Respirology Case ReportsPub Date : 2025-07-16eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70276
Hiroyuki Miura, Jun Miura, Shinichi Goto, Tomoko Yamamoto
{"title":"A Case of Mesothelial-Cell Inclusions in the Mediastinal Lymph Nodes After Lung Cancer Surgery.","authors":"Hiroyuki Miura, Jun Miura, Shinichi Goto, Tomoko Yamamoto","doi":"10.1002/rcr2.70276","DOIUrl":"10.1002/rcr2.70276","url":null,"abstract":"<p><p>Mesothelial-cell inclusion (MCI) is an inclusion of mesothelial cells found in lymph nodes. Although it is a rare condition, differentiating it from lymph node metastasis is essential to avoid a misdiagnosis. We reported, for the first time, a case of MCI after lung cancer surgery. The patient was a 76-year-old Japanese man with a history of bilateral radical surgery for lung cancer. Follow-up computed tomography performed at 7 years after the initial surgery revealed an enlarged right cardiophrenic angle lymph node. It was resected through video-assisted thoracic surgery, and histopathology revealed non-dysplastic ductal proliferation. Immunohistochemistry was positive for AE1/3, D2-40, calretinin, and WT-1, and negative for CD31, CD34, and factor VIII. Based on these findings, MCI was finally diagnosed. Although the presence of metastasis is the first possible cause for the enlarged lymph nodes in such cases, MCI must also be considered.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70276"},"PeriodicalIF":0.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660632","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}
Respirology Case ReportsPub Date : 2025-07-16eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70279
Hai Quan Lee, Aaron Tay How Tan, Cheryl Hui Ling Khoong, Glenn Khai Wern Yong
{"title":"Tract Metastasis of Squamous Cell Carcinoma of the Lung.","authors":"Hai Quan Lee, Aaron Tay How Tan, Cheryl Hui Ling Khoong, Glenn Khai Wern Yong","doi":"10.1002/rcr2.70279","DOIUrl":"10.1002/rcr2.70279","url":null,"abstract":"<p><p>A 78-year-old man with a history of haemothorax developed a chest wall mass at the site of a previous chest drain 2 months ago. Imaging revealed a right lung mass with pleural involvement and a soft tissue tract to the chest wall. Histology confirmed squamous cell carcinoma. This case highlights a rare instance of metastasis via a chest drain tract.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70279"},"PeriodicalIF":0.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660645","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}
Respirology Case ReportsPub Date : 2025-07-16eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70283
Ruojin Bu, Lakshmi Puttagunta, Kieran Halloran, Justin G Weinkauf, Dale C Lien, Bryce Laing, Eric Leung, Doug Helmersen, Mitesh V Thakrar, Alim Hirji
{"title":"Asbestosis Requiring Lung Transplantation in a Retired Hairdresser: An Occupational Exposure to Comb Through.","authors":"Ruojin Bu, Lakshmi Puttagunta, Kieran Halloran, Justin G Weinkauf, Dale C Lien, Bryce Laing, Eric Leung, Doug Helmersen, Mitesh V Thakrar, Alim Hirji","doi":"10.1002/rcr2.70283","DOIUrl":"10.1002/rcr2.70283","url":null,"abstract":"<p><p>Asbestosis is a form of fibrotic interstitial lung disease caused by the inhalation of excessive asbestos fibres. We describe a patient who developed asbestosis due to occupational exposures while working as a hairdresser in the 1970s and 1980s. Not appreciating this profession as a risk factor for developing asbestosis led to several treatment strategies that were ineffective and eventually led to the need for lung transplantation. More recent changes to governmental policy have effectively reduced the incidence of such an exposure risk; however, given the long latency of the disease, we emphasise that a broad occupational history including potential historic exposures remains an important component of the assessment of interstitial lung disease. We also outline many reasons for a second wave of asbestosis-related lung disease that is only now emerging and encourage clinicians to continue to maintain asbestosis on the differential for working up undifferentiated fibrotic lung disease.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70283"},"PeriodicalIF":0.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660643","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}
Respirology Case ReportsPub Date : 2025-07-16eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70282
Chee Kiang Phua, Chee Kiang Tay, Carrie Kah Lai Leong
{"title":"Bronchial Dieulafoy: Diagnostic Utility of Endobronchial Ultrasound.","authors":"Chee Kiang Phua, Chee Kiang Tay, Carrie Kah Lai Leong","doi":"10.1002/rcr2.70282","DOIUrl":"10.1002/rcr2.70282","url":null,"abstract":"<p><p>We report a case of bronchial Dieulafoy presenting with haemoptysis, initially resembling an endobronchial tumour on bronchoscopy. This case highlights the critical role of EBUS in the assessment of suspicious endobronchial lesions and in preventing potentially life-threatening complications from inadvertent biopsy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70282"},"PeriodicalIF":0.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660644","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}
Respirology Case ReportsPub Date : 2025-07-15eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70266
Antonio Fabozzi, Alessandro Siena, Alessia Steffanina, Silvia Iannuzzi, Matteo Bonini, Paolo Palange
{"title":"Association of Pulmonary Septic Embolism and Pulmonary Arterial Thromboembolism in Lemierre Syndrome: A Case Report and Literature Review.","authors":"Antonio Fabozzi, Alessandro Siena, Alessia Steffanina, Silvia Iannuzzi, Matteo Bonini, Paolo Palange","doi":"10.1002/rcr2.70266","DOIUrl":"10.1002/rcr2.70266","url":null,"abstract":"<p><p>Lemierre syndrome (LS) is a rapidly progressing disease characterised by a recent oropharyngeal infection, complicated by septic emboli and thrombophlebitis of the internal jugular vein (IJV). We describe a case of a 65-year-old woman who presented to the emergency room with a 14-day history of progressive occipital headache, fever and odynophagia. Radiological investigations showed bilateral IJV thrombophlebitis, multiple cavitated pulmonary nodules suggestive of septic emboli and a subsegmental pulmonary arterial thromboembolism. A diagnosis of LS was made. The patient received antibiotic treatment with intravenous ceftriaxone and clindamycin for 2 weeks, followed by 4 weeks of oral clindamycin at home and anticoagulation with enoxaparin followed by warfarin. One-month follow-up imaging revealed complete resolution of IJV thrombosis and pulmonary findings. This case displayed the rarely reported association of pulmonary arterial thromboembolism and pulmonary septic emboli.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70266"},"PeriodicalIF":0.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650822","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}
Respirology Case ReportsPub Date : 2025-07-14eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70166
Daisy Lu, Steven Y C Tong, Belinda Cruse, Kasha P Singh, Justin T Denholm, Megan Rees
{"title":"<i>Mycobacterium abscessus</i> Pulmonary Disease in a Myasthenia Gravis Patient: A Case Report.","authors":"Daisy Lu, Steven Y C Tong, Belinda Cruse, Kasha P Singh, Justin T Denholm, Megan Rees","doi":"10.1002/rcr2.70166","DOIUrl":"10.1002/rcr2.70166","url":null,"abstract":"<p><p>There is limited guidance on managing <i>Mycobacterium abscessus</i> pulmonary disease in Myasthenia Gravis patients. Macrolides and aminoglycosides form the backbone of <i>M. abscessus</i> pulmonary disease treatment but are avoided in Myasthenia Gravis patients due to the risk of precipitating myasthenic crisis. A 29-year-old female, with a history of anti-acetylcholine receptor antibody-positive Myasthenia Gravis and bronchiectasis, was diagnosed with <i>M. abscessus</i> pulmonary disease. She was commenced on a macrolide-based regime safely with close monitoring, pretreatment with intravenous immunoglobulin (1 g/kg),10 mg prednisolone, 500 mg rituximab and augmentation of the neuromuscular junction with pyridostigmine and 3,4-Diaminopyridine. She was safely discharged to the hospital in the home program and achieved clinical, radiological and microbiological response.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70166"},"PeriodicalIF":0.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638369","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}
Respirology Case ReportsPub Date : 2025-07-14eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70228
Aasir M Suliman, Irfan Ul Haq, Khalid Albsheer, Mohamed Elgara
{"title":"Rituximab and Pirfenidone in the Treatment of Steroid-Refractory Bleomycin Lung Injury.","authors":"Aasir M Suliman, Irfan Ul Haq, Khalid Albsheer, Mohamed Elgara","doi":"10.1002/rcr2.70228","DOIUrl":"10.1002/rcr2.70228","url":null,"abstract":"<p><p>Bleomycin-induced lung injury (BILI) is a well-recognised but potentially life-threatening complication of ABVD chemotherapy (adriamycin, bleomycin, vinblastine and dacarbazine), often requiring prompt diagnosis and intervention. We present a case of a 43-year-old female with Hodgkin's lymphoma who developed progressive respiratory symptoms following her fourth cycle of ABVD. A broad infectious and autoimmune workup was unremarkable, and chest imaging was consistent with interstitial lung disease. Her condition deteriorated despite empirical antibiotics and high-dose corticosteroids. The addition of rituximab and pirfenidone led to significant clinical and radiological improvement, highlighting the potential role of these agents in managing steroid-refractory BILI.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70228"},"PeriodicalIF":0.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638370","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}
{"title":"A Case Report on the Development of Ulcerative Colitis During Osimertinib Therapy for Epidermal Growth Factor Receptor Mutation-Positive Non-Small-Cell Lung Cancer.","authors":"Tomoki Tamura, Misaki Tani, Hiromichi Ogata, Tomoya Osedo, Masahiro Yamashita, Taisaku Koyanagi, Tatsuya Nishi, Takahiro Umeno, Shoichi Kuyama","doi":"10.1002/rcr2.70272","DOIUrl":"10.1002/rcr2.70272","url":null,"abstract":"<p><p>Osimertinib, a standard treatment for epidermal growth factor receptor (EGFR)-positive non-small-cell lung cancer, commonly causes manageable diarrhoea. We report osimertinib-induced refractory diarrhoea diagnosed as ulcerative colitis, remitting with mesalazine. A 69-year-old woman with advanced-stage EGFR mutation-positive lung adenocarcinoma developed persistent diarrhoea 3 weeks after starting osimertinib, complicated by anorexia, hypotension, anaemia and renal failure requiring hospitalisation. While anaemia and renal failure improved after osimertinib cessation, diarrhoea persisted. A colonoscopy revealed ulcerative colitis, confirmed by neutrophil and lymphocyte infiltration in the intestinal mucosa, glandular deformation and decreased goblet cells. This case demonstrates that osimertinib-induced ulcerative colitis was successfully treated with mesalazine.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70272"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609917","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}
Respirology Case ReportsPub Date : 2025-07-10eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70243
Guru Prasad T J, Athish Kannan Karur, Spurthy Padmanabha, K R Harshitha, Suggula Vamsi Krishna, Rashmi Priya Murthy, Samuel Olaniyan, Adewale Oyeneye, Anwadevi Arun, Franklin John
{"title":"Chylothorax in Uncommon Contexts: Pulmonary Tuberculosis and Mantle Cell Lymphoma.","authors":"Guru Prasad T J, Athish Kannan Karur, Spurthy Padmanabha, K R Harshitha, Suggula Vamsi Krishna, Rashmi Priya Murthy, Samuel Olaniyan, Adewale Oyeneye, Anwadevi Arun, Franklin John","doi":"10.1002/rcr2.70243","DOIUrl":"10.1002/rcr2.70243","url":null,"abstract":"<p><p>Chylothorax, characterised by the accumulation of chyle in the pleural space, is a rare yet clinically significant condition. This lymphatic fluid, rich in fats absorbed from the intestine, can be caused by various factors including trauma, malignancy, and tuberculosis (TB). Traumatic causes, particularly iatrogenic procedures, account for a significant proportion of cases, followed by rare etiologies like malignancies such as lymphoma, and less commonly, tuberculosis. In the first two cases, the patient was diagnosed with tuberculosis during evaluation for chylothorax; however, in the third case, the patient developed chylothorax as a complication of mantle cell lymphoma (MCL). Two male patients, aged 43 and 45, presented with respiratory symptoms and milky pleural effusions (triglycerides > 180 mg/dL). In both, bronchoalveolar lavage confirmed rifampicin-sensitive TB. Both patients responded to anti-tubercular therapy and dietary modification. A 69-year-old male with a history of non-Hodgkin's lymphoma developed chylothorax (triglycerides 286 mg/dL) and lymphadenopathy; imaging and biopsy confirmed MCL. He responded to chemotherapy. This series underscores the importance of considering uncommon causes of chylothorax during evaluation and tailoring treatment based on specific etiologies.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70243"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609868","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}
Respirology Case ReportsPub Date : 2025-07-10eCollection Date: 2025-07-01DOI: 10.1002/rcr2.70267
Koji Matsuda, Keiki Yokoo, Yoshikazu Toshima, Koki Kamada, Takayuki Nagao, Koki Kikuchi, Takafumi Shimizu, Shinsuke Onishi, Satoshi Nara, Takeshi Yokoyama, Gen Yamada
{"title":"A Severe Case of <i>Streptococcus pyogenes</i> Pneumonia Following Influenza A Virus Infection Diagnosed by FilmArray Pneumonia Panel and Bronchoalveolar Lavage.","authors":"Koji Matsuda, Keiki Yokoo, Yoshikazu Toshima, Koki Kamada, Takayuki Nagao, Koki Kikuchi, Takafumi Shimizu, Shinsuke Onishi, Satoshi Nara, Takeshi Yokoyama, Gen Yamada","doi":"10.1002/rcr2.70267","DOIUrl":"10.1002/rcr2.70267","url":null,"abstract":"<p><p>A previously healthy 63-year-old woman, unvaccinated for influenza A, had a mild fever for a week followed by alerted consciousness. On the day of admission, she developed shortness of breath, high fever, hypotension and alterations of consciousness. Chest CT revealed rapidly progressing bilateral infiltrates. She was diagnosed with disseminated intravascular coagulation, hypogammaglobulinemia and acute renal failure, requiring intensive care for respiratory failure and hypotension. A Sputum FilmArray Pneumonia Panel (PN panel) performed on admission identified multiple pathogens, including influenza A virus and <i>Streptococcus pyogenes</i> (<i>S. pyogenes</i>), although only <i>S. pyogenes</i> was cultured from bronchoalveolar lavage fluid. Intensive care, including antibiotics and steroids, led to clinical improvement. Blood cultures remained negative throughout the course. Even healthy adults can develop severe <i>S. pyogenes</i> pneumonia following influenza A infection. Rapid bacterial identification by PN panel and bronchoscopy, along with an appropriate treatment strategy, may improve outcomes.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 7","pages":"e70267"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609918","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}