Respirology Case Reports最新文献

{"title":"Primary Mediastinal T-Lymphoblastic Lymphoma With Airway Stenosis Diagnosed Using Endobronchial Ultrasound-Guided Transbronchial Mediastinal Cryobiopsy: A Case Report.","authors":"Hiroaki Nagamine, Midori Bungo, Yuichiro Nagaki, Akira Todoriki, Kohei Niina, Koji Enomoto, Shigeki Kakuno, Toshiyuki Nakai, Kazuhiro Yamada, Tetsuya Watanabe, Kazuhisa Asai, Daiki Mukai, Joji Nagasaki, Hirohisa Nakamae, Tomoya Kawaguchi","doi":"10.1002/rcr2.70756","DOIUrl":"10.1002/rcr2.70756","url":null,"abstract":"<p><p>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for sampling mediastinal lesions but may be inadequate for diagnosing lymphoma because of limited tissue acquisition. We report a case of T-lymphoblastic lymphoma (T-LBL) successfully diagnosed using endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-Cryo). An 18-year-old woman presented with an anterior mediastinal mass causing severe tracheal compression. EBUS-TBNA followed by EBUS-Cryo using a 1.1-mm cryoprobe was performed under endotracheal intubation without complications. Although EBUS-TBNA specimens were nondiagnostic because of crush artefacts and blood contamination, EBUS-Cryo yielded well-preserved tissue, enabling comprehensive immunohistochemical evaluation and a definitive diagnosis of T-LBL. This case demonstrates that EBUS-Cryo can provide sufficient tissue for diagnosing mediastinal T-LBL and may be safely performed in carefully selected patients, even in the presence of substantial airway compression.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70756"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906494","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":"False Detection of Cheyne-Stokes Respiration on Continuous Positive Airway Pressure Resolved After Treatment of Nasal Obstruction.","authors":"Emilie Castermans, Dimitri Impens, Walter Libert, Marie Bruyneel","doi":"10.1002/rcr2.70745","DOIUrl":"10.1002/rcr2.70745","url":null,"abstract":"<p><p>Cheyne-Stokes respiration (CSR) is a potentially dangerous abnormal breathing pattern that can be associated with serious cardiac events and poor prognosis. This case describes the unexpected recording of CSR events by a continuous positive airway pressure (CPAP) apparatus in a patient who was consistently CPAP compliant and had a stable medical history except for recent nasal obstruction. Respiratory polygraphy (RP) suggested the CPAP device had erroneously recorded obstructive sleep apnea (OSA) as CSR due to mixed apnea features that mimicked CSR. Treatment of the nasal obstruction resolved the problem with the erroneous readings, suggesting the nasal obstruction was the cause of the aberrant CPAP recording. This case highlights the limits of CPAP device reliability for detection of CSR and the need for standardized CSR detection criteria across CPAP devices.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70745"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913592","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":"Therapeutic Strategy of Extracorporeal Carbon Dioxide Removal in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Combined With Central Airway Stricture: A Case Report.","authors":"Jingjing Deng, Yinjie Ye, Ming Zhang, Lunjie Lu","doi":"10.1002/rcr2.70753","DOIUrl":"10.1002/rcr2.70753","url":null,"abstract":"<p><p>This case report highlights a novel and successful therapeutic strategy for a patient with acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) and severe central airway stricture (CAS). We demonstrate the use of extracorporeal CO₂ removal (ECCO₂R) as a critical physiological bridge, stabilizing the patient's hypercapnic respiratory failure and allowing for the safe and definitive management of the airway stenosis through bronchoscopic stenting.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70753"},"PeriodicalIF":0.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897986","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 Rare Case of COPA Syndrome: Multisystem Relapse and Fatal Septic Complication.","authors":"Flavia Castro Velasco Fernandes, Pedro Paulo Teixeira E Silva Torres, Elisângela de Paula Silveira-Lacerda, Matheus Rabahi, Lucas Velasco Magalhaes Fernandes, Laís Rocha Lopes, Marise Amaral Rebouças Moreira, Marcelo Fouad Rabahi","doi":"10.1002/rcr2.70742","DOIUrl":"10.1002/rcr2.70742","url":null,"abstract":"<p><p>COPA syndrome is a rare autosomal dominant autoimmune disorder caused by COPA gene mutations, leading to immune dysregulation and multisystem involvement. We report a 45-year-old man with recurrent respiratory failure, haemoptysis, renal dysfunction and arthritis. Symptoms began at Age 27 with diffuse alveolar damage requiring mechanical ventilation. Imaging showed progressive interstitial lung disease and biopsy revealed follicular bronchiolitis. Immunosuppression provided temporary stabilisation. In 2024, next-generation sequencing confirmed a likely pathogenic COPA variant. The patient later discontinued therapy and remained untreated for 1 year, returning with worsening renal dysfunction and significant proteinuria, while pulmonary findings remained stable. Cyclophosphamide was initiated for suspected renal relapse. During treatment, he developed acute diverticulitis complicated by sepsis, progressing to septic shock and multiorgan failure despite surgery and antibiotics, resulting in death. Early recognition and multidisciplinary management are essential to improve outcomes of the disease.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70742"},"PeriodicalIF":0.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897626","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":"First-Line Lorlatinib in Striatin-Anaplastic Lymphoma Kinase-Positive Lung Adenocarcinoma: A Case Report and Literature Review.","authors":"Masaru Maebeya, Shinobu Tamura, Takeshi Shono, Takanobu Hoso, Hitomi Tatsuta","doi":"10.1002/rcr2.70750","DOIUrl":"10.1002/rcr2.70750","url":null,"abstract":"<p><p>Striatin-anaplastic lymphoma kinase (STRN-ALK) is a rare fusion variant in non-small cell lung cancer (NSCLC), and the efficacy of first-line lorlatinib for this subgroup is poorly defined. We report a 45-year-old treatment-naïve male with STRN-ALK-positive lung adenocarcinoma and symptomatic brain metastases. Following stereotactic radiosurgery for intracranial lesions, the patient initiated lorlatinib at 100 mg once daily as the first systemic therapy. After starting treatment, neuropsychiatric side effects necessitated a gradual reduction in dosage to 75 mg and then to 50 mg. The patient achieved a durable partial response with sustained intracranial disease control for over 1 year. Adjusting the dosage improved tolerability without compromising efficacy, allowing for ongoing treatment. This case demonstrates that first-line lorlatinib can achieve durable systemic and intracranial disease control in STRN-ALK-positive NSCLC, including in patients presenting with brain metastases, while maintaining antitumor efficacy despite dose reduction.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70750"},"PeriodicalIF":0.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897852","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":"An Unusual Cause of Superior Vena Cava Compression: Delayed Mediastinal Migration of Hyaluronic Acid Breast Fillers.","authors":"Ng Boon Hau, Low Hsueh Jing, Nik Nuratiqah Nik Abeed, Nor Safiqah Sharil, Nurul Aisyah Abd Rahman, Rose Azzlinda Osman, Nur Yazmin Yaacob, Mohd Ramzisham Abdul Rahman, Andrea Ban Yu-Lin","doi":"10.1002/rcr2.70752","DOIUrl":"10.1002/rcr2.70752","url":null,"abstract":"<p><p>Injectable breast fillers are increasingly used as minimally invasive alternatives to implants. Delayed complications such as migration and lymphadenopathy are increasingly reported. Mediastinal lymphadenopathy due to hyaluronic acid (HA) filler migration is rare. A woman in her 50s presented with progressive facial puffiness and chest wall venous distension. Six months earlier, an evaluation at another center had revealed mediastinal lymphadenopathy causing superior vena cava (SVC) compression. Video-assisted thoracoscopic (VATS) biopsy revealed chronic inflammatory infiltrates. Further targeted history revealed prior bilateral breast augmentation using HA fillers. Repeat computed tomography demonstrated interval enlargement of the mediastinal lymphadenopathy with worsening SVC compression, together with radiological features suggestive of migration of filler material into the mediastinal nodes. Endobronchial ultrasound-guided transbronchial needle aspiration yielded polymorphous lymphocytes. Magnetic resonance imaging of the breast demonstrated multiple bilateral lesions with irregular capsules. Following corticosteroid therapy, the patient experienced marked improvement in clinical symptoms, with a reduction in the mediastinal lesion on follow-up imaging.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70752"},"PeriodicalIF":0.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889162","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":"Isolated Central Nervous System Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-Case Report and Literature Review.","authors":"Mithen Ravisankar, Muniza Bai, Vignesh Kumar Kathiresan, Jefferson Daniel Jawahar, Balamugesh Thangakunam, Angel Miraclin Thirugnanakumar, Elanthenral Sigamani","doi":"10.1002/rcr2.70728","DOIUrl":"10.1002/rcr2.70728","url":null,"abstract":"<p><p>An immunocompetent young male in his early 20s presented with a 1-month history of central chest pain, dyspepsia and significant weight loss. Initial evaluation revealed a large, deep oesophageal ulcer and extensive necrotic mediastinal lymphadenopathy. Endobronchial ultrasound-guided fine-needle aspiration of the mediastinal nodes confirmed necrotising granulomatous inflammation, suggestive of tuberculosis. Following initiation of anti-tuberculosis treatment (ATT), he initially showed systemic improvement. However, within 2 weeks, he developed drug-induced liver injury along with new-onset focal neurological deficits, including right-sided hemiparesis and vocal cord palsy. Neuroimaging revealed multiple new intracranial lesions involving the left temporal lobe, right posterior parietal region and brainstem, whilst repeat cross-sectional imaging of the chest and abdomen was suggestive of interval improvement. A diagnosis of paradoxical isolated central nervous system tuberculosis-associated immune reconstitution inflammatory syndrome was made. He was managed with high-dose systemic corticosteroids and a modified hepatoprotective ATT regimen, resulting in clinical improvement.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70728"},"PeriodicalIF":0.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889118","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":"Study Protocol of the Endobronchial VAlves for Pneumothorax to Reduce Admission Time (EVAPoRATe) Pilot Multicentre Randomised Clinical Trial.","authors":"Nai-Chien Huan, Niranjan Ananda Setty, Ai Ling Tan, Dhaval Thakkar, Taha Huseini, Elaine Yap, Jonathan Williamson, Phan Nguyen, Paul Lilburn, Matthew Salamonsen, Arash Badiei, Matthew Ing, Sanjeevan Muruganandan, Bapti Roy, Brent Gardiner, Lonny B Yarmus, Steven P Walker, Y C Gary Lee","doi":"10.1002/rcr2.70738","DOIUrl":"10.1002/rcr2.70738","url":null,"abstract":"<p><strong>Background: </strong>Pneumothorax with persistent air leak (PAL) is a debilitating condition. Patients with PAL often require prolonged chest drainage, with associated complications, such as, hospital-acquired infections, thromboembolism, and deconditioning. Endobronchial valves (EBVs) are an approved bronchoscopic treatment for PAL and may allow earlier chest tube removal and hospital discharge. Current evidence supporting the use of EBV is limited to case series and uncontrolled studies. EBVs are usually used as a last resort when other treatments failed. Whether early referral for EBV placement is feasible and can reduce hospital length of stay in patients with pneumothorax and PAL has not been tested in a randomised controlled trial (RCT).</p><p><strong>Methods: </strong>EVAPoRATe is a prospective, open-labelled, pilot, multi-centre RCT. Forty patients with pneumothorax of any cause and PAL who are unsuitable for or unwilling to undergo surgical management will be randomised 1:1 to the Early EBV Referral arm or the Standard Care arm. Patients in the Early EBV Referral arm will be assessed by an interventional clinician for EBV placement at the earliest feasible time from Day 5 of pneumothorax. Patients allocated to the Standard Care arm will receive conventional management by the attending team; EBV is allowed if clinically appropriate when air leak persists after 12 days. Participants will be followed for 6 months after discharge.</p><p><strong>Discussion: </strong>The primary outcome is the feasibility of the trial protocol, assessed by recruitment rate, adherence to the intervention arm, and retention at follow-up. Secondary outcomes include total hospital length of stay, PAL-related length of stay, interventions for PAL and EBV complications, time to air leak cessation, time to chest drain removal, pneumothorax recurrence, adverse events and serious adverse events, removal of EBVs, performance status, and mortality. This pilot feasibility study will assess whether a future full-scale RCT of EBV for PAL is practical and will provide data to guide protocol refinement and sample size calculation.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry: ACTRN12625000360415; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=388086&isReview=true.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70738"},"PeriodicalIF":0.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882026","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":"Endobronchial Aspergillosis Presenting as an Isolated Airway Lesion in an Immunocompromised Patient.","authors":"Mohsen Sadeghi, Fatemeh Sadat Hosseini Khajouei, Haniyeh GhanbarAliAkhavan, Amir Morteza Soleimani","doi":"10.1002/rcr2.70701","DOIUrl":"10.1002/rcr2.70701","url":null,"abstract":"<p><p>Endobronchial aspergillosis (EBA) is an uncommon manifestation of <i>Aspergillus</i> airway disease characterized by fungal involvement of the tracheobronchial lumen. It may present with non-specific respiratory symptoms, including dyspnea, cough and hemoptysis, and can mimic endoluminal airway tumours. Predisposing factors include immunosuppressive conditions such as corticosteroid therapy, malignancy, chemotherapy and neutropenia. Definitive diagnosis relies on bronchoscopic evaluation with histopathological confirmation. Due to its rarity, evidence regarding optimal management remains limited. This case emphasizes that isolated airway <i>Aspergillus</i> infection may occur without parenchymal lung involvement and may be associated with a rapidly fatal clinical course despite prompt antifungal therapy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70701"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876125","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":"Sarcomatoid Mesothelioma Revealed After Treatment for Tuberculous Pleurisy: A Case Report.","authors":"Daiki Nagayama, Keiki Yokoo, Yousuke Yabushita, Motoki Sekikawa, Masaru Abe, Hiroaki Kato, Ayumi Takayanagi, Bunya Takahashi, Marie Kato-Shinomiya, Satoshi Ota, Gen Yamada, Kenzo Hiroshima, Hirofumi Chiba","doi":"10.1002/rcr2.70734","DOIUrl":"10.1002/rcr2.70734","url":null,"abstract":"<p><p>Differentiating tuberculous (TB) pleurisy from malignant pleural mesothelioma is challenging due to similar clinical presentations. We report an 83-year-old man with sarcomatoid mesothelioma initially treated for TB pleurisy. He presented with lymphocyte-predominant exudative pleural effusion and a positive Interferon-Gamma Release Assay. Thoracoscopy revealed purulent effusion, but biopsies were non-diagnostic. Despite empiric anti-tuberculosis therapy, the effusion persisted. A subsequent surgical biopsy showed fibrosis and scattered spindle cells. However, 2 months later, a rapidly growing chest wall mass with bone invasion appeared. A CT-guided percutaneous biopsy showed proliferation of atypical spindle cells and fluorescence in situ hybridization (FISH) analysis allowed for the diagnosis of sarcomatoid mesothelioma. This case highlights the aggressive nature of sarcomatoid mesothelioma and its diagnostic difficulty. For treatment-refractory pleurisy, clinicians must maintain high suspicion, ensuring vigilant follow-up and prompt repeat biopsies despite negative initial results, while consulting pathologists to consider additional FISH testing.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 9","pages":"e70734"},"PeriodicalIF":0.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876137","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}