Respirology Case Reports最新文献

Primary Hepatoid Adenocarcinoma of the Lung With Signet Ring Cell Differentiation and Widespread Osseous Metastases: A Case Report. 原发性肺类肝腺癌伴印戒细胞分化及广泛骨转移1例报告。

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Respirology Case Reports Pub Date : 2026-05-06 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70604

Rami Khader, Esraa Elhakim, Mohammad Bdair, Rajaa Abu Sultan, Ameed Khader, Mousa Almasalma, Saleh Ferwana, Mohammed Z A Baraka

{"title":"Primary Hepatoid Adenocarcinoma of the Lung With Signet Ring Cell Differentiation and Widespread Osseous Metastases: A Case Report.","authors":"Rami Khader, Esraa Elhakim, Mohammad Bdair, Rajaa Abu Sultan, Ameed Khader, Mousa Almasalma, Saleh Ferwana, Mohammed Z A Baraka","doi":"10.1002/rcr2.70604","DOIUrl":"https://doi.org/10.1002/rcr2.70604","url":null,"abstract":"Pulmonary hepatoid adenocarcinoma (HAL) is an extremely rare and highly aggressive extrahepatic adenocarcinoma that exhibits hepatocellular carcinoma-like morphology and hepatocytic immunophenotype, often leading to diagnostic delay due to nonspecific respiratory presentations. We report a male patient in his 50s with a long history of heavy tobacco use who presented with a persistent cough initially treated as pneumonia without clinical improvement. Over subsequent weeks, he developed progressive dyspnea, weight loss, fatigue and diffuse bone pain. Computed tomography demonstrated left upper-lobe consolidation with pleural effusion and underlying collapse, mediastinal lymphadenopathy, and multiple lytic skeletal lesions consistent with metastatic disease, while triphasic abdominal imaging showed no focal hepatic lesions. Laboratory testing revealed mild anaemia with leukocytosis and thrombocytosis, markedly elevated carcinoembryonic antigen and normal alpha-fetoprotein. Tru-cut biopsy showed poorly differentiated adenocarcinoma with prominent signet ring cell differentiation. Immunohistochemistry demonstrated diffuse CK7 and HepPar-1 positivity with focal CDX2 positivity and negativity for TTF-1, CK20, p63, and D2-40, supporting a diagnosis of primary pulmonary hepatoid adenocarcinoma. The patient received 3 cycles of gemcitabine plus carboplatin but experienced rapid clinical deterioration. This case underscores that HAL may mimic nonresolving pneumonia and that normal AFP does not exclude the diagnosis; early biopsy and a targeted immunohistochemical panel are essential for timely recognition of this lethal entity.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70604"},"PeriodicalIF":0.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Paradoxical Pyogenic Granuloma Associated With Ramucirumab but Not Bevacizumab: A Case Suggesting Differential Effects of VEGF Receptor and Ligand Inhibition. 与Ramucirumab而非Bevacizumab相关的矛盾化脓性肉芽肿：一个提示VEGF受体和配体抑制差异效应的病例。

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Respirology Case Reports Pub Date : 2026-05-05 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70606

Akina Nigi, Keisuke Iwamoto, Hidetoshi Itani, Shigeto Kondou

{"title":"Paradoxical Pyogenic Granuloma Associated With Ramucirumab but Not Bevacizumab: A Case Suggesting Differential Effects of VEGF Receptor and Ligand Inhibition.","authors":"Akina Nigi, Keisuke Iwamoto, Hidetoshi Itani, Shigeto Kondou","doi":"10.1002/rcr2.70606","DOIUrl":"https://doi.org/10.1002/rcr2.70606","url":null,"abstract":"Pyogenic granuloma is a benign vascular lesion that may bleed repeatedly and impair daily activities. Although ramucirumab is an anti-angiogenic agent, paradoxical pyogenic granuloma has rarely been reported during its use. We describe a 75-year-old man with advanced lung adenocarcinoma who developed multiple bleeding pyogenic granulomas during docetaxel plus ramucirumab therapy. Histopathology confirmed lobular capillary proliferation consistent with pyogenic granuloma. Because the lesions repeatedly bled and reduced quality of life, they were excised and ramucirumab was discontinued. The patient was subsequently treated with docetaxel plus bevacizumab, and no recurrence or worsening of pyogenic granuloma was observed. This intra-patient contrast suggests that VEGFR-2 blockade and VEGF ligand inhibition may have different effects on paradoxical vascular proliferative lesions. Clinicians should recognize this rare toxicity and consider switching anti-angiogenic strategy in selected cases.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70606"},"PeriodicalIF":0.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extracorporeal Membrane Oxygenation Haemoperfusion for Leptospirosis Pulmonary Hemorrhagic Disease: Report of 1 Case. 体外膜氧合血液灌流治疗钩端螺旋体肺出血性疾病1例报告。

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Respirology Case Reports Pub Date : 2026-05-05 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70565

Qigang Zeng, Longyun Xie, Wenshan Dai, Feilong Xu, Yong Dai

{"title":"Extracorporeal Membrane Oxygenation Haemoperfusion for Leptospirosis Pulmonary Hemorrhagic Disease: Report of 1 Case.","authors":"Qigang Zeng, Longyun Xie, Wenshan Dai, Feilong Xu, Yong Dai","doi":"10.1002/rcr2.70565","DOIUrl":"https://doi.org/10.1002/rcr2.70565","url":null,"abstract":"Severe pulmonary leptospirosis (SPFL), characterized by diffuse alveolar haemorrhage (DAH) and acute respiratory distress syndrome (ARDS), carries a high mortality, often due to diagnostic delays and complex management. We report a case of a 42-year-old male with outdoor occupational exposure who presented with fever and hemoptysis, rapidly progressing to severe respiratory failure and thrombocytopenia. Chest imaging confirmed DAH/ARDS. For refractory hypoxemia, veno-venous extracorporeal membrane oxygenation (VV-ECMO) was initiated without systemic anticoagulation due to active pulmonary haemorrhage. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid rapidly identified Leptospira interrogans, enabling targeted antimicrobial therapy alongside multidisciplinary support. The patient gradually improved, was successfully weaned from ECMO and ventilator support, and was discharged without residual organ dysfunction. This case demonstrates that early application of anticoagulation-free VV-ECMO combined with mNGS-based rapid diagnosis and multidisciplinary care can improve outcomes in SPFL, highlighting the importance of considering this diagnosis in febrile patients with DAH and environmental exposure.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70565"},"PeriodicalIF":0.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Case of Anti-AMY1-Positive Lung Squamous Cell Carcinoma With Severe Hyperamylasemia Linked to Disease Progression. 抗amy1阳性肺鳞状细胞癌伴疾病进展相关的严重高淀粉酶血症1例

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Respirology Case Reports Pub Date : 2026-05-05 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70609

Yusuke Nakamura, Shohei Hara, Noriaki Nishimura, Yuto Goto, Nobuhiko Tsukada, Nana Yazawa, Yoshimasa Nakazato, Yokose Tomoyuki, Kazuyuki Ishida, Yasuo Shimizu, Seiji Niho

{"title":"A Case of Anti-AMY1-Positive Lung Squamous Cell Carcinoma With Severe Hyperamylasemia Linked to Disease Progression.","authors":"Yusuke Nakamura, Shohei Hara, Noriaki Nishimura, Yuto Goto, Nobuhiko Tsukada, Nana Yazawa, Yoshimasa Nakazato, Yokose Tomoyuki, Kazuyuki Ishida, Yasuo Shimizu, Seiji Niho","doi":"10.1002/rcr2.70609","DOIUrl":"https://doi.org/10.1002/rcr2.70609","url":null,"abstract":"A 74-year-old man presented with abdominal pain. Preoperative evaluation for small bowel perforation revealed a 74-mm tumour shadow obstructing the right lower lobe bronchus. Endobronchial biopsy from the truncus intermedius was diagnostic of squamous cell carcinoma (SCC). Pathological findings in the small intestine were consistent with SCC. Based on other radiological findings, the patient was diagnosed with stage IVB (cT4N3M1c) lung SCC (LUSC). Serum amylase levels were elevated at 1693 U/L (pancreatic amylase 184 U/L) prior to treatment. AMY1 (2D4) immunohistochemistry was positive, confirming amylase-producing LUSC, a rarely reported entity. Amylase levels decreased to 203 U/L following combination therapy with carboplatin, nab-paclitaxel and pembrolizumab. The patient had no symptoms or signs of pancreatic or salivary gland disease. To our knowledge, this is the first reported case of LUSC with both histological evidence of amylase production and hyperamylasemia. This case provides new evidence that LUSC can produce amylase and cause hyperamylasemia.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70609"},"PeriodicalIF":0.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pleuritis Induced by Brigatinib During the Treatment of Non-Small Cell Lung Cancer. 布加替尼治疗非小细胞肺癌时引起的胸膜炎。

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Respirology Case Reports Pub Date : 2026-05-04 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70598

Shohei Yano, Moon Hee Hwang, Tomoko Harima, Shota Takahashi, Takumi Yamada, Nao Yoshida, Yuki Yoshida, Atsushi Hirai

{"title":"Pleuritis Induced by Brigatinib During the Treatment of Non-Small Cell Lung Cancer.","authors":"Shohei Yano, Moon Hee Hwang, Tomoko Harima, Shota Takahashi, Takumi Yamada, Nao Yoshida, Yuki Yoshida, Atsushi Hirai","doi":"10.1002/rcr2.70598","DOIUrl":"https://doi.org/10.1002/rcr2.70598","url":null,"abstract":"This report describes the first documented case of brigatinib-induced pleuritis in a patient with ALK-positive non-small cell lung cancer. A 77-year-old woman developed dyspnoea, fever, elevated inflammatory markers, and bilateral pleural effusion shortly after starting brigatinib as third-line therapy. Pleural fluid analysis showed lymphocyte-predominant exudative effusion without evidence of malignancy or infection, suggesting drug-induced pleuritis. Discontinuation of brigatinib led to rapid clinical and radiographic improvement. Although disease progression later occurred, pleuritis did not recur. Re-administration of brigatinib at a reduced dose of 30 mg/day achieved tumour shrinkage without pleuritis recurrence, and subsequent dose escalation to 60 mg/day was also tolerated. This case highlights that clinicians should consider drug-induced pleuritis when pleural effusion develops during brigatinib therapy, particularly when it is inconsistent with the disease progression. Dose reduction to as low as 30 mg/day may be a safe and effective therapeutic option for selected patients.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70598"},"PeriodicalIF":0.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful Sequential and Additive Drug Challenge With Rapid Oral Desensitization in Rifampicin-Induced Fever. 利福平致发热快速口服脱敏成功的序次和加性药物刺激。

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Respirology Case Reports Pub Date : 2026-05-01 DOI: 10.1002/rcr2.70584

Xin Yue Guo, Constantine Zois

{"title":"Successful Sequential and Additive Drug Challenge With Rapid Oral Desensitization in Rifampicin-Induced Fever.","authors":"Xin Yue Guo, Constantine Zois","doi":"10.1002/rcr2.70584","DOIUrl":"https://doi.org/10.1002/rcr2.70584","url":null,"abstract":"Adverse drug reactions to first-line antituberculosis (anti-TB) therapy are common and may necessitate treatment interruption. While drug desensitization is increasingly used for delayed hypersensitivity, evidence supporting outpatient rapid oral desensitization in mild delayed reactions such as drug-induced fever is limited. We report a 63-year-old man with active pulmonary tuberculosis who developed drug-induced fever after commencing standard anti-TB therapy. Sequential and additive drug challenge identified rifampicin as the offending agent. The patient subsequently underwent successful rapid oral rifampicin desensitization in an outpatient setting, enabling completion of 6 months of therapy without recurrence of adverse effects. This case demonstrates the feasibility of outpatient rapid oral desensitization for mild delayed hypersensitivity reactions, including drug-induced fever. Such an approach may reduce treatment interruption and hospitalisation, particularly in settings where standardised outpatient desensitization protocols are lacking. Further studies are needed to define optimal strategies for managing mild delayed hypersensitivity reactions to anti-TB medications.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70584"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gynaecological Laparoscopy Surgery Complicated Into CO₂ Embolism, Cardiac Arrest and Severe ARDS Requiring ECMO Therapy. 妇科腹腔镜手术并发CO2栓塞、心脏骤停和需要ECMO治疗的严重ARDS。

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Respirology Case Reports Pub Date : 2026-05-01 DOI: 10.1002/rcr2.70387

Jawdat Alali, Umm E Amara, Malek Abusannuga, Umme Nashrah, Firdous Ummunnisa, Nissar Shaikh

{"title":"Gynaecological Laparoscopy Surgery Complicated Into CO2 Embolism, Cardiac Arrest and Severe ARDS Requiring ECMO Therapy.","authors":"Jawdat Alali, Umm E Amara, Malek Abusannuga, Umme Nashrah, Firdous Ummunnisa, Nissar Shaikh","doi":"10.1002/rcr2.70387","DOIUrl":"https://doi.org/10.1002/rcr2.70387","url":null,"abstract":"Laparoscopic surgeries have revolutionised surgical practice due to their advantages, including minimal invasiveness, fewer postoperative complications, quicker recovery and reduced hospital stay. Carbon dioxide (CO2) is used for abdominal insufflation because of its inert nature, colorlessness, low cost, high solubility, low combustibility and wide availability. Despite these advantages, laparoscopy is not without complications-it can cause hypotension, arrhythmia, pulmonary barotrauma and, rarely, carbon dioxide embolism (CO2E) and cardiac arrest. CO2E is commonly associated with cardiac arrest and has rarely been linked to acute respiratory distress syndrome (ARDS). Cases of CO2E complicated by ARDS have shown improvement with conventional invasive lung-protective ventilation. However, CO2E complicated by severe ARDS with hypoxia refractory to standard therapy has not been reported. We report a case of CO2E complicated by severe ARDS with refractory hypoxia requiring extracorporeal membrane oxygenation (ECMO) therapy, which resulted in a favourable outcome.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70387"},"PeriodicalIF":0.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diffuse Large B-Cell Lymphoma With Pulmonary and Gastric Involvement Mimicking Nontuberculous Mycobacterial Lung Disease. 弥漫性大b细胞淋巴瘤累及肺和胃，与非结核性分枝杆菌肺病相似。

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Respirology Case Reports Pub Date : 2026-04-30 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70601

Kosuke Masuda, Kazuhiro Asada, Yuu Saitoh, Makoto Suzuki, Emi Fukasawa, Yumi Fujita, Kosuke Suzuki, Sho Murai, Daisuke Akahori, Mika Saigusa, Taisuke Akamatsu, Akito Yamamoto, Satoru Morita, Toshihiro Shirai

引用次数: 0

A Giant Solitary Fibrous Tumour Arising From the Right Hemidiaphragm Detected Incidentally During a Routine Health Checkup. 在常规健康检查中偶然发现的一个巨大的孤立性纤维性肿瘤，起源于右半膈。

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Respirology Case Reports Pub Date : 2026-04-29 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70589

Yuka Sasaki, Masachika Fukui, Akihiro Tsukamoto, Yu Kitamura, Komei Yanase, Hiroshi Kawada, Saki Fukutomi, Yukari Tsubata

引用次数: 0

Seropositive Rheumatoid Arthritis Emerging During Acute Phase of Lung Abscess: A Case Report. 肺脓肿急性期出现血清阳性类风湿关节炎1例。

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Respirology Case Reports Pub Date : 2026-04-29 eCollection Date: 2026-05-01 DOI: 10.1002/rcr2.70602

Yusuke Arai, Hiromu Tanaka, Kazuoto Hiramoto, Aina Nomura, Takahiro Asami, Takashi Inoue

{"title":"Seropositive Rheumatoid Arthritis Emerging During Acute Phase of Lung Abscess: A Case Report.","authors":"Yusuke Arai, Hiromu Tanaka, Kazuoto Hiramoto, Aina Nomura, Takahiro Asami, Takashi Inoue","doi":"10.1002/rcr2.70602","DOIUrl":"https://doi.org/10.1002/rcr2.70602","url":null,"abstract":"Rheumatoid arthritis (RA) is an autoimmune disease where immunological activation often precedes clinical onset. Although respiratory infections are recognized risk factors for RA, the onset of RA shortly after acute infection remains poorly characterized. Herein, we report a rare case of seropositive RA that became clinically apparent during the acute phase of lung infection. An 87-year-old man who had never smoked was diagnosed with a lung abscess caused by methicillin-susceptible Staphylococcus aureus. Post discharge, he developed polyarthritis, and laboratory tests revealed positive results for rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA). He was diagnosed with seropositive RA, and his symptoms improved with corticosteroid therapy. Retrospective review of positron emission tomography scans performed before admission revealed inflammatory uptake in multiple joints, suggesting a preclinical phase. This case suggests that acute respiratory infection may accelerate the transition from latent autoimmunity to clinically overt RA, highlighting the diagnostic value of RF and ACPA testing in new-onset arthritis after infection.","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 ","pages":"e70602"},"PeriodicalIF":0.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0