| Case Series |
Interstitial lung disease induced by docetaxel and ramucirumab chemotherapy after nivolumab treatment
Komugi Okeya, Yukio Kawagishi, Mako Yamoto, Mami Shimizu, Toshihide Imizuda, Hiroshi Tsuji DOI: 10.1002/rcr2.564
We report cases of three patients who developed interstitial lung disease (ILD) during combination therapy with docetaxel and ramucirumab after nivolumab treatment. |
Granulomatous lymphocytic interstitial lung disease: limiting immunosuppressive therapy—a single-centre experience
Thomas J Beaton, David Gillis, Karen Morwood, Michael Bint DOI: 10.1002/rcr2.565
Granulomatous lymphocytic interstitial lung disease (GLILD) can be a progressive ILD-associated common variable immunodeficiency (CVID) that results in increased mortality. There are no treatment guidelines; however, progressive disease often responds to immunosuppression when intravenous immunoglobulin g (IVIg) monotherapy fails. This series adds evidence that immunosuppression can be limited with close observation in clinically stable patients and some patients can consider ceasing immunosuppression when disease has initially responded. |
| Case Reports |
Non-invasive ventilation and airway exchange catheter using a novel adapter in a difficult airway patient with post-extubation respiratory failure
Oscar Ivan Quintero Osorio, Janer V Arenas, Juan A Cuervo, Gustavo A Ospina Tascón DOI: 10.1002/rcr2.558
We describe the case of a woman with a difficult airway who developed post-extubation respiratory failure. We provided successful non-invasive ventilation support using a novel tube adapter for non-invasive mechanical ventilation, which improved the patient's adaptation to a nasoenteric tube and an oronasal mask. Simultaneously, an airway exchanger catheter placed in the trachea was maintained in situ until emergency reintubation risk was overcome. |
Longitudinal lung involvement of systemic lupus erythematosus-related vasculitis and alveolar proteinosis-like reaction
Takahito Suzuki, Noriyuki Enomoto, Yasuoki Horiike, Kazuhiro Asada, Toshihiro Shirai, Takafumi Suda DOI: 10.1002/rcr2.559
Here, we present a case of systemic lupus erythematosus (SLE)-related lung vasculitis concomitantly with pulmonary alveolar proteinosis (PAP)-like reaction in a 44-year-old woman. |
Pembrolizumab-induced secondary sclerosing cholangitis in a non-small cell lung cancer patient
Sachiko Matsumoto, Keisuke Watanabe, Nobuaki Kobayashi, Kuniyasu Irie, Shoji Yamanaka, Takeshi Kaneko DOI: 10.1002/rcr2.560
Pembrolizumab, a humanized anti-programmed cell death-1 (PD-1) monoclonal antibody, demonstrates efficacy in treating non-small cell lung cancer (NSCLC). However, it can cause immune-related adverse events (irAEs), including inflammatory manifestations. Cholangitis is a rare irAE. Herein, we report on an NSCLC patient who developed pembrolizumab-induced cholangitis and review the relevant literature. |
Successful treatment of pyopneumothorax with bronchopleural fistula using endobronchial Watanabe spigots
Chan Sin Chai, Swee Kim Chan, Sze Shyang Kho, Mei Ching Yong, Siew Teck Tie DOI: 10.1002/rcr2.562
We describe a case of necrotizing pneumonia complicated with bronchopleural fistula (BPF) and pyopneumothorax which was treated successfully with endobronchial Watanabe spigot (EWS). This case highlights the role of EWS in the management of BPF in patients with high surgical risk. |
Pulmonary alveolar proteinosis after lung transplantation
Chandima Divithotawela, Simon H Apte, Maxine E Tan, Tharushi A De Silva, Daniel C Chambers DOI: 10.1002/rcr2.566
Here, we report a case of secondary pulmonary alveolar proteinosis (PAP) after double lung transplantation with highly oxidized protein and pro-inflammatory gene expression in whole lung lavage (WLL) fluid. Our patient was successfully treated with WLL. His repeat bronchoalveolar lavage (BAL) fluid analysis showed reduced lipofuscin and normalized macrophage size and gene expression. |
Giant intrapulmonary malignant peripheral nerve sheath tumour
Desdiani Desdiani, Siti Darifah, Chairul Azali DOI: 10.1002/rcr2.567
We present a rare case of primary lung malignant peripheral nerve sheath tumours (MPNSTs) in an adult female non-smoker patient, in whom surgical thoracotomy approach has obtained a good control of the disease. Low-grade MPNST was established from excisional biopsy followed by immunohistochemistry. |
Drainage of middle lobe vein into anomalous right lower lobe vein: management during thoracoscopic lobectomy
Dario Amore, Alessandro Saglia, Dino Casazza, Tullio Valente, Pasquale Imitazione, Carlo Curcio DOI: 10.1002/rcr2.568
Here, we report a case of middle lobe vein draining into a right inferior lobar vein formed by two anomalous trunks lying on the superior surface of the common basal bronchus: in such instance, to avoid compromising the middle lobe vein drainage during a thoracoscopic right lower lobectomy, the two main tributaries of the lower lobe vein were individually identified and dissected peripherally from the anterior aspect after division of the major fissure. A careful hilar dissection and a precise surgical strategy can help surgeons perform correct procedures in presence of pulmonary vascular anomalies. |
Autoimmune pulmonary alveolar proteinosis prior to myelodysplastic syndrome
Chuan Tai Foo, Louis Chhor, Francis Thien DOI: 10.1002/rcr2.569
We report the first case of autoimmune pulmonary alveolar proteinosis associated with and preceding myelodysplastic syndrome. |
Destroyed lung due to sustained inflammation after chemoradiotherapy followed by durvalumab
Kageaki Taima, Hisashi Tanaka, Masamichi Itoga, Yoshiko Ishioka, Akira Kurose, Sadatomo Tasaka
DOI: 10.1002/rcr2.580
This report has presented a case of destroyed lung in a patient with non-small cell lung cancer (NSCLC) who received chemoradiotherapy followed by durvalumab. Because of the sustained inflammation and abolished function of the left lung, left pneumonectomy was required. We considered that durvalumab might further accelerate the inflammatory response, which had been introduced by fungal infection, leading to uncontrollable inflammation of the lung. |
Pleural cryobiopsy is useful for comprehensive cancer genetic panel testing
Satoru Ishii, Hiromu Watanabe, Shinyu Izumi, Masayuki Hojo, Haruhito Sugiyama DOI: 10.1002/rcr2.581
Here, we describe a case of an 83-year-old woman in whom insufficient pleural tissue to perform comprehensive cancer genetic panel testing was obtained with biopsy forceps, but sufficient tissue was obtained with cryobiopsy. |
An extremely rare case of nivolumab-associated macroscopic duodenitis with spontaneous regression
Takatora Akizawa, Takeshi Saraya, Hiroki Takakura, Masachika Fujiwara, Haruyuki Ishii, Hajime Takizawa DOI: 10.1002/rcr2.582
Immune-related adverse events usually occur in the colon; however, the duodenum could be affected by the immune checkpoint inhibitors. This is an extremely rare phenomenon that is characterized by pathologically non-specific inflammation. |
Diffuse large B-cell lymphoma presenting with cavitary lung disease
Yukiko Hibino, Ryosuke Imai, Torahiko Jinta DOI: 10.1002/rcr2.584
We herein report a case in which a patient with diffuse large B-cell lymphoma (DLBCL) presented with cavitary lung disease and splenic mass, which was diagnosed by transbronchial biopsy. DLBCL should be considered as a differential diagnosis in patients with cavitary lung diseases who have rare metastatic lesions for primary lung cancer, such as intra-abdominal lymph nodes or spleen. |
Bronchogenic cysts mimicking thymoma in the anterior mediastinum
Jonggeun Lee, Jee Won Chang DOI: 10.1002/rcr2.583
We present two cases of surgically resected bronchogenic cysts in the anterior mediastinum mimicking thymoma. |
Pulmonary tuberculosis in an immunocompetent patient with primary laryngeal aspergillosis
Nirmal Kanti Sarkar, Bijoy Pada Gope DOI: 10.1002/rcr2.586
A 45-year-old physician presented with dry cough and progressive vocal fatigue and was diagnosed as primary laryngeal aspergillosis. Further work-up revealed coexistent pulmonary tuberculosis. |
High-pressure leakage of pleural fluid through the healed entry site of the indwelling pleural catheter from undrained locules
Ka Pang Chan, Ka Ching Joyce Ng, Chi To Kevin Li
DOI: 10.1002/rcr2.587
This is the first case report for fluid leakage through a healed entry site of the indwelling pleural catheter due to high pressure built from undrained pleural fluid locules. The condition was successfully treated with an additional drain targeting the largest undrained locule. |
Sleep-related breathing disorders associated with the characteristics of underlying congenital rare diseases of Moebius syndrome and Poland syndrome
Ai Inagaki Sugiyama, Satomi Shiota, Tomoko Yamada, Jun Ito, Kazuhiro Suzuki, Kazuhisa Takahashi DOI: 10.1002/rcr2.579
Here, we describe in detail the causal interactions between underlying two intractable and rare diseases, namely Moebius syndrome and Poland syndrome, and sleep-related breathing disorders in a 24-year-old woman. |
| Clinical Image |
An unanticipated use of the nasogastric feeding tube
Satoru Yanagisawa, Ohe Takashi DOI: 10.1002/rcr2.561
Nasogastric feeding (NGF) tube should be used only for the main intended purpose such as feeding, and the correct insertion of the NGF tube into the gastrointestinal tract is encouraged; however, an NGF tube aberrantly inserted into the lung might provide a valuable opportunity of obtaining samples from the lower respiratory tract. Here, we present the case of a 77-year-old-man with right lower pneumonia who required NGF. The NGF tube was inadvertently inserted into the right main airway to the lower lung and immediately removed. However, the tube had collected some sample which was used to confirm the presence of methicillin-resistant Staphylococcus aureus (MRSA) which guided treatment. |
Miliary opacities in pulmonary sarcoidosis
Keishi Sugino, Hirotaka Ono, Masahiro Ando, Seiji Igarashi, Atsuko Kurosaki, Eiyasu Tsuboi DOI: 10.1002/rcr2.563
We present a rare case of a 37-year-old woman diagnosed with pulmonary sarcoidosis who presented with unusual bilateral upper lobes miliary opacities on chest high-resolution computed tomography. |
Incidental synchronous bronchial tumour: an unusual bronchoscopic finding
Umberto Caterino, Dario Amore, Chiara Petagna, Albina Palma, Danila Caroppo, Simona Massa DOI: 10.1002/rcr2.585
We describe a patient with incidental endobronchial synchronous hamartoma and typical carcinoid and the management strategy. |
