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Respirology Case Reports

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https://www.readbyqxmd.com/read/28316788/chemical-pleurodesis-using-mistletoe-extracts-via-spray-catheter-during-medical-thoracoscopy-for-management-of-malignant-pleural-effusion
#1
Jung Seop Eom, Tae Hwa Kim, Geewon Lee, Hyo Yeong Ahn, Jeong Ha Mok, Min Ki Lee
We present three cases of successful chemical pleurodesis with a liquid solution of mistletoe extract using a spray catheter during medical thoracoscopy. The medical thoracoscopy was performed in all presented cases to remove pleural effusion and conduct chemical pleurodesis to manage symptomatic malignant pleural effusion. A spray catheter was used to instil the mistletoe extract evenly into the pleural cavity, and there were no pleurodesis-related complications. Respiratory symptoms caused by pleural effusion improved after pleurodesis, and successful pleurodesis was maintained for more than 3 months after medical thoracoscopy in all three patients...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28286654/it-s-better-to-be-lucky%C3%A2-%C3%A2-%C3%A2-successful-management-of-an-acute-endobronchial-tumour-embolism-in-the-icu-a-case-report-and-review-of-the-literature
#2
Christopher J Walsh, Ron Olivenstein, Eric Forget, Anne V Gonzalez
Endobronchial tumour embolism is a rare cause of acute central airway obstruction. It is primarily reported during pneumonectomy, and the outcome is frequently fatal. Successful management requires the urgent removal of tumour with rigid or flexible bronchoscopy. We present the case of a 62-year-old woman with poorly differentiated non-small cell lung cancer (NSCLC), referred to our institution for Nd:YAG laser photoresection of endobronchial tumour completely obstructing the right mainstem bronchus (RMSB)...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28286653/diffuse-panbronchiolitis-in-a-samoan-man
#3
Justine Gibson, Harrison King, Mahendra Singh, Khoa Tran
Diffuse panbronchiolitis (DPB) is an idiopathic inflammatory disease which is predominantly recognised in the Japanese population with only isolated case reports in Western populations. This is the first reported case of DPB in a Samoan man with typical radiological and histopathological features. He had an excellent response to long-term erythromycin and this case highlights the importance of recognising this rare disease.
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28275428/control-of-brain-metastases-with-alectinib-in-anaplastic-lymphoma-kinase-rearranged-lung-cancer
#4
Wang Chun Kwok, Terence Chi Chun Tam, Macy Mei Sze Lui, David Chi Leung Lam, James Chung Man Ho
Brain metastasis from non-small cell lung cancer remains a challenge to physicians. It occurs in 30% of patients with advanced stage adenocarcinoma of lung and is often regarded as the ominous sign of disease progression and death. Alectinib is likely to be a promising agent, even after the failure of crizotinib and ceritinib, for patients with anaplastic lymphoma kinase (ALK) -driven non-small cell lung cancer with brain metastasis, resulting in a durable response for both intracranial and extra-cranial diseases...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28261483/granulomatosis-with-polyangiitis-involving-the-epiglottis
#5
Yuya Aono, Shiro Imokawa, Tomohiro Uto, Jun Sato, Fumihiko Tanioka, Takafumi Suda
Granulomatosis with polyangiitis (GPA) frequently involves the upper respiratory tracts, but involvement of the epiglottis is extremely rare. This report describes a patient initially presenting with dysphagia and increasing stridor due to epiglottitis. Bronchoscopy showed swelling of the epiglottis with partly whitish nodular lesions, with biopsy specimens showing neutrophil infiltration and necrosis. Chest computed tomography showed multiple nodular consolidations in the bilateral lung parenchyma, and histological findings were consistent with vasculitis...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28261482/pneumonic-type-mucinous-lung-adenocarcinoma-diagnosed-by-transbronchial-cryobiopsy
#6
Rick Balestra, Akilan Selvaraju, Sadia Benzaquen, Dani S Zander
Primary lung adenocarcinoma with lepidic growth can mimic diffuse pulmonary parenchymal processes like infectious pneumonia or idiopathic inflammatory pneumonitis. We report a case of subacute pneumonitis refractory to antibiotic therapy and empirical corticosteroids, proven to be diffuse mucinous adenocarcinoma with lepidic growth on transbronchial cryobiopsy.
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28250932/edoxaban-treatment-for-pulmonary-arterial-thromboembolism-associated-with-azygous-vein-aneurysm
#7
Takao Mochimaru, Ichiro Kawada, Shotaro Chubachi, Akihiro Tsutsumi, Hanako Hasegawa, Tomoko Betsuyaku
A 76-year-old woman, diagnosed 5 years previously with an asymptomatic mediastinal bronchogenic cyst, was referred to our department as the mass had grown slightly larger. Contrast-enhanced computed tomography and magnetic resonance imaging scans revealed an azygous vein aneurysm with a pulmonary arterial thromboembolism. The patient was treated with heparin for 5 days, and anticoagulation therapy with edoxaban was continued for 12 months. The thrombus resolved, and the aneurysm remained unchanged. An azygous vein aneurysm is a very rare condition that causes pulmonary arterial thromboembolism...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28250931/chylothorax-and-central-vein-thrombosis-an-under-recognized-association-a-case-series
#8
Sze Shyang Kho, Siew Teck Tie, Swee Kim Chan, Mei Ching Yong, Sing Ling Chai, Pei Jye Voon
Chylothorax is defined as the presence of chyle in the pleural cavity. Central vein thrombosis is an under-recognized cause of chylothorax in the adult population and is commonly related to central venous catheterization. Case 1 illustrates a patient with AIDS and disseminated tuberculosis with left chylothorax and central vein thrombosis after a month of antituberculosis therapy. Case 2 was a patient with advanced seminoma who presented with left chylothorax and central vein thrombosis while on chemotherapy...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28250930/disseminated-histoplasmosis-a-rare-clinical-phenotype-with-difficult-diagnosis
#9
Xiao-Feng Xiong, Li-Li Fan, Mei Kang, Jia Wei, De-Yun Cheng
We describe a rare and interesting case of a 37-year-old man who presented with an intermittent fever, progressive cytopenia, and hepatosplenomegaly. Histopathological examination of a bone marrow smear revealed haemophagocytes and intracellular yeast-like Histoplasma capsulatum (H. capsulatum); thus, we prolonged the blood culture duration to detect fungi, and H. capsulatum was detected in the peripheral blood. After the diagnosis of disseminated histoplasmosis, the patient was successfully treated with amphotericin B and symptomatic therapy...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28250929/ambiguous-presentation-of-mycobacterium-avium-complex-associated-rasmussen-aneurysm
#10
Hsin-Wei Chiu, Shu-Hung Kuo, Ruay-Sheng Lai, Ming-Ting Wu, Hsiu-Fu Wu
A 77-year-old man with a progressively dry cough (two months duration) was admitted with hemoptysis. Chest computed tomography (CT) revealed left lingular lobe consolidation and one thick-walled cavity lesion over the left lower lobe, which was accompanied by satellite micro-nodules in a tree-in-bud pattern. CT-guided biopsy confirmed mycobacterial infection, and subsequent culture yielded Mycobacterium avium complex (MAC). Unremitting hemoptysis was present despite treatment (14 days) with ethambutol, rifampin, clarithromycin, and streptomycin...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28191315/emergency-surgery-for-lung-cancer-with-abscess-formation-after-transbronchial-biopsy
#11
Yusuke Takanashi, Koichi Miyashita, Shogo Tajima, Takamitsu Hayakawa, Hiroshi Neyatani, Kazuhito Funai
Abscess formation in lung cancer after transbronchial biopsy (TBB) is a rare complication with no standard consensus on a coping strategy or prophylaxis. We describe an instructive case of lung cancer which developed into an abscess after TBB. An 80-year-old man with poorly controlled diabetes mellitus underwent TBB for diagnosing a mass lesion in the left upper lobe. The TBB specimen confirmed a diagnosis of lung cancer, and he was scheduled for radical surgery. However, the tumour was revealed to have progressed into an enlarged abscess 24 days after TBB...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28116091/pulmonary-benign-metastasizing-leiomyoma-presented-as-acute-respiratory-distress
#12
Jean Pastré, Karine Juvin, Bertrand Grand, Laure Gibault, Judith Valcke, Dominique Israël-Biet
Benign metastasizing leiomyoma (BML) is a very rare condition and is characterized by the presence of benign smooth muscle tumours in organs distant from the uterus, most commonly the lung. It generally affects women of reproductive age and prognostic is usually excellent. However, the course of the disease is unpredictable. We report here the case of a 76-year-old woman with a previous medical history of uterine benign leiomyomas in whom BML was acutely revealed by a respiratory distress due to voluminous pulmonary and pleural leiomyomas requiring surgical extraction...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28096998/treatment-with-nintedanib-for-acute-exacerbation-of-idiopathic-pulmonary-fibrosis
#13
Hiromi Tomioka, Hirohito Takada
There is currently no effective treatment for acute exacerbation of idiopathic pulmonary fibrosis (IPF). We herein report the case of a patient with acute exacerbation of IPF which was treated with nintedanib, an intracellular inhibitor of tyrosine kinases, and showed improvement of the condition. An 84-year-old man with IPF was admitted to our hospital because of dry cough and worsening of dyspnoea within last 1 month. He presented with hypoxemia, and chest high-resolution computed tomography (HRCT) revealed new, bilateral multifocal ground-glass opacities superimposed on the background of lung fibrosis...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28096997/bronchial-tree-shaped-mucous-plug-in-cystic-fibrosis-imaging-guided-management
#14
Ignazio Salamone, Baldassare Mondello, Maria Cristina Lucanto, Simona Cristadoro, Mariangela Lombardo, Mario Barone
We report the case of a 17-year-old boy with cystic fibrosis (CF) who presented with persistent cough; after starting intravenous antibiotics for Pseudomonas aeruginosa he underwent a computed tomography (CT) scan of the chest. CT revealed extensive consolidation in the right lower lobe with relative bronchus obstruction; the cause of bronchial obstruction was detected in the mediastinal window, corresponding to a bronchial tree-shaped, thick, tenacious mucous plug. This was extracted 48 h after unresponsive bronchial washing and endobronchial instillation of rhDNAse, using foreign-body forceps, with subsequent resolution of cough...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28096996/recurrent-haemoptysis-as-a-symptom-of-severe-pulmonary-vein-stenosis-a-rare-complication-of-catheter-ablation-in-atrial-fibrillation
#15
Jan Romantowski, Krzysztof Kuziemski, Alicja Janowicz, Alicja Siemińska, Edyta Szurowska, Ewa Jassem
A pulmonary vein stenosis is a known adverse event of catheter ablation in atrial fibrillation. However, it should be considered due to high frequency of such procedures. Haemoptysis, a symptom of severe stenosis, is often misdiagnosed as other different diseases. We present a case report of a 52-year-old patient with recurrent haemoptysis, dyspnoea, and fatigue, which turned out to be complication after catheter ablation. Successful treatment with drug-eluting stent (DES) was implemented with vast clinical improvement and follow-up...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28035284/transcaval-biopsy-of-a-mediastinal-mass-compressing-the-superior-vena-cava
#16
Anthony Logaraj, Philip Edwards
Imaging-guided percutaneous chest biopsy is a commonly performed procedure and considered the minimally invasive gold standard for histopathological investigation of thoracic masses. Recognized complications include pneumothorax, air embolism, and seeding of the biopsy tract. We describe a novel approach to diagnostic sampling of a mediastinal mass in a critically unwell patient using a transjugular hepatic biopsy needle. Transcaval mediastinal biopsy may represent a safer alternative to percutaneous biopsy of mediastinal masses in critically unwell patients...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/27999676/recurrent-pneumothorax-related-to-diffuse-dendriform-pulmonary-ossification-in-genetically-predisposed-individual
#17
Amy Po Yu Tsai, John C English, Darra Murphy, Don D Sin
Diffuse pulmonary ossification (DPO) is a rare disease with unknown pathogenesis, clinical manifestations, and treatment options. This report describes the diagnosis of DPO in an otherwise healthy 26-year-old man with recurrent spontaneous pneumothorax. His father was diagnosed with a similar lung condition in his 30's with computed tomography (CT) images that were strikingly similar to those of the patient. This report suggests that DPO can induce spontaneous pneumothorax and its pathogenesis may have a possible genetic predisposition that needs further research...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/27999675/mechanical-insufflation-exsufflation-for-an-individual-with-duchenne-muscular-dystrophy-and-a-lower-respiratory-infection
#18
Emma Koenig, Bhajan Singh, Jamie Wood
Duchenne muscular dystrophy (DMD) is an X-linked recessive myopathy associated with progressive muscle weakness and wasting, loss of ambulation, respiratory insufficiency, weak cough, repeated respiratory infections, and ultimately death from respiratory failure in early adulthood. Mechanical insufflation-exsufflation (MI-E) devices, such as the CoughAssist®, are used in individuals with neuromuscular weakness to augment cough and help clear secretions; however, there is no consensus on the optimal treatment regimen...
March 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28078088/immunoglobulin-g4-related-disease-presenting-as-a-pulmonary-nodule-with-an-irregular-margin
#19
Tetsuyuki Okubo, Yumiko Oyamada, Masaya Kawada, Yo Kawarada, Shuji Kitashiro, Shunichi Okushiba
We report a case of immunoglobulin G4 (IgG4)-related lung disease presenting as a solitary pulmonary nodule with an irregular margin on computed tomography. The nodule showed a high standardized uptake value on positron emission tomography. A malignant pulmonary tumour could not be excluded. Middle lobectomy was performed. Histological analysis revealed marked lymphoplasmacytic infiltration and storiform fibrosis. Immunostaining indicated the presence of IgG4-positive plasma cells. A definitive diagnosis of IgG4-related disease was confirmed...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28078087/clostridium-difficile-infection-in-cystic-fibrosis-an-uncommon-but-life-threatening-complication
#20
Francesco Piccolo, Anna Sze Tai, Hooi Ee, Siobhain Mulrennan, Scott Bell, Gerard Ryan
Adults with cystic fibrosis (CF) have significant rates of asymptomatic Clostridium difficile carriage and are frequently exposed to risk factors for C. difficile infection (CDI). Despite this, the rate of reported CDI in CF is low. We describe three cases of near fatal CDI in adults with CF and review the literature regarding presentation, management, and recurrence prevention. Early recognition is important as the clinical presentation may be atypical and the illness can be severe and even life-threatening...
January 2017: Respirology Case Reports
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