| Case Series |
Transthoracic placement of fiducials with ultrasound or electronic navigational bronchoscopy needle guidance by the interventional pulmonologist: A case series
Dany Gaspard, Ziad Boujaoude, Gregory Kubicek, Wissam Abouzgheib
DOI: 10.1002/rcr818
In this study, we aim to evaluate the feasibility and safety of transthoracic ultrasound or electronic navigational bronchoscopy (ENB) needle-guided fiducial placement in the chest performed by interventional pulmonologists in the bronchoscopy suite. We describe six such cases performed at Cooper University Hospital in Camden, New Jersey, USA. |
| Case Reports |
An unusual case of invasive pleuritis and miliary Mycoplasma pneumonia during check-point inhibitor therapy
Daniel Bird, Maninder Singh
DOI: 10.1002/rcr813
A novel case of disseminated miliary Mycoplasma pneumonia with invasive diffuse pleural involvement is reported. This is an atypical manifestation of a relatively common presentation likely due to altered immunity from concurrent check-point inhibitor immunotherapy for metastatic melanoma. |
Non-pneumophila Legionella species pneumonia with orange-coloured sputum
Maki Asami-Noyama, Misa Harada, Kaori Murakawa, Junki Suizu, Keita Murakawa, Ayumi Chikumoto, Kazuki Hamada, Yoriyuki Murata, Keiji Oishi, Yoshikazu Yamaji, Nobutaka Edakuni, Tsunahiko Hirano, Tomoyuki Kakugawa, Kazuto Matsunaga
DOI: 10.1002/rcr814
In non-endemic countries such as Japan, Legionella longbeachae pneumonia is thought to be underdiagnosed due to inadequate recognition. We report a case of the orange-coloured sputum and bronchoalveolar lavage fluid and the detailed medical interview about recent gardening activity and exposure to compost or potting mix, which might be signs for rapid diagnosis of non-pneumophila Legionella species pneumonia with a negative urinary antigen test. |
Rapid growing mediastinal ectopic pancreas within ruptured thymic cyst treated using video-assisted thoracic surgery
Kazuki Sugata, Koichiro Kajiura, Haruki Taniguchi, Tomoya Kuda, Akiko Matsuzaki, Taizo Fukumoto
DOI: 10.1002/rcr815
Ectopic pancreas (EP) is typically found within other gastrointestinal organs. Its discovery in other parts of the body, especially in the mediastinum, is exceedingly rare. This paper presents a case of a 17-year-old female patient with EP in a large, rapidly growing thymic cyst. |
Bronchial ethanol injection therapy for airway obstruction in lung cancer patients
Fukuko Okabe, Yukihiro Yano, Tomoki Kuge, Takeshi Uenami, Masaki Kanazu, Masahide Mori
DOI: 10.1002/rcr816
Obstructive endobronchial tumours often cause decreased quality of life. Bronchial ethanol injection (BEI) therapy is considered an effective modality for airway dilatation or haemoptysis without specialist equipment. Here, we report experiences of two cases in which BEI therapy was effective for obstructive endobronchial tumours. |
Dramatic response to alectinib in an ALK-positive LCNEC patient with a poor performance status: A case report
Kazuki Masuda, Masafumi Saiki, So Shimamura, Shuichiro Ide, Yoshinori Uchida, Yusuke Sogami, Hiroshi Ishihara, Fumi Ikeda, Kiyotaka Kugiyama
DOI: 10.1002/rcr817
We report a patient with LCNEC harbouring ALK rearrangement with a poor performance status, who showed a good response to alectinib as first-line treatment. The patient's PS also improved, made him eligible for further chemotherapy when alectinib had failed. |
Pulmonary melioidosis complicating foreign body aspiration in a young adult
Mahesh Babu Vemuri, Archana Malik, Madhusmita Mohanty Mohapatra, Sujatha Sistla, Shahana Madan Purath, Sruthi Raj, Manju Rajaram
DOI: 10.1002/rcr819
Melioidosis is caused by an environmental Gram-negative bacilli Burkholderia pseudomallei. Diabetes mellitus, occupational exposure to soil and water, pre-existing renal diseases and thalassemia are significant independent risk factors for melioidosis. Herein, we report a case of melioidosis following foreign body aspiration and briefly review the literature on melioidosis. |
Localized tracheobronchial amyloidosis: A rare case presentation and tailored management approaches
Jonathan Arulanantham, Charlotte Officer, Chelsie O'Connor, Tina Baillie, Simon Bass, Jonathan P. Williamson, Alan Carew
DOI: 10.1002/rcr820
Localized tracheobronchial amyloidosis (TBA) is a rare manifestation of pulmonary amyloidosis, resulting from the pathological deposition of amyloid protein within the central airway wall. We present the initial management and subsequent outcomes of a patient with localized TBA, presenting with central airway obstruction. |
COVID-19 pneumonia suspected to be co-infection with Mycoplasma pneumoniae and improved by early administration of favipiravir and ciclesonide
Keima Ito, Takako Yokoyama, Minoru Horiuchi, Munehiro Kato, Ikuji Usami
DOI: 10.1002/rcr821
We present the case of a patient with coronavirus disease 2019 (COVID-19) pneumonia who was suspected to have co-infection with Mycoplasma pneumoniae and a nosocomial infection from a patient treated with a high-flow nasal cannula, and who did not worsen and was relieved by early administration of favipiravir and ciclesonide. |
Posaconazole-induced hypertension in children with cystic fibrosis
Rachael Marpole, Daniel K. Yeoh, Adelaide L. Withers
DOI: 10.1002/rcr822
Posaconazole is a triazole antifungal with a broad spectrum of activity against moulds including Aspergillus spp. Rarely, it can cause pseudohyperaldosteronism. We describe two cases of children with cystic fibrosis who developed hypertension, likely due to pseudohyperaldosteronism, following the initiation of posaconazole for the treatment of allergic bronchopulmonary aspergillosis. |
A case of granulomatosis with polyangiitis mimicking lung malignancy
Michael Han, Corinna Pan
DOI: 10.1002/rcr824
Granulomatosis with polyangiitis (GPA) may present with varied manifestations including lung nodules/masses mimicking malignancy. We present the case of a patient presenting with cough, haemoptysis and constitutional symptoms on a background of significant past smoking history, with multiple lung nodules and mediastinal lymphadenopathy found on chest computed tomography. Biopsy showed granulomatous inflammation and elevated c-ANCA/PR3 confirmed the diagnosis of GPA. |
Negative pressure pulmonary oedema due to rigors and chills associated with liver abscess
Haroon Chaudhry, Swathi Nimmala, Bhavani Nagendra Papudesi, Fizza Sajjad, Sanu Paul, Zimran Gohar, Reuben Azad, Hannah Naveen, Joseph Demidovich
DOI: 10.1002/rcr826
Negative pressure pulmonary oedema (NPPE) is caused by upper airway obstruction and rapid negative pressure due to inspiratory efforts against an obstruction in a patient with preserved ejection fraction. NPPE is a perioperative life-threatening emergency, but it is rarely diagnosed and reported due to unfamiliarity. Here, we discuss the case of a patient who developed acute respiratory failure with bacteraemia due to NPPE after an intense inspiratory effort against transient laryngeal dyskinesia |
Systemic sclerosis-associated interstitial lung disease in a Vietnamese adult female: Case report and literature review
Thi Thuy Linh Nguyen, Thi Y Nhi Nguyen, Trong Khoan Le, Thao Nguyen Thanh, Trong Binh Le
DOI: 10.1002/rcr827
Systemic sclerosis-associated interstitial lung disease (ILD) is a rare disease in the Asian population and should be included in the list of differential diagnoses of ILD. |
An unusual cause of pleural effusion
Chi-Wei Shih, Yi-Jia Lin, Hung-Yi Yang, Chia-Hsin Liu
DOI: 10.1002/rcr828
Here, we report a rare case of human herpes virus-8-associated primary effusion lymphoma in the setting of HIV/AIDS presenting with fever, oral thrush and malignant lymphomatous pleural effusion. |
Bilateral pleural metastases of a primary central nervous system neuroblastoma in an adult: First case in the world
Lobna Loued, Asma Migaou, Mabrouk Abdelaaly, Ahlem Bellalah, Nesrine Fahem, Rania Kaddoussi, Ahmed Ben Saad, Samah Joobeur, Saoussen Cheikh Mhamed, Naceur Rouatbi
DOI: 10.1002/rcr829
This study presents an unusual case of bilateral pleural metastases of a primary cerebral tumour. The metastases were confirmed through pathology. Pleural secondary location was never described before. |
A case of epithelioid cell granulomas arising at the margin of lung resection, with high accumulation on 18F-fluorodeoxyglucose-positron emission tomography
Shinnosuke Yokotsuka, Shugo Uematsu, Momoka Okada, Shinnosuke Takamiya, Shinichi Ohashi, Yoko Tanaka, Kosuke Suzuki, Akihiko Kitami, Tetsuo Nemoto
DOI: 10.1002/rcr830
It seems crucial to differentiate tumour recurrence from other conditions that could show high accumulation on 18F-fluorodeoxyglucose-positron emission tomography. We present a case of epithelioid cell granulomas arising at the margin of lung resection for carcinoid treatment 20 years previously. |
Multiple cerebral infarctions in ROS1-rearranged lung adenocarcinoma
Hiroaki Ikushima, Yoshihisa Hiraishi, Kanto Toriumi, Takahiro Ando, Hiroyuki Tamiya, Junichi Ishida, Yosuke Amano, Hidenori Kage, Goh Tanaka, Takahide Nagase
DOI: 10.1002/rcr831
In Case 1, after 1 day of bronchoscopy, the patient developed neurological symptoms and brain magnetic resonance imaging showed multiple acute cerebral infarction. |
A case of giant intradiaphragmatic bronchogenic cyst
Naoya Kitamura, Tomohiko Takahashi, Tetsuya Takayama, Jun Kawamukai, Hideki Shinno, Hideki Miyazawa
DOI: 10.1002/rcr832
We present an exceedingly rare case of a giant bronchogenic cyst that had developed within the right diaphragm. The cyst was successfully surgically resected. |
Low-dose oestrogen–progestin associated pulmonary infarction mimicking pneumonia and pleurisy
Kyoko Gocho, Shinnosuke Kitazawa, Shinya Matsushita, Nobuyuki Hamanaka
DOI: 10.1002/rcr833
We report a case of pulmonary infarction in a young woman with a history of treatment with a low-dose oestrogen–progestin (LEP) formulation that was misdiagnosed as infection because of response to antibiotics and similar computed tomography findings. Therefore, careful evaluation of the patient history and clinical findings are imperative for accurate diagnosis. Venous thromboembolism can occur frequently around 3 months after the start of LEP treatment. |
Myelin basic protein expression in thymoma after methylprednisolone administration for multiple sclerosis
Tomomi Isono, Naoko Ose, Keisuke Kawasaki, Ayumi Shibata, Soichiro Funaki, Yasushi Shintani
DOI: 10.1002/rcr834
The relationship between thymic epithelial tumour and demyelinating disease (DD) is unknown and surgical resection has not been optimized. We present the case of a 39-year-old woman with newly diagnosed multiple sclerosis with a thymic tumour in the antero-superior mediastinum. Video-assisted thoracoscopic thymectomy was performed and the tumour was diagnosed as a Type AB thymoma. Immunohistochemical staining showed positive myelin basic protein (MBP) in the cytosol of spindle cells in the tumour specimen. This case suggests that ectopic MBP presentation in thymoma might be correlated with DD. |
Asthma caused by durvalumab after chemoradiotherapy in two patients with non-small cell lung cancer
Takehiro Uemura, Kensuke Fukumitsu, Ken Maeno, Satoshi Fukuda, Tomohiro Onuki, Yoshihiro Kanemitsu, Tetsuya Oguri, Akio Niimi, Toyoaki Hida
DOI: 10.1002/rcr835
This study reported two cases in which asthma was caused by durvalumab after chemoradiotherapy in patients with non-small cell lung cancer. Asthma should be considered as one of the possible side effects when immune checkpoint inhibitors are used in cancer treatment. |
Conservative management of a complete primary spontaneous pneumothorax
Thisuri Jayawardena, Sophie Krivinskas, Y C Gary Lee
DOI: 10.1002/rcr837
A recent randomized trial investigating conservative management of large primary spontaneous pneumothoraces (PSP) showed similar re-expansion rates and reduced adverse events compared to chest tube drainage. Nonetheless, clinicians are understandably anxious with a conservative observational approach for patients with very large pneumothorax. Here, we report a patient with a right-sided PSP and total lung collapse that was managed successfully without intervention with minimal time in hospital or off work. |
| Clinical Images |
Spigot in pneumothorax cavity: A rare complication of endobronchial Watanabe spigot
Shion Miyoshi, Kyohei Kaburaki, Hajime Otsuka, Kazuma Kishi
DOI: 10.1002/rcr823
Spigot dropping is a rare but an intractable complication of bronchial occlusion because it is difficult to salvage a dropped spigot from the thoracic cavity. If the pneumothorax with a large fistula is recurrent, replacement with a larger size spigot may be recommended. |
Waterproof spray-induced lung injury while using a heater
Yasuyuki Higashi, Kei Yamasaki, Takeshi Orihashi, Kazuhiro Yatera
DOI: 10.1002/rcr825
Fluororesin in waterproof spray becomes a pyrolysis product due to the heat of tobacco as well as a heater and can cause lung injury. We report the case of a 32-year-old non-smoker man who developed non-productive cough, dyspnoea and headache 1 h after using waterproof spray near a heater in a closed room. Chest computed tomography revealed bilateral diffuse ground-glass attenuations and lung biopsy showed mild inflammation. The internal temperature of a heater is higher than the set temperature, and it is considered that this temperature is sufficient to produce the pyrolysis product of fluororesin. Few cases of spray-related lung injury while using a heater are reported. Physicians should know that injury can occur with heater usage as in smoking. |
