Respirology Case Reorts

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August 2018
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Case Reports
Multiple pulmonary Aspergillus fumigatus cysts and cavities that disappeared with anti-fungal agents
Miwako Saitou, Tomoko Suzuki, Katsunao Niitsuma
DOI: 10.1002/rcr2.327

We encountered a case in whom Aspergillus fumigatus caused multiple cysts, cavitary lesions and an allergic state. After anti-fungal treatment, all cysts and cavities disappeared. This represents a very unusual form of pulmonary involvement with A. fumigatus.

An unusual case of pleural nodularity
Ruth Williams, Helen E Davies
DOI: 10.1002/rcr2.330

A 65 year old gentleman underwent investigations following an abnormal x-ray, including a CT thorax which demonstrated widespread pleural nodularity. Whilst a pleural biopsy confirmed adenocarcinoma, it was unable to identify a primary site. Further investigations including abdominal and pelvic CT and a PSA confirmed this as an usual presentation of advanced prostate cancer.

Sarcoid-resembling granulomatous lung disease secondary to occupational magnetite iron dust exposure
Lewis Xiao, Anil Kookana, Robert McClure, Subash Heraganahally
DOI: 10.1002/rcr2.331

Non-caseating granulomatous pulmonary conditions resembling sarcoidosis secondary to industrial/occupation exposure to magnetite iron ore dusts have been rarely documented in the literature. This is a case report of a 58-year-old blast crew member involved in iron ore/magnetite mining who presented with a 12-month history of chronic dry cough. High-resolution computed tomography revealed bilateral interstitial opacities. Lung biopsy demonstrated sarcoid-like granulomatous inflammation. Oral corticosteroid treatment improved the cough. Radiological features did not resolve despite treatment and yet remained stable following no subsequent exposure to iron mining dust.

A complicated cockroach-ectomy
Jaideep Vazirani, Christiaan Yu, Robert Stirling
DOI: 10.1002/rcr2.332

Foreign body aspiration (FBA) is a frequent and life threatening occurrence in children. The exact incidence of FBA amongst adults is unknown. We present a previously undescribed occurrence of cockroach (Periplaneta australasiae) aspiration in an adult, followed by flexible bronchoscopic extraction. We highlight the importance of definitive airway support during endobronchial interventions and raise the question regarding significance of transient bacteraemia following bronchoscopic manipulation.

Successful treatment of total paraplegic patient due to tuberculous spondylitis
Noni Novisari Soeroso, Andika Pradana, Netty Lubis, Luhur Soeroso
DOI: 10.1002/rcr2.333

We describe a case with successful treatment of a total paraplegic 12-year-old boy due to tuberculous spondylitis after 12 months of regular anti-tuberculosis drugs regimen alone without surgery.

Severe upper gastrointestinal disorders in pembrolizumab-treated non-small cell lung cancer patient
Tsugitoshi Onuki, Eri Morita, Noritaka Sakamoto, Yoshiaki Nagai, Masafumi Sata, Koichi Hagiwara
DOI: 10.1002/rcr2.334

Pembrolizumab is an immune checkpoint inhibitor that induces side effects called "immune-related adverse events" (irAEs). Various types of organs are affected by irAEs, although reports of upper gastrointestinal disorders are rare. Here, we report a case of extensive inflammatory pathologies in the oesophagus, stomach, duodenum, and jejunum after the administration of pembrolizumab for non-small cell lung cancer.

Acute pneumonitis following breast silicone liquid injection
Noni Novisari Soeroso, Ella Rhinsilva, Luhur Soeroso
DOI: 10.1002/rcr2.335

Silicone injection, although well known for its adverse effect, is still widely used around the world. Pneumonitis after injection of silicone liquid has been reported in several patients. Silicone liquid injection is frequently performed into the buttocks area but rarely used for the breasts. We report a case of presumed pneumonitis following breast silicone liquid injection.

Novel application of cryobiopsy in the diagnosis of pulmonary alveolar proteinosis
Meng-fang Shen, Teressa Reanne, Ju Chi, Chan Lee, Chih-Yen Tu
DOI: 10.1002/rcr2.336

We present a case report where cryobiopsy was used for the diagnosis of pulmonary alveolar proteinosis (PAP). Cryobiopsy has emerged as a novel technique for obtaining lung tissues in pulmonary diseases and appears to offer several diagnostic advantages compared to conventional techniques. Cryobiopsy appears to be a potential diagnostic tool for diagnosing PAP.

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