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Respiratory Medicine Case Reports

Naureen Narula, Sam Ngu, Dikshya Sharma, Faraz Siddiqui, Michel Chalhoub
Placental transmogrification of the lung (PTL) is a rare benign pulmonary lesion resembling chorionic villi. With fewer than 40 cases reported in literature, associations have thus far been made with bullous emphysema, pulmonary fibrochondromatous hamartomas and adenocarcinoma of the lung. Typically presenting as unilateral solitary cystic or bullous lesion, we report the first case of PTL presenting with unilateral pleural effusion. A 70-year-old male presented with recurrent unilateral pleural effusion that failed to resolve with multiple thoracenteses...
2019: Respiratory Medicine Case Reports
Marwa Kacem, Nidhal Belloumi, Imene Bachouche, Mariem Mersni, Fatma Chermiti Ben Abdallah, Soraya Fenniche
Introduction: Paraneoplastic limbic encephalitis is a rare disease, usually associated with small cell lung cancer. Case report: We report in this publication the cases with different age brackets, who presented with various neurological symptoms such as repetitive seizures or anterograde amnesia. Cerebral CT-scan, cerebral MRI and anti onco-neural paraneoplastic antibodies were suggesting the diagnosis of paraneoplastic limbic encephalitis. Etiological exploration lead to the diagnosis of locally advanced small cell carcinoma of the lung...
2019: Respiratory Medicine Case Reports
Mario Tamburrini, Dipti Gothi, Carlo Barbetta, Alessandro Del Conte, Sandro Sulfaro, Umberto Zuccon
A 45-year old man, chronic smoker with a pancoast tumor due to squamous cell carcinoma has been described. The initial diagnosis of lung carcinoma was based on a scant tissue so the exact cell typing was not possible. The initial treatment consisted of platinum based chemotherapy and radiotherapy. He developed a left adrenal lesion on treatment. There was a possibility of metachronous primary. Also, a large tissue sample was required for tumor markers. The lung mass was difficult to access and was static on treatment...
2019: Respiratory Medicine Case Reports
Yang Zhao, Wei Guo
Primary pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare. MALT lymphoma patients usually show no clinical symptoms or physical signs. Chest radiograph or computed tomography (CT) may confuse MALT lymphoma with other pulmonary diseases, which would lead to misdiagnosis or a delayed diagnosis. In the present study, a 33-year-old male patient had cough and fever. Chest CT showed consolidation on both sides. Those clinical symptoms disappeared after he had been misdiagnosed and treated for community-acquired pneumonia for three weeks...
2019: Respiratory Medicine Case Reports
A Lazopoulos, D Krimiotis, N C Schizas, T Rallis, A S Gogakos, F Chatzinikolaou, T Tsiouda, P Zarogoulidis, P Sarafis, P Kamparoudi, D Paliouras, N Barbetakis
Gynecomastia with mastodynia and galactorrhea as a paraneoplastic syndrome due to lung cancer with complete response after surgical excision is rare. A 62-year-old Caucasian male presented with mastodynia, galactorrhea and right breast enlargement. Chest x-ray revealed a left upper lobe tumor. The patient had high levels of serum beta-human chorionic gonadotropin (b-HCG) and prolactine. Complete staging was negative for metastases. A typical left upper lobectomy with radical mediastinal lymph node dissection was performed...
2019: Respiratory Medicine Case Reports
Yonas Raru, Mahmoud Abouzid, Julia Parsons, Fuad Zeid
Rasburicase is a recombinant urate-oxidase enzyme and is a very important medication for tumor lysis syndrome. Methemoglobinemia and hemolysis are known side effects of rasburicase that result from oxidative stress caused by hydrogen peroxide, a byproduct generated during the breakdown of uric acid to allantoin. Patients with G6PD deficiency have a decreased tolerance to oxidative stress and are therefore at a greater risk of hemolysis and methemoglobinemia with rasburicase. Our patient is a 56-year-old Caucasian male with a recent diagnosis of grade 2-3a non-Hodgkin's lymphoma who presented to our emergency department with shortness of breath and dark discoloration of urine...
2019: Respiratory Medicine Case Reports
Christopher A Febres-Aldana, Sabrina Oneto, Marc Csete, Cristina Vincentelli
Non-fully reversible airway obstruction in fatal asthma is often seen in association with profound structural changes of the bronchial wall, termed airway remodeling. Evidence suggests that heavy precipitation events can trigger epidemics of severe asthma. We present a case of fatal asthma in a young woman with no prior near-fatal exacerbations and postulate that the patient's extensive airway remodeling and puerperal state (susceptibility factors), in combination with a massive allergen challenge during a hurricane landfall (triggering factor), played a central role in her death...
2019: Respiratory Medicine Case Reports
Mena Shehata, Fouad Zaid, Peter Ottaviano, Yousef Shweihat, Nancy Munn
Malignant pleural mesothelioma (MPM) is an asbestos-related tumor arising in the pleural cavity. Symptoms reflect extension of disease and include shortness of breath and chest pain. Unexplained pleural effusion and pleural pain in patients exposed to asbestos should raise the suspicion of MPM. The most common radiologic presentation is ipsilateral pleural effusion with or without pleural thickening or a mass. Thoracoscopic biopsy remains the most appropriate procedure for definitive diagnosis of mesothelioma...
2019: Respiratory Medicine Case Reports
Gianluca Sambataro, Domenico Sambataro, Francesca Pignataro, Sebastiano Emanuele Torrisi, Ada Vancheri, Mauro Pavone, Stefano Palmucci, Nicoletta Del Papa, Carlo Vancheri
Introduction: Severe morning stiffness with painful involvement of the girdles are often referred by patients with Interstitial Lung Disease (ILD), but the association between ILD and Polymyalgia Rheumatica (PMR) is rarely reported. The purpose of the work is to describe a series of patients classified as having PMR with ILD. Material and methods: We retrospectively enrolled patients with a diagnosis of PMR referred to our center during the previous year for respiratory symptoms...
2019: Respiratory Medicine Case Reports
Keigo Okamoto, Jun Hanaoka
Combined subsegmentectomy (CSS) is procedure as diagnostic purpose adding sufficient surgical margin. Compared to other procedure, CSS is not common, with the surgical results also being controversial. We analyzed the patients who had undergoing CSS in the right upper lobe for ground glass opacity (GGO) -dominant nodules. Between April 2011 and March 2017, we experienced 7 cases underwent CSS. In all cases, three subsegments resection and lymph node dissection using Video-Assisted Thoracic Surgery (VATS) was performed...
2019: Respiratory Medicine Case Reports
S R Sousa, P Caetano Mota, N Melo, H N Bastos, E PadrĂ£o, J M Pereira, R Cunha, C Souto Moura, S GuimarĂ£es, A Morais
Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease of unknown cause that occurs sporadically, but it can also occur in families and so named as Familial Pulmonary Fibrosis (FPF). Some forms of FPF overlaps IPF features, namely the radiological and histological pattern of usual interstitial pneumonia (UIP). Genetic and environmental factors commonly play an important role in the pathogenesis of FPF and the most commonly identified mutations involve the telomerase complex. Here, we report a rare case of FPF in a male at the age of 44, in whom genetic testing showed heterozygous variants for the telomerase reverse transcriptase gene ( TERT )...
2019: Respiratory Medicine Case Reports
Ryota Otoshi, Hideaki Yamakawa, Tamiko Takemura, Takuma Katano, Naoto Aiko, Goushi Matama, Kohsuke Isomoto, Tomohisa Baba, Eri Hagiwara, Takashi Ogura
A 66-year-old man, an ex-smoker, was referred to our hospital for slightly progressive respiratory symptoms of cough and dyspnea on exertion and chest abnormal shadow. Chest high-resolution computed tomography showed wide-ranging ground-glass attenuation and reticulation with lower lobe predominance. Bronchoalveolar lavage (BAL) fluid revealed a marked increase in lymphocytes (53.0%), and a surgical lung biopsy revealed a pattern of desquamative interstitial pneumonia (DIP) with hyperplasia of the lymphoid follicles...
2019: Respiratory Medicine Case Reports
Akihiro Shiroshita, Kei Nakashima, Shinji Motojima, Masahiro Aoshima
Here we report on a 61-year-old man with refractory eosinophilic granulomatosis with polyangiitis (EGPA) who presented with dyspnea. Despite treatment with glucocorticoids, intravenous cyclophosphamide, and plasma exchange, his symptoms worsened despite his eosinophil count and myeloperoxidase antineutrophil cytoplasmic antibody titer trending downwards. EGPA with diffuse alveolar hemorrhage was diagnosed on analysis of bronchoalveolar lavage fluid. The patient was treated with rituximab and methylprednisolone pulse therapy and a remission was achieved...
2019: Respiratory Medicine Case Reports
Di-Hong Yang, Yuan Xu, Lu Hong, Zhou-Ye Song, Wei-Hong Ge
Background: Pneumocystis jirovecii pneumonia (PCP) is an opportunistic infection with a difficult diagnosis, rapid progression, high mortality rate and poor prognosis. The primary treatment and prevention of PCP is trimethoprim/sulfamethoxazole (TMP/SMZ). However, there are many cases of intolerance or resistance to the drug, so the convenient and effective alternatives are deficient. Case presentation: A 66-year-old woman who took an immunosuppressive agent for a long time was diagnosed with PCP...
2019: Respiratory Medicine Case Reports
Nathan E Smith, Thomas Fabian, John Nabagiez
Intro: Unilateral pulmonary artery atresia (UPAA), while encountered frequently in the congenital cardiac anomaly cohort, is occasionally diagnosed in adulthood after typical symptoms of hemoptysis, pulmonary infection, or as an incidental finding on contrast CT scan. Due to its rarity, a brief discussion of UPAA and its treatment is warranted. Case report: A 35 year old male presented with three days of hemoptysis. After diagnosis of right UPAA, he underwent angioembolization of 6 large systemic collaterals supplying his right lung, followed by right pneumonectomy...
2019: Respiratory Medicine Case Reports
Iwao Shimomura, Yoshihiro Miki, Eiko Suzuki, Mineo Katsumata, Dai Hashimoto, Yoshifumi Arai, Yoshiro Otsuki, Hidenori Nakamura
A 61-year-old woman with a history of palpebral conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma, treated with rituximab, was referred to the authors' hospital after follow-up positron emission tomography/computed tomography revealed 18 F-fluoro-2-deoxy-d-glucose uptake in a tumor located in the left main bronchus. The diagnosis of MALT lymphoma was made by pathological and immunohistochemical findings homologous to previous palpebral conjunctival lesion via bronchoscopic biopsy. The disease was controlled with rituximab, cyclophosphamide, oncovin, and prednisolone (i...
2019: Respiratory Medicine Case Reports
N N M Razafimanjato, O A Vita, M R Randriamizao, T A Rajaonera, F A Hunald, H J L Rakotovao
If acute or severe infectious are know that risk factors for venous thromboembolism (VTE), the role active tuberculosis is ill defined, despite different case reports and many small case series have proposed an association between VTE and chronic infectious such as tuberculosis. We are highlighting an exceptional phenomenon correlation between intra-cardiac thromboembolism and pulmonary tuberculosis and concluded that active tuberculosis should include in the physician's evaluation of intra-cardiac thromboembolism risk...
2019: Respiratory Medicine Case Reports
Subash Heraganahally, Madeline Digges, Madeleine Haygarth, Kosala Liyanaarachchi, Akash Kalro, Sumit Mehra
Amyloidosis is a heterogeneous group of disorders characterized by misfolding of extracellular proteins. Pulmonary amyloidosis secondary to Sjogren's syndrome (SS) is rare and to the best our knowledge has not been described in indigenous population. There is also minimal information on its clinical and radiological features. We' describe here 52-year-old Australian Indigenous women with underlying Sjogren's syndrome who was initially suspected to have a metastatic lung cancer with FGD avid lung nodule on PET scan...
2019: Respiratory Medicine Case Reports
Yonas Raru, Mahmoud Abouzid, Fuad Zeid, Samson Teka
Our patient is a 67-year-old male with a past medical history significant for hypertension and hyperlipidemia came to a hospital with hemoptysis. He was also having cough and shortness of breath for the last 1 month. He said that his hemoptysis was about 1 cup per day mixed with yellowish sputum. He noticed around 20 pounds of weight loss in the last 1 month. He also complained of night sweats but had no fever. He had no history of travel outside the USA. He has never been incarcerated before, but he endorsed that his son has been to Jail before and he visited him twice a year in patient's home...
2019: Respiratory Medicine Case Reports
Toshiyuki Aokage, Kohei Tsukahara, Yasushi Fukuda, Fumiaki Tokioka, Akihiko Taniguchi, Hiromichi Naito, Atsunori Nakao
Background: Although the cause of acute eosinophilic pneumonia (AEP) has not yet been fully clarified, cigarette smoking is reported to be a risk factor for developing AEP. The heat-not-burn cigarette (HNBC) was developed to reduce the adverse effects of smoke on the user's surroundings. However, the health risks associated with HNBCs have not yet been clarified. We report a successfully treated case of fatal AEP presumably induced by HNBC use. Presentation of case: A 16-year-old man commenced HNBC smoking two weeks before admission and subsequently suffered from shortness of breath that gradually worsened...
2019: Respiratory Medicine Case Reports
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