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Respirology Case Reports

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https://www.readbyqxmd.com/read/28638620/chest-pain-and-recurrent-chylothorax-an-unusual-presentation-of-malignant-pleural-mesothelioma
#1
David R Darley, Emily Granger, Allan R Glanville
Malignant mesothelioma presenting with recurrent chylous effusion is rare. We describe the case of a 34-year-old female Macedonian immigrant who presented with central chest pain and subsequently a left-sided chylous pleural effusion. The diagnosis was made on pleural biopsy via video-assisted thoracoscopic surgery (VATS). Our case demonstrates the utility of thoracic magnetic resonance imaging (MRI) and the difficulties associated with pleural cytology and cervical lymph node biopsy in the establishment of a diagnosis of mesothelioma...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28638619/propionibacterium-acnes-pleural-empyema-following-medical-thoracoscopy
#2
Hannah Lawrence, Thomas Moore, Karmel Webb, Wei Shen Lim
Propionibacterium acnes (P. acnes) is a Gram-positive anaerobic rod and a common skin commensal that colonizes sebaceous glands. It has infrequently been associated with invasive opportunistic infections and can cause implant-associated infections through a biofilm mode of growth. Medical thoracoscopy is a common procedure for diagnosis and treatment of exudative pleural effusions; empyema is a recognized complication. We present a rare case of P. acnes pleural empyema 3 weeks following medical thoracoscopy and subsequent intercostal drain insertion for 3 days in a 75-year-old man...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28638618/swyer-james-macleod-syndrome-a-rare-diagnosis-presented-through-two-adult-patients
#3
Sumit Mehra, Thilini Basnayake, Henrik Falhammar, Subash Heraganahally, Suryakant Tripathi
Swyer-James-MacLeod syndrome (SJMS) is a rare syndrome of acute obliterative bronchiolitis following an early childhood infective insult to the lungs. This causes arrest of alveolarization, affecting lung development with hypoplasia of the ipsilateral pulmonary artery and results in a characteristic radiological pattern, such as a unilateral hyperlucent lung with expiratory air-trapping and pruned-tree appearance on pulmonary angiogram. The clinical presentation is either recurrent chest infections, exertional dyspnoea or it may be an incidental finding...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28616240/metastatic-pancreatic-carcinoma-masquerading-as-cystic-lung-disease-a-rare-presentation
#4
Emily Stern, Taha Huseini, YiJin Kuok, Fiona Lake
This 52-year-old male ex-smoker presented with a six-month history of progressive breathlessness and weight loss. He deteriorated acutely, and was admitted with severe type 1 respiratory failure. Apart from diffuse coarse crackles on chest auscultation, physical examination was unremarkable. High-resolution computed tomography (HRCT) showed diffuse cystic changes throughout the lungs. A diagnosis of pulmonary Langerhans cell histiocytosis (PLCH) was considered. Further workup identified a coincidental pancreatic lesion of uncertain significance, which remained indeterminate on magnetic resonance imaging (MRI) and on positron emission tomography (PET)...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28603622/a-bronchial-fibroepithelial-polyp-with-abnormal-findings-on-auto-fluorescence-imaging
#5
Naomi Saito, Masahiro Yamasaki, Wakako Daido, Sayaka Ishiyama, Naoko Deguchi, Masaya Taniwaki
Bronchial fibroepithelial polyps represent a rare type of tumour that displays endobronchial growth. The findings of these lesions on auto-fluorescence imaging (AFI) bronchoscopy have not been reported, despite the usefulness of AFI in detecting early lung cancer. We report the case of a patient with a bronchial fibroepithelial polyp that displayed positivity (magenta colour) on AFI. The patient was a 65-year-old man, in whom an endobronchial polypoid lesion of 10 mm diameter had been detected in the right basal bronchus by chest computed tomography (CT)...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28580148/post-tuberculosis-mycetoma-bronchoscopic-removal
#6
Liam J Chawke, Eoin B Hunt, Marcus P Kennedy, Desmond M Murphy
A 76-year-old male non-smoker presented to our institution with cough and haemoptysis. He had been treated for cavitatory pulmonary Mycobacterium tuberculosis of the right upper lobe 10 years previously. Chest radiograph and subsequent computed tomography (CT) of the chest demonstrated a right upper cavity containing a mass suspicious for mycetoma. Flexible bronchoscopy under conscious sedation demonstrated a mass obstructing the anterior segment of the right upper lobe. The abnormality was subsequently removed using a flexible endobronchial cryoprobe...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28560041/severe-acute-asthma-caused-by-chlamydophila-pneumoniae-infection
#7
Yoshinari Endo, Toshihiro Shirai, Mika Saigusa, Eisuke Mochizuki
Asthma exacerbation is associated with respiratory infections, including those by viruses and atypical bacteria. We herein report a case of severe acute asthma in an adult caused by Chlamydophila pneumoniae (C. pneumoniae) infection. A 39-year-old woman without a history of asthma reported to the emergency department with progressive worsening of cough, shortness of breath, and wheezing with low oxygen saturation. A computed tomography (CT) scan revealed patchy ground-glass opacity and bronchial wall thickening...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28491322/erratum
#8
(no author information available yet)
[This corrects the article DOI: 10.1002/rcr2.230.].
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28469919/osimertinib-administration-via-nasogastric-tube-in-an-egfr-t790m-positive-patient-with-leptomeningeal-metastases
#9
Takayuki Takeda, Hideki Itano, Mayumi Takeuchi, Yurika Nishimi, Masahiko Saitoh, Sorou Takeda
Patients with an epidermal growth factor receptor (EGFR) mutation are usually administered EGFR-tyrosine kinase inhibitors (TKIs) as standard-of-care treatment. However, acquired resistance occurs between 9 and 13 months. The T790M-resistant mutations are the most common, and osimertinib has been found to be effective in treating EGFR-T790M-positive patients. A 73-year-old female lung cancer patient with an EGFR-sensitizing mutation was receiving fourth-line chemotherapy when she complained of anorexia, headache, and irritability...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28469918/a-chest-wall-mass-after-breast-carcinoma-surgery-a-simple-diagnosis
#10
Fabrizio Minervini, Ladina Greuter, Peter Kestenholz, Tino Schneider, Christine Gutmann, André Emanuel Dutly
Tuberculosis affects pulmonary and extra-pulmonary sites with a multitude of differing presentations. The involvement of thoracic wall is a rare entity. We report the case of a patient who had a tumefaction on the right chest wall 6 months after a right breast mastectomy. After an initial radiological suspicion of malignancy, we detected intraoperatively an abscess in which histologic examination revealed granulomas with multinucleated giant cells.
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28469917/an-uncommon-cause-of-miliary-pattern-of-pulmonary-nodules-diffuse-pulmonary-meningotheliomatosis
#11
Vivek Jayaschandran, Sandra Gjorgova-Gjeorgjievski, Haamid Siddique
Pulmonary meningothelial-like nodules are benign lesions that are often incidentally detected in surgically resected lung tissue. These nodules are usually asymptomatic and single. Rarely, they present as diffuse micronodules similar to the miliary pattern seen in tuberculosis or metastatic cancer. While diffuse meningothelial-like micronodules are usually benign, it is important to include this condition in the differential diagnosis of patients presenting with diffuse micronodules. We present the case of a 74-year-old asymptomatic female referred to the pulmonary clinic for evaluation of incidentally detected diffuse bilateral pulmonary nodules...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28451433/lenalidomide-induced-eosinophilic-pneumonia
#12
Andrew Toma, Aaron P Rapoport, Allen Burke, Ashutosh Sachdeva
Multiple myeloma is a plasma cell dyscrasia accounting for 10% of haematologic malignancies. Lenalidomide is an immunomodulatory drug analogous to thalidomide that is approved for use in patients with myelodysplastic syndrome, and in combination with dexamethasone for refractory or relapsed multiple myeloma. Lenalidomide is preferred to thalidomide because of reduced toxicity, and pulmonary side effects are considered rare. We present, to our knowledge, an unusual and first reported case of a patient with relapsed multiple myeloma who received lenalidomide after autologous stem cell transplant, then developed eosinophilic pneumonia presenting as dyspnoea, peripheral eosinophilia, and bilateral pulmonary opacities...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28435681/a-hol-e-y-predicament
#13
Shaiva Ginoya Meka, Daniel Shelden, Amy Mertens, Paul Christensen, Meet Patel
Endocardial cushion defects are congenital abnormalities that result in valvular dysfunction as well as defects (or "holes") in the septa of the heart. They are typically diagnosed in early infancy; presentation late in life is rare. We present the case of a 72-year-old female admitted to the hospital with dyspnoea and palpitations. She was found to have multifocal atrial tachycardia. She suffered cardiac arrest associated with refractory hypoxaemia that required mechanical ventilation and vasodilator therapy with inhaled nitric oxide...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28428888/multimodal-imaging-findings-in-an-adult-case-of-swyer-james-macleod-syndrome
#14
Hitoshi Kawasuji, Kensuke Suzuki, Hideaki Furuse, Takeshi Tsuda, Yasuaki Masaki, Hirokazu Taniguchi
Swyer-James-MacLeod syndrome (SJMS) is an uncommon obliterative lung disease that is radiologically characterized by hyperlucency of a part of or the entire lung. A 33-year-old man presented to our hospital for chest tightness. A chest X-ray revealed unilateral hyperlucency of left lower lung, and contrast-enhanced computed tomography (CT) of the chest disclosed a hyperlucent left lung without vascularity. Three-dimensional CT reconstruction and ventilation-perfusion scan findings were concordant with SJMS...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28413686/cytokine-profiles-of-amyopathic-dermatomyositis-with-interstitial-lung-diseases-treated-with-mycophenolate
#15
Masachika Hayashi, Ami Aoki, Katsuaki Asakawa, Takuro Sakagami, Toshiaki Kikuchi, Toshinori Takada
A 59-year-old Japanese man diagnosed with interstitial lung disease associated with amyopathic dermatomyositis with anti-melanoma differentiation-associated gene 5 (MDA-5) antibodies was treated with intravenous methyl prednisolone (PSL) 1000 mg, oral PSL 1 mg/kg, and oral cyclosporin 200 mg daily. His respiratory condition worsened after treatment with two times of intravenous cyclophosphamide and another steroid pulse therapy as well as PSL and cyclosporin. Addition of mycophenolate mofetil (MMF), 1...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28413685/empyema-associated-with-campylobacter-curvus-infection
#16
Yukihiro Horio, Yoshiki Shiraishi, Nobuo Watanabe, Shigeaki Inoue, Tadashi Imanishi, Koichiro Asano
We report the first case of thoracic empyema associated with Campylobacter curvus infection. A 65-year-old woman with a history of bronchiectasis presented with acute cough and phlegm. The patient reported dyspnoea and left chest pain accompanied by left pleural effusion, despite treatment with sitafloxacin. Curved Gram-negative rods, eventually identified as C. curvus using 16S ribosomal RNA- and atpA-specific polymerase chain reaction (PCR) and sequencing, were cultured in anaerobic condition of pleural effusion together with Peptostreptococci...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28392920/coexistence-of-diffuse-panbronchiolitis-and-asthma-reciprocity-of-neutrophilic-and-eosinophilic-inflammation
#17
Kiyoshi Takeyama, Yuri Shimizu, Masanobu Ishii, Hiroko Hara, Mitsuko Kondo, Jun Tamaoki
Diffuse panbronchiolitis (DPB) and asthma are obstructive airway diseases, the former being characterized by Th1-type and the latter by Th2-type airway inflammation. Differential diagnosis is often a problem, but coexistence has rarely been reported. A 76-year-old man with asthma was admitted to our hospital because of one-month history of dyspnoea on exertion with bilateral diffuse granular shadows. He also had a history of chronic sinusitis. Auscultation of the lungs showed coarse crackles and wheezes. Laboratory data revealed an elevated total serum immunoglobulin E and a high titre of cold agglutinin...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28392919/respiratory-bronchiolitis-associated-interstitial-lung-disease-secondary-to-electronic-nicotine-delivery-system-use-confirmed-with-open-lung-biopsy
#18
Mark Flower, Lakshmy Nandakumar, Mahendra Singh, David Wyld, Morgan Windsor, David Fielding
As a modern phenomenon, there is currently limited understanding of the possible toxic effects and broader implications of electronic nicotine delivery systems (ENDS). Large volumes of aerosolized particles are inhaled during "vaping" and there are now an increasing number of case reports demonstrating toxic effects of ENDS, as well as human studies demonstrating impaired lung function in users. This article presents a case of respiratory bronchiolitis interstitial lung disease (RB-ILD) precipitated by vaping in a 33-year-old male with 10 pack years of traditional cigarette and prior treatment for mixed germ cell tumour...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28361002/a-case-of-lung-abscess-successfully-treated-by-transbronchial-drainage-using-a-guide-sheath
#19
Hiroki Izumi, Masahiro Kodani, Shingo Matsumoto, Yuji Kawasaki, Tadashi Igishi, Eiji Shimizu
A 51-year-old man was diagnosed with colon cancer in September 2011, and a solitary pulmonary nodule was detected by computed tomography (CT) scan. We performed a transbronchial biopsy with endobronchial ultrasonography using a guide sheath (GS) and diagnosed lung metastasis of colon cancer. The patient experienced remittent fever after the biopsy in spite of intravenous antibiotic therapies. Moreover, his CT scan showed a large lung abscess at the biopsy site. We performed transbronchial drainage using a GS as salvage therapy...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28357112/immunoglobulin-g4-related-disease-a-rare-steroid-responsive-disease
#20
Vorawut Thanthitaweewat, Poonchavist Chantranuwatana, Naricha Chirakalwasan
A 70-year-old man presented with progressive dyspnoea and weight loss. Physical examination revealed only mild pale conjunctiva. The workup showed mild anaemia, mild impaired renal function, and high globulin level. Multiple myeloma was excluded by normal serum protein electrophoresis. The chest radiography and computed tomography (CT) revealed bilateral multifocal patchy infiltration with mediastinal adenopathy. Bronchoscopy was performed. Bronchoalveolar lavage (BAL) fluid examination was negative for infection and malignancy...
May 2017: Respirology Case Reports
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