Respirology Case Reorts

Diana Marangu, Komala Pillay, Ebrahim Banderker, Diane Gray, Aneesa Vanker, Marco Zampoli
DOI: 10.1002/rcr2.356

Exogenous lipoid pneumonia is an important cause of interstitial lung disease that often goes unrecognized.

Lin Tong, Guixiang Gan, Chen Xu, Ling Yuan, Zhuozhe Li, Huayin Li
DOI: 10.1002/rcr2.346

A 65-year-old male presented with cough and dyspnoea, with irregular wall thickening of the trachea and bilateral bronchi on chest computed tomography (CT). A bronchoscopy revealed a diffuse irregular surface of the tracheal and bilateral bronchial mucosa and polyposis-like lesions. He was diagnosed as having mantle cell lymphoma (MCL) based on an endobronchial biopsy, and then, the diagnosis was confirmed with biopsy of the FDG-avid nasal mucosal soft tissue.

Makoto Hibino, Kazunari Maeda, Shigeto Horiuchi, Minoru Fukuda, Tetsuri Kondo
DOI: 10.1002/rcr2.347

We report an immunocompromised rheumatoid arthritis patient in respiratory failure with diffuse ground-glass opacities (GGOs), who was diagnosed with pulmonary lymphangitic carcinomatosis as the initial presentation of prostate cancer. He was successfully treated with chemohormonal androgen deprivation therapy, including bicalutamide, leuprorelin acetate, denosumab, and docetaxel. Metastatic pulmonary lymphangitis, rarely from the prostate, should always be considered in the differential diagnosis of GGOs, even when the patient has no known prior malignancies.

Akihiro Yoshimura, Taisuke Tsuji, Yuka Kawaji, Yoshiko Hirakawa, Hitoji Uchiyama, Noriya Hiraoka
DOI: 10.1002/rcr2.348

The patient with diffuse large B-cell lymphoma developed BK virus (BKV) pneumonia. We performed bronchoalveolar lavage (BAL), and BKV DNA load was elevated in BAL fluid (BALF). The detection of BKV DNA in BALF is useful for diagnosing BKV pneumonia.

Mário Bruno, Ribeiro de Oliveira, Santos Paulo Mergulhã
DOI: 10.1002/rcr2.349

Severe drug-induced lung disease, resistant to steroids, is a dramatic situation due to the absence of therapeutic alternatives. We describe a case of vinorelbine-induced acute respiratory distress syndrome that did not respond to supportive care plus high-dose steroids. Cyclophosphamide pulse therapy was initiated with subsequent clinical and radiological improvement, allowing the patient to be discharged the patient. We suggest that vinorelbine-induced lung toxicity is driven by a primarily immune-mediated mechanism and that it can respond favourably to immunosuppressive therapy.

Takamasa Hotta, Sun Rong, Yukari Tsubata, Yasuyuki Taooka, Noriaki Kurimoto, Takeshi Isobe
DOI: 10.1002/rcr2.350

Polypoid bronchogenic cysts are rare congenital bronchopulmonary malformations, commonly occurring in the mediastinum or occasionally in the intrapulmonary region. Herein, we report the case of polypoid intrapulmonary bronchogenic cyst successfully treated by bronchoscopic resection alone.

Masayuki Nakayama, Shinichi Yamamoto, Naoki Kaneko, Naoko Mato, Takuji Suzuki, Koichi Hagiwara
DOI: 10.1002/rcr2.351

When removing a bronchial foreign body by flexible bronchoscopy, choosing the most suitable device and a short intervention time are very important, particularly in older patients or those in critical condition. However, identification of the foreign body before bronchoscope insertion is often difficult. Three-dimensional (3D) printing is a promising new technology for medical education development and can create sophisticated patient-specific models from imaging databases. Here, we report a case involving simulated grasping and the removal of a bronchial foreign body with several forceps using a low-cost 3D printer.

Hiroyuki Miura, Jun Miura, Hiroshi Hirano
DOI: 10.1002/rcr2.353

Azygos vein varix is a very rare disease associated with a risk of rupture or thrombosis. We report a case of azygos vein varix in a 79-year old female presenting with abnormal shadows on a chest X-ray. A plain computed tomography (CT) scan showed a well-defined tumour behind the trachea, which was diagnosed as a bronchogenic cyst in the absence of a contrast-enhanced CT scan. Thoracoscopy revealed a dark purple-red saccular tumour continuing on to the azygos vein.

Makoto Hibino, Kazunari Maeda, Shigeto Horiuchi, Minoru Fukuda, Tetsuri Kondo
DOI: 10.1002/rcr2.355

Here, we report the first case of pembrolizumab-induced myasthenia gravis (MG) and myositis in a patient with lung cancer. The patient developed symptoms after the second infusion of pembrolizumab and was successfully treated with systemic corticosteroid therapy. With the accelerated development of immune checkpoint inhibitors as mono- or combination therapies for various malignancies, clinicians should closely monitor patients for important immune-related adverse events, such as MG, especially during the early phase of the treatment.

Jessica Quah Teck, Boon Low, Raymond Fong
DOI: 10.1002/rcr2.357

We describe a middle-aged man who presented with disseminated Cryptcococus gattii infection. This preceded the onset of pulmonary alveolar proteinosis (PAP). Opportunistic infections are known to occur concurrently with PAP due to alveolar macrophage dysfunction.

Ryoichi Matsumoto, Koichi Yoshiyama, Shintaro Yokoyama, Masahiro Mitsuoka, Shinzo Takamori, Yoshito Akagi
DOI: 10.1002/rcr2.358

This is a report of the case of a patient in whom lateral posterior mediastinal masses were incidentally detected during treatment for hereditary spherocytosis. We performed a video-assisted thoracic surgery. The pathological findings were consistent with intrathoracic extramedullary haematopoiesis.

Lokesh Yagnik, Hilman Harryanto, Mei Hui Eleanor Koay, Ben Dessauvagie, Matthew Salamonsen
DOI: 10.1002/rcr2.359

Granular cell tumours are rare tumours of neural/Schwann cell origin and occur at any site. The tumours are typically benign and run an indolent clinical course, with malignancy being rare. In the absence of distant or nodal metastases, establishing malignant potential is challenging.

Wang Chun Kwok, Terence Chi Chun, Tam David Chi Leung Lam
DOI: 10.1002/rcr2.360

We report the first case of toxic megacolon associated with afatinib use, which is a potentially fatal complication, with risks of colonic perforation. In this case, the condition improved on stopping afatnib. Clinicians need to be alert of this rare but fatal adverse effect and to avoid anti-diarrhoeal agents, which can worsen toxic megacolon.

Shunichi Nagata, Misa Ishihara, Mitsugu Omasa, Takao Nakanishi, Hideki Motoyama
DOI: 10.1002/rcr2.361

We report a rare case of a patient whose histopathology presented a series of cholesterol granuloma formations.

aMasahiro Yamasaki, Takenori Okada, Yoji Sumimoto, Noboru Hattori
DOI: 10.1002/rcr2.352

Influenza myocarditis is a rare but life-threatening complication of influenza infection. The primary treatment for influenza myocarditis is supportive intervention. We report a case of influenza myocarditis diagnosed from pulmonary congestion observed on chest computed tomography (CT), and that recovered after intensive care using percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pumping (IABP).