Respirology Case ReportsPub Date : 2025-09-08eCollection Date: 2025-09-01DOI: 10.1002/rcr2.70341
Hiroshi Takahashi, Tadashi Ishida
{"title":"Asymptomatic Neurosyphilis Presenting With Bilateral Pulmonary Nodules: A Case Report.","authors":"Hiroshi Takahashi, Tadashi Ishida","doi":"10.1002/rcr2.70341","DOIUrl":"10.1002/rcr2.70341","url":null,"abstract":"<p><p>Globally, syphilis cases have been increasing and pulmonary lesions have been reported. However, asymptomatic neurosyphilis has not been documented. This condition is often unrecognised and presents with symptoms similar to those of other infectious and non-infectious lung diseases. In syphilitic pneumonia, defined as a secondary form of syphilis, intramuscular injection of benzylpenicillin (24 million units) remains the gold standard for treatment, with a favourable prognosis. This report presents for the first time a case of asymptomatic neurosyphilis with multiple pulmonary nodules and buttock lipodystrophy. If rapid plasma reagin (RPR) antibody titres are high and RPR testing is difficult during follow-up, cerebrospinal fluid (CSF) examination may be considered for further evaluation of asymptomatic neurosyphilis. This case showed a high expression of RPR (154 R.U.) and given the nature of the patient's work (long-distance transportation), short-term follow-up was difficult. Therefore, CSF was performed to enable early diagnosis and treatment.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70341"},"PeriodicalIF":0.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041740","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":"Two-Scope Technique for Tracheal Epithelial-Myoepithelial Carcinoma-A Rare Case Report and Review.","authors":"Saurabh Karmakar, Vinay Venugopal, Abdul Raouf Wani, Gaurav Kumar Singh, Debapriya Maji, Alpana Srivastava","doi":"10.1002/rcr2.70333","DOIUrl":"10.1002/rcr2.70333","url":null,"abstract":"<p><p>Epithelial myoepithelial carcinoma (EMC) is an exceptionally uncommon salivary gland type tumour of the lung accounting for only 0.1% to 1% of all primary pulmonary malignancies. We describe a 40-year-old man presenting with hemoptysis, in whom computed tomography (CT) of the chest revealed an endoluminal mass in the upper trachea. The initial biopsy suggested adenoid cystic carcinoma. Following complete removal using two-scope flexible bronchoscopic technique combining tumour snaring with cryoprobe-assisted retrieval, the final diagnosis of primary tracheal EMC was confirmed on histopathology and immunohistochemistry. This case not only contributes to the limited reports of tracheal EMC but also illustrates that the two-scope method may be a practical alternative to rigid bronchoscopy, especially in resource-limited or complex airway situations.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70333"},"PeriodicalIF":0.8,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030983","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 : 2025-09-04eCollection Date: 2025-09-01DOI: 10.1002/rcr2.70335
Sebastian Fernandez-Bussy, Anna Kornafeld, Bryan Husta, Linh H Vu, Alejandra Yu Lee-Mateus, Mohammed A Alqawasma, David Abia-Trujillo
{"title":"AIM (Anticipate/Adjust, Image, Manage) to Prevent Bleeding During Robotically-Assisted Bronchoscopic Ablation.","authors":"Sebastian Fernandez-Bussy, Anna Kornafeld, Bryan Husta, Linh H Vu, Alejandra Yu Lee-Mateus, Mohammed A Alqawasma, David Abia-Trujillo","doi":"10.1002/rcr2.70335","DOIUrl":"10.1002/rcr2.70335","url":null,"abstract":"<p><p>Therapeutic treatment of lung nodules by ablation is a new field. Even though not considered standard of care, lung nodule ablation can be appropriate for select cases. Even though ablation is a safe and well-tolerated procedure, bleeding is a potential complication. We introduce our stepwise approach through two cases on how we AIM (Anticipate/Adjust, Image, Manage) to prevent uncontrolled bleeding during Robotically Assisted Bronchoscopic Ablation: 1. Anticipate structures with high risk for bleeding and adjust accordingly, accounting for the needle ablation field; 2. Image: utilise cone beam CT before the first and after each ablation session to screen for bleeding; 3. Manage bleeding by pre-emptively utilising Fogarty balloon occlusion.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70335"},"PeriodicalIF":0.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013354","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":"BRAF V600E-Mutant Diffuse Pulmonary Langerhans Cell Histiocytosis Successfully Treated With Dabrafenib Plus Trametinib: A Case Report.","authors":"Akiko Sakurai, Tetsutaro Nagaoka, Chisato Tadokoro, Shunichi Kataoka, Yuriko Terayama, Yuichi Nagata, Yoshifumi Suzuki, Taichi Miyawaki, Motoyasu Kato, Takuo Hayashi, Kazuhisa Takahashi","doi":"10.1002/rcr2.70339","DOIUrl":"10.1002/rcr2.70339","url":null,"abstract":"<p><p>Pulmonary Langerhans cell histiocytosis (PLCH) is a rare diffuse lung disease that is strongly associated with cigarette smoking, with the BRAF V600E mutation identified in approximately half of all cases. In Japan, combination therapy with BRAF and MEK inhibitors has recently been approved as an alternative treatment option. We report the case of a 30-year-old woman diagnosed with BRAF V600E-mutant PLCH who was treated with dabrafenib in combination with trametinib. Chest computed tomography performed 3 months after the initiation of therapy demonstrated improvement in pericystic opacities, and this radiological response was sustained for over 1 year. Improvements in exercise tolerance, pulmonary function, and pulmonary haemodynamics have been observed clinically. These findings suggest that dabrafenib plus trametinib is a promising therapeutic option for patients with PLCH.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70339"},"PeriodicalIF":0.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013368","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 : 2025-09-02eCollection Date: 2025-09-01DOI: 10.1002/rcr2.70331
Mas Fazlin Mohamad Jailaini, Azat Azrai Azmel, Mohd Zulkifli Mohd Zain, Mohamed Faisal Abdul Hamid
{"title":"Synergistic Sealing of the Pleural Space: Combining Thoracoscopic Talc Poudrage and IPC for Malignant Pleural Effusion-A Case Series.","authors":"Mas Fazlin Mohamad Jailaini, Azat Azrai Azmel, Mohd Zulkifli Mohd Zain, Mohamed Faisal Abdul Hamid","doi":"10.1002/rcr2.70331","DOIUrl":"10.1002/rcr2.70331","url":null,"abstract":"<p><p>Management of malignant pleural effusion (MPE) via medical thoracoscopy presents a clinical challenge, particularly when deciding whether to proceed with talc poudrage during the same setting. This decision is often complicated by uncertainty about lung re-expansion and the potential failure of pleurodesis. We describe a series of three patients with cancer-associated MPE who underwent medical thoracoscopy with talc poudrage combined with indwelling pleural catheter (IPC) insertion. This combined approach served as a practical and effective strategy, offering immediate symptom relief, facilitating early pleural symphysis when feasible, and providing a reliable fallback option in cases of non-expanding lung. The dual-modality technique highlights a safe, flexible pathway for managing MPE with improved procedural confidence and patient-centred outcomes. We report 3 cases of MPE successfully achieving pleurodesis with a combination of talc poudrage and IPC, resulting in removal of IPC on follow-up.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70331"},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993812","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":"Hybrid Tracheal Stent Ingestion in Malignant Central Airway Stenosis: A Case Report.","authors":"Yuya Ishikawa, Hironori Ishibashi, Yukitaka Sato, Yuri Sumi, Ayaka Asakawa, Ryo Wakejima, Kenichi Okubo","doi":"10.1002/rcr2.70329","DOIUrl":"10.1002/rcr2.70329","url":null,"abstract":"<p><p>Airway stents provide symptomatic relief in malignant central airway stenosis, but carry the risk of migration, which may result in potentially lethal stent ingestion. A 22-year-old man underwent hybrid stent placement for tracheobronchial stenosis caused by an undiagnosed large mediastinal mass. Within 3 weeks after placement, following initial chemotherapy for provisionally diagnosed B-cell lymphoma, the stent migrated and was ingested. The stent was successfully retrieved endoscopically. This is the first reported case of hybrid tracheal stent ingestion. Early surveillance is warranted in patients with anticipated tumour regression.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70329"},"PeriodicalIF":0.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993854","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":"Cardiopulmonary Exercise Testing in Dysfunctional Breathing: A Case Series of Five Young Women.","authors":"Arup Haldar, Raja Dhar, Diptendu Dey, Amrita Bhattacharya, Beauty Biswas, Shyam Krishnan","doi":"10.1002/rcr2.70336","DOIUrl":"10.1002/rcr2.70336","url":null,"abstract":"<p><p>Dysfunctional breathing (DB) is an underdiagnosed condition in young patients presenting with unexplained exertional breathlessness. Cardiopulmonary exercise testing (CPET) provides valuable diagnostic insights in these challenging cases. We present a case series of five young women (mean age 23.2 years) who underwent comprehensive evaluation including CPET and body plethysmography for persistent exertional dyspnea. All patients demonstrated characteristic CPET findings of oscillatory breathing patterns, preserved ventilatory reserve, elevated VE/VCO<sub>2</sub> slope, and absence of oxygen desaturation. Body plethysmography revealed consistently elevated residual volumes (162%-296% predicted) and RV/TLC ratios (40.39%-50.21%). CPET is crucial for diagnosing DB in young patients with unexplained dyspnea. The consistent plethysmography abnormalities suggest potential underlying airway pathology or maladaptive breathing patterns.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 9","pages":"e70336"},"PeriodicalIF":0.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993829","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 Lipoma Treated With Endoscopic Microwave Coagulation to Relieve Atelectasis: The First Case Report.","authors":"Eri Takase, Atsushi Washioka, Keita Nakaguchi, Mitsumasa Kawago, Fumihiro Tanaka, Masanori Kitaichi","doi":"10.1002/rcr2.70313","DOIUrl":"10.1002/rcr2.70313","url":null,"abstract":"<p><p>Various endobronchial therapies, as well as complete surgical resection, have recently been reported. Among them, microwave coagulation is a promising endobronchial therapy for a wide range of neoplasms due to its high efficacy and safety. Meanwhile, endobronchial lipoma is a benign tumour that is rarely observed in the lungs. To our knowledge, the efficacy of microwave coagulation has not been reported in the treatment of endobronchial lipoma. Here, we report the effectiveness of endoscopic microwave coagulation therapy in safely resolving atelectasis and cough caused by endobronchial lipoma. Surgical resection was deemed to be unsuitable in this case due to the likelihood of extensive surgery such as right lower lobectomy being required, and comorbidities including poorly controlled diabetes mellitus. There was an elevated risk of perioperative complications. This report presents a new, effective, and minimally invasive treatment option for endobronchial lipoma in endoscopic microwave coagulation to relieve atelectasis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 8","pages":"e70313"},"PeriodicalIF":0.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973547","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":"Lung Transplantation Following Paraquat Poisoning: Time to Think.","authors":"Hari Kishan Gonuguntla, Somesh Tripathi, Vimi Varghese, Sricharan Goda, Chetan Rao Vaddepally, Balasubramoniam Kavumkal Rajagopalan, M Sheetal Kumar, Belgundi Preeti Vidyasagar","doi":"10.1002/rcr2.70324","DOIUrl":"10.1002/rcr2.70324","url":null,"abstract":"<p><p>Paraquat, a commonly available herbicide, when consumed in high doses, affects organs with high blood flow (lungs, heart, kidney and liver), leading to pulmonary fibrosis, respiratory failure and death. Few reports of rescue lung transplantation exist. Complete depletion of paraquat from the body is necessary prior to transplant; however, timing for and concerns after lung transplantation remain unknown. We report 2 patients (median age 19 years) with severe respiratory failure requiring extracorporeal membrane oxygenation support, acute kidney injury requiring haemodialysis and acute liver injury in the pre-transplant period. Volume of paraquat consumption was more than 30 mL and PF ratio less than 100 before transplant. Once their urine paraquat level was negative (median time 32 days), both underwent bilateral lung transplantation after receiving an induction agent with basiliximab and were continued on triple immunosuppressant following the transplant. With reported mortality rates reaching up to 90%, <b>l</b>ung transplantation remains a reasonable option for patients with paraquat poisoning not responding to conventional treatment options. Once paraquat levels are negative and after optimising renal and liver function, these patients could be considered for bilateral lung transplantation and have successful outcomes as reported here.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 8","pages":"e70324"},"PeriodicalIF":0.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973574","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 : 2025-08-27eCollection Date: 2025-08-01DOI: 10.1002/rcr2.70334
Ad Rian Chong, Khai Lip Ng, Nai-Chien Huan, Nur Husna Mohd Aminudin, Raja Nor Adilla Raja Rahaizat, Kasuma Mohamed Nordin
{"title":"Successful Treatment of Aspergilloma With Antifungal Alone: A Case of Conservative Management.","authors":"Ad Rian Chong, Khai Lip Ng, Nai-Chien Huan, Nur Husna Mohd Aminudin, Raja Nor Adilla Raja Rahaizat, Kasuma Mohamed Nordin","doi":"10.1002/rcr2.70334","DOIUrl":"10.1002/rcr2.70334","url":null,"abstract":"<p><p>Pulmonary aspergilloma can cause life-threatening haemoptysis. Surgical resection and/or bronchial artery embolization (BAE) are established treatment modalities, but both can be risky in frail patients with comorbidities. Spontaneous regression of aspergilloma with antifungal agents alone is rare. We report an elderly gentleman with a background history of treated pulmonary tuberculosis, who presented with haemoptysis due to a large left upper lobe aspergilloma. He declined surgery and BAE due to perceived risks. Oral voriconazole and later isavuconazole were prescribed, which led to clinical improvement and significant reduction in the size of the aspergilloma over 6 months. Antifungal agents might be a viable therapeutic option for aspergilloma patients unsuitable or who declined more invasive procedures. Further studies are needed to validate the efficacy and safety of this approach.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"13 8","pages":"e70334"},"PeriodicalIF":0.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973602","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}