ALERT:

Respiratory Conditions

Overview

Lahey Hospital & Medical Center’s pulmonary specialists have the expertise and technology to diagnose and treat the full range of respiratory diseases and conditions, from bronchitis to tuberculosis. We have special clinical interests in the following areas:

Conditions

Alpha-1 Antitrypsin Deficiency

This is an inherited genetic disorder that results in emphysema and liver disease. Lahey Hospital & Medical Center’s Pulmonary and Critical Care Medicine Department has been involved in the diagnosis and treatment of alpha-1 antitrypsin deficiency since 1988.

Asthma

This is a disease primarily of the airways and can occur both early and later in life. The pathophysiology of this disease includes smooth muscle bronchospasm of the airways and excessive inflammation with overproduction of secretions. Asthma can be fully treated with a combination of medical therapies. Our state-of-the-art Asthma Center provides our patients with disease management education and assists with optimizing medical therapy. We also offer the newest treatments for asthma, including thermoplasty.

Emphysema

Emphysema is one of the most common forms of chronic obstructive pulmonary disease (COPD). A long-term lung disease, emphysema occurs when there is damage to the air sacs in the lungs. These air sacs pick up oxygen from the air. When the air sacs are damaged they cannot pick up enough oxygen, which causes breathing problems. While there is no cure for emphysema, it can be controlled with medicines and breathing treatments.

Pleural Disorders

Diseases that involve the lining of the lungs (the pleura). Pleural disorders may lead to inflammation of this lining (pleurisy), thickening of the lining, or excess fluid accumulation (pleural effusion). Using X-rays and tools such as drainage catheters, biopsy needles and special cameras called thoracoscopes, Lahey Clinic specialists can diagnose diseases of the pleura and offer treatment options in interventional pulmonology.

Pneumonia

There are many kinds of pneumonia, but the most common types are caused by bacterial and viral infections. Both forms of the disease cause increased fluid in the lungs. Viral pneumonia occurs most commonly in the winter. Pneumonia is most serious when it occurs in young children and people over 60. Today many people can be treated at home, but hospitalization may be required depending on the nature and severity of the infection. Lahey’s Department of Pulmonary & Critical Care collaborates with the Department of Infectious Diseases in the treatment of pneumonia.

Pulmonary Arterial Hypertension

Pulmonary Hypertension is a disorder in which there is high blood pressure in the arteries of the lungs. It can be caused by several underlying disorders such as liver disease, rheumatological disorders, HIV, heart disease, blood clots in the lungs, and/or existing lung diseases such as COPD or Obstructive sleep apnea. However, there is a rare form called Pulmonary Arterial Hypertension (PAH) in which the blood pressure in the arteries is increased due to narrowed, thickened, or stiffened arteries in the lungs. PAH requires specialized evaluation by a pulmonologist for diagnosis and management. Though there is no cure for PAH, specialized medications can be used to help manage the disease.

Pulmonary Fibrosis

This is the medical term for a group of about 180 lung diseases whose common characteristic is scarring in the tissues of the lungs. Also called interstitial lung disease (ILD), this condition can occur as a result of previous infection, inflammation or even environmental exposure. In some cases the scarring, or fibrosis, can be extensive and interfere with normal lung function. This can lead to symptoms such as shortness of breath and coughing. People usually get ILD between the ages of 40 and 70. While there is currently no cure for ILD, there are treatments to control its symptoms.

Sarcoidosis

Sarcoidosis is a disease that causes inflammation, or swelling, of the body’s tissues. The inflammation produces small lumps (also called nodules or granulomas) in the tissues. Sarcoidosis often starts in the lungs and then spreads to other organs and tissues in the body. Treatments can be given to control symptoms and improve the function of lungs and other organs affected by the disease.

Tuberculosis

Tuberculosis (TB) is a highly contagious infection of the lungs and is prevalent worldwide. Lahey Hospital & Medical Center offers a state-funded clinic supported by the Division of Tuberculosis Prevention and Control. Our goal is to manage and eradicate TB in Massachusetts by targeting and treating high-risk individuals who have or are suspected of having TB.

Diagnosis & Treatment

Pulmonary Function Testing and Cardiopulmonary Function Testing

Lahey Hospital & Medical Center maintains two state-of-the-art pulmonary function testing (PFT) laboratories-one in Burlington, Mass., and one in Peabody, Mass. – in addition to a bronchoscopy suite in Burlington. All testing is performed by certified personnel.

Full exercise physiology testing is available in addition to standard PFT. All tests are reviewed by board-certified Lahey pulmonologists.

We also offer a flight clinic that assesses and treats people with lung disease who might be at risk for air travel.

Percepta

Lahey Hospital & Medical Center is the first hospital in New England utilizing a registry to offer an innovative way to help diagnose lung cancer which may reduce the risks associated with more invasive biopsies and diminish the uncertainties of bronchoscopy results.

Lahey pulmonologists are using advanced genomic technology called Percepta to help determine whether a spot found on a patient’s lung is benign or malignant. By improving preoperative diagnostic accuracy, the aim is to help patients avoid unnecessary more invasive procedures.

Diagnosing Lung Cancer

When a CT scan shows a lung nodule or lesion, doctors commonly perform bronchoscopy, a procedure in which a scope is inserted down a sedated patient’s throat and guided to the lung. Unfortunately, bronchoscopies produce inconclusive results up to 40% of the time, meaning that cancer cannot always be ruled out.

That leaves doctors with the dilemma of whether to subject patients to an invasive, expensive and potentially unnecessary follow-up biopsy procedure or just monitor them, with the chance that they do have cancer.

These follow-up procedures can involve a needle biopsy, which has up to a 25% risk of collapsed lung, or surgery, which is costly and carries its own health risks. About one-third of patients who undergo surgery prove to have benign (noncancerous) nodules.

How Percepta Works

With Percepta, Lahey pulmonologists use a tiny brush to collect cell samples from a specific location in the lung at the same time they are performing the initial bronchoscopy. If the bronchoscopy results are inconclusive, these samples are then sent to a Percepta laboratory in San Francisco for state-of-the-art genomic testing.

Percepta has been shown to identify patients at “low risk” with a high degree of accuracy. These patients may then be monitored with CT scans in lieu of undergoing invasive diagnostic procedures.

The Percepta Bronchial Genomic Classifier was created by the diagnostics company Veracyte, which made the test available to a limited number of U.S. institutions in 2015. Recognizing the importance of this new technology, Lahey’s Department of Pulmonary & Critical Care Medicine committed the time and resources to learn the procedure in order to offer this option to patients.

Lung Cancer Screening at Lahey

Lung cancer is the number-one cause of cancer deaths in the United States. But early detection can increase the 5-year survival rate for stage 1 lung cancer to nearly 90%.

In 2015, more than 8 million Americans at high risk for lung cancer became eligible for low-dose computed tomography (LDCT) lung cancer screenings through Medicare or other insurance. This means more nodules and lesions will likely be found, making Percepta a significant option for many.

Lahey is a pioneer and leader in LDCT and has the largest clinical lung cancer screening program in the country. Learn more and see if you qualify for lung cancer screenings.

Interventional Pulmonary Treatment

Lahey Hospital & Medical Center has achieved international recognition for its pioneering work in the field of interventional pulmonary medicine. This field includes diagnostic and therapeutic procedures related to critical care medicine and the care of patients with a variety of pulmonary conditions such as lung cancer, pleural disease and airway disorders.

Lahey pulmonologists are experts in rigid bronchoscopy, a specialized procedure used in conjunction with radiation or laser therapy for the diagnosis and treatment of lung cancers. Our pulmonologists also use a diagnostic technique called autofluorescence bronchoscopy, which is used to evaluate central airways and can detect cancerous changes that cannot be seen with conventional bronchoscopy.

  • Autofluorescence bronchoscopy
  • Basic and advanced bronchoscopy
  • Cryotherapy
  • Electrocautery
  • Endobronchial ultrasound-guided (EBUS) TBNA
  • Endobronchial valves for broncho-pleural fistula
  • Laser bronchoscopy
  • Medical pleuroscopy
  • Navigational bronchoscopy
  • Percutaneous tracheostomy
  • Photodynamic therapy
  • Pleural catheter placement
  • Pulmonary stent placement
  • Rigid bronchoscopy
  • Thermoplasty

We also a post-graduate CME course designed for experienced thoracic endoscopists and will cover indications, contraindications, and clinical applications of various procedures in the field of interventional pulmonology including: rigid bronchoscopy, laser bronchoscopy, endobronchial stent insertion, transbronchial needle aspiration, percutaneous dilatational tracheostomy, cryotherapy, electrocautery, photodynamic therapy and medical thoracoscopy.