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Respirology Case Reorts

Table of Contents for
Volume 04 Issue 6
November 2016

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Severe bilateral bronchial stenosis with acute respiratory failure from granulomatosis with polyangiitis
Pattraporn Tajarernmuang, Atikun Limsukon, Chalerm Liwsrisakun and Yutthaphan Wannasopha
DOI: 10.1002/rcr2.189

This report showed the advantage of urgent flexible-BBD that could be used as a rescue therapy in a GPA patient who presented life-threatening acute respiratory failure from severe bilateral bronchial stenosis.

Acute eosinophilic pneumonia following heat-not-burn cigarette smoking
Takahiro Kamada, Yosuke Yamashita and Hiromi Tomioka
DOI: 10.1002/rcr2.190

A 20-year-old man was diagnosed as acute eosinophilic pneumonia following HC smoking. HC attract attention as a cigarette generating less harmful substances than a conventional cigarette and are expected to spread around the world. In the same way as a conventional cigarette, HC should be recognized as a potential cause of AEP.

Pemetrexed for epithelioid haemangioendothelioma of the pleura
Shingo Kanemura, Kozo Kuribayashi, Yumiko Moriya, Shigeki Shimizu, Tohru Tsujimura and Takashi Nakano
DOI: 10.1002/rcr2.19110.1002/rcr2.191

Epithelioid hemangioendothelioma (EHE) is a rare slow-growing neoplasm, which can occur in any organ but is found most often in the lung and liver. We describe here a rare case of primary pleural epithelioid hemangioendothelioma (PEH) that presented with pleural effusion, mimicking malignant pleural mesothelioma (MPM), which is the most frequent mesenchymal tumour affecting the pleura. PEH is one type of mesenchymal tumour. While pemetrexed, a multitargeted antifolate, is a key drug in the treatment of MPM, there is no report of its use for treating PEH. We report here of the successful treatment of an EHE patient with pemetrexed and chemotherapy, and recommend this treatment for patients with advanced pulmonary EHE.rcr2.191

Three simultaneous cases of hypersensitivity pneumonitis and acute lung injury caused by dichloromethane
Kei Takamura, Takahiro Ogi, Makoto Yamamoto and Keisuke Kikuchi
DOI: 10.1002/rcr2.193

We report the simultaneous occurrence of three cases of hypersensitivity pneumonitis (HP) and acute lung injury (ALI) caused by exposure to dichloromethane present in paint remover. To our knowledge, there have been no reports in the literature on HP and ALI caused by dichloromethane exposure. So this is the first paper on this subject.

Summer-type hypersensitivity pneumonitis in a patient with rheumatoid arthritis on methotrexate and tacrolimus
Hirotsugu Ohkubo, Minami Okayama, Kensuke Fukumitsu and Akio Niimi
DOI: 10.1002/rcr2.194

We report a case of summer-type hypersensitivity pneumonitis in a patient with rheumatoid arthritis (RA) during treatment with methotrexate and tacrolimus. Physicians must pay attention to the possibility of accidental suppression of summer-type hypersensitivity pneumonitis by immunosuppressants.

Development of diffuse alveolar damage after initiation of Nijutsuto
Motoyasu Kato, Shinichi Sasaki, Hiroshi Izumi, Toshimasa Uekusa, Shigeru Tominaga and Kazuhisa Takahashi
DOI: 10.1002/rcr2.195

Nijutsu-to is known as a herbal medicine and is often used for patients with osteoarthritis and frozen shoulder. Here, we present the first case of diffuse alveolar damage after initiation of Nijutsu-to be diagnosed by autopsy. Although the patient received methylprednisolone and cyclophosphamide, he died of respiratory failure.

Intestinal perforation due to paradoxical reaction during treatment for miliary tuberculosis
Miwako Saitou, Tomoko Suzuki and Katsunao Niitsuma
DOI: 10.1002/rcr2.196

A 61-year-old man with dermatomyositis had miliary tuberculosis (TB) due to intestinal TB. During successful TB therapy, he developed intestinal perforation. Paradoxical reaction and poor nutritional status may have contributed to the intestinal perforation.

Effectiveness of afatinib in lung cancer with paralytic ileus due to peritoneal carcinomatosis
Haruki Kobayashi, Kazushige Wakuda and Toshiaki Takahashi
DOI: 10.1002/rcr2.197

To the best of our knowledge, this is the first report of a non-small cell lung cancer patient harbouring an uncommon epidermal growth factor receptor mutation and progressive disease presenting with peritoneal carcinomatosis and paralytic ileus who was effectively treated with afatinib.

Respiratory bronchiolitis-associated interstitial lung disease with obvious paraseptal emphysema
Yun Zhou, Zhiyi He, Jing Bai and Xiaoning Zhong
DOI: 10.1002/rcr2.198

We present a case of respiratory bronchiolitis-associated interstitial lung disease with obvious paraseptal emphysema. The patient is a 59-year-old current smoker. A chest computed tomography scan reveals paraseptal emphysema and diffuse ground glass opacity. The diagnosis of respiratory bronchiolitis-associated interstitial lung disease was confirmed by the lung biopsy.

Birt–Hogg–Dubé syndrome in an Indonesian patient with folliculin gene mutation
Wiwien Heru Wiyono, Fariz Nurwidya, Hario Baskoro and Andika Chandra Putra
DOI: 10.1002/rcr2.199

In this study, we describe a 51-year-old Indonesian female who presented with recurrent spontaneous pneumothorax, multiple cysts in both lungs, and a renal cyst on magnetic resonance imaging (MRI). We identified an aberrant band in the DNA fragment derived from folliculin (FLCN) exon 6 that represents pathogenic mutation, which caused premature termination of folliculin protein translation. This is the first case of an Indonesian patient with confirmed Birt–Hogg–Dubé (BHD) syndrome by FLCN exon 6 mutation detection.

Pulmonary lymphoepithelioma-like carcinoma with echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene
Naoko Ose, Teruka Kawai, Daisuke Ishida, Yuko Kobori, Yukiyasu Takeuchi and Hidetoshi Senba
DOI: 10.1002/rcr2.200

This is the first reported case of pulmonary lymphoepithelioma-like carcinoma (PLELC) with echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) rearrangement.

Pulmonary alveolar proteinosis: a case report and world literature review
Armando J. Huaringa and Wassem H. Francis
DOI: 10.1002/rcr2.201

Pulmonary alveolar proteinosis is a relatively rare disease, originally thought to be idiopathic, but has also been found linked to several inhalational triggers. The disease management has changed slowly over the years from therapeutic bronchoalveolar lavage towards administration of granulocyte macrophage – colony stimulating factor (GM-CSF), which would turn down the gene that causes type II pneumocytes to produce a great deal of surfactant, thereby overwhelming the absorptive capacity of the macrophages and leading to alveolar filling and impairment of gas exchange.

Carcinomatous pleuritis and pericarditis accompanied by pulmonary tuberculosis
Munechika Hara, Shin-ichiro Iwakami, Naohisa Matsumoto, Taichi Miyawaki, Ryo Wada and Kazuhisa Takahashi
DOI: 10.1002/rcr2.202

Although both lung cancer and pulmonary tuberculosis (TB) commonly occur in clinical practice, little attention has been paid to their coexistence. This study reports a case of coexisting lung cancer and pulmonary TB treated with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) and anti-tuberculous therapy.

Stromal micropapillary predominant lung adenocarcinoma: A rare histological phenotype with poor prognosis
Takamitsu Hayakawa, Shogo Tajima, Masaru Tsukui, Yusuke Takanashi, Hiroshi Neyatani and Kazuhito Funai
DOI: 10.1002/rcr2.203

An extremely rare case of stromal micropapillary predominant lung adenocarcinoma is presented in this study. Because the prognosis of stromal micropapillary pattern (SMP) lung adenocarcinomas is known to be worse than that of aerogenous micropapillary pattern (AMP) lung adenocarcinomas, the discrimination of SMP from AMP is important for both pathologists and clinicians.