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Respirology Case Reports

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https://www.readbyqxmd.com/read/29075498/a-saccular-superior-vena-cava-aneurysm-with-unique-diagnostic-computed-tomography-findings
#1
Tetsuya Yokoyama, Taro Setoguchi, Kazuo Sakamoto, Shun Mashimoto, Daisuke Eto, Hiroshi Wataya
A saccular superior vena cava aneurysm is a rare venous aneurysm that presents as mediastinal mass lesions. An evaluation using contrast-enhanced computed tomography is indispensable for the diagnosis.
January 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29075497/traumatic-left-main-bronchial-rupture-delayed-but-successful-outcome-of-robotic-assisted-reconstruction
#2
Hu-Lin C Wang, Cheng-Hung How, Heng-Fu Lin, Jang-Ming Lee
Tracheobronchial injuries are rare but life-threatening conditions in patients with blunt thoracic trauma. The diagnosis and management of such injury may often be delayed due to other concomitant severe injuries. No reported case of a robotic-assisted bronchial reconstruction has ever been performed for a traumatic bronchial injury. A 23-year-old male suffered from traumatic left main bronchial (LMB) rupture with an initial presentation of pneumothorax and pneumomediastinum that eventually progressed to left main bronchus fibrosis and total obstruction, which led to left lung atelectasis and consolidation...
January 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29046807/pulmonary-schistosomiasis-mimicking-igg4-related-lung-disease
#3
Timothy Baird, Caroline L Cooper, Richard Wong, Naomi Runnegar, Gregory Keir
IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterized by tumefactive lesions in various organ systems, including the lungs. Clinical and radiological manifestations of IgG4-RD are relatively non-specific, and we report a case highlighting the importance of histopathological confirmation in cases of suspected IgG4-related lung disease. A 44-year-old male with significantly elevated serum IgG4 levels, patchy consolidation on thoracic CT imaging, and cough was referred with suspected IgG4-related lung disease...
January 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29093818/the-novel-19g-endobronchial-uss-ebus-needle-samples-processed-as-tissue-core-biopsies-facilitate-pd-l1-and-other-biomarker-testing-in-lung-cancer-specimens-case-report-and-the-view-point-from-the-respiratory-physician-and-the-pathologist
#4
Samantha Herath, Wendy A Cooper
The immunohistochemical expression of Programmed Death Ligand (PD-L1) predicts responses to PD-1/PD-L1 inhibitors in non-small cell lung cancer (NSCLC). PD-L1 testing is currently only recommended on tissue specimens; however, in many patients, cytology samples are the only specimens available. The introduction of the novel 19G "core-biopsy" needle has revolutionized the utility of endobronchial USS-guided biopsy (EBUS) by providing solid tissue "microbiopsies" rather than traditional liquid cytology samples...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/29026608/diffuse-idiopathic-pulmonary-neuroendocrine-cell-hyperplasia-diagnosed-by-tranbronchoscopic-cryoprobe-biopsy-technique
#5
Ravi Patel, Carolina Collazo-Gonzalez, Arthur Andrews, Jean Johnson, Mark Rumbak, Maxwell Smith
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) remains a poorly understood clinical entity. It is currently classified as a premalignant condition by the World Health Organization (WHO). Symptoms are similar to those associated with obstructive lung disease, including breathlessness and cough. The presentation is often initially ascribed to other diseases such as asthma or chronic obstructive pulmonary disease. Here, we present what we believe is the first described case of DIPNECH diagnosed by transbronchoscopic cryoprobe biopsy...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/29026607/wheezing-and-dyspnoea-caused-by-aberrant-left-innominate-artery
#6
Masamichi Hayashi, Kazuyoshi Imaizumi, Hidekazu Hattori, Hiroshi Toyama, Mitsushi Okazawa
We present a rare case of a branching anomaly of the aortic arch that resulted in wheezing and dyspnoea. The patient was a 60-year-old male with severe wheezing from babyhood, originally diagnosed with severe bronchial asthma. On auscultation, the inspiratory and expiratory wheezes appeared when the patient leaned forward. He also had difficulty in swallowing solid mass. Tests for airway reversibility and hyperresponsiveness were negative, and asthma treatment was ineffective. He had a right aortic arch. A barium oesophagogram and endoscopic examination indicated narrowing of the oesophagus from behind...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28944061/thoracic-splenosis-diagnosis-without-invasive-investigations
#7
Kirryn Williams, Graham Simpson
This case report describes a case of thoracic splenosis. Splenosis is often interpreted as malignancy on initial imaging. Case reports described in the literature reveal that diagnosis is most often confirmed with invasive investigations. A 99 m technetium-labelled sulphur colloid scan when used with single photon emission computed tomography/computed tomography (SPECT/CT) is highly specific for splenic tissue and more readily available and time efficient than other modalities used for this purpose. Awareness of this may prevent unnecessary or dangerous invasive diagnostic procedures...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28932400/mediastinal-peripheral-t-cell-lymphoma-diagnosed-by-repeated-biopsies-after-an-initial-diagnosis-of-fibrosing-mediastinitis
#8
Naoko Kakuta, Mitsuhiro Sumitani, Arata Sugitani, Kenji Nakahama, Yuzo Miki, Seichi Syoji
We report a case of mediastinal peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) diagnosed by repeated biopsies. A 44-year-old man was admitted to our hospital with a 2-week history of facial swelling, neck distension, and dyspnoea on exertion. Computed tomography of the chest showed a mediastinal mass. Initial needle biopsy and video-assisted thoracoscopic biopsy revealed the pathological diagnosis of fibrosing mediastinitis (FM). Glucocorticoid therapy (prednisolone) was temporarily effective in reducing tumour size...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28852519/fatal-diffuse-alveolar-haemorrhage-mimicking-acute-exacerbation-in-idiopathic-pulmonary-fibrosis-treated-with-nintedanib
#9
Keishi Sugino, Yasuhiko Nakamura, Muneyuki Sekiya, Hiroshi Kobayashi, Kazutoshi Shibuya, Sakae Homma
A 75-year-old man was referred to our hospital with a 1-year history of persistent dry cough and progressive dyspnoea on exertion. He was treated with aspirin due to thrombosis of internal carotid artery. He was diagnosed with idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP), and started on inhaled N-acetylcysteine therapy and pirfenidone. Since his clinical condition progressively deteriorated after 6 months, he was switched from pirfenidone to nintedanib. As a result, his general condition worsened rapidly...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28811904/concurrence-of-nivolumab-induced-interstitial-lung-disease-and-cancer-invasion
#10
Osamu Kanai, Koichi Nakatani, Kohei Fujita, Misato Okamura, Tadashi Mio
Nivolumab improves overall survival rates of patients with advanced or recurrent non-small-cell lung cancer (NSCLC). Among immune-related adverse events caused by nivolumab, interstitial lung disease (ILD) is a clinically serious and potentially life-threatening toxicity, for which appropriate treatment is needed immediately. However, ILD is sometimes difficult to distinguish from invasive lung adenocarcinoma using only computed tomography (CT) findings. A 71-year-old man was diagnosed with advanced lung adenocarcinoma...
November 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28808575/reduced-ventilation-perfusion-v-q-mismatch-following-endobronchial-valve-insertion-demonstrated-by-gallium-68-v-q-photon-emission-tomography-computed-tomography
#11
Paul Leong, Pierre-Yves Le Roux, Jason Callahan, Shankar Siva, Michael S Hofman, Daniel P Steinfort
Endobronchial valves (EBVs) are increasingly deployed in the management of severe emphysema. Initial studies focussed on volume reduction as the mechanism, with subsequent improvement in forced expiratory volume in 1 s (FEV1). More recent studies have emphasized importance of perfusion on predicting outcomes, though findings have been inconsistent. Gallium-68 ventilation-perfusion (V/Q) photon emission tomography (PET)/computed tomography (CT) is a novel imaging modality with advantages in spatial resolution, quantitation, and speed over conventional V/Q scintigraphy...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28748094/metastatic-squamous-cell-carcinoma-of-the-lung-mimicking-multiple-bone-abscesses
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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