{"title":"Extended 73-month survival in an elderly patient with BRAF V600E-mutated lung adenocarcinoma: A case report.","authors":"Kensuke Namba, Kazutoshi Isobe, Hiroki Wakabayashi, Ryogo Ohashi, Hiromasa Sakurai, Daiki Sakai, Yusuke Irie, Kenta Takashima, Yu Murakami, Kaichi Kaneko, Nobuyuki Hiruta, Yasuo Matsuzawa","doi":"10.1002/rcr2.70040","DOIUrl":"https://doi.org/10.1002/rcr2.70040","url":null,"abstract":"<p><p>BRAF is a mediator that activates the mitogen-activated protein kinase pathway. A mutation in BRAF can cause abnormal pathway activation, leading to cell proliferation. In a Phase II study, the combination therapy of the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib was found to be effective in non-small cell lung cancer (NSCLC) patients with the BRAF mutation. However, this study has limited efficacy and safety data for elderly patients. We present a case of a patient who started treatment at 87 years old and showed a good prognosis, remaining alive 73 months from the start of treatment with no significant adverse events. The patient also maintained a partial response (PR) according to RECIST 1.1 at the last follow-up. This case suggests that the dabrafenib and trametinib combination therapy is safe and effective for elderly NSCLC patients with the BRAF mutation.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394137","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 : 2024-10-07eCollection Date: 2024-10-01DOI: 10.1002/rcr2.70038
Kyota Shinfuku, Naoki Takasaka, Ryutaro Ohashi, Taiki Fukuda, Makiko Takatsuka, Ryo Sato, Mitsuyoshi Mita, Tsukasa Hasegawa, Masami Yamada, Yumie Yamanaka, Yusuke Hosaka, Kai Ryu, Tokio Hoshina, Hiroshi Takeda, Takeo Ishikawa, Jun Araya
{"title":"Infective endocarditis due to nasal septal perforation during home oxygen therapy.","authors":"Kyota Shinfuku, Naoki Takasaka, Ryutaro Ohashi, Taiki Fukuda, Makiko Takatsuka, Ryo Sato, Mitsuyoshi Mita, Tsukasa Hasegawa, Masami Yamada, Yumie Yamanaka, Yusuke Hosaka, Kai Ryu, Tokio Hoshina, Hiroshi Takeda, Takeo Ishikawa, Jun Araya","doi":"10.1002/rcr2.70038","DOIUrl":"https://doi.org/10.1002/rcr2.70038","url":null,"abstract":"<p><p>We report a case of infective endocarditis (IE) due to nasal septal perforation during Home oxygen therapy (HOT). A 64-year-old man with a history of interstitial pneumonia (IP) and on HOT was hospitalized for dyspnea. Methicillin-sensitive <i>Staphylococcus aureus</i> (MSSA) was repeatedly detected in blood cultures. Echocardiography revealed tricuspid valve vegetation and regurgitation. The patient was diagnosed with IE, according to the modified Duke criteria. A full-body examination revealed nasal septal perforation and MSSA was isolated from the nasal cavity. The patient was treated with cefazolin and clindamycin. However, he developed aspiration pneumonia and subsequently died. The portal of entry of MSSA was damaged nasal mucosa, caused by dryness and curettage of the dried nasal mucus during HOT. Nasal septal perforation, a potential complication of HOT, may cause severe bacterial infections. Consequently, diligent nasal care is crucial during HOT.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394138","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":"Intrabronchial schwannoma with right lower lobe obstructive bronchiectasis and organizing pneumonia: A case report.","authors":"Bo-Hsiang Lu, You-Cheng Jiang, Jang-Shian Liang, Ping-Chung Tsai, En-Kuei Tang","doi":"10.1002/rcr2.70044","DOIUrl":"https://doi.org/10.1002/rcr2.70044","url":null,"abstract":"<p><p>We present the case of a 60-year-old female patient with no prior history of any systemic disease. She suffered from a prolonged cough that lasted more than 3 months, associated with poor appetite and weight loss of 5 kg. The pathology report of the pre-operative transbronchial needle biopsy was consistent with a neurogenic tumour. Chest computed tomography (CT) revealed a right lower lobe (RLL) mass-like consolidation of 8.67 cm with obstructive pneumonitis and suspicious posterior mediastinal invasion. The tumour was surgically resected with bronchial reconstruction, and the pathological diagnosis was intrabronchial schwannoma located inside the bronchus, a rare tumour that should be included as one of the differential diagnoses of primary bronchial tumours. The possibility of a surgical completed resection should be considered in patients with airway obstruction symptoms.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11456806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394139","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 : 2024-09-30eCollection Date: 2024-10-01DOI: 10.1002/rcr2.70035
Hamza Azam, Mohammed Affan Guliyara, Bapti Roy
{"title":"Bilothorax as an endoscopic retrograde cholangiopancreatography complication and a review of the literature.","authors":"Hamza Azam, Mohammed Affan Guliyara, Bapti Roy","doi":"10.1002/rcr2.70035","DOIUrl":"10.1002/rcr2.70035","url":null,"abstract":"<p><p>Bilothorax, the accumulation of bile in the pleural space, is an uncommon but serious condition often linked to biliary tract or diaphragmatic injury. This case report describes a 70-year-old female with decompensated liver cirrhosis due to primary sclerosing cholangitis, who developed a moderate sized pleural effusion following ERCP and biliary stenting. The patient's pleural effusion persisted for 2 months without respiratory symptoms, indicating a self-limited low-volume leak. She eventually underwent thoracentesis for a non-resolving unilateral effusion, which drained 435 mL of bilious fluid with an elevated pleural fluid bilirubin level, confirming the diagnosis of bilothorax. This case highlights the importance of considering bilothorax as a cause of pleural effusion in patients with biliary tract disease and who undergo high risk procedures including ERCP.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362200","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":"Multiple cavitary pulmonary metastases from pancreatic cancer diagnosed using transbronchial lung cryobiopsy.","authors":"Takashi Funasaka, Yasushi Makino, Tomofumi Shibata, Hirotoshi Yasui, Yasutaka Fukui, Mitsuru Odate, Takayasu Ito","doi":"10.1002/rcr2.70031","DOIUrl":"https://doi.org/10.1002/rcr2.70031","url":null,"abstract":"<p><p>Multiple cavitary pulmonary metastases are rare, and cavitary lung lesions have various aetiologies and differential diagnoses. Therefore, radiological diagnosis of lung cavities is extremely difficult. Herein, we report a case of pancreatic cancer with multiple cavitary pulmonary metastases diagnosed using transbronchial lung cryobiopsy (TBLC), that required differentiation from pulmonary lesions of Sjögren's syndrome whose pulmonary manifestation may present as bronchiectasis and cystic change. TBLC may be useful for the diagnosis of multiple lesions because sufficiently large specimens can be obtained to allow pathological evaluation of the lung parenchyma and bronchiolar lesions.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356079","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 : 2024-09-24eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70030
Jean-Benoit Martinot, Lorent Hostaux, Atul Malhotra, Dennis Hwang, Jean-Louis Pépin
{"title":"Air leak phenotyping by mandibular jaw movement analysis in CPAP therapy: Key insights for practitioners.","authors":"Jean-Benoit Martinot, Lorent Hostaux, Atul Malhotra, Dennis Hwang, Jean-Louis Pépin","doi":"10.1002/rcr2.70030","DOIUrl":"https://doi.org/10.1002/rcr2.70030","url":null,"abstract":"<p><p>Monitoring unintentional air leaks in continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea (OSA) is essential for therapy success. While leaks are often attributed to improperly sealed masks, mouth openings may also cause them, requiring interventions. Recent studies demonstrated distinctive mandibular jaw movement (MJM) signal patterns during sleep related to respiratory events and sleep stages. Analysing MJM during CPAP treatment reveals air leak peaks coinciding with maximal MJM amplitude during obstructive events, and air leak decreases corresponding to arousals. Examining leaks with MJM offers valuable insights into their origins and might open new avenues for CPAP management.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356077","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":"Re-expansion pulmonary edema and atelectasis due to mucus plug following chest tube placement for pneumothorax.","authors":"Nghi Nguyen-Dang, Quoc-Khanh Tran-Le, Lam Nguyen-Ho","doi":"10.1002/rcr2.70032","DOIUrl":"https://doi.org/10.1002/rcr2.70032","url":null,"abstract":"<p><p>Re-expansion pulmonary edema (REPE) and mucus plug-induced atelectasis are potential complications that clinicians should be aware of following chest tube placement for pneumothorax.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356080","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 : 2024-09-24eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70033
Anjali Murali, Anju Farsana A, Sobha Subramaniam, Malini Eapen, Indu R Nair, Keechilat Pavithran
{"title":"Exceptional long term response to crizotinib in ROS 1-postive advanced non small cell lung cancer.","authors":"Anjali Murali, Anju Farsana A, Sobha Subramaniam, Malini Eapen, Indu R Nair, Keechilat Pavithran","doi":"10.1002/rcr2.70033","DOIUrl":"https://doi.org/10.1002/rcr2.70033","url":null,"abstract":"<p><p>Non-small-cell lung cancer (NSCLC) accounts for the majority of lung cancer cases worldwide, with a significant proportion of patients harbouring actionable oncogenic alterations. Among these alterations, the ROS1 rearrangement represents a distinct subset with therapeutic implications. Here, we present the case of a 52-year-old man diagnosed with advanced NSCLC harbouring the ROS1 fusion gene. Despite the initial poor response to conventional chemotherapy, the patient exhibited an exceptional and sustained response to crizotinib, with a progression-free survival of 94 months and complete metabolic response on PET scan. This case underscores the importance of molecular profiling in guiding treatment decisions and highlights the efficacy of targeted therapies for ROS1-positive NSCLC.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356078","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":"Successful treatment of tracheal stenosis due to a broken uncovered metallic stent placed over 20 years ago in a patient with recurrent polychondritis using argon plasma coagulation and airway ballooning.","authors":"Yuki Takigawa, Ken Sato, Kenichiro Kudo, Takeru Ichikawa, Yuto Sasano, Shoichiro Matsumoto, Tomoyoshi Inoue, Miho Fujiwara, Suzuka Matsuoka, Hiromi Watanabe, Akiko Sato, Keiichi Fujiwara, Takuo Shibayama","doi":"10.1002/rcr2.70034","DOIUrl":"https://doi.org/10.1002/rcr2.70034","url":null,"abstract":"<p><p>A woman in her mid-60s with recurrent polychondritis was admitted to our hospital due to airway stenosis secondary to an uncovered metallic stent. She underwent a bronchoscopic intervention under general anaesthesia. During the procedure, the stent fracture was cauterized using Argon Plasma Coagulation (APC) cauterisation, performed with argon flow at 1 L/min and power set at 70 W. APC cauterisation caused the stent wire to flex circularly, gradually improving the stenosis. Tracheal dilatation was then performed using an airway balloon. Following the ballooning, a thin bronchoscope was easily passed through the lower trachea, and the left and right main bronchi were observed; therefore, the procedure was completed without any complications. APC coagulation and airway ballooning are viable choices for the temporary treatment of airway stenosis due to broken metallic stents.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356081","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 : 2024-09-19eCollection Date: 2024-09-01DOI: 10.1002/rcr2.70027
Raul Leguizamon, Ian McLaren, Tara John, Rasha Khan, Alexander Prendergast, Phuuwadith Wattanachayakul, Andrew Geller, John Malin, Simone A Jarret, Kevin Bryan Lo, Jose Manuel Martinez Manzano, Christian Witzke
{"title":"Pulmonary vasodilators in patients with advanced chronic kidney disease and pre-capillary pulmonary hypertension-A case series.","authors":"Raul Leguizamon, Ian McLaren, Tara John, Rasha Khan, Alexander Prendergast, Phuuwadith Wattanachayakul, Andrew Geller, John Malin, Simone A Jarret, Kevin Bryan Lo, Jose Manuel Martinez Manzano, Christian Witzke","doi":"10.1002/rcr2.70027","DOIUrl":"https://doi.org/10.1002/rcr2.70027","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is a prevalent complication among patients with chronic kidney disease (CKD). In these patients, pulmonary vasodilators may be useful but are underused. We describe a group of patients with precapillary PH and advanced CKD treated with pulmonary vasodilators. This was a case series of patients with CKD stage 4 and 5 and precapillary PH (isolated or combined) based on right heart catheterization (RHC) treated with pulmonary vasodilators from 2018 to 2023. Of 263 patients with isolated precapillary or combined PH and advanced CKD, only 17 (6%) were treated with pulmonary vasodilators; 53% (<i>n</i> = 9) with precapillary PH and 47% (<i>n</i> = 8) with combined PH. Most patients (94%, <i>n</i> = 16) received phosphodiesterase-5 antagonists, while 12% (<i>n</i> = 2) received endothelin receptor antagonists. Adverse clinical outcomes were seen in 35% of patients within a year. The use of pulmonary vasodilator did not prevent adverse outcomes in patients with precapillary PH and advanced CKD.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298224","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}