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Respiratory Medicine Case Reports

Takayuki Shiroyama, Shingo Nasu, Ayako Tanaka, So Takata, Kentaro Masuhiro, Hiromune Takada, Satomu Morita, Naoko Morishita, Hidekazu Suzuki, Norio Okamoto, Kunimitsu Kawahara, Tomonori Hirashima
Acquiring resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) is inevitable. Transformation to small cell lung cancer (SCLC) is reported as a possible mechanism of this acquired resistance. We describe the case of a 35-year-old man with lung adenocarcinoma harboring EGFR exon 19 deletion. After 7 months of successful treatment with afatinib, he experienced relapse and rebiopsy revealed SCLC with EGFR exon 19 deletion. Tumor marker tests at this point showed normal levels of serum neuron-specific enolase and pro-gastrin releasing peptide...
2018: Respiratory Medicine Case Reports
Konstantinos Sapalidis, Christoforos Kosmidis, Nikolaos Michalopoulos, Charilaos Koulouris, Stylianos Mantalobas, Dimitrios Giannakidis, Alexandru Munteanu, Valeriu Surlin, Stella Laskou, Paul Zarogoulidis, Dimitrios Drougas, Crysanthi Sardeli, Chrysanthi Karapantzou, Ilias Karapantzos, Wolfgang Hohenforst-Schmidt, Haidong Huang, Isaak Kesisoglou
Nowadays we have novel equipment for lung cancer diagnosis, however; due to lack of symptoms, lung cancer is still diagnosed at a late stage. Currently we have the following therapies for non-small cell lung cancer: a) non-specific cytotoxic agents, b) targeted therapies and c) immunotherapy. Each therapy has its own advantages and adverse effects. In the current case we will present a rare case of psoriacic arthritis that was presented after two cycles of nivolumab administration and we will also present a review of the literature...
2018: Respiratory Medicine Case Reports
Takuto Sueyasu, Kazunori Tobino, Masanobu Okahisa, Kojin Murakami, Yuki Goto, Miyuki Munechika, Kohei Yoshimine, Saori Nishizawa, Yuki Ko, Yuki Yoshimatsu, Mina Asaji, Kosuke Tsuruno, Hiromi Ide, Hiroyuki Miyajima
Peripheral T cell lymphoma not otherwise specified (PTCL-NOS) is a rare entity of lymphoma. We herein report an even rarer case of a 68-year-old male with PTCL-NOS presenting as an endobronchial lesion, and review previously published cases in the literature. Initially, he was referred to our hospital for further investigation of the right upper lobe consolidation on chest radiograph. Computed tomography and 18F-fludeoxyglucose positron emission tomography revealed a right hilar mass with obstruction of the main bronchus and submandibular, right axillary and mediastinal lymphadenopathy...
2018: Respiratory Medicine Case Reports
P El Boustany, R Epaud, C Grosse, F Barriere, E Grimont-Rolland, A Carsin, J C Dubus
Homozygous or compound heterozygous for frameshift or nonsense mutations in the ATP-binding cassette transporter A3 (ABCA3) is associated with neonatal respiratory failure and death within the first year of life without lung transplantation. We report the case of a newborn baby girl who developed severe respiratory distress soon after birth. She was diagnosed with compound heterozygous frameshift mutation of the ABCA3 gene. Despite extensive treatment (intravenous corticosteroids pulse therapy, oral corticosteroids, azithromycin, and hydroxychloroquine), she developed chronic respiratory failure...
2018: Respiratory Medicine Case Reports
Naureen Narula, Faraz Siddiqui, Abdul Hasan Siddiqui, Wai C Man, Michel Chalhoub
The purpose of this article is to report a case of secondary tension pneumothorax presenting seven weeks post Transbronchial Lung biopsy. A 62 year old male with a known history of germ cell tumor was found to have a left-sided pneumothorax which later complicated to a tension pneumothorax.To the best of our knowledge this is the second case being reported for a delayed pneumothorax post a Transbronchial Lung Biopsy .The purpose of this case report is to create awareness among physicians to consider this diagnosis even at a later stage and the importance of patient education regarding the signs and symptoms of pneumothorax...
2018: Respiratory Medicine Case Reports
Marta E Gajewska, Sajitha S Sritharan, Eric Santoni-Rugiu, Elisabeth M Bendstrup
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare parenchymal lung disease characterized by accumulation of surfactant in the airways with high levels of granulocyte-macrophage colony stimulating factor (GM-CSF) antibodies in blood. Disease leads to hypoxemic respiratory failure. Whole lung lavage (WLL) is considered the first line therapy, but procedure can be quite demanding, specifically for children. Recently alternative treatment options with inhaled GM-CSF have been described but no consensus about the standard treatment exists...
2018: Respiratory Medicine Case Reports
Amos Lal, Jamal Akhtar, Mohammad Saud Khan, Yayan Chen, Yaron Goldman
Primary localized endobronchial amyloidosis is a rare entity, as pulmonary amyloidosis most commonly occurs as a part of systemic AL amyloidosis. It can be asymptomatic or can present with nonspecific symptoms such as progressive dyspnea, cough, wheezing and rarely respiratory failure. It is frequently misdiagnosed as asthma, COPD or pneumonia. Solitary endobronchial amyloidosis having a nodular appearance can mimic endobronchial tumor. The diagnosis is usually delayed by 8-37 months. The average life expectancy for primary tracheobronchial amyloidosis is approximately 9 years, so the early diagnosis of this disease is very critical to improve the prognosis of patients...
2018: Respiratory Medicine Case Reports
Muhammad Fachri, Mochammad Hatta, Sahlan Abadi, Slamet Sudi Santoso, Tri Ariguntar Wikanningtyas, Amir Syarifuddin, Ressy Dwiyanti, Rizki Amelia Noviyanthi
Background: According to the Global Tuberculosis Report 2015, Indonesia ranked as second country in the world with the highest number of pulmonary tuberculosis cases. By 2015, the number of pulmonary TB new cases in Indonesia has increased to 330.910 cases of 2014 where 324.539 cases. DM is one of the most important factors that influence the occurrence worsening TB. Now is known that DM patients have body's immune response disorder thereby facilitating M. tuberculosis infection and causing TB...
2018: Respiratory Medicine Case Reports
William W Storms, Judi E Miller
We report an improvement in symptoms and quality of life with long-term use of guaifenesin for the treatment of mucus-related symptoms in a patient with chronic bronchitis, who presented with mucus hypersecretion, cough and dyspnea.
2018: Respiratory Medicine Case Reports
Nadia Sattar, Richard Durrance, Ahmed Khan, Nilesh Patel, Maximo Mora, Artur Shalonov
Malignant Pleural Mesothelioma (MPM) is a rare pleural malignancy, with a vague presentation complicated by a decades-long latency period between environmental exposure and clinical manifestations. Spontaneous hydro-pneumothorax is a rare presentation of MPM, most often requiring invasive tissue biopsy to confirm the etiologic diagnosis. We present the case of 79-year-old male smoker with no documented history of asbestos exposure, who was found to have MPM after presenting with dyspnea and subsequently found to have recurrent hydro-pneumothorax...
2018: Respiratory Medicine Case Reports
Lakshmi Saladi, Swati Roy, Gilda Diaz-Fuentes
Unilateral pulmonary artery agenesis (UPAA) is a rare malformation that can present as an isolated anomaly or may be associated with certain congenital cardiac anomalies, such as tetralogy of Fallot, atrial septal defect, coarctation of aorta, right aortic arch, truncus arteriosus and pulmonary atresia. Clinical presentation is non-specific which makes the diagnosis elusive; chronic dyspnea, hemoptysis or recurrent infections are the most common manifestations. Patients may remain asymptomatic until adulthood...
2018: Respiratory Medicine Case Reports
Cora Legarreta, Javier Brea Folco, Diego Burgos, Santiago Arce, Carlos Luna
Diaphragmatic paralysis is an uncommon cause of pulmonary dysfunction and can occur after traumatic phrenic nerve injury. Penetrating and blunt trauma to the neck is the most recognized mechanism of injury being stretching of the nerves very uncommon. We report a case of a 39-year-old man with bilateral diaphragmatic paralysis due to violent stretching of the phrenic nerves. Clinical features and diagnosis methods are also reviewed.
2018: Respiratory Medicine Case Reports
Ranjit Kumar Singh, Sanjib Pattari
This case presentation relates to a 21 year young male, cachectic in appearance, who presented with progressive shortness of breath, and dull pain on the lower part of the chest ongoing over three months. The patient received antitubercular drugs by local physician for suspected tuberculosis with no significant improvement. He was referred to our Respiratory Department for further evaluation of his chest pain and breathlessness. His X-ray showed moderate pleural effusion on the left side which confirmed by USG chest screening which showed multiple septation with thick parietal pleura and USG abdomen was normal...
2018: Respiratory Medicine Case Reports
Yannick Vande Weygaerde, Charlot Versteele, Elke Thijs, Anton De Spiegeleer, Jerina Boelens, Daisy Vanrompay, Eva Van Braeckel, Karim Vermaelen
Background: Chlamydia psittaci is a gram-negative, obligate intracellular organism. Birds are the main reservoir, but also non-avian domestic animals and humans can be infected. In humans it mostly causes respiratory infections due to occupational exposure with varying severity. Sensitive and specific diagnostic tests are needed to define psittacosis in humans as these tests also allow rapid tracing of the animal source. However, diagnosis in humans is often based on time-consuming culture techniques and antibody detection assays as in many countries, the existing molecular diagnostic tests for psittacosis are not reimbursed by the public health insurance...
2018: Respiratory Medicine Case Reports
Jamal Akhtar, Amos Lal, Kevin B Martin, Joel Popkin
A 55 year old male presented with a complaint of dyspnea and non productive cough. He was found to have right paratracheal opacity on Chest X ray. Chest CT scan revealed right sided azygos lobe. An azygos lobe is a rare congenital variant of the right lung, usually diagnosed as an incidental finding.
2018: Respiratory Medicine Case Reports
Hideyuki Niwa, Sakiko Otani, Norihiro Nakada, Jiichiro Sasaki, Hideo Saka, Noriyuki Masuda
Carcinosarcoma is a rare histological type of non-small cell carcinoma (NSCLC), and its prognosis has been reported to be worse compared with other NSCLCs. Nanoparticle albumin-bound paclitaxel (nab-PTX) + carboplatin (CBDCA) achieves a favorable response rate in patients with non-small cell lung cancer (NSCLC). We administered nab-PTX + CBDCA to a 68-year-old man with postoperative recurrent carcinosarcoma with interstitial lung disease (ILD). A partial response was evident after four cycles of chemotherapy...
2018: Respiratory Medicine Case Reports
Ranjit Singh, Tiyas Sen, Sanjeev Pattari
Amyloidosis is a condition wherein there is an over-expression of specific proteins culminating in the extracellular deposition of insoluble beta pleated sheets of fibres. These deposits disrupt function of the target organ. Its aetiology remains unknown. Primary Amyloidosis localized to the trachea and bronchus is a rare entity. It produces tumour like lesion in the tracheo-bronchial tree. We hereby discuss a patient who presented with persistent hoarseness of voice who was referred to a tertiary care centre to rule out malignancy...
2018: Respiratory Medicine Case Reports
Konstantinos Sapalidis, Christoforos Kosmidis, Stella Laskou, Paul Zarogoulidis, Ilias Karapantzos, Chrysa Karapantzou, Anastasios Kallianos, Wolfgang Hohenforst-Schmidt, Michael Karanikas, Vasilis Thomaidis, Haidong Huang, Chong Bai, Isaak Kesisoglou
Nowadays we use novel diagnostic equipment for lung cancer. Bronchoscopy was the tip of the arrow for diagnosis, however; ultrasound systems have brought a revolution. We have the radial-endobronchial ultrasound for peripheral lesions and the convex probe endobronchial ultrasound for central lesions. Ultrasound endoscopic systems can be used for the diagnosis of any lesion that can be approached from the airways. In the current manuscript we will present two methods for the biopsy of thyroid gland. The first method is using anesthisiological tools and the second tools from the ear, nose and throat department...
2018: Respiratory Medicine Case Reports
Chi Chan Lee, Osman Perez, Faryal I Farooqi, Trupti Akella, Sameer Shaharyar, Melissa Elizee
Intravenous sedation during colonoscopy has become the standard practice in the United States given its higher patient satisfaction and procedural quality. This practice is not free of side effects as a significant proportion of patients undergoing this procedure tend to have respiratory depression and desaturation events. Obesity, as it relates to higher levels of body mass index (BMI) has a positive correlation with the incidence of hypoxemia. During colonoscopy High flow nasal cannula (HFNC) may potentially improve oxygen performance in patients receiving colonoscopy under intravenous sedation...
2018: Respiratory Medicine Case Reports
Debapriya Datta, Daniel A Gerardi, Bimalin Lahiri
Angiosarcomas are malignant vascular tumors. Angiosarcomas arising in the thorax such as angiosarcoma of the lungs, heart and mediastinum are extremely rare. There are no reports of mediastinal angiosarcomas presenting with diffuse alveolar hemorrhage, which is a clinical syndrome characterized by the presence of hemoptysis, dyspnea, hypoxia, diffuse lung infiltrates and anemia. Usually, diffuse alveolar hemorrhage is caused by pulmonary capillaritis. Local invasion is more common with these tumors than distant metastasis...
2018: Respiratory Medicine Case Reports
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