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Respirology Case Reorts

Table of Contents for
Volume 05 Issue 3
May 2017

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Case series

Chylothorax and central vein thrombosis, an under-recognized association: a case series
Sze Shyang Kho, Siew Teck Tie, Swee Kim Chan, Mei Ching Yong, Sing Ling Chai and Pei Jye Voon
DOI: 10.1002/rcr2.221

Chylothorax is defined as the presence of chyle in the pleural cavity. Central vein thrombosis is an under-recognised cause of chylothorax in the adult population, and is commonly related to central venous catheterization. We present three cases that illustrate the unique association of central vein thrombosis and chylothorax, and the importance of anticoagulation in its management.

Chemical pleurodesis using mistletoe extracts via spray catheter during medical thoracoscopy for management of malignant pleural effusion
Jung Seop Eom, Tae Hwa Kim, Geewon Lee, Hyo Yeong Ahn, Jeong Ha Mok and Min Ki Lee
DOI: 10.1002/rcr2.227

We present three cases of successful chemical pleurodesis with a liquid solution of mistletoe extract using a spray catheter during medical thoracoscopy.

Case Reports

Diffuse panbronchiolitis in a Samoan man
Justine Gibson, Harrison King, Mahendra Singh and Khoa Tran
DOI: 10.1002/rcr2.217

Diffuse panbronchiolitis (DPB) is an idiopathic inflammatory disease which is predominantly recognised in the Japanese population. This is the first reported case of DPB in a Samoan man with the typical radiological and histopathological features. He had an excellent response to long-term erythromycin and this case highlights the importance of recognising this rare disease.

Ambiguous presentation of Mycobacterium avium complex-associated Rasmussen aneurysm
Hsin-Wei Chiu, Shu-Hung Kuo, Ruay-Sheng Lai, Ming-Ting Wu and Hsiu-Fu Wu
DOI: 10.1002/rcr2.219

This case report highlights a rare but catastrophic MAC-associated pseudoaneurysm and relevant treatment options.

Disseminated histoplasmosis: a rare clinical phenotype with difficult diagnosis
Xiao-feng Xiong, Li-li Fan, Mei Kang, Jia Wei and De-yun Cheng
DOI: 10.1002/rcr2.220

We present a rare and interesting case of disseminated histoplasmosis in a patient without AIDS. To the best of our knowledge, this is the first case in which Histoplasma capsulatum was cultivated in blood in southwest China.

Pneumonic-type mucinous lung adenocarcinoma diagnosed by transbronchial cryobiopsy
Rick Balestra, Akilan Selvaraju, Sadia Benzaquen and Dani S. Zander
DOI: 10.1002/rcr2.222

Subacute pneumonitis presentation of unsuspected lung adenocarcinoma with lepidic growth. The diagnosis was made by transbronchial lung cryobiopsy.

Edoxaban treatment for pulmonary arterial thromboembolism associated with azygous vein aneurysm
Takao Mochimaru, Ichiro Kawada, Shotaro Chubachi, Akihiro Tsutsumi, Hanako Hasegawa and Tomoko Betsuyaku
DOI: 10.1002/rcr2.223

Azygous vein aneurysm is a very rare cause of a mediastinal mass and sometimes causes pulmonary arterial thromboembolism. The treatment for azygous vein aneurysm remains controversial, but surgical resection is recommended in cases complicated by rupture, embolism, or obstruction. We present a case of pulmonary arterial thromboembolism due to an azygous vein aneurysm that is successfully treated with anticoagulation therapy (edoxaban) rather than surgical intervention.

Control of brain metastases with alectinib in anaplastic lymphoma kinase-rearranged lung cancer
Wang Chun Kwok, Terence Chi Chun Tam, Macy Mei Sze Lui, David Chi Leung Lam and James Chung Man Ho
DOI: 10.1002/rcr2.224

We report a young man who had ALK-driven adenocarcinoma of lung with progressive brain metastases despite targeted therapy and chemotherapy. Salvage treatment with alectinib resulted in durable response in both systemic and intra-cranial diseases. The rationale of therapeutic selection among various ALK tyrosine kinase inhibitors (TKI) is illustrated with this case in the era of personalized lung cancer treatment.

It's better to be lucky – successful management of an acute endobronchial tumour embolism in the ICU: a case report and review of the literature
Christopher J. Walsh, Ron Olivenstein, Eric Forget and Anne V. Gonzalez
DOI: 10.1002/rcr2.225

This article is a case report of successful removal of acute endobronchial tumour embolism in an intensive care setting. We include a comparative review of 16 previously published cases in surgical and non-surgical settings.

Granulomatosis with polyangiitis involving the epiglottis
Yuya Aono, Shiro Imokawa, Tomohiro Uto, Jun Sato, Fumihiko Tanioka and Takafumi Suda
DOI: 10.1002/rcr2.226

Granulomatosis with polyangiitis (GPA) frequently involves the upper respiratory tracts, but involvement of the epiglottis is extremely rare. This report describes a patient initially presenting with dysphagia and increasing stridor due to epiglottitis associated with GPA.

A case of lung abscess successfully treated by transbronchial drainage using a guide sheath
Hiroki Izumi, Masahiro Kodani, Shingo Matsumoto, Yuji Kawasaki, Tadashi Igishi and Eiji Shimizu
DOI: 10.1002/rcr2.228

We report the first successful case of transbronchial drainage using guide sheath (GS) for lung abscess complicated by bronchoscopic biopsy. This treatment procedure using GS may be an effective and safe strategy in the treatment of lung abscess with airway connection in patients who are refractory to antibiotic therapy.

Successful treatment of pulmonary nocardiosis with fluoroquinolone in bronchial asthma and bronchiectasis
Hironori Sadamatsu, Koichiro Takahashi, Hiroki Tashiro, Kazutoshi Komiya, Tomomi Nakamura and Naoko Sueoka-Aragane
DOI: 10.1002/rcr2.229

We present a case that illustrates that pulmonary nocardiosis with bronchial asthma and bronchiectasis can be successfully treated with fluoroquinolone as an alternative to trimethoprim/sulfamethoxazole or minocycline.

Respiratory bronchiolitis-associated interstitial lung disease secondary to electronic nicotine delivery system use confirmed with open lung biopsy
Mark Flower, Lakshmy Nandakumar, Mahendra Singh, David Wyld, Morgan Windsor and David Fielding
DOI: 10.1002/rcr2.230

We believe this is an important case as it demonstrates clearly the direct toxic effects of the poorly understood electronic nicotine delivery system (ENDS). Further we believe this is the first case in the literature to demonstrate ENDS-associated respiratory bronchiolitis interstitial lung disease (RB-ILD) on open lung biopsy.

Immunoglobulin G4-related disease: a rare steroid-responsive disease
Vorawut Thanthitaweewat, Poonchavist Chantranuwatana and Naricha Chirakalwasan
DOI: 10.1002/rcr2.231

IgG4-related disease is a rare immune-mediated disorder with various clinical presentations. Diagnosis is typically made with clinicopathological correlation. Treatment with steroid usually results in dramatic response.

Coexistence of diffuse panbronchiolitis and asthma: reciprocity of neutrophilic and eosinophilic inflammation
Kiyoshi Takeyama, Yuri Shimizu, Masanobu Ishii, Hiroko Hara, Mitsuko Kondo and Jun Tamaoki
DOI: 10.1002/rcr2.232

In this study, we present a case of diffuse panbronchiolitis that also showed clinical and pathological features of asthma. In this case, both neutrophilic and eosinophilic inflammation coexisted in the airways, and was reciprocally altered by low-dose macrolide therapy.