Radiologic Diagnostics of Lung Lesions by Granulomatosis with Polyangiitis in the Context of the COVID-19 Pandemic

Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, and lung damage in coronavirus infection have many common clinical and radiological symptoms. In the context of the COVID-19 pandemic the ability of a radiologist to differentiate a viral lung lesion from a granulomatous one is relevant due to the difficulty of recognizing them. In order to develop differential radiation diagnostics, a comparative analysis of the computer tomographic picture of lung lesions in each disease was carried out and the leading X-ray patterns were determined. 61 patients with lung damage were examined, including 30 with HPA, 30 with COVID-19 and 1 patient with a combination of these diseases. A total of 74 native computer tomography examinations of the chest organs were accomplished using a Toshiba Aquilion 64 multi-slice CT scanner. It was found that the most informative radiological sign of HPA are nodes, nodules and masses in the lungs, which were detected in 22 (73.3 %) patients, including 11 (36.7 %) with a necrotic cavitation. Ground-glass opacity is often found in both diseases, but COVID-19 is more characterized by a rounded (56.7 %) or polygonal shape (20.0 %) of pathological areas and their peripheral location (70.0 %) mainly in the posterior parts of the lungs, and triangular areas (42.1 %) with a central location (42.1 %) are more often found in HPA. The rapid dynamics of changes in the lungs on control CT scans is of great diagnostic value, which indicates the viral nature of the disease.

AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2019

Every year the Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO), a group of gynecological oncologists specialized in breast cancer and interdisciplinary members specialized in pathology, radiologic diagnostics, medical oncology, and radiation oncology, prepares and updates evidence-based recommendations for the diagnosis and treatment of patients with early and metastatic breast cancer. Every update is performed according to a documented rule-fixed algorithm, by thoroughly reviewing and scoring the recent publications for their scientific validity and clinical relevance. This current publication presents the 2019 update on the recommendations for metastatic breast cancer.

The simultaneous detection of tuberculosis and HIV-infection

The clinical and roentgenologic manifestations of tuberculosis in cases of its detection simultaneously with HIV-infection are considered. The physician is to be guided by different techniques of radiologic diagnostics because of low rate of bacteria isolation for timely detection of HIV-combined tuberculosis. In case of simultaneous detection of HIV-infection and activation of endogenous tuberculosis infection with development of tuberculosis in the same individual, the infection with HIV-infection occurs as a primary one. The specific inflammation develops against the background of immunodeficiency induced by HIV-infection. This occurrence can take place both at the stage of primary manifestations of HIV-infection (stage II) and late stage (stage of secondary diseases).