| Case Series |
Effect of bevacizumab on brain radiation necrosis in anaplastic lymphoma kinase-positive lung cancer
Kengo Tanigawa, Keiko Mizuno, Yusuke Kamenohara, Taiji Unoki, Shunsuke Misono, Hiromasa Inoue DOI: 10.1002/rcr2.454
We assessed four anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) patients who were treated with ALK-tyrosine kinase inhibitors (TKIs). They developed brain radiation necrosis and brain oedema after stereotactic irradiation. Here, we report the efficacy and safety of bevacizumab given in combination with ALK-TKIs for brain radiation necrosis in ALK-positive NSCLC. |
Active pulmonary tuberculosis presenting with acute respiratory failure
Satish Chandra Kilaru Sudhir Prasad Hemanth Kilaru Raghavender Reddy Anneela Ashfaq Hasan Eshwar Chandra Nandury DOI: 10.1002/rcr2.460
We report the clinical course of four patients with active pulmonary tuberculosis presenting with acute respiratory failure who were treated successfully. |
| Case Reports |
Exertion during a hypoxia altitude simulation test helps identify potential cardiac decompensation
Leigh Seccombe, Matthew Peters, Claude Farah DOI: 10.1002/rcr2.450
We present the novel case of a 64-year-old female with a history of chronic thromboembolic pulmonary arterial hypertension and moderate bronchiectasis who experienced right ventricular failure during a clinically indicated flight simulation. While the subject recorded acceptable oxygenation during the simulation in resting conditions, echocardiography demonstrated underlying cardiopulmonary limitation that significantly worsened with mild exercise. |
Successful salvage surgery following multimodal therapy in a patient who harboured ALK-rearranged advanced lung adenocarcinoma with multiple organ metastases
Yoshitsugu Horio, Tetsuya Mizuno, Yukinori Sakao, Yoshitaka Inaba, Yasushi Yatabe, Toyoaki Hida DOI: 10.1002/rcr2.451
This case report highlights that multidisciplinary treatment planning is critical for stage IIIb-IV non-small cell lung cancer (NSCLC) patients in the era of highly effective treatments, including chemotherapy, molecular targeted therapy, and immunotherapy, which may demonstrate treatment-free remission (TFR) even in highly selected advanced lung cancer patients with poly-metastases, and we need more information about the association between each genetic alteration and the significance of salvage surgery. |
Syncope due to tracheal adenoid cystic carcinoma
Eva Marianne Theresa Bots, Abraham Christoffel van Wyk, Jacques Teran Janson, Riegardt Wagenaar, Gerald Paris, Coenraad Frederik Nicolaas Koegelenberg DOI: 10.1002/rcr2.452
We report the case of a 34-year-old male who presented with syncope secondary to a large adenoid cystic carcinoma (ACC) of the distal trachea. Tracheal tumours comprise a small proportion of respiratory tract neoplasm, accounting for only about 2% of airway malignancies. Syncope as a presenting symptom is exceedingly rare. |
Non-small cell lung cancer with mesenchymal-epithelial transition gene exon 14 skipping mutation treated with crizotinib
Seigo Katakura, Nobuaki Kobayashi, Kohei Somekawa, Nami Masumoto, Makoto Kudo, Takeshi Kaneko DOI: 10.1002/rcr2.453
Non-small cell lung cancer patients with mesenchymal-epithelial transition gene exon 14 skipping mutation were treated with crizotinib. The treatment was effective, and the patient had stable disease for 7 months. |
Tracheobronchial calcification on bronchoscopy in a patient with end stage renal failure: an unusual cause of chronic cough
Alice Sawka, April Crawford, Chen Au Peh, Phan Nguyen DOI: 10.1002/rcr2.456
In this report, we describe a 64-year-old female with a history of inadequate peritoneal dialysis who presented with severe and persistent chronic cough. Extensive white nodular tracheobronchial mucosal changes were identified on bronchoscopy despite the absence of corresponding abnormalities on CT imaging. We believe that the bronchoscopic findings represent a highly unusual presentation of metastatic pulmonary calcification and an unusual cause of chronic cough amongst patients with end-stage renal failure. |
Very low-dose intrapleural tPA for indwelling pleural catheter-associated symptomatic fluid loculation
Norris Si Hao Lan, Sona Vekaria, Calvinjit Sidhu, Yun Chor Gary Lee DOI: 10.1002/rcr2.457
This case report describes the successful use of 0.5 mg (the lowest reported dose) of tissue plasminogen activator in a patient with significant bleeding risks whose indwelling pleural catheter was complicated by symptomatic loculation. |
Endobronchial one-way valve for persistent air leak and lung volume reduction
Wai Cho Yu, Hau Chung Kwok, Yu Hong Chan, Man Ying Ho, Ming Chiu Chan, Yiu Cheong Yeung DOI: 10.1002/rcr2.461
Our patient with severe emphysema was denied bronchoscopic lung volume reduction by endobronchial valves because he failed the diffusion study. Later, he had endobronchial one-way valves (EBV) deployed for treatment of persistent air leak complicating a pneumothorax. His clinical status and lung function showed marked improvement afterwards. |
Pulmonary nocardiosis caused by Nocardia exalbida mimicking lung cancer
Chika Miyaoka, Keitaro Nakamoto, Tatsuya Shirai, Maki Miyamoto, Yuka Sasaki, Ken Ohta DOI: 10.1002/rcr2.458
Nocardiosis is an uncommon infection caused by Nocardia species that can often occur, mostly as pulmonary lesions, in immunocompromised patients with organ transplantation and cancer. Consolidation, masses, and nodules are frequent computed tomography (CT) findings, but lymph node enlargement is rare. We report a rare case of pulmonary nocardiosis caused by Nocardia exalbida with CT findings of a mass and lymph node enlargement, requiring differentiation from lung cancer and that was difficult to diagnose. |
A case of central neurogenic hyperventilation without tachypnoea
Saori Murata, Saeko Takahashi Hisako, Kunieda Koichi, Oki Morio Nakamura
DOI: 10.1002/rcr2.462
Central neurogenic hyperventilation (CNH) is a rare condition. Primary central nervous system lymphoma (PCNSL) is the most common cause of CNH and is usually accompanied by tachypnoea. Here, we present a rare case of PCNSL-induced CNH in a 60-year-old man without tachypnoea. |
Pneumocystis jirovecii in a patient on dose-dense chemotherapy for early breast cancer
Chloe Khoo, Jenny Gilchrist, Jonathan Philip Williamson, Miriam Paul, Richard Kefford DOI: 10.1002/rcr2.459
Adjuvant chemotherapy is associated with improved survival in early breast cancer (EBC) and is used as standard treatment for many patients following surgery. We present a fatal case of Pneumocystis jirovecii pneumonia – a rare and under-recognized complication – in an otherwise well patient undergoing a dose-dense adjuvant chemotherapy following surgery for EBC. |
Neurofibromatosis type 1-associated malignant peripheral nerve sheath tumour carcinomatous pleurisy: an autopsy case
Marie Furukawa, Hiroki Ota, Yasuhiko Nakamura, Yasuhiro Nihonyanagi, Naobumi Tochigi, Sakae Homma
DOI: 10.1002/rcr2.463
We report a rare autopsy case of neurofibromatosis type 1-associated malignant peripheral nerve sheath tumor carcinomatous pleurisy with giant intrathoracic meningoceles. |
Allergic bronchopulmonary aspergillosis complicated by eosinophilic chronic rhinosinusitis successfully treated with mepolizumab
Nobuhiro Matsumoto, Takafumi Shigekusa, Ayako Matsuo, Hironobu Tsubouchi, Shigehisa Yanagi, Masamitsu Nakazato
DOI: 10.1002/rcr2.465
Mepolizumab, an anti-interleukin-5 monoclonal antibody, remarkably improved the pulmonary infiltrations of allergic bronchopulmonary aspergillosis. |
Hypotensive episodes associated with azithromycin infusion: a potentially fatal adverse drug reaction
Jeffrey Wong, Maitri Munsif, Robyn O'Hehir, Mark Hew, Eli Dabscheck
DOI: 10.1002/rcr2.464
We report the first case of hypotensive episodes associated with intravenous azithromycin administration. It is a potentially fatal complication and must be recognized and treated immediately. |
A false-positive pneumococcal rapid urinary antigen test in Streptococcus intermedius infection
Saeko Takahashi, Takahiro Ishitsuka, Kaoru Namatame, Morio Nakamura
DOI: 10.1002/rcr2.466
This is the first report of a false-positive result for a pneumococcal rapid urinary antigen test in empyema caused by Streptococcus intermedius. |
Haemoptysis and bronchial congestion due to pulmonary vein stenosis after maze procedure
Takayuki Nakaizumi, Kei Nakamura, Kentaro Nakamura, Masanobu Ishigaki, Haruki Taniguchi, Koichiro Kajiura
DOI: 10.1002/rcr2.467
Pulmonary vein stenosis (PVS) is a rare congenital or acquired disease. Here, we describe the diagnosis and treatment strategy for the first case of acquired PVS with haemoptysis due to the maze procedure. |
Focal organizing pneumonia simulating lung malignancy: treated with prednisolone
Hemanth Kilaru, Mohd Vaseem Jalna, Satish Chandra Kilaru, Eshwar Chandra Nandury, Mohammed Zia Ur Rehman Khan
DOI: 10.1002/rcr2.469
Focal cryptogenic organizing pneumonia can be diagnosed with computed tomography-guided biopsy, avoiding surgical resection and can be treated with oral corticosteroids. Early treatment can reduce relapses and is cost-effective. |
Artificial stone-associated silicosis: clinical-pathological-radiological correlates of disease
Kovi Levin, Catriona McLean, Ryan Hoy
DOI: 10.1002/rcr2.470
We describe the clinical-radiological-histological correlates of disease for artificial stone-associated silicosis from two patients who underwent lung transplantation. We identified the presence of both alveolar proteinosis and nodular fibrosis within the same lung parenchyma. |
First successful case of chemical pleurodesis with oxytetracycline through Rocket® Pleural Vent™: ambulatory pneumothorax device for pneumothorax
Wang Chun Kwok, Ka Chun Cheng, David Chi Leung Lam, Terence Chi Chun Tam
DOI: 10.1002/rcr2.471
This is the first reported case of successful chemical pleurodesis through Rocket® Pleural Vent™ for pneumothorax, which may serve to provide additional alternatives to the management of secondary spontaneous pneumothorax that is indicated for pleurodesis after lung re-expansion. |
Invasive tracheal aspergillosis after chemoradiotherapy treatment
Shok Yin Lee, Phan Nguyen, Sally Chapman
DOI: 10.1002/rcr2.473
Invasive tracheobronchial aspergillosis is a rare disease with most reported cases in the literature occurring in immunocompromised hosts. We report an unusual case of a patient with persistent cough and dyspnoea in the context of prior chemoradiotherapy for primary lung cancer who was subsequently found to have invasive tracheobronchial aspergillosis of the distal trachea and proximal of right main bronchus. |
| Clinical Image |
Pulmonary artery pseudoaneurysm
Saeko Takahashi, Risa Shigematsu, Eisuke Shiomi, Kuniaki Ohori, Nobutake Ito, Morio Nakamura
DOI: 10.1002/rcr2.468
We highlight the importance of computed tomography angiography before performing transbronchial biopsy in patients with haemoptysis. |
Asymptomatic congenital tracheal stenosis
Toshiyuki Sumi, Takumi Ikeda, Hisashi Nakata
DOI: 10.1002/rcr2.472
We describe a rare case of asymptomatic congenital tracheal stenosis in an adult with a mild degree of stenosis. |
