosis
			Emerging non-aspergillus mold infections
			Endemic mycoses
	References
Chapter 32:Viral infections
	Etiology
	Epidemiology and transmission
	Pathogenesis
	Pathology
	Clinical features
		Respiratory presentations
		Extrathoracic manifestations
	Diagnosis
		Laboratory diagnosis
	Management
		Influenza
		Other antiviral agents
		Vaccination
			INFLUENZA
			RESPIRATORY SYNCITIAL VIRUS
	Emerging respiratory viruses
		SARS coronavirus
		H1N1 influenza (swine flu)
		Middle East respiratory syndrome coronavirus
	References
Chapter 33:Pulmonary complications of HIV infection
	Introductions
	Risk Factors for Specific Pulmonary Diseases in HIV
		Immune status
			CD4 count
		Demographic factors
		Prophylactic antibiotics and antiretroviral therapy (cART)
		Diagnostic tests used in patients with HIV infection and pulmonary disease
	Pulmonary infections
		Bacterial CAP
			Etiology
			Investigations
			Treatment of CAP
			Outcome
			Pneumoccocal vaccine in HIV-positive patients
		Pneumocystis
			Clinical case
			Microbiological diagnosis
			Treatment
			Role of steroids in treating moderate-severe PCP
			Respiratory failure and IC
			PCP prophylaxis
				Stopping PCP prophylaxis
		Pulmonary TB
			Clinical features
			CXR
			Diagnosis
			Treatment
				Immune reconstitution inflammatory syndrome (IRIS)
	Fungal pulmonary infections
		Aspergillosis
			Invasive pulmonary parenchymal aspergillosis in HIV
				Symptoms
				Diagnosis
			Tracheobronchial aspergillosis
				Symptoms
				Treatment
		Cryptococcosis
			Symptoms
			Diagnosis
			Treatment
	Lung malignancy
		Pulmonary Kaposi's Sarcoma (KS)
			Symptoms
			Diagnosis
			Radiographic findings
			Treatment
		Lymphoma
			Non-Hodgkin’S B-cell Lymphoma (NHL)
				Symptoms
				Radiology
				Diagnosis
			Primary effusion lymphoma
	Non-Small Cell Carcinoma of the Lung
	Other pulmonary conditions
		Pulmonary hypertension
			Symptoms
			Treatment
		COPD
			Management
		Asthma and bronchial hyperresponsiveness
		Bronchiectasis
		Interstitial lung disease
	Reference
Part 10:Diffuse lung disease
Chapter 34:Pulmonary sarcoidosis
	Definition and epidemiology
	Etiology
	Clinical presentations of pulmonary sarcoidosis
		General
		Pulmonary
			Upper respiratory tract
			Airways
			Parenchyma
	Evaluation of the patient with suspected pulmonary sarcoidosis
	Diagnosis
	Imaging
	Blood tests
	Other ancillary diagnostic tests
		Pulmonary function tests
		Echocardiography
		Bronchoscopy, lavage, endobronchial ultrasound, and biopsy
	Treatment
	Treatment options
		Corticosteroids
		Methotrexate
		Azathioprine
		Cyclophosphamide
		Hydroxychloroquine
		Anti-tumor necrosis factor therapy
		Lung transplantation
	Cases
Chapter 35:Idiopathic pulmonary fibrosis
	Introduction
	Epidemiology
	Etiology
	Pathogenesis
	Symptoms and natural history
	Diagnosis
		Clinical
		Radiology
		Histology
	Natural history of IPF and disease complications
		Acute exacerbations of IPF
		Pulmonary hypertension
		Infection
		Primary lung cancer
	Management of IPF
		Antifibrotic therapy
	Other pharmacotherapy
		Symptom-based therapy
		Oxygen and exercise
		Transplant
		End-of-life care
	The future
	Conclusion
	Case histories
Chapter 36:Hypersensitivity pneumonitis
	Definition
	Epidemiology and Etiology
	Pathogenesis
	Clinical Features
		Acute
		Subacute
		Chronic
	Diagnosis
		HRCT scan
			Acute
			Subacute
			Chronic
		Lung function tests
		Serum antibodies
		Bronchoalveolar lavage
		Histopathology
	Treatment
	Prognosis
	Acknowledgments
Chapter 37:Connective tissue disease-associated interstitial lung disease
	Connective tissue diseases and the lung
	Epidemiology
	Clinical presentation
	Diagnosis
		Multidisciplinary evaluation
		Approach to evaluation
	Whom to treat: Determining impairment
		Subjective assessment of impairment
		Six-minute walk test
		Pulmonary function testing
		Thoracic HRCT
	Treatment
		Treating extrathoracic manifestations in the context of CTD-ILD
	Pharmacologic therapy
		Corticosteroids
		Cyclophosphamide
		AZA
		Mycophenolate mofetil
		Rituximab
	Nonpharmacologic therapies and strategies
		Cardiopulmonary rehabilitation
		Oxygen supplementation
		Gastroesophageal reflux disease and aspiration
		PH screening and treatment
		Acute ILD exacerbation
		Immunizations and smoking cessation
		Pneumocystis prophylaxis
		Bone health measures
		Lung transplantation
	Questions
	Further reading
Chapter 38:Pulmonary vasculitis
	Introduction
	Epidemiology
	Pathogenesis
	Clinical presentations
	Serologies—ANCA-associated or immune-complex-mediated small-vessel vasculitis
	Chest imaging
	Biopsy
	Granulomatosis with polyangiitis
	Eosinophilic granulomatosis with polyangiitis
	Microscopic polyangiitis
	Treatment
	Take home messages
	Cases
	References
Chapter 39:Rare lung diseases
	Eosinophilic pneumonias
		Acute eosinophilic pneumonia
		Chronic eosinophilic pneumonia
	Lymphoproliferative diseases
		Lymphoid interstitial pneumonia
		Castleman’s disease
		Primary pulmonary lymphoma and MALT lymphoma
	Pulmonary alveolar proteinosis
	Amyloidosis
	Pulmonary langerhans’ cell histiocytosis (histiocytosis X)
	LAM and tuberous sclerosis complex
	Idiopathic pulmonary hemosiderosis
	Neurofibromatosis
	Lipid storage disorders
	Erdheim–Chester disease
	Pulmonary alveolar microlithiasis
Part 11:Environmental and occupational lung disease
Chapter 40:Smoking cessation
	Smoking cessation
	Pharmacologic therapy
		Nicotine replacement therapy
		Bupropion
		Varenicline
	New approach
	Summary
	Further reading
Chapter 41:Occupational lung disease
	Occupational asthma and other airway diseases related to work
		Etiology
		Pathology
		Natural history
		Clinical features
		Diagnosis
		Treatment
	Inhalation injury
	Hypersensitivity pneumonitis
	Pneumoconioses
		Acute silicosis
	Asbestos-related lung disease
		Asbestosis
	Hard metal lung disease
	Welding and the lung
	Further reading
Chapter 42:Asbestosis, pneumoconiosis, and other occupational lung diseases
	Asbestos lung disease
		Introduction
		Epidemiology and history
		Pathophysiology
		Clinical picture
		Asbestos-related pleural diseases
			Benign pleural diseases
			Malignant asbestos-related disease
			Asbestos interstitial lung disease (Asbestosis)
		Recommendations after diagnosis
	Pneumoconiosis
		Introduction
		Etiology and epidemiology
		Pathogenesis
		Diagnosis of silicosis and CWP
		Other pulmonary manifestations
		Extrapulmonary manifestations
		Other pneumoconiosis
		Treatment
	Other occupational lung diseases
		Beryllium sensitization and chronic beryllium disease
		Acute inhalation injury
		Radon
		Indium lung disease
	References
Chapter 43:Drug-induced lung disease and radiation-induced disease
	Drug-induced respiratory diseases
		Introduction
		Epidemiology
		Risk factors/susceptibility
		Initial evaluation of the patient with drug-induced lung disease
		Patterns of lung disease
		Specific drugs and related syndromes
			Amiodarone
			Methotrexate
			Nonsteroidal anti-inflammatory drugs
			Nitrofurantoin
			Minocycline
			Angiotensin-converting enzyme inhibitors
			Biologics
			Interferon
			Rarer medications
			Dietary/herbal supplements
			Illegal drugs
				Heroin/opiates
				Cocaine and methamphetamine
			Chemotherapy
		Diagnosis
		Treatment
		Future
	Radiation-induced lung injury
		Introduction
		Risk factors
		Radiology in radiation-induced lung disease
		Treatment
	References
Part 12:Mediastinial disease
Chapter 44:Mediastinal disease
	Introduction
	Pneumomediastinum
	Mediastinitis
	Mediastinal fibrosis
	Castleman’s disease
	Further reading
Part 13:Pleural disease
Chapter 45:Pleural diseases
	Introduction
	Transudative pleural effusions
		Left ventricular failure
			Clinical Features
			Diagnosis
		Pleural fluid analysis
			Treatment
		Hepatic cirrhosis
			Clinical Features
			Diagnosis
			Treatment
		Transudative effusions from hypoproteinemia
	Exudative pleural effusions
		Pleural infection
			Etiology
			Classification
			Presentations
			Bacteriology
			Imaging
			Risk stratification
			Treatment
				Antibiotics and drainage
				Fibrinolytics
				Nutrition
				Surgery
		Malignant pleural effusions
			Etiology And Pathogenesis
			Clinical Presentation
			Imaging
			Diagnosis
			Management
		Uncommon causes of pleural effusion
			Pleural Effusion Due to Pulmonary Emboli
			Chylothorax
			Pseudochylothorax
			RA-Related Effusion/Pleuritis
			Systemic Lupus Erythematosus-Related Effusion
			Drug-Related Pleural Effusion
			Amyloidosis-Related Pleural Effusion
			Pleural Effusion Secondary to IgG4-Related Disease
	Pneumothorax
		Etiology
		Presentation and initial management
		Ambulatory management
		Failure of medical management
		Recurrence rates
		Surgical treatment options
		Medical treatment options
	Further reading
		Pleural infection
		Malignant pleural effusion
		Transudative effusion
	Uncommon causes of pleural effusion
		Pulmonary emboli
		Chylothorax
		Pseudochylothorax
		Rheumatoid-related pleural effusion
		SLE/Lupus-related pleural effusion
		Drug-Related Pleural Effusion
		Amyloidosis-related pleural effusion
		IgG4-related pleural effusion
		Pneumothorax
Chapter 46:Malignant pleural mesothelioma
	Epidemiology
	Etiology
		Asbestos
		Other fibers
		Simian virus 40
		Radiation
		Tobacco smoking
	Clinical features
	Diagnosis
		Radiology
		Pleural fluid analysis
		Pleural biopsy
		Pathology
		Biomarkers
		Staging
	Prognosis
	Management
		Medical
			Dyspnea
			Pain
		Psychological
		Chemotherapy
		Radiotherapy
		Surgery
		Others
	Medicolegal
	Future direction
		Prevention
		Screening for mesothelioma
		Treatment
	Further reading
Part 14:Pulmonary vascular disease
Chapter 47:Pulmonary hypertension and other disorders of the pulmonary vasculature
	Definition
	Epidemiology and aetiology
		Epidemiology
			Group 1
				IPAH, HPAH, drug- and toxin-induced PAH
				Conditions associated with PAH
					Connective tissue diseases
					HIV
					Portopulmonary hypertension
					Congenital heart disease
					Schistosomiasis
			Group 2
			Group 3
			Group 4
			Group 5
	Pathology and natural history
	Clinical features
	Diagnosis and work-up
		Relevant blood tests
		Electrocardiogram
		Imaging
		Lung function tests
		Cardiac tests
	Management
		General measures and supportive therapy
		Initial therapy with calcium channel blockers and PAH approved drugs
			Molecular pathways relevant in PAH and approved drugs
				Endothelin
				Nitric oxide
				Prostacyclin
		Assessment of clinical response
		Management of CTEPH
			Pulmonary endarterectomy
			Pulmonary vasodilator therapy
			Balloon pulmonary angioplasty
	Surgical procedures for PAH
		Atrial septostomy
		Transplantation
	Outcomes of treatment for PAH and CTEPH
	Pulmonary arteriovenous malformations
	Further reading
Chapter 48:Pulmonary embolism
	Definition
	Epidemiology
	Etiology
	Clinical presentation and diagnosis
		Radiologic diagnosis
		Clinical algorithm
	Prevention and treatment
		Prevention
		Treatment
		Duration of anticoagulation
	Prognosis and follow-up
		Follow-up
	References
Part 15:Critical care
Chapter 49:Acute respiratory distress syndrome (ARDS)
	Epidemiology, incidence, and mortality
	Pathophysiology
	Pathology
		Exudative stage
		Proliferative stage
		Fibrotic stage
	Clinical diagnosis
	Therapies for ARDS
		Ventilator-associated lung injury
		Lung protective mechanical ventilation
		Other types of intervention to improve ventilation
			Positive End-Expiratory Pressure
		Fluid management in ARDS
		Anti-inflammatory therapeutic approaches
	Future directions and emerging therapeutic strategies
	Questions
	Further reading
Chapter 50:Infections in critical care: Ventilator-associated pneumonia
	Definition
	Incidence
	Pathogenesis
	Diagnosis
	Differential diagnosis
	Risk factors
	Biomarkers
	Etiology
	Treatment
	Prevention
	References
Part 16:Developmental disorders
Chapter 51:Developmental disorders in adults
	Introduction
	General principles
		Why should the adult chest physician bother with pediatrics at all?
		Developmental aspects of disease: More than just a pediatric problem
		Childhood airway disease: More than just “asthma”
	Consequences of prematurity
	Congenital thoracic malformations
	Interstitial lung disease
		NEHI
		Sp abnormalities
	Summary and conclusions
	References
Part 17:Respiratory manifestations of extrapulmonary disease
Chapter 52:Bone marrow transplantation and hematological disorders
	Hematological malignancies
		Classification
		Clinical features of hematological neoplasms
		Respiratory complications of hematological malignancies
			Infective complications of hematological neoplasms
			Noninfective complications of hematological malignancies
				Pulmonary leukemic infiltration
				Pulmonary leukostasis
				Pulmonary embolism
				Mediastinal mass
				Radiation pneumonitis
	Pulmonary toxicities of chemotherapy
	Hematopoietic cell transplantation
	Respiratory complications of allo-HCT
		Pulmonary GVHD
			Work-up for patients with suspected pulmonary GVHD
		Idiopathic pneumonia syndrome
		Diffuse alveolar hemorrhage
		Chronic organizing pneumonia
		Engraftment syndrome
	Respiratory infections following HCT
	Viral respiratory infections following allo-HCT
	Respiratory complications of nonmalignant hematological disease
		Sickle cell disease
		Acute chest syndrome
		Infections
		Pulmonary hypertension
	Clinical cases
	Further reading
Chapter 53:Skeletal disorders and neuromuscular disease
	Classification and prevalence of skeletal disorders
		Scoliosis
		Kyphosis
		Pectus disorders
	Neuromuscular disorders: Classification and prevalence
	Pathophysiology
		Effects of chest wall deformity and neuromuscular disease on pulmonary and cardiac function
			Lung Volumes
			Chest Wall Mechanics
			Pulmonary Compliance
		Respiratory muscles/thoracic pump during sleep
	Management
		Skeletal disorders—Identification of high-risk cases
		Neuromuscular disease—Identification of high-risk cases
		Monitoring high-risk patients
	Treatment
		Management of spinal deformity
		Surgery for scoliosis
		Ventilatory impairment
			Optimization of Respiratory Function
		Ventilatory failure
	Further reading
Chapter 54:Cardiovascular disease
	Introduction
	Heart failure
	Etiology of heart failure
		Heart failure with reduced ejection fraction
		Heart failure with preserved ejection fraction
	Pulmonary abnormalities in heart failure
	Investigations in heart failure
	Right ventricular failure
	Treatment of heart failure
	Valve disease
	Multisystem myopathies with cardiac and respiratory manifestations
		Polymyositis and dermatomyositis
		Systemic sclerosis
		Inherited myopathies
	Vasculitis-Induced cardiomyopathy
	Cardiac sarcoidosis
		Best practice for diagnosis of sarcoidosis: HRS Expert Consensus Recommendations 2014
		Treatment of cardiac sarcoidosis
	Congenital heart disease
		Shunts
		Atrial septal defects
			Recognizing atrial septal defects
		Ventricular septal defect
			Pathogenesis
			Symptoms
			Signs
	Stenotic lesions
		Bicuspid aortic valve
		Coarctation of the aorta
	References
Chapter 55:Pulmonary renal syndromes
	Introduction
	Goodpasture’s syndrome (anti-GBM)
		Background
		Epidemiology
		Etiology
		Pathogenesis
		Clinical manifestations
		Treatment
	Antinuetrophil cytoplasmic antibody-associated vasculitis
		Background
		Epidemiology
		Etiology
		Pathogenesis
		Clinical manifestations
		Treatment
	Summary
	Questions
	Further reading
Answers
Index