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Respirology Case Reports

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https://www.readbyqxmd.com/read/28748094/metastatic-squamous-cell-carcinoma-of-the-lung-mimicking-multiple-bone-abscesses
#1
Yuki Haruta, Yuki Kataoka, Hiroshi Ito, Taro Mori, Masaki Matsuo
Squamous cell carcinoma of the lung is known to metastasize to the bones, but a presentation similar to bone abscess is rare. We encountered a case with bone metastases that mimicked bone abscess, which delayed the diagnosis of squamous cell lung carcinoma. A 67-year-old man presented with a left upper lung infiltrate and lytic lesions on the left first rib and right fifth rib. In consideration of a possible infectious process, cultures of the aspirate from the right fifth rib lesion and blood were taken; however, results were non-specific...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28748093/pathological-features-of-explant-lungs-with-fibrosis-in-autoimmune-pulmonary-alveolar-proteinosis
#2
Manabu Ono, Ryoko Saito, Junya Tominaga, Yoshinori Okada, Shinya Ohkouchi, Tamiko Takemura
Association of fibrosis with autoimmune pulmonary alveolar proteinosis (aPAP) is rare. However, prognoses of such cases are poor and the process of the formation of fibrosis is still unknown. In this study, we report a case of aPAP with progressive fibrosis occurring in a 46-year-old woman. She had undergone several repetitions of whole lung lavage (WLL) for 7 years and granulocyte-macrophage colony-stimulating factor (GM-CSF) inhalation for 3 months; however, the progression of fibrosis was not hindered...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28736615/pulmonary-arteriovenous-malformations-complicated-by-splenic-infarction-and-abscess
#3
Jun Naito, Hajime Kasai, Masaki Suga, Toshihiko Sugiura, Nobuhiro Tanabe, Koichiro Tatsumi
Pulmonary arteriovenous malformation (PAVM) is an abnormal blood vessel connecting a pulmonary artery and a vein, and is accompanied by paradoxical embolism to other organs due to a right-to-left shunt. We report the case of a 66-year-old woman with PAVM complicated by splenic infarction and abscess. Although the PAVM had been detected on a chest image 2 years previously, and she had been advised to have further investigations, she decided not to follow this further at the time. She then visited our hospital complaining of worsening dyspnoea on exertion...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28736614/tracheal-granuloma-7-years-after-extubation
#4
Kazuhisa Nakashima, Tateaki Naito, Masahiro Endo, Takashi Nakajima, Toshiaki Takahashi
Tracheal granuloma can cause severe stenosis long after extubation. When a patient with a history of endobronchial intubation has an intratracheal tumour, we should consider the possibility of this condition.
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28674613/an-intimal-sarcoma-of-pulmonary-artery-mimicking-pulmonary-embolism-a-case-report-and-literature-review
#5
Xiaojing Liu, Jun Hou, Xiangdong Wang, Zhihong Chen
Pulmonary artery intimal sarcoma is a highly aggressive disease, and is most often misdiagnosed as pulmonary thromboembolism (PTE) due to the similar clinical symptoms and its rarity, which leads to the use of inappropriate treatments such as prolonged anticoagulant therapy. We reported a case of pulmonary artery intimal sarcoma in a patient who was misdiagnosed as having PTE. Pathology after surgery confirmed malignant disease. We concluded that when a patient presents with mild clinical manifestations yet with strong imaging manifestations, pulmonary artery malignancy should be suspected...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28638620/chest-pain-and-recurrent-chylothorax-an-unusual-presentation-of-malignant-pleural-mesothelioma
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
(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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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