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Respirology Case Reorts

Table of Contents for
Volume 05 Issue 6
November 2017

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Case Reports

Concurrence of nivolumab-induced interstitial lung disease and cancer invasion
Osamu Kanai, Koichi Nakatani, Kohei Fujita, Misato Okamura and Tadashi Mio
DOI: 10.1002/rcr2.257

Nivolumab-related interstitial lung disease (ILD) may concur with cancer invasion in non-small-cell lung cancer (NSCLC) patients. These conditions are difficult to distinguish from each other by computed tomography (CT) findings, and in such cases, aggressive biopsy should be considered.

Fatal diffuse alveolar haemorrhage mimicking acute exacerbation in idiopathic pulmonary fibrosis treated with nintedanib
Keishi Sugino, Yasuhiko Nakamura, Muneyuki Sekiya, Hiroshi Kobayashi, Kazutoshi Shibuya and Sakae Homma
DOI: 10.1002/rcr2.258

Fatal diffuse alveolar haemorrhage (DAH) in this patient could have been induced by the use of aspirin and rhTM in addition to nintedanib.

The novel 19G endobronchial USS (EBUS) needle samples processed as tissue "core biopsies" facilitate PD-L1 and other biomarker testing in lung cancer specimens: case report and the view point from the Respiratory Physician and the Pathologist
Samantha Herath and Wendy A Cooper
DOI: 10.1002/rcr2.271

The novel 19G EBUS needle samples could be maximally utilized for Programmed Death Ligand (PD-L1) testing when processed in formalin as "micro core-biopsies".

Mediastinal peripheral T-cell lymphoma diagnosed by repeated biopsies after an initial diagnosis of fibrosing mediastinitis
Naoko Kakuta, Mitsuhiro Sumitani, Arata Sugitani, Kenji Nakahama, Yuzo Miki and Seichi Syoji
DOI: 10.1002/rcr2.272

Initial needle biopsy and video-assisted thoracoscopic biopsy revealed the pathological diagnosis of fibrosing mediastinitis for mediastinal mass. However, other laboratory features suggested that the diagnosis of fibrosing mediastinitis might not be correct. Finally, a fourth biopsy established the diagnosis of mediastinal PTCL-NOS.

Wheezing and dyspnoea caused by aberrant left innominate artery
Masamichi Hayashi, Kazuyoshi Imaizumi, Hidekazu Hattori, Hiroshi Toyama and Mitsushi Okazawa
DOI: 10.1002/rcr2.273

We present a rare case of a branching anomaly of the aortic arch that resulted in wheezing and dyspnea. The patient was a 60-year old male with severe wheezing from babyhood, originally diagnosed with severe bronchial asthma. Careful examination and testing indicated a right aortic arch and an aberrant enlarged left innominate, which compressed and narrowed the esophagus and trachea from behind. Although the patient had been diagnosed with intractable bronchial asthma, his symptoms were more likely caused by this mechanical narrowing since wheezing and dyspnea disappeared completely after total aortic arch replacement operation.

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia diagnosed by tranbronchoscopic cryoprobe biopsy technique
Ravi Patel, Carolina Collazo-Gonzalez, Arthur Andrews, Jean Johnson, Mark Rumbak and Maxwell Smith
DOI: 10.1002/rcr2.275

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) remains a poorly understood clinical entity. Here we present what we believe to be the first described case of DIPNECH diagnosed by transbronchoscopic cryoprobe biopsy.

Thoracic splenosis: diagnosis without invasive investigations
Kirryn Williams and Graham Simpson
DOI: 10.1002/rcr2.274

This image illustrates a case of thoracic splenosis. Splenosis is often misinterpreted as malignancy on initial imaging. This literature reveals case studies where diagnosis is most often confirmed with invasive investigations. A 99 m technetium-labelled sulphur colloid scan when used with single photon emission computed tomography/computed tomography (SPECT/CT) is highly specific for splenic tissue and more readily available and time efficient than other modalities used for this purpose. Awareness of this may prevent unnecessary or dangerous invasive diagnostic procedures.