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Case Reports in Pulmonology

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https://www.readbyqxmd.com/read/29675281/coexistent-non-small-cell-carcinoma-and-small-cell-carcinoma-in-a-patient-presenting-with-hyponatremia
#1
Mitchell D Ross, Sreeja Biswas Roy, Pradnya D Patil, Jasmine L Huang, Nitika Thawani, Ralph Drosten, Tanmay S Panchabhai
Despite recent advances in screening methods, lung cancer remains the leading cause of cancer-related deaths worldwide. By the time lung cancer becomes symptomatic and patients seek treatment, it is often too advanced for curative measures. Low-dose computed tomography (CT) screening has been shown to reduce mortality in patients at high risk of lung cancer. We present a 66-year-old man with a 50-pack-year smoking history who had a right upper lobe (RUL) pulmonary nodule and left lower lobe (LLL) consolidation on a screening CT...
2018: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29666741/a-novel-mutation-in-tsc2-gene-a-34-year-old-female-with-pulmonary-lymphangioleiomyomatosis-with-concomitant-hepatic-lesions
#2
Mehdi Nadiri, Mortaza Raeisi, Seyed Ali Mousavi Aghdas
Tuberous sclerosis complex (TSC) is an autosomal dominant disease resulting from mutation(s) in TSC1 or TSC2 genes. TSC is associated with the formation of hamartomas in the brain, heart, eyes, skin, kidneys, and lymphangioleiomyomatosis (LAM) of the lungs. LAM is almost restricted to women in reproductive age. Different mutations in TSC1 and TSC2 genes have been reported in the literature. Here, we present a female patient with TSC-LAM with a novel mutation in TSC2 gene. The patient also had multiple hepatic angiomyolipomas, which is a relatively less-reported manifestation of the disease...
2018: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29607238/pulmonary-alveolar-proteinosis-in-setting-of-inhaled-toxin-exposure-and-chronic-substance-abuse
#3
Meirui Li, Salem Alowami, Miranda Schell, Clive Davis, Asghar Naqvi
Pulmonary alveolar proteinosis (PAP) is a rare lung disorder in which defects in alveolar macrophage maturation or function lead to the accumulation of proteinaceous surfactant in alveolar space, resulting in impaired gas exchange and hypoxemia. PAP is categorized into three types: hereditary, autoimmune, and secondary. We report a case of secondary PAP in a 47-year-old man, whose risk factors include occupational exposure to inhaled toxins, especially aluminum dust, the use of anabolic steroids, and alcohol abuse, which in mice leads to alveolar macrophage dysfunction through a zinc-dependent mechanism that inhibits granulocyte macrophage-colony stimulating factor (GM-CSF) receptor signalling...
2018: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29568657/use-of-extracorporeal-membrane-oxygenation-in-postpartum-management-of-a-patient-with-pulmonary-arterial-hypertension
#4
Humna Abid Memon, Zeenat Safdar, Ahmad Goodarzi
Current guidelines do not recommend pregnancy in patients with pulmonary arterial hypertension (PAH). This is due to the associated high mortality, which both dissuades PAH patients from becoming pregnant and encourages termination of pregnancy due to high maternal mortality risk. As a result, there is a lack of data and, consequently, there are only general guidelines available for management of pregnancy in PAH patients. Additionally, novel therapeutic strategies such as extracorporeal membrane oxygenation (ECMO), although used in the management of nonpregnant PAH patients as a bridge to lung transplantation, have not been used to treat cardiopulmonary collapse in pregnant PAH patients...
2018: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29535882/robot-assisted-thoracoscopic-resection-of-a-posterior-mediastinal-mullerian-cyst
#5
Calvin Chao, Vijay Vanguri, Karl Uy
First described in 2005, the Mullerian derived cyst in the mediastinum is a rare finding with few subsequent reports. We report a case of Mullerian cyst occurring in the mediastinum of a 49-year-old female that was resected by robot-assisted thoracoscopic surgery. To our knowledge, this is the first report of robot-assisted resection of Hattori's cyst. Histopathologic analysis revealed ciliated Mullerian-type tubal epithelium positive for paired box gene 8 (PAX8), estrogen receptor (ER), and progesterone receptor (PR), confirming Mullerian differentiation...
2018: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29391962/seizure-and-pulmonary-embolism-a-differential-that-can-save-a-life
#6
Seyedmohammad Pourshahid, Sneha Dedhia, Shakeeb Hakim, Mohamed Barakat, Dennis Genin
Seizures is a relatively common presentation with a wide differential diagnosis. However, seizures presenting secondary to underlying pulmonary emboli are rare and, without prompt recognition and management, this easily treatable condition can be potentially fatal. The few available case reports discussing seizures and PE reveal a high mortality rate which underscores the importance of prompt diagnosis. A 38-year-old woman presented to the emergency room having experienced loss of consciousness and a generalized tonic-clonic seizure at home...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29362683/a-rare-case-of-metastatic-choriocarcinoma-of-lung-origin
#7
Parth Rali, Jianwu Xie, Grishma Rali, Mayur Rali, Jan Silverman, Khalid Malik
Choriocarcinoma is part of the spectrum of gestational trophoblastic disease that occurs in women of reproductive age. Although the most common metastatic site of choriocarcinoma is the lung, primary pulmonary choriocarcinoma is rare. To diagnose primary pulmonary choriocarcinoma, the patient should have no previous gynecologic malignancy, have elevated human chorionic gonadotropin, and have pathological confirmation of the disease excluding gonadal primary site of the tumor. Due to the paucity of data, there are no guidelines for treatment...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29250453/pulmonary-neuroendocrine-cell-hyperplasia-associated-with-surfactant-protein-c-gene-mutation
#8
Norlalak Jiramethee, David Erasmus, Lawrence Nogee, Andras Khoor
Familial interstitial lung disease (ILD) is defined as presence of ILD in 2 or more family members. Surfactant protein C (SFTPC) gene mutations are rare, but well-known cause of familial ILD. We reported a 20-year-old male, who was referred for lung transplantation. He was symptomatic at age 3 and underwent surgical lung biopsy at age 6, which revealed a nonspecific interstitial pneumonia (NSIP) pattern. Genetic workup revealed a novel SFTPC mutation in the first intron with a C to A transversion. At age 21, he underwent bilateral lung transplantation...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29225987/daptomycin-induced-acute-eosinophilic-pneumonia-late-onset-and-quick-recovery
#9
Mohamad Rachid, Khansa Ahmad, Meghan Saunders-Kurban, Aelia Fatima, Aditya Shah, Anas Nahhas
Background: Daptomycin is a cyclic lipopeptide antibiotic that provides great coverage for gram positive cocci. From the early years of daptomycin use, concerns were raised regarding the pulmonary side effects of daptomycin and potential development of acute eosinophilic pneumonia (AEP) secondary to daptomycin therapy. Discussion: AEP could be idiopathic or induced by drugs or toxins. It is a distinct entity from atopic diseases and autoimmune, parasitic, or fungal infections that can also cause pulmonary eosinophilia...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29201483/purulent-appearing-material-in-an-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-of-mediastinal-lymph-node-a-diagnostic-challenge
#10
Damaris Pena, Gilda Diaz-Fuentes, Sindhaghatta Venkatram
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29163998/multifocal-pulmonary-granular-cell-tumor-presenting-with-postobstructive-pneumonia
#11
Samid M Farooqui, Muhammad S Khan, Laura Adhikari, Viral Doshi
Granular cell tumor (GCT) is a neoplasm of Schwann cell origin. Its presence in the aerodigestive tract is uncommon and becomes a diagnostic challenge on initial presentation. Our case is of a 59-year-old woman who presented to the emergency department with a history of productive cough and dyspnea associated with fever and chest pain. An initial chest X-ray (CXR) showed a right middle lobe consolidation with follow-up Computed Tomography (CT) scan showing a mass in the right bronchus. Bronchoscopy revealed a polypoid, sessile granular mass in the right bronchus intermedius with multiple white lesions in trachea, left main bronchus, and right upper bronchi...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29158938/orthodeoxia-without-platypnea-in-hereditary-hemorrhagic-telangiectasia-in-the-presence-of-a-cerebral-abscess-and-multiple-pulmonary-arteriovenous-malformations-unusual-complications-and-transcatheter-endovascular-treatment
#12
Carlos Salazar, Jacky Bruce Blank, Veronica Palmero
Hereditary hemorrhagic telangiectasia is a rare autosomal-dominant condition affecting visceral blood vessel development. Cerebral and most commonly pulmonary arteriovenous malformations are found in the majority of symptomatic patients. The most common complications include embolic strokes and cerebral abscesses, which have been attributed to abnormal vessel communications. Platypnea orthodeoxia is a rare condition that presents dyspnea and oxygen desaturation when adopting an upright position and is relieved on decubitus...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29123934/symptomatic-patent-foramen-ovale-with-hemidiaphragm-paralysis
#13
Hussain Ibrahim, Adnan Khan, Shawn P Nishi, Ken Fujise, Syed Gilani
Dyspnea accounts for more than one-fourth of the hospital admissions from Emergency Department. Chronic conditions such as Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, and Asthma are being common etiologies. Less common etiologies include conditions such as valvular heart disease, pulmonary embolism, and right-to-left shunt (RLS) from patent foramen ovale (PFO). PFO is present in estimated 20-30% of the population, mostly a benign condition. RLS via PFO usually occurs when right atrium pressure exceeds left atrium pressure...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29123933/hemoptysis-following-talc-pleurodesis-in-a-pneumothorax-patient
#14
Yusuke Kakiuchi, Fumihiro Yamaguchi, Makoto Hayashi, Yusuke Shikama
The purpose of this article is to report a case of hemoptysis occurring in combination with secondary spontaneous pneumothorax following chemical pleurodesis by talc. A Japanese male with cancer of renal pelvis was found with the left pneumothorax and multiple lung metastases. A computed-tomography scan revealed severe emphysema throughout the lungs. Talc pleurodesis was employed to arrest air leakage. The patient developed hemoptysis 45 minutes after talc injection into the thorax. This is the first report of hemoptysis following talc pleurodesis...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29109889/a-case-report-on-vt-from-tv-dvt-and-pe-from-prolonged-television-watching
#15
Alan Lucerna, James Espinosa, Lindsey Ackley, Philip Carhart, Douglas Stranges, Risha Hertz
Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29098106/a-rare-case-of-idiopathic-plastic-bronchitis
#16
Mohammed Raoufi, Leila Achachi, Fatima Zahra Mrabet, Laila Herrak, Mustapha El Ftouh, Najoua Bourhroum, Nezha Ouazzani Taibi
Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29057135/rare-congenital-aberrant-left-superior-pulmonary-vein-discovered-with-central-line-placement-in-a-patient-with-critical-cardiorespiratory-collapse
#17
Spencer Knox, Mario Madruga, S J Carlan
BACKGROUND: Partial anomalous pulmonary venous connection is a rare congenital vascular disorder that may be asymptomatic. Left-sided connections with the innominate vein are discovered infrequently and those without an atrial septal defect are extremely rare. CASE: A 66-year-old male was found to have an anomalous left pulmonary vein when a central venous catheter was inserted for management of hypoxemia. In addition to the connection with the left innominate vein an echocardiogram revealed no atrial septal defect...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28932614/acute-low-dose-hydralazine-induced-lupus-pneumonitis
#18
Sarah K Holman, Donique Parris, Sarah Meyers, Jason Ramirez
A 35-year-old female was started on hydralazine 10 mg orally three times a day for treatment of postpartum hypertension. Three months later, after multiple unsuccessful courses of prednisone and antibiotics for presumed pneumonia and asthma exacerbations, her respiratory symptoms progressed in severity and she developed resting hypoxia. Previous diagnostic work-up included spirometry with a restrictive pattern, chest CT showing bilateral basilar consolidation, negative BAL, and nonspecific findings on lung biopsy of mild inflammatory cells...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28932613/primary-pulmonary-lymphoma-presenting-with-superior-vena-cava-syndrome-in-a-young-female
#19
Divya Salhan, Prakash Verma, Tun Win Naing, Ebad Ur Rehman, Saroj Kandel, Danillo Enriquez, Joseph Quist, Frances Schmidt
Primary Pulmonary Diffuse Large B Cell Lymphoma (PPDLBCL) is an extremely rare entity, which exhibits an aggressive behavior by compressing local blood vessels. It represents only 0.04% of all lymphoma cases and is extremely rare in young age. We present a case of a primary pulmonary lymphoma with superior vena cava syndrome (SVCS) in a young female. 27-year-old African American female presented with fever, cough, and facial puffiness for 2 weeks and unintentional weight loss. Chest examination showed decreased breath sounds and dullness on percussion on right side...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/28845317/arterial-thoracic-outlet-syndrome-treated-successfully-with-totally-endoscopic-first-rib-resection
#20
Sofoklis Mitsos, Davide Patrini, Sara Velo, Achilleas Antonopoulos, Martin Hayward, Robert S George, David Lawrence, Nikolaos Panagiotopoulos
Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection...
2017: Case Reports in Pulmonology
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