| Case series |
Acute hypercapnic respiratory failure in patients with obesity hypoventilation syndrome during the COVID-19 pandemic: Four case reports
Sato Nakamura, Yukio Kawagishi, Akihiro Kikushima, Atsushi Muto, Yoshifumi Suda, Kazuki Gohara, Shinichi Takeda
DOI: 10.1002/rcr2.1151
The current coronavirus disease-2019 (COVID-19) pandemic has greatly impacted society and individual lifestyles. Recently, we encountered four patients with obesity hypoventilation syndrome (OHS) who developed acute hypercapnic respiratory failure (AHRF) during the COVID-19 pandemic. It is suggested that increased rates of obesity due to lifestyle changes during the COVID-19 pandemic may be responsible for an increase in the prevalence of OHS-associated AHRF. |
| Case reports |
Prolonged response to first-generation tyrosine kinase inhibitor in a metastatic non-small cell lung cancer harbouring complex G719X and S768I mutations: A case report from Vietnam and literature review
Kien Hung Do, Duc Thanh Le, Tai Van Nguyen, Tu Anh Do, Chu Van Nguyen
DOI: 10.1002/rcr2.1131
In this study, we report a patient with metastatic non-small cell lung cancer carrying rare EGFR compound mutations of G719X and S768I who benefited from first-line treatment with gefitinib in Vietnam. This patient had a prolonged response lasting over 44 months with first-generation TKI. He continued to take gefitinib without experiencing serious adverse events. |
Malignant neoplasm of lacrimal gland with pulmonary metastasis
Victoria Lewis, Kate Sutton, Helen Davies
DOI: 10.1002/rcr2.1132
A 65-year-old male diagnosed with a right lacrimal gland ACC T2N0M0 (surgically resected 12 years prior) presented with an incidentally noted 1.2 cm right lower lobe lung nodule seen on MRI liver. Subsequent imaging confirmed a non-FDG avid 1.6 cm solitary ovoid subpleural lesion, percutaneous biopsy confirmed adenocarcinoma. A surgical metastasectomy was performed and recovery was complete. Prognosis in ACC is improved with radical management of the metastatic disease. Rather than a simple chest radiograph, more detailed imaging, such as MRI or CT scanning may increase the probability of early detection of pulmonary metastasis and, thereby facilitate radical treatment and improve survival. |
Krukenberg tumour as the initial manifestation of lung adenocarcinoma
Guat Yee Lim, Yen Shen Wong, Zahrah Tawil, Roqiah Fatmawati Abdul Kadir, Annamalai Ramanathan, Aisya Natasya Musa
DOI: 10.1002/rcr2.1133
Krukenberg tumour from pulmonary malignancy represents an extremely rare situation. This is an elaboration of a case of young women with Krukenberg tumour rising from lung adenocarcinoma. |
A case of bunashimeji mushroom-induced hypersensitivity pneumonitis diagnosed by inhalational provocation test in a hospital room
Tomoe Akagami, Kazuyuki Nakagome, Sotaro Takagi, Susumu Yamazaki, Shohei Minezaki, Hidetoshi Nakamura, Kenji Tsushima, Makoto Nagata
DOI: 10.1002/rcr2.1134
Hypersensitivity pneumonitis (HP) is an immunological disorder related to repeated inhalation of sensitizing allergens. Only a small number of reports have described HP caused by mushrooms. Here, we report a case of bunashimeji mushroom-induced HP, diagnosed by environmental provocation test and inhalational provocation test in a hospital room. |
Cardiovascular autonomic dysfunction induced by mechanical insufflation-exsufflation in Guillain–Barré syndrome
Ryota Kuroiwa, Yoshihisa Tateishi, Taku Oshima, Kazumoto Shibuya, Takeshi Inagaki, Astushi Murata, Satoshi Kuwabara
DOI: 10.1002/rcr2.1135
We herein describe two cases of Guillain–Barré syndrome with cardiovascular autonomic dysfunction during MI-E. While Guillain–Barré syndrome itself may cause cardiac autonomic dysfunction, MI-E possibly caused or enhanced the autonomic dysfunction by an alternation of thoracic cavity pressure. The possibility of MI-E-related cardiovascular complications should be recognized, and its appropriate monitoring and management are necessary, particularly when used for Guillain–Barré syndrome patients. |
An 83-year-old patient with RET fusion-positive non-small cell lung cancer experiencing severe hepatic disorder due to selpercatinib administration
Kazuhisa Nakashima, Yuki Mitarai, Seiko Tanaka, Mika Nakao, Takae Okuno, Tamio Okimoto, Ryo Tanabe, Takashi Yanagawa, Yukari Tsubata, Takeshi Isobe
DOI: 10.1002/rcr2.1136
The efficacy and safety of selpercatinib in older patients remain unclear. We report a case of an old female patient with RET fusion-positive NSCLC who experienced severe hepatic disorder caused by selpercatinib. |
A case of resected pulmonary capillary hemangioma with a literature review
Emi Hagui, Tadashi Sakane, Keisuke Hioki, Tomoharu Nakano, Hiroshi Haneda
DOI: 10.1002/rcr2.1138
We report a 63-year-old man who was diagnosed with a pulmonary capillary hemangioma with a literature review. On chest CT, the lesion was shown to be a solid nodule with contrast-enhanced margins. This finding was thought to reflect the dense vascular hyperplasia of the central part of the tumour based on the pathologic findings. |
Severe COVID-19 pneumonia in pregnant woman treated with pulse corticosteroids therapy and third-trimester caesarean section: A case report
Nghia Thinh Bui, Minh Nhat Huynh, Hung Tran, Dinh Kha Le, Tan Thanh Pham, Thanh Tung Pham, Tien Nhan Nguyen, Nguyen-Huy Do-Tran, Hoang-Anh Ngo, Thuy-Anh Do
DOI: 10.1002/rcr2.1139
In this case report, we present a critical COVID-19 case of a 44-year-old woman at 30 weeks of pregnancy. Her treatment was based on pulse corticosteroid therapy, accompanied by caesarean delivery. After nearly 1 month of hospitalization, with most of the time being in the intensive care unit, she was discharge and showed full recovery upon re-examination 10 months later. |
A rare case of hemophagocytic lymphohistiocytosis mimicking flare of systemic lupus erythematosus
Areeb Tiwana, Maida Tiwana, Jiang Wang, Muhammad Umair Khawar
DOI: 10.1002/rcr2.1140
Disseminated histoplasmosis can cause multiorgan involvement especially in a patient with underlying autoimmune disease as in this case of a 24-year-old female with HLH who was initially treated as a flare of autoimmune disease but later etiology was confirmed as disseminated histoplasmosis on bone marrow histopathological examination. |
Rapidly progressive respiratory failure due to antisynthetase syndrome related interstitial lung disease
Marwan Almubarek, Darryl P Boy, Usha Lalla, Brian W Allwood, Elvis M Irusen, Coenraad F N Koegelenberg
DOI: 10.1002/rcr2.1141
Rapidly progressive respiratory failure due to antisynthetase syndrome related interstitial lung disease. |
The benefit of indwelling pleural catheter with ambulatory pneumothorax device and autologous blood patch pleurodesis in lymphangioleiomyomatosis with persistent air leak
Boon Hau Ng, Hsueh Jing Low, Nik Nuratiqah Nik Abeed, Mas Fazlin Mohamad Jailaini, Mohamed Faisal Abdul Hamid, Andrea Ban Yu-Lin
DOI: 10.1002/rcr2.1143
Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease with the progressive formation of numerous small cysts. The course of the disease is complicated by recurrent pneumothoraces. This occurs due to cyst rupture into the pleural space or through alveolar wall disruption resulting in an air leak. Chemical or surgical pleurodesis is performed to prevent a recurrence. Persistent air leak (PAL) can complicate this condition. We report the successful use of IPC with an ambulatory pneumothorax device in a patient with LAM with PAL. |
Fatal sequelae of hydrogen sulphide poisoning
Nadirah Goolam, Raisa Bhikoo, Coenraad F N Koegelenberg, Usha Lalla
DOI: 10.1002/rcr2.1144
We describe a case of a 30-year-old sewer worker with a history of heavy accidental occupational exposure of inhaled H2S admitted with acute respiratory distress syndrome and a rapid respiratory decline ultimately leading to death. |
Spontaneous pulmonary herniation in COVID-19
Andrew Macdonald, Cameron Butcher, Thuy Nhu Nguyen
DOI: 10.1002/rcr2.1145
We report a case of spontaneous pulmonary hernia (SPH) secondary to extreme coughing and COVID-19 infection. Clinicians should be aware of the risk factors and clinical features of SPH to aid diagnosis of this rare condition. |
Targeted alveo-pleural fistula endobronchial valve treatment using ventilation scintigraphy
Calvin Sidhu, Shoba Ratnagobal, Rajesh Thomas, Gary Y C Lee, Enya Drudy, Roslyn J Francis
DOI: 10.1002/rcr2.1146
Persistent air-leaks can be difficult to localize in radiology. Bronchoscopic management of air-leaks requires identification of the leak's location to allow suitable targeted treatment. One-way endobronchial valves have become a suitable option for persistent air-leaks. In this report, a combination scintigraphy and one-way endobronchial valve treatment successfully resolved a persistent air-leak. |
Tezepelumab treatment for allergic bronchopulmonary aspergillosis
Hiroaki Ogata, Kachi Sha, Yasuaki Kotetsu, Aimi Enokizu-Ogawa, Katsuyuki Katahira, Akiko Ishimatsu, Kazuhito Taguchi, Atsushi Moriwaki, Makoto Yoshida
DOI: 10.1002/rcr2.1147
The patient with allergic bronchopulmonary aspergillosis (ABPA) underwent treatment with tezepelumab; the mucus plugs and pulmonary opacities diminished gradually parallel to the improvement in the control of asthmatic symptoms. Tezepelumab might provide a novel steroid-sparing strategy for the management of ABPA. |
Adenoid cystic carcinoma of the trachea mimicking asthma
Sugeesha Wickramasinghe, Mohammed Munavvar, Mohamad Nidal Bittar, Deepa Jacob, Sarah Nicholson, Robert Stockwell, Thyusha Devineni
DOI: 10.1002/rcr2.1148
Adenoid cystic carcinoma is primarily a salivary gland tumour that rarely involves the respiratory tract. Here we describe a 58-year-old lady who had an adenoid cystic carcinoma that needed a tracheal stent insertion followed by radiotherapy. |
Lambert-Eaton myasthenic syndrome with primary thymic marginal zone B-cell lymphoma: A case report
Toshihiko Soma, Akira Matsumoto, Tsuyoshi Shoji, Hiromichi Katakura
DOI: 10.1002/rcr2.1149
Lambert-Eaton myasthenic syndrome (LEMS) is a condition in which antibodies are produced against voltage-gated calcium channels in presynaptic nerve endings, resulting in an inability to release acetylcholine. It is characterized by fatigue and weakness of the proximal muscles of the extremities and is complicated by ocular symptoms, autonomic symptoms, and cerebellar ataxia. We report the case of a patient in whom comprehensive care with multiple departments successfully improved LEMS symptoms with primary thymic marginal zone B-cell lymphoma. |
Adenocarcinoma with mediastinal lymph node involvement developed from a pure ground grass nodule during 14 years
Hiroyuki Miura, Jun Miura, Shinichi Goto, Tomoko Yamamoto
DOI: 10.1002/rcr2.1152
We had an interesting case of a pure ground-glass nodule that developed into lung adenocarcinoma with mediastinal lymph node involvement over 14 years. Here we report the temporal change in the opacity of the GGN and the concept of image interpretation. |
| Clinical images |
Transbronchial needle aspiration in severe cardiac failure patient: 'The old bull knows best'
Umberto Caterino, Cristiano Cesaro, Raffaella Lucci, Flavio Cesaro, Umberto Masi, Alessandra Cotroneo, Dario Amore
DOI: 10.1002/rcr2.1112
We present a case where EBUS was not an option due to the patient's condition and where conventional transbronchial needle aspiration (cTBNA) allowed us to diagnose mediastinal lymph-node pulmonary adenocarcinoma. |
Severe heart failure due to peripartum cardiomyopathy
Haruhiko Michimata, Toshiyuki Sumi, Daiki Nagayama, Yuta Koshino, Hiroki Watanabe, Yuichi Yamada, Hirofumi Chiba
DOI: 10.1002/rcr2.1137
Perinatal cardiomyopathy develops during pregnancy or postpartum in women with no history of cardiac disease, presenting similarly to dilated cardiomyopathy. The pathogenesis is unknown but may be associated with both vascular damage and a genetic component. Physicians should consider pulmonary oedema due to perinatal cardiomyopathy in perinatal women with dyspnoea. |
Physiologic 18F-FDG muscle uptake in severe COPD: Implications for accurate lung cancer staging
Yuma Yoshida, Satoshi Ikeo, Naoaki Yasuda, Yuki Sakai, Yasuyuki Hayashi, Akihiko Sokai, Toshiyuki Iwata, Takashi Nishimura
DOI: 10.1002/rcr2.1150
18F-FDG accumulates in pathologic lesions, and minimal 18F-FDG may be observed in healthy muscles. However, physiologic 18F-FDG uptake is seen in patients with COPD due to excessive metabolic activity as presented in our patient in this case. Clinicians should be aware of this phenomenon and exercise caution when staging lung cancer in these patients to avoid misdiagnosis and unnecessary interventions. |
