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Respirology Case Reports

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https://www.readbyqxmd.com/read/29760926/diffuse-endobronchial-metastasis-from-sigmoid-carcinoma-presenting-as-wheezing-and-respiratory-failure
#1
Nattawat Jantarangsi, Poonchavist Chantranuwatana, Naricha Chirakalwasan
A 66-year-old Thai man with underlying asthma, history of traumatic right haemothorax, and sigmoid carcinoma with bladder invasion developed productive cough, whitish sputum, dyspnoea, and wheezing for 2 months. Physical examination showed generalized expiratory wheezing in both lungs. Computed tomography scan of the chest revealed diffuse thickening of bronchial wall, predominantly at lower lobes; several various sizes of pulmonary nodules; diffuse interlobular septal thickening; multiple enlarged mediastinal lymph nodes and hilar lymph nodes; and right pleural effusion...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29760925/methimazole-induced-anca-associated-vasculitis-with-diffuse-alveolar-haemorrhage
#2
Naoki Arai, Kenji Nemoto, Shuji Oh-Ishi, Mizu Nonaka, Kenji Hayashihara, Takefumi Saito
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) caused by methimazole (MMI) is known to be relatively rare; therefore, the optimal therapeutic approach for these cases remains to be established. A 59-year-old man who was treated with MMI for a diagnosis of Graves' disease was referred to our hospital because of progressive haemoptysis. The patient was diagnosed with diffuse alveolar haemorrhage (DAH) secondary to AAV based on increased inflammatory reactions with positive myeloperoxidase-ANCA in the serum and the results of bronchoalveolar lavage fluid...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29750110/non-specific-interstitial-pneumonia-associated-with-clinically-amyopathic-dermatomyositis-showing-crazy-paving-appearance-on-thin-section-lung-ct
#3
Yuya Aono, Tatsuru Eifuku, Tomohiro Uto, Jun Sato, Shiro Imokawa, Takafumi Suda
The "crazy paving" appearance consists of ground-glass opacity superimposed on a network of linear opacities on thin-section computed tomography (CT) images of the lung. This finding has been described in a variety of diseases but is extremely rare in patients with non-specific interstitial pneumonia (NSIP). We describe a 45-year-old woman with biopsy-proven NSIP associated with clinically amyopathic dermatomyositis that showed a "crazy paving" appearance on thin-section CT of the lung. Clinicians should include NSIP in the differential diagnosis in patients presenting with "crazy paving" appearance on thin-section chest CT...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29750109/mediastinal-cysts-with-mullerian-differentiation
#4
Hiroyuki Miura, Jun Miura, Hiroshi Hirano
Mediastinal cysts with Mullerian differentiation are characterized by oestrogen receptor and progesterone receptor positive cell linings. We treated four patients with mediastinal cysts with Mullerian differentiation. All patients were female, from 46 to 52 years old, and had BMIs greater than 26 kg/m2 . All but one patient with cough were asymptomatic. The tumours were located in the paravertebral areas around the Th-1-7 vertebrae. There was no left/right difference. All of the preoperative diagnoses were bronchial cysts...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29736241/pseudomonas-pharyngitis-in-a-cystic-fibrosis-patient
#5
Shyamala Pradeepan, Peter Wark
We report a case of Pseudomonas pharyngitis in a cystic fibrosis (CF) patient not known to have prior colonization of Pseudomonas. We believe that this is one of the first cases of pseudomonas pharyngitis in a CF patient.
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29736240/postoperative-intercostal-lung-hernia
#6
Akane Ishida, Masahide Oki, Hideo Saka, Yukio Seki
Lung hernia is a rare condition defined as the external protrusion of lung tissue from the thorax, which usually occurs after trauma or thoracic surgery. A chest computed tomography while performing the Valsalva manoeuvre is useful for a definitive diagnosis.
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29721319/successful-ventilator-weaning-following-vascular-bypass-in-patient-with-vascular-tracheobronchial-compression
#7
Kei Sonehara, Toshitaka Shomura, Masanori Yasuo, Atsuhito Ushiki, Hiroshi Yamamoto, Masayuki Hanaoka
A 74-year-old man, who had undergone thoracoplasty for tuberculous sequelae 54 years earlier, was referred to our hospital with a chief complaint of dyspnea. He had recently received mechanical ventilation due to pneumonia. However, although the pneumonia had improved, extubation was prevented by the presence of hypercapnic respiratory failure with tracheal stenosis due to compression of the right aortic arch and the left common carotid artery. Bypass surgery was performed, during which the left subclavian artery was placed over the left common carotid artery...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29721318/central-airway-obstruction-caused-by-adenoid-cystic-carcinoma-in-pregnancy-a-case-report-and-review-of-the-literature
#8
Samaneh Shafiee, Alan Adno, Bruce French, Cherynne Johansson, Anthony Frankel, Jonathan P Williamson
Malignancy complicates one in a thousand pregnancies. The most frequently diagnosed of these are breast, cervical, melanoma, ovarian, and haematological neoplasms. Tumours of respiratory origin are very uncommon during pregnancy. We present a case of tracheal adenoid cystic carcinoma (ACC), a rare type of primary airway tumour, diagnosed in a pregnant woman. To our knowledge, this is the third reported case of tracheal ACC complicating pregnancy. We discuss potential barriers to timely diagnosis of malignancies during pregnancy and consider optimal management strategies, taking into account the potential harm to the mother and foetus in a field with a limited evidence base...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29686875/nivolumab-induced-sialadenitis
#9
Saeko Takahashi, Xu Chieko, Tetsuya Sakai, Shigemichi Hirose, Morio Nakamura
Nivolumab has been increasingly used for a range of malignancies, and a variety of immune-related adverse events (irAEs) have been reported with its use. Nivolumab-induced sialadenitis (inflammation of salivary glands) and xerostomia (dry mouth) have been reported to occur in 0.03% and 0.05% respectively, but there have been no case reports published about these side effects. Sialadenitis is not a life-threatening irAEs, but xerostomia can become irreversible if not recognized and treated as it can otherwise lower quality of life and result in susceptibility to infection...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29657718/endotracheal-tube-clamping-and-extracorporeal-membrane-oxygenation-to-resuscitate-massive-pulmonary-haemorrhage
#10
Chien-Feng Lee, Chun-Ta Huang, Sheng-Yuan Ruan
Massive pulmonary haemorrhage is a life-threatening and difficult-to-manage condition. In certain circumstances, traditional approaches for haemoptysis may not be effective. Here, we report a 64-year-old man presenting with dyspnoea and leg oedema. He was diagnosed with microscopic polyangiitis due to positive perinuclear anti-neutrophil cytoplasmic antibody and other supportive evidence. His hospital course was complicated with massive pulmonary haemorrhage, which led to hypoxic respiratory failure, shock, and pulseless electrical activity...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29657717/closure-of-a-bronchopleural-fistula-complicating-cryoprobe-biopsy-of-the-lung
#11
Rahul H Mehta, Jeffrey Hoag, Amit Borah, Emil Abramian
Cryoprobe biopsies are routinely performed by the interventional pulmonologist. Diagnostic yields are larger, with complication rates that are equal to or lower than that of traditional forceps biopsies. We will specifically evaluate one instance where a cryoprobe biopsy led to an alveolo-pleural fistula that did not resolve with simple tube thoracostomy. An endobronchial valve was placed and successfully resolved the pneumothorax and persistent air leak.
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29619223/respiratory-exacerbation-in-a-young-adult-with-cystic-fibrosis-and-tricuspid-atresia
#12
Jamie Wood, Abbey Sawyer, Siobhain Mulrennan, Andrew Bullock
Tricuspid atresia (TAt) is a complex congenital heart defect (CHD) characterized by the absence of the tricuspid valve and right ventricular hypoplasia requiring surgery in childhood, the Fontan procedure. We present a case of a 21-year-old male with TAt and cystic fibrosis (CF), who underwent a Fontan procedure in childhood, presenting to an adult CF clinic with severe deterioration in his respiratory status and multi-organ dysfunction associated with CF. This report describes problems associated with the management of a CF respiratory exacerbation and extrapulmonary manifestations of CF in the unique situation of a Fontan circulation, a circulation with absence of a subpulmonary ventricle and pulsatile pulmonary arterial blood flow where maintenance of systemic cardiac output is totally dependent on good respiratory function and low pulmonary artery pressures...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29619222/laryngomalacia-presenting-as-severe-uncontrolled-asthma
#13
Kanami Tamura, Toshihiro Shirai, Aya Matsubara
Congenital laryngomalacia is the most common cause of stridor in infants and usually resolves without therapy by 12-18 months of age. However, a recent study found that laryngomalacia may leave structural and functional traces with increased risk of later respiratory symptoms, suggesting that late-onset laryngomalacia may represent long-term consequences of milder or even undiagnosed forms. Unusual cases demonstrated that inspiratory stridor developed subsequent to upper respiratory tract infections. The lack of airway hyperresponsiveness in adulthood also raised questions regarding the diagnosis of childhood asthma...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29619221/primary-racemose-hemangioma-with-bronchial-pulmonary-arterial-fistula
#14
Atsushi Ito, Motoshi Takao, Akira Shimamoto, Hideto Shimpo
Primary racemose hemangioma with bronchial-pulmonary arterial fistula is a very rare abnormality. We herein report an asymptomatic case of primary racemose hemangioma with no significant size change in 5 years.
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29564136/safety-of-nintedanib-before-lung-transplant-an-italian-case-series
#15
Elisabetta Balestro, Paolo Solidoro, Piercarlo Parigi, Massimo Boffini, Alessandro Lucianetti, Federico Rea
Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal disease that can only be cured by lung transplantation. Pharmacological agents play a role in preserving lung function and prolonging survival until a suitable donor organ becomes available. However, data on the effects of newer antifibrotic therapies on lung transplantation outcomes in IPF patients are lacking. The nine patients included in this case series were treated with nintedanib 150 mg twice daily for 3-30 (mean 13 ± 9) months before lung transplant surgery...
May 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29507727/rapid-diffuse-pleural-thickening-due-to-metastatic-meningioma
#16
Fumi Kobayashi, Takeshi Saraya, Kosuke Ohkuma, Masachika Fujiwara, Hajime Takizawa
A 64-year-old man was referred to our hospital because of persistent dyspnoea for the past 1 month. He had recurrent brain anaplastic meningioma after two operations and irradiation. He suffered from right pleural effusion in the previous few months and was diagnosed with malignant mesothelioma via pleural biopsy 1 month prior to coming to our hospital. At his first visit to our hospital, thoracic computed tomography demonstrated rapidly developed large inhomogeneously enhancing pleural thickening up to 3 cm, which surrounded the right hemithorax, together with left-sided pleural effusion...
May 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29507726/report-on-the-breakage-of-the-tip-of-a-radial-endobronchial-ultrasonic-probe-sheath-during-bronchoscopy
#17
Daizo Yaguchi, Motoshi Ichikawa, Noriko Inoue, Daisuke Kobayashi, Masato Shizu, Naoyuki Imai
A lesion in a 73-year-old woman that was suspected to be right lung cancer was biopsied under ultrasound-guided bronchoscopy with a guide sheath. The procedure was completed without a noticeable problem, but after 3 days, it was found that the tip of the ultrasonic probe sheath was broken and that the broken fragment was missing. Based on the concern that the fragment had been left in the lung, the patient was examined by computed tomography scan 4 days after the biopsy, and bronchoscopy was repeated 38 days after the biopsy, but no fragment was detected...
May 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29507725/desmoid-fibromatosis-of-the-chest-wall
#18
QiHao Ong, Janice Wong, Sanjay Sinha, Nand Kejriwal
We report a case of desmoid fibromatosis of the chest wall. A 70-year-old woman was referred to our hospital with right shoulder blade pain and paresthesia over the right upper breast. Chest X-ray and computed tomography demonstrated a 5 cm right apical mass in the chest. Biopsy of the mass demonstrated features of desmoid fibromatosis. The patient subsequently underwent surgical resection of the mass and received adjuvant radiation therapy for microscopic positive margins. In conclusion, although desmoid tumour of the chest is rare, it is worth considering in the differential diagnoses of chest wall tumours...
May 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29507724/respiratory-failure-patient-with-lung-cancer-diagnosed-by-transesophageal-bronchoscopic-ultrasound-guided-aspirates
#19
Takayasu Ito, Masahide Oki, Hideo Saka, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka
A 71-year-old man, who had received long-term oxygen therapy for respiratory failure caused by chronic obstructive pulmonary disease, had an enlarged mediastinal lymph node for one year. As his lung function was poor, we tried performing endobronchial ultrasound-guided transbronchial needle aspiration under non-invasive positive pressure ventilation for diagnosis but could not obtain sufficient specimens. Later, we performed an endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) using a transesophageal approach...
May 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29507723/extrapleural-pneumonectomy-of-recurrent-thymoma-with-pleural-dissemination
#20
Haruhiko Shiiya, Yasuhiro Hida, Kichizo Kaga, Rei Inoue, Reiko Nakada-Kubota, Yoshiro Matsui
Complete surgical resection has been considered the only curable treatment for thymoma. The efficacy of extrapleural pneumonectomy (EPP) for stage IV thymomas remains controversial. In this case report, we utilize EPP for recurrent thymoma with pleural dissemination and describe the resulting outcome. A 39-year-old female with a history of thoracoscopic thymectomy for type B2 thymoma was referred to our hospital for a recurrence of thymoma with pleural dissemination. She underwent EPP as a radical surgery. Histopathological investigation revealed complete resection...
May 2018: Respirology Case Reports
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