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Respirology Case Reports

Ryoko Oi, Hisashi Saji, Hideki Marushima, Ichiro Maeda, Masayuki Takagi, Haruhiko Nakamura
Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare malignant tumour with histological features similar to undifferentiated nasopharyngeal carcinoma. A close association is known to exist between pulmonary LELC and Epstein-Barr virus infection in Southeast Asian countries. We report a 69-year-old man with pulmonary LELC arising from a thin-walled cavity with a smooth inner surface and characterized by an unexpectedly rapid progression.
September 2016: Respirology Case Reports
Shinichi Okuzumi, Naoto Minematsu, Mamoru Sasaki, Kazuma Ohsawa, Marohito Murakami
Mycobacterium avium complex (MAC) infection is a major medical concern in Japan because of its increased prevalence and associated mortality. A common radiological feature in pulmonary MAC infection is a mixture of two basic patterns: fibrocavitary and nodular bronchiectatic; however, lobar consolidation is rare. We report an 83-year-old man with lobar caseous pneumonia caused by pulmonary MAC infection. Radiological findings were predominantly composed of dense lobar consolidation and ground-glass opacity...
September 2016: Respirology Case Reports
Takamitsu Hayakawa, Shogo Tajima, Yusuke Takanashi, Tsuyoshi Takahashi, Hiroshi Neyatani, Kazuhito Funai
A case of sarcomatoid malignant pleural mesothelioma showing extremely rare growth pattern is described. A 63-year-old man presented to our hospital with left pleural effusion. A computed tomography (CT) scan of the chest showed diffusely thickened left visceral and parietal pleura associated with intermingled pulmonary infiltrative shadowing. Biopsy of the pleura under general anaesthesia confirmed the diagnosis of sarcomatoid malignant pleural mesothelioma. The patient underwent left extra-pleural pneumonectomy...
September 2016: Respirology Case Reports
Shunsuke Sugimoto, Jiro Terada, Akira Naito, Rintaro Nishimura, Kenji Tsushima, Koichiro Tatsumi
Idiopathic pulmonary haemosiderosis (IPH) is a rare cause of diffuse alveolar haemorrhage during childhood, and its precise pathophysiology and long-term clinical course remain unclear. A 31-year-old man was diagnosed with IPH at four years of age and had recurrent episodes of haemoptysis. The patient's symptoms responded well to steroids. However, pulmonary fibrosis and the cystic region in the lung progressively worsened. At age 27, the patient developed polyarthritis with positive anti-cyclic citrullinated peptide antibodies...
September 2016: Respirology Case Reports
Kentaro Sakashita, Kengo Murata, Yuji Inagaki, Souichi Oota, Mikio Takamori
Thrombocytopenia (T), anasarca (A), myelofibrosis (F), renal dysfunction (R), and organomegaly (O) (TAFRO) syndrome is a variant of multicentric Castleman's disease. We describe here a 57-year-old man who presented with persistent fever, pleural effusion, and ascites. He was negative for human immunodeficiency virus and human herpes virus-8. A computed tomography scan showed an anterior mediastinal mass and small inguinal lymphadenopathy. Although a biopsy of the anterior mediastinum showed fatty tissue infiltrated with CD20 (+) and CD45RO (+) lymphocytes, a biopsy of the left inguinal lymph node revealed a hyaline vascular type of Castleman's disease...
September 2016: Respirology Case Reports
Takamasa Hotta, Yukari Tsubata, Tamio Okimoto, Teppei Hoshino, Shun-Ichi Hamaguchi, Takeshi Isobe
Exogenous lipoid pneumonia is caused by aspiration or inhalation of oily substances. Generally, lipoid pneumonia has non-specific clinical and radiological presentations and may be misdiagnosed as bacterial pneumonia. Our patient, a 68-year-old man who had been diagnosed with pneumonia on three previous occasions, was admitted to our hospital with a fourth similar episode. Computed tomography of the chest revealed extensive consolidations with air bronchograms in lung fields on the right side. The bronchoalveolar lavage fluid (BALF) increased ghost-like macrophages that stained positive for lipid...
September 2016: Respirology Case Reports
Timothy Baird, Michael Putt, Andrew Dettrick
We present the case of a 26-year-old stonemason with accelerated silicosis in the setting of treatment for psoriasis with the tumour necrosis factor alpha (TNF-alpha) inhibitor adalimumab. Accelerated silicosis is an important occupational lung disease with a poor prognosis and limited treatment options [1]. Although the exact pathogenesis remains unknown, it is suggested that secretion of cytokines, including TNF-alpha, plays a central role in disease progression [1,2]. Importantly, however, TNF-alpha inhibitors, in addition to resulting in an increased risk of infection, are also now being seen to cause interstitial lung disease [3,4]...
September 2016: Respirology Case Reports
Wang C Kwok, Sonia H Y Lam, Maria P Wong, Mary S M Ip, David C L Lam
Organizing pneumonia is a rare complication of influenza infection that has substantial morbidity. We report the first case of organizing pneumonia associated with influenza B and Streptococcus pneumoniae coinfection that had significant improvement with corticosteroid treatment. The clinical and radiological features of organizing pneumonia associated with this coinfection are similar to those after influenza A infection. Timely use of systemic glucocorticosteroids would be of benefit in promoting resolution for influenza-associated organizing pneumonia...
September 2016: Respirology Case Reports
(no author information available yet)
[This corrects the article DOI: 10.1002/rcr2.167.].
July 2016: Respirology Case Reports
Tetsuro Sawata, Masashi Bando, Masayuki Nakayama, Naoko Mato, Tamiko Takemura, Yukihiko Sugiyama
Pulmonary sarcoidosis is reported to have complication of lymphoproliferative disease such as malignant lymphoma, but the complication of multicentric Castleman's disease (MCD) is rarely reported. In our case of a 60-year-old woman, bilateral hilar lymphadenopathy was noted in her chest X-ray. We performed a transbronchial lung biopsy. She was diagnosed as having pulmonary sarcoidosis (Stage II). The shadow on chest X-ray disappeared without treatment. However, after 8 years, swelling of the mediastinal and abdominal lymph node, thickened bronchovascular bundle, and multiple nodular shadows were identified, and a thoracoscopic lung biopsy was performed...
July 2016: Respirology Case Reports
Yasushi Murakami, Masahide Oki, Hideo Saka, Shigehisa Kajikawa, Ayuka Murakami, Akane Ishida
We herein report a rare case of disseminated cryptococcosis presenting as mediastinal and hilar lymphadenopathy in a young immunocompetent man. A previously healthy 26-year-old man presented with persistent headache and nonproductive cough. Chest computed tomography indicated mediastinal and hilar lymphadenopathy. Cryptococcal lymphadenitis and meningitis was confirmed by endobronchial ultrasound-guided transbronchial needle aspiration and central spinal fluid examination, respectively. He received liposomal amphotericin B and flucytosine followed by fluconazole and finally improved...
July 2016: Respirology Case Reports
Yusuke Takanashi, Takamitsu Hayakawa, Hiroshi Neyatani, Kazuhito Funai
Descending necrotizing mediastinitis (DNM) is a potentially lethal disease that originates from a deep neck infection (DNI); it is often associated with an immunocompromised state. Hyperimmunoglobulin E syndrome (HIES) is an extremely rare complex immune deficiency characterized by recurrent abscesses of staphylococcal etiology. A rare case of a 34-year-old woman wherein HIES putatively promoted the development of DNI into DNM is described. She presented with cervical purulent lymphadenitis and retropharyngeal abscess...
July 2016: Respirology Case Reports
Naoki Shiota, Makoto Furonaka, Kazuya Kikutani, Keiko Haji, Seiji Fujisaki, Toshihiro Nishida
Peritoneal disseminations from lung cancer are difficult to detect during the patient's clinical course. Therefore, complications of this condition are unclear. We report a case in which peritoneal dissemination from lung cancer complicated appendicitis. A 74-year-old man with lung cancer who was receiving maintenance therapy presented at our hospital because of abdominal pain. It was the seventh day after the 14th cycle of maintenance therapy with bevacizumab. He was diagnosed with acute appendicitis. The resected appendix showed acute appendicitis complicated by appendiceal metastasis from lung cancer...
July 2016: Respirology Case Reports
Anuk Kruavit, Mukesh Jain, David Fielding, Subash Heraganahally
The phenomenon of exercise-induced hemoptysis is still relatively underrecognised in humans. We report a case of recurrent hemoptysis brought on by vigorous exercise. A 33-year-old male presented with several episodes of intermittent fresh small-volume hemoptysis reproducible on vigorous exercise. There was no other significant medical history other than a past history of testicular tumor, treated with orchidectomy and adjuvant Bleomycin-based chemotherapy 1 year prior to onset of symptoms. Computed tomography scan showed no major abnormalities other than few small bilateral non-specific nodules...
July 2016: Respirology Case Reports
Lam Nguyen Ho, Ngoc Tran Van, Thuong Vu Le
Boerhaave's syndrome is a rare and severe condition with high mortality partly because of its atypical presentation resulting in delayed diagnosis and management. Diagnostic clues play an important role in the approach to this syndrome. Here, we report a 48 year-old male patient hospitalized with fever and left chest pain radiating into the interscapular area. Two chest radiographs undertaken 22 h apart showed a rapidly developing tension hydropneumothorax. The amylase level in the pleural fluid was high...
July 2016: Respirology Case Reports
Joy Sha, David Langton
Pulmonary alveolar proteinosis (PAP) is a rare diffuse lung disease characterized by accumulation of lipoproteinacious material in alveoli, with distinct features on high resolution computed tomography and biopsy. Its association with pulmonary fibrosis is infrequently encountered, and a clear understanding of the underlying pathogenesis is yet to be established. We report the case of a 48-year-old woman with known autoimmune PAP (aPAP) first diagnosed 20 years ago, who presented with worsening hypoxemia and radiological features consistent with pulmonary fibrosis, after many years of stable disease...
July 2016: Respirology Case Reports
Lorraine Thong, Barry J Plant, Julie McCarthy, Desmond M Murphy
A 58-year old lady under active follow-up with the respiratory services at our institution for bronchiectasis secondary to hypogammaglobulinaemia presented with hoarseness and haemoptysis. She was also receiving rituximab maintenance therapy for follicular lymphoma. Bronchoscopy demonstrated vesicular lesions on her vocal cords and trachea, confirmed as herpes simplex virus (HSV) on cytological analysis of brushings. She responded well to intravenous valacyclovir. Rituximab is increasingly utilised in the treatment of haematological and auto-immune disorders...
July 2016: Respirology Case Reports
Manabu Hayama, Shingo Sato, Takayuki Shiroyama, Takuji Nishida, Takashi Nishihara, Norio Okamoto
A 68-year-old woman with interstitial lung disease related to dermatomyositis and systemic scleroderma was admitted to our hospital with fever and dyspnoea. Although the fever was reduced after antibiotic therapy, a left pneumothorax suddenly occurred on day 27 after admission. A continuous air leak persisted despite chest drainage with three tubes and repeated pleurodesis. Chest computed tomography (CT) images showed a cavitary lesion with a pinhole in the left upper division, which was suspected to be the affected lesion with the air leak...
July 2016: Respirology Case Reports
(no author information available yet)
[This corrects the article DOI: 10.1111/rcr2.151.].
July 2016: Respirology Case Reports
Satoru Fujiuchi, Yuka Fujita, Takaaki Sasaki, Yoshinobu Ohsaki
A 70-year-old woman with lung adenocarcinoma, harbouring anaplastic lymphoma kinase gene rearrangement, was treated with crizotinib as third-line chemotherapy. After 2 months, crizotinib was discontinued because of the development of crizotinib-induced interstitial lung disease (ILD). Steroid treatment was then introduced and tapered off. Following complete resolution of the interstitial shadow, cytotoxic chemotherapy was initiated, and continued for over 2 years, until new intrapulmonary lesions developed...
May 2016: Respirology Case Reports
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