Respirology Case Reorts

Anna Kornafeld, Sebastian Fernandez-Bussy, David Abia-Trujillo, Juan C Garcia, Ryan M Chadha
DOI: 10.1002/rcr.903

Humidified rapid-insufflation ventilatory exchange (HRIVE) was able to maintain adequate oxygenation via the rigid bronchoscope in a select group of patients. We suggest HRIVE now potentially offers an option of oxygenation via the rigid bronchoscope that allows for continuous oxygenation without interruption of the procedure, a cost-effective option compared to high-frequency jet ventilation, and a less labour-intensive option compared to low-frequency jet ventilation.

Yasuhito Sekimoto, Yuichi Nagata, Motoyasu Kato, Yuta Arai, Yuichi Fujimoto, Haruhi Takagi, Takehiko Shukuya, Takuo Hayashi, Tetsutaro Nagaoka, Yasuko Yoshioka, Kazuhisa Takahashi
DOI: 10.1002/rcr.896

Dendriform pulmonary ossification (DPO) is a rare condition characterized by heterotopic bone production of unknown origin within the pulmonary tissue. This is the case of a 37-year-old man whose high-resolution computed tomography revealed diffuse reticular shadows and micronodules, consistent with calcification, who underwent transbronchial lung cryobiopsy (TBLC) and was diagnosed with idiopathic DPO based on pathological findings. To our knowledge, this is the first reported case of DPO diagnosed using TBLC.

Francesco Satriano, Giulia Scioscia, Maria Grazia Cagnazzo, Federica Maci, Leonida Refolo, Paolo Fuso, Emanuele Gerardi, Diego Grasso, Piera Soccio, Donato Lacedonia
DOI: 10.1002/rcr.836

Here, we report the case of a patient with coronavirus disease 2019 (COVID-19) pneumonia complicated by the onset of chylothorax. Chylothorax is a rare condition that results from thoracic duct damage with chyle leakage from the lymphatic system into the pleural space, usually on the right side. To date, few reports on chylothorax have been detected in COVID-19 patients. This case demonstrates chylothorax as a possible and uncommon complication of COVID-19.

Colin Tuft, Krishan Maheepala, Ajantha Raguparan, Anas Naeem, Suhrid Lodh, Steven Lindstrom
DOI: 10.1002/rcr.897

Pulmonary artery intimal sarcoma (PAIS) is a rare malignancy which closely mimics acute or chronic pulmonary thromboembolism. Prompt diagnosis avoids inappropriate anticoagulation and facilitates early surgical management which may improve prognosis. We present two cases of PAIS diagnosed at a single centre within a 2-year period and review the literature.

Emily Lawton, Chien-Li Holmes-Liew
DOI: 10.1002/rcr.898

An immunocompromised female with a background of common variable immunodeficiency (CVID) presented with haemoptysis and dyspnoea. Investigations demonstrated intrapulmonary right-to-left shunting and liver cirrhosis, and a diagnosis of hepatopulmonary syndrome (HPS) was made. This extremely rare association of CVID and HPS is one of the few cases reported in the literature.

Takuya Ohashi, Mitsumasa Kawago, Yoshimitsu Hirai, Megumi Kiyoi, Miwako Miyasaka, Yumi Yata, Mari Kawaji, Aya Fusamoto, Hideto Iguchi, Hitomi Nakanishi, Yoshiharu Nishimura
DOI: 10.1002/rcr.899

We report a case of capillary haemangioma diagnosed by robot-assisted thoracic surgery (RATS). A 72-year-old man was incidentally found to have an anterior mediastinal tumour on chest computed tomography. The preoperative imaging findings suggested thymoma, and surgical treatment by RATS was selected. The intraoperative findings indicated that the tumour was a haemangioma originating from the pericardiophrenic vein, which was pathologically confirmed to be a capillary haemangioma.

Shakti Dabholkar, Bo Gao, Brian Chuong
DOI: 10.1002/rcr.902

This case report is of a 78-year-old female with concurrent non-small cell lung cancer (NSCLC, stage IIIB) and idiopathic pulmonary fibrosis (IPF). After no longer able to continue conventional chemotherapy, the patient was commenced on nintedanib to treat IPF and interestingly had continued radiological regression of her NSCLC over a 2-year period with stability of IPF. This case report and literature review discuss the effectiveness of nintedanib in treating patients with concurrent IPF and NSCLC, in particular for patients poorly tolerant of conventional chemotherapy.

Melissa Neumann, Karen A Wong, Kevin Lazo, Diane Stover
DOI: 10.1002/rcr.904

In this case report, we review pulmonary arterial hypertension (PAH) especially associated with systemic sclerosis (SSc), its treatment and identify a possible novel therapeutic approach for those with PAH-SSc.

Phool Iqbal, Sinda Dakhlia, Sara Seife Hassen, Salah Mahdi
DOI: 10.1002/rcr.905

Invasive aspergillosis (IA) is a fatal disease and is related to immunocompromised patients. Diagnosis is challenging due to the non-specific nature of symptoms. We present a case of IA in a 49-year-old man with end-stage renal disease who presented with fever and developed a submandibular swelling.

Ali Sharifpour, Hossein Zarrinfar, Mahdi Fakhar, Zakaria Zakariaei, Mostafa Soleymani, Elham Sadat Banimostafavi, Maryam Nakhaei
DOI: 10.1002/rcr.906

We report the first case of pulmonary lophomoniasis in a known case of acute myeloid leukaemia (AML-2) from Qeshm Island, Persian Gulf, southern Iran. Diagnosis of lophomoniasis was confirmed using microscopy and molecular examinations of bronchoalveolar lavage fluid. The patient was treated with metronidazole (500 mg TDS for 3 weeks). We conclude that immunocompromised patients with unjustified respiratory disorders should be screened for Lophomonas infection.

Hiroko Okabayashi, Hiroko Machida, Aiko Masunaga, Hidenori Ichiyasu, Takuro Sakagami
DOI: 10.1002/rcr.900

In patients with severe respiratory disease, accessory respiratory muscles, such as the sternocleidomastoid muscles, are used to maintain ventilation. We present a patient with pleuroparenchymal fibroelastosis with intense 18F-fluorodeoxyglucose uptake in accessory respiratory muscles using positron emission tomography/computed tomography reflecting the strong respiratory effort.

Hung-Yi Lin, Jih-Chin Lee
DOI: 10.1002/rcr.901

The complications of endobronchial tuberculosis (TB) include bronchostenosis and fistula. We highly recommend that a TB test be included in the diagnosis of endobronchial lesions.