Respirology Case Reorts

Fabiana Diaz-Churion, Alejandra Yu Lee-Mateus, David Abia-Trujillo, Margaret M Johnson, Andras Khoor, Neal M Patel, Janani Reisenauer, Sebastian Fernandez-Bussy
DOI: 10.1002/rcr2.1092

The combined use of robotic-assisted bronchoscopy with needle-based confocal laser endomicroscopy may potentially enhance the differentiation of malignant cells in real-time and increase sample adequacy, accuracy, and diagnostic yield when doing a biopsy of a suspicious pulmonary lesion.

Ajit Nair, Paul Leong
DOI: 10.1002/rcr2.1088

Pulmonary leiomyoma has a diverse clinical spectrum of disease. Here we describe two patients with vastly different presentations, which highlights the clinical heterogeneity in this disease, and thus, complexity in devising standardized diagnostic and therapeutic protocols.

Christopher Chan, Jenny C L Ngai, Ken K P Chan, Joyce K C Ng, David S C Hui
DOI: 10.1002/rcr2.1090

Pneumomediastinum is uncommon in the absence of pneumothorax, and can occur as a complication of lung abscess formation. Computed tomography of the thorax is an excellent tool to facilitate early detection of this complication, and in this case, enabled the patient to receive timely treatment. We report the clinical and radiological findings and following treatment in such a patient.

Changhwan Kim, Hae-Seong Nam, Yousang Ko
DOI: 10.1002/rcr2.1091

Primary tracheobronchial schwannomas are extremely rare. Surgical treatment has been the first choice for these benign tumors due to the substantial residual rates and recurrences. The preset study suggests that rigid bronchoscopic treatment with multiple instruments such as snare electrocautery, insulation-tipped knife, and argon plasma coagulation can be a good option for tracheobronchial schwannomas.

Saeko Takahashi, Tomohiro Takehara, Tetsuo Tani, Kota Ishioka, Seiji Madoiwa
DOI: 10.1002/rcr2.1093

Disseminated intravascular coagulation (DIC) following tumour lysis syndrome (TLS) is a rare but serious life-threatening complication that clinicians need to be aware of when treating patients with advanced small cell lung cancer (SCLC). To the best of our knowledge, this is the first report of DIC following TLS in a case of SCLC.

Tinku Joseph, Sumita Agrawal, Sreeraj Nair, Chandrasekhara Jayakumar, Rajesh Gopalakrishnan, Ajit Nambiar
DOI: 10.1002/rcr2.1096

Transbronchial lung cryobiopsy (TBLC) has been reported to have high diagnostic yield for adult interstitial lung disease (ILD) with limited complications. However, this technique has not been utilised for diagnosis of diffuse parenchymal lung diseases (DPLD) in an infant. We present the first case of infant lung cryobiopsy done using rigid tracheoscope in a suspected case of childhood interstitial lung disease.

Miwako Kogure, Eri Takase, Aya Fusamoto, Koichi Sato, Yukiko Tsuchihashi, Hirotaka Nakanishi, Takeshi Ikeda, Tomokazu Kuchibiro, Yoshimitsu Hirai, Kuninobu Kanai
DOI: 10.1002/rcr2.1098

Pulmonary nocardiosis is a rare disease that is often difficult to cure because of its tendency to recur. This report shows that the treatment with combination of medication and surgery was useful for treating refractory localized pulmonary nocardiosis caused by Nocardia mexicana.

Tae Gyoung Kim, Jiyeon Kang, Woo Jung Seo, Jieun Kang, So-Hee Park, Hyeon-Kyoung Koo, Hye Kyeong Park, Sung-Soon Lee, Jung Gon Kim, Hyung Koo Kang
DOI: 10.1002/rcr2.1097

The patient presented with unilateral alveolar opacification on chest radiographs and anemia without hemoptysis. She was diagnosed with microscopic polyangiitis with diffuse alveolar hemorrhage (DAH). This case highlights the importance of prompt recognition of clinical symptoms and signs for the diagnosis of DAH.

Takahiro Shimizu, Hiroki Shirasaki, Kazuhiro Okafuji, Aiko Sawazaki, Tasuku Iwabuchi, Ryo Matubayashi
DOI: 10.1002/rcr2.1099

A 54-year-old patient with COVID-19 had a medical history of follicular lymphoma treated with obinutuzumab, an anti-CD20 monoclonal antibody. This prevented the production of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus resulting in persistent pneumonia. Administration of 300 mg of tixagevimab and cilgavimab markedly improved the patient's general condition, and led to remittance of pneumonia.

Ryan Welch, Brooke Kelly, Ken Whyte, Kevin Ellyett, Clair King
DOI: 10.1002/rcr2.1103

Our case report details the ventilatory response during exercise of a 17-year-old female who suffered a sports related concussion and subsequently post-concussion syndrome. On exercise test 1 (two-years following concussion), the striking abnormality was hypoventilation, however on repeat exercise test two-years later the ventilatory response was normal. Improved ventilatory response following concussion may be related to improved CO2 sensitivity or neuroplasticity remodelling the ventilatory response during exercise.

Charles Wong, Chin Tou Lam, Loretta Yin Chun Yam
DOI: 10.1002/rcr2.1104

A young adult presented with non-specific symptoms with CXR features of left pleural effusion. Before attempting drainage, ultrasound demonstrated features of intra-thoracic intestinal structures, which was confirmed by CT thorax to be Bochdalek hernia. Acute recurrent symptoms three months post-discharge was associated with BH enlargement and early bowel ischemia, which was successfully managed by emergency surgery.

Maissa Jellali, Mohamed Ali Chaouch, Sadok Ben Jabra, Amani Moussa, Hanene Zenati, Khadija Zouari, Faouzi Noomen
DOI: 10.1002/rcr2.1105

An extremely rare case of upper gastrointestinal haemorrhage caused by duodenal metastasis from primary lung cancer.

Mamiko Hoshi, Yutaka Kozu, Michio Kawamura, Naho Furusho, Ryosuke Ozoe, Yusuke Jinno, Kenichi Sugaya, Hisato Hiranuma, Kazuo Chin, Yasuhiro Gon
DOI: 10.1002/rcr2.1106

We herein describe a patient with severe sleep apnoea who was diagnosed with platypnoea–orthodeoxia syndrome (POS) after identification of unexplained hypoxia. The changes in SpO2 before and after surgery were characteristic of POS.

Wei-Chiang Lin, Shang-Yi Lin, Meng-Che Tsai, Fu-Tsai Chung, Hsiu-Mei Chang
DOI: 10.1002/rcr2.1107

This case report discusses the effect of recruitment manoeuvre in an ARDS patient who was infected by COVID-19.

Yuya Kogita, Naoko Ose, Kotaro Kawagishi, Eiichi Morii, Yasushi Shintani
DOI: 10.1002/rcr2.1109

Rare colloid adenocarcinoma of lung may have a good prognosis for its size if completely resected.

Ryosuke Kataoka, Yoshiro Kai, Hiroya Ohara, Hiromasa Hirai, Kentaro Suzuki, Masato Takano, Yoshifumi Yamamoto, Shigeo Muro
DOI: 10.1002/rcr2.1110

Sarcoidosis that involves the optic nerve can cause progressive visual impairment and blindness. Here we present a case of sarcoidosis that presented with optic neuritis and with systemic disease in the mediastinal/hilar lymph nodes and skin.

Nobuhiro Fujioka, Yoshiro Kai, Ryosuke Kataoka, Kentaro Suzuki, Kazuhiro Sakaguchi, Yoshifumi Yamamoto, Takeshi Kawaguchi, Noriyoshi Sawabata, Haruyuki Tanaka, Minami Matsuoka, Maiko Takeda, Shigeo Muro
DOI: 10.1002/rcr2.1111

Here, we report our experience with a case of primary pulmonary lymphoma-diffuse large B-cell lymphoma (PPL-DLBCL) detected as multiple pulmonary nodules and masses mimicking metastasis. The cause of multiple nodules of the lung in the elderly is mostly metastasis. In our case, the images suggested metastatic lung disease; however, the final diagnosis was a PPL. Sometimes, rare malignancies may result in a better prognosis than common lung malignancies. Histological diagnosis of lung lesions is important.

Naho Sakamoto, Motoyasu Kato, Toshihiko Ohni, Yuriko Terayama, Shun Nakazawa, Shouichi Okamoto, Jun Ito, Kazuhisa Takahashi
DOI: 10.1002/rcr2.1085

This is the first case confirming the association between pneumatosis intestinalis (PI) development and nintedanib by the reproducibility of PI development. In patients taking a combination treatment with corticosteroid and nintedanib, clinicians should be careful regarding the development of PI although the patient improved only after discontinuation of nintedanib treatment.

Cosimo Carlo De Pace, Pasquale Tondo, Gianluca Libero Ciliberti, Massimo Selmi, Donato Lacedonia
DOI: 10.1002/rcr2.1094

Rasmussen's aneurysm was originally described as a rare cause of hemoptysis in tuberculosis. Dilatation of the pulmonary artery wall is caused by tuberculosis inflammation. Recently, the incidence of non-tuberculous mycobacterial (NTM) disease has increased; it now exceeds that of tuberculosis. We report a Rasmussen's aneurysm due to NTM.

Cosimo Carlo De Pace, Pasquale Tondo, Gianluca Libero Ciliberti, Massimo Selmi, Donato Lacedonia
DOI: 10.1002/rcr2.1095

Broncholithiasis is a rare condition that can be ignored or misinterpreted by pulmonologist. In our opinion, it is important to know this disease because it is associated in many cases to hemoptysis. Etiology is unknown and after our research in the literature, we found no other cases of broncholithiasis in which the cultural examination resulted positive for Providencia rettgeri.

Yasuhito Sekimoto, Makiko Kohmaru, Tomoko Okuma, Manabu Tajima, Mitsuaki Sekiya
DOI: 10.1002/rcr2.1100

Diagnostic thoracentesis is a basic and relatively safe diagnostic method for patients with pleural effusion. However, complications of thoracentesis are rare and not well known because of the low incidence. Herein, we report a case of subcutaneous and muscle layer seroma following thoracentesis.

Steven Tessier, Santo Longo, Firas Ido
DOI: 10.1002/rcr2.1102

We present a case of isolated IgG2-deficiency in a patient with Yellow Nail Syndrome (YNS), manifested by yellow-green nails, bilateral pleural effusions, pericardial effusion, bronchiectasis, and lower extremity edema. Given the rarity of the condition (estimated prevalence <1/1,000,000) and lack of thorough population-based studies, association of new or rare manifestations with YNS relies heavily on individual case reports.

Hugh Buzacott, Jaideep Vazirani, Gregory Ian Snell
DOI: 10.1002/rcr2.1108

We present imaging of lipiodil escape after thoracic duct embolization for transplant associated chylothorax leading to transient impairment, then resolution in a 67-year-old woman.