{"title":"Ramucirumab-induced ascites with endothelial growth factor receptor mutation-positive non-small cell lung cancer: Two case reports.","authors":"Keisuke Shiraha, Tomoki Tamura, Taisaku Koyanagi, Takahiro Umeno, Kazuya Nishii, Shoichi Kuyama","doi":"10.1002/rcr2.70046","DOIUrl":"https://doi.org/10.1002/rcr2.70046","url":null,"abstract":"<p><p>Ramucirumab (RAM) has been approved for the treatment of non-small cell lung cancer (NSCLC). Here, we report two cases of RAM-induced ascites with epidermal growth factor receptor-mutant NSCLC. Patient 1, a 72-year-old man, developed ascites 20 months after erlotinib (ERL) and RAM administration, which resolved after their discontinuation and performing paracentesis. Patient 2, an 83-year-old woman, developed ascites 9 months after ERL and RAM administration, which resolved after RAM discontinuation and furosemide administration. Ramucirumab administration can cause ascites due to increased hepatic sinusoidal pressure. Clinicians should be aware of RAM-induced ascites in patients with NSCLC and should appropriately manage it.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 10","pages":"e70046"},"PeriodicalIF":0.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477288","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 : 2024-10-13eCollection Date: 2024-10-01DOI: 10.1002/rcr2.70042
Belgundi Preeti Vidyasagar, Harikishan Gonuguntla, Sejal B Radia, Suhas Dhulipala
{"title":"A novel technique of airway silicon stent deployment under vision-Dr. Vidyasagar's technique.","authors":"Belgundi Preeti Vidyasagar, Harikishan Gonuguntla, Sejal B Radia, Suhas Dhulipala","doi":"10.1002/rcr2.70042","DOIUrl":"https://doi.org/10.1002/rcr2.70042","url":null,"abstract":"<p><p>The conventional methods of silicon stent insertion recommend usage of external loading devices, where the stent is folded into the loading device and pushed in to the tracheobronchial tree using an external pusher which is blind, and leads to placement of stent either distally or proximally needing repositioning or is done with fluoroscopy that involves radiation exposure. We demonstrate our experience in 16 cases of successful silicon stent placement using this technique, wherein an Ultrathin flexible bronchoscope or Hopkins Rigid telescope is pushed alongside the forceps that hold upper end of the folded silicon stent allowing stent placement under direct vision with control over the stent. The Proximal end of the stent can be pulled under vision before deployment for appropriate positioning while pulling the rigid barrel. The stent is always under the operator's control providing excellent control over placement, simplifies the procedure and is safe with no reported complications.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 10","pages":"e70042"},"PeriodicalIF":0.8,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477280","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 : 2024-10-11eCollection Date: 2024-10-01DOI: 10.1002/rcr2.70045
Po-Keng Su, Chen-Chieh Lin, Szu-Yen Hu, Ming-Hsien Lin, Chun-Yu Wu, Shun-Mao Yang, Takahiro Oto
{"title":"Neoadjuvant immunochemotherapy followed by ex situ lung auto-transplant (Oto procedure) for central lung cancer: A case report with literature review.","authors":"Po-Keng Su, Chen-Chieh Lin, Szu-Yen Hu, Ming-Hsien Lin, Chun-Yu Wu, Shun-Mao Yang, Takahiro Oto","doi":"10.1002/rcr2.70045","DOIUrl":"https://doi.org/10.1002/rcr2.70045","url":null,"abstract":"<p><p>Sleeve and double-sleeve lobectomies are lung-sparing techniques for treating central lung cancers. However, if the tumour extends to involve the bronchi and vessels, lung auto-transplantation may be an alternative to pneumonectomy. Neoadjuvant therapy after surgery is the most common strategy for patients with extensive central lung cancer. Herein, we report a case of central lung cancer in a patient who underwent immunochemotherapy as neoadjuvant therapy following lung auto-transplantation. A 68-year-old man with stage IIIA non-small cell lung cancer and left upper lobe squamous cell carcinoma underwent neoadjuvant immunochemotherapy. Following partial regression, a multidisciplinary team decided on a back-table procedure with auto-lung transplantation after pneumonectomy to preserve pulmonary function. The patient had an uneventful recovery and was discharged after three weeks with no residual tumour or lymph node metastases. Lung auto-transplantation can be successfully performed in non-lung transplantation centres, potentially broadening treatment options for patients with central lung cancer.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 10","pages":"e70045"},"PeriodicalIF":0.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477285","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 : 2024-10-10eCollection Date: 2024-10-01DOI: 10.1002/rcr2.70037
Jelena Solujic, Phan Nguyen, Peter Bardy, Yao Ly, Emily Lawton
{"title":"A case of VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome presenting as progressive multisystem involvement with parenchymal infiltrates following infection with Epstein Barr virus.","authors":"Jelena Solujic, Phan Nguyen, Peter Bardy, Yao Ly, Emily Lawton","doi":"10.1002/rcr2.70037","DOIUrl":"https://doi.org/10.1002/rcr2.70037","url":null,"abstract":"<p><p>VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic) syndrome is a rare multisystem disease affecting predominantly males over 50 and manifesting as widespread progressive inflammatory sequelae and haematological dysfunction. We describe a patient who presented with systemic symptoms of fevers, night sweats and weight loss, and developed progressive inflammatory sequelae including cutaneous lesions, haematological dysfunction, lymphadenopathy, migratory inflammatory arthropathies, with new pulmonary infiltrates, following infection with Epstein Barr Virus. Laboratory investigations, bronchoscopy, bone marrow biopsy and imaging were consistent with an inflammatory aetiology. The constellation of organ system involvement, laboratory, biopsy, and imaging results were suspicious for VEXAS syndrome, and this diagnosis was confirmed by identification of a somatic mutation in the UBA1 gene following extensive exclusion of infectious and autoimmune causes. Interestingly the onset of the VEXAS syndrome coincided with serological confirmation of Epstein Barr Virus raising the importance of further exploration into the underlying aetiology of VEXAS syndrome.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 10","pages":"e70037"},"PeriodicalIF":0.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477268","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 : 2024-10-10eCollection Date: 2024-10-01DOI: 10.1002/rcr2.70039
Coskun Ardan Sener, Aylin Ozgen Alpaydın, Oguz Kılınc
{"title":"A rare pathology that mimics lung cancer: IgG4-related vasculitis.","authors":"Coskun Ardan Sener, Aylin Ozgen Alpaydın, Oguz Kılınc","doi":"10.1002/rcr2.70039","DOIUrl":"https://doi.org/10.1002/rcr2.70039","url":null,"abstract":"<p><p>Immunoglobulin-G4 (IgG4)-related disease is essentially a fibro-inflammatory disease that can affect any organ simultaneously or at different times. The disease usually presents with organ growth that mimics a tumour and can affect the lacrimal glands, major salivary glands, pancreas, bile ducts, retroperitoneal area, lungs, kidneys, aorta, meninges and thyroid gland. The immunopathogenesis behind this new disease has not yet been elucidated. Histopathological distinguishing features of the disease include dense lymphoplasmocytic infiltrates dominated by IgG4 positive plasma cells, storiform fibrosis and obliterative phlebitis. The likelihood of developing with immunoglobulin G4 (IgG4-RD) is a recently identified rare systemic fibroinflammatory disease with an estimated incidence of less than 1 in 100,000 people worldwide. We present our case, which was diagnosed with IGG4-related vasculitis by lung fine needle aspiration biopsy, which is very rare in the literature.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 10","pages":"e70039"},"PeriodicalIF":0.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477281","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":"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":"12 10","pages":"e70040"},"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":"12 10","pages":"e70038"},"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":"12 10","pages":"e70044"},"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":"12 10","pages":"e70035"},"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":"12 9","pages":"e70031"},"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}