Respirology Case ReportsPub Date : 2026-08-18eCollection Date: 2026-08-01DOI: 10.1002/rcr2.70730
Zhong Xhen Khor, Kai Sheng Chung, Jia Yi Lim, Christine Hwee Ming Tay, Atiqah Binti Ayub
{"title":"Culture-Negative Pyogenic Liver Abscess Presenting as Lung Abscess and Empyema Through Transdiaphragmatic Spread.","authors":"Zhong Xhen Khor, Kai Sheng Chung, Jia Yi Lim, Christine Hwee Ming Tay, Atiqah Binti Ayub","doi":"10.1002/rcr2.70730","DOIUrl":"10.1002/rcr2.70730","url":null,"abstract":"<p><p>A woman in her 40s presented with progressive dyspnoea and cough, preceded by anorexia and significant weight loss. Initial chest radiography showed apparent elevation of the right hemidiaphragm with right lower zone opacification, raising concern for thoracic or intra-abdominal malignancy. Laboratory investigations revealed severe normocytic anaemia, leucocytosis, hypoalbuminaemia and elevated alkaline phosphatase. Contrast-enhanced CT demonstrated a large subcapsular right hepatic abscess with contiguous transdiaphragmatic extension into the right lower thorax, complicated by lung abscess and pleural empyema. Blood and liver abscess cultures were negative; the liver aspirate was obtained after 7 days of antimicrobial therapy. She was treated with antimicrobial therapy and image-guided liver abscess drainage, achieving sustained clinical and biochemical recovery, with ultrasonographic resolution of the hepatic collection. This case highlights the importance of considering a subdiaphragmatic source in patients presenting with lung abscess or empyema adjacent to the right hemidiaphragm.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70730"},"PeriodicalIF":0.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799314","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 Hamartoma Masquerading as Endobronchial Tuberculosis-A Case Report.","authors":"Manoj Kumar Panigrahi, Aneri Parekh, Shameema Farween, Siddarth Singh, Supantha De, Mukund Sable","doi":"10.1002/rcr2.70722","DOIUrl":"10.1002/rcr2.70722","url":null,"abstract":"<p><p>Endobronchial hamartoma (EH) is a rare benign bronchial tumour that represents a small subset of pulmonary hamartomas. EH often presents with non-specific symptoms and may mimic malignancy or chronic infections such as tuberculosis, leading to delayed diagnosis or inappropriate treatment. We report here a case of a 60-year-old man who presented with 6 months of progressive dyspnoea and productive cough, and 2 months of low-grade fever. Flexible bronchoscopy showed an endobronchial mass, and forceps biopsies performed twice were reported as granulomatous inflammation. He received antitubercular treatment based on presumptive diagnosis of endobronchial tuberculosis. However, there was no clinical and radiological improvement despite 7 months of treatment. We performed rigid bronchoscopy and removed the endobronchial tumour using an electrocautery snare and cryoextraction. The excisional biopsy confirmed the diagnosis of EH. This case highlights the limitations of small biopsy specimens in diagnosing hamartoma and reemphasises the role of advanced pulmonary interventions, such as electrocautery snare and cryotherapy, as diagnostic-cum-therapeutic tools in such lesions.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70722"},"PeriodicalIF":0.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799309","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":"Chronic Myeloid Leukaemia Developing During Long-Term Alectinib Therapy Successfully Managed With Concomitant Nilotinib: A Case Report.","authors":"Yuki Ikematsu, Miiru Izumi, Kentaro Wakamatsu, Masayuki Kawasaki","doi":"10.1002/rcr2.70717","DOIUrl":"10.1002/rcr2.70717","url":null,"abstract":"<p><p>Therapy-related chronic myeloid leukaemia (t-CML) is an extremely rare myeloid neoplasm. Here, we report a first case of CML developing during long-term treatment with alectinib, a highly selective tyrosine kinase inhibitor (TKI) targeting anaplastic lymphoma kinase (ALK). A 53-year-old never-smoking woman with <i>ALK</i>-positive non-small cell lung cancer (NSCLC) developed mediastinal lymph node and brain metastases after curative surgery. Alectinib therapy achieved sustained systemic and intracranial disease control for nearly 3 years without serious adverse events. However, 3 years and 1 month after initiating alectinib, progressive leukocytosis with marked basophilia and circulating immature myeloid cells was observed. Bone marrow analysis confirmed the diagnosis of CML with <i>BCR-ABL1</i> fusion. Nilotinib was initiated while alectinib was continued, resulting in a rapid hematologic response without serious adverse events. Further accumulation of cases is needed to clarify the potential leukemogenic risk of ALK-TKIs and to establish the safety and clinical utility of combined ALK-TKI and BCR-ABL-TKI therapy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70717"},"PeriodicalIF":0.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13478838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799327","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":"Bronchial Chondronecrosis After Proton Beam Therapy Successfully Treated With Hyperbaric Oxygen Therapy.","authors":"Masataka Hirai, Takamasa Kitajima, SungChul Park, Takehisa Takagi, Ikuko Honda, Yokiko Ohe, Daiki Inoue, Motonari Fukui, Satoshi Marumo","doi":"10.1002/rcr2.70705","DOIUrl":"10.1002/rcr2.70705","url":null,"abstract":"<p><p>Airway chondronecrosis is a rare but serious manifestation of late radiation-induced toxicity. We report the case of a 67-year-old woman with epidermal growth factor receptor mutation-positive lung adenocarcinoma who developed bronchial chondronecrosis 8 years after proton-beam therapy (PBT) to the right upper lobe nodule. For 2 years, she was treated for cough-variant asthma owing to a persistent cough. Chest computed tomography (CT) showed only a subtle irregularity of the right main bronchial wall. Bronchoscopy revealed yellow necrotic deposits in the right main bronchi. Although a conventional forceps biopsy was nondiagnostic, transbronchial lung cryobiopsy (TBLC) obtained cartilage specimens, confirming bronchial chondronecrosis without malignancy. Hyperbaric oxygen therapy (HBOT) (90 sessions in total) led to symptomatic and bronchoscopic improvement. This case highlights that very-late-onset airway chondronecrosis following PBT must be considered, even with minimal CT findings. TBLC is a valuable tool for diagnosing submucosal lesions and HBOT appears to be an effective therapy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70705"},"PeriodicalIF":0.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725053","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 : 2026-08-12eCollection Date: 2026-08-01DOI: 10.1002/rcr2.70707
Chun-Chen Sun, Chen-Hsiu Chen
{"title":"Incidental Diagnosis of Hereditary Hemorrhagic Telangiectasia Following Perioperative Hypoxemia in a 4-Year-Old Child.","authors":"Chun-Chen Sun, Chen-Hsiu Chen","doi":"10.1002/rcr2.70707","DOIUrl":"10.1002/rcr2.70707","url":null,"abstract":"<p><p>A 4-year-old girl with no prior respiratory history developed refractory intraoperative hypoxemia during elective dental surgery under general anaesthesia. Despite 100% inspired oxygen and systematic exclusion of all conventional causes of desaturation, pulse oximetry (SpO<sub>2</sub>) failed to exceed 94%. Postoperative contrast-enhanced chest computed tomography identified a 2.01-cm pulmonary arteriovenous malformation (PAVM) in the right lung, and subsequent molecular genetic testing confirmed hereditary hemorrhagic telangiectasia (HHT). The patient was discharged with baseline SpO<sub>2</sub> of 85%-95% on room air and established on long-term paediatric pulmonary follow-up. This case highlights that PAVMs associated with HHT can manifest as unexplained perioperative hypoxemia in asymptomatic children, and that general anaesthesia with positive pressure ventilation may unmask previously compensated right-to-left shunting. Early recognition enables appropriate perioperative management and timely HHT surveillance.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70707"},"PeriodicalIF":0.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13468903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765033","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 : 2026-08-12eCollection Date: 2026-08-01DOI: 10.1002/rcr2.70719
Fnu Mahparah, Ali Gohar, Hafiza Manahil Majeed, Abdul Rehman, Zawaiba Tanveer, Muhammad Husnain Ahmad
{"title":"Diaphragmatic Eventration Masquerading as Lobar Collapse in Severe ABPA.","authors":"Fnu Mahparah, Ali Gohar, Hafiza Manahil Majeed, Abdul Rehman, Zawaiba Tanveer, Muhammad Husnain Ahmad","doi":"10.1002/rcr2.70719","DOIUrl":"10.1002/rcr2.70719","url":null,"abstract":"<p><p>Allergic bronchopulmonary aspergillosis (ABPA) characteristically causes transient mucus plugging and lung collapse. We present a 62-year-old asthmatic with acute ABPA whose severe right-sided diaphragmatic elevation initially mimicked mucus-induced atelectasis. High-resolution CT and positional spirometry unmasked a massive diaphragmatic eventration, highlighting a rare structural mimic of lobar collapse.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70719"},"PeriodicalIF":0.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723200","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 Myoepithelioma With Fluorodeoxyglucose Uptake.","authors":"Taro Abe, Keitaro Nakamoto, Eriko Ieki, Miku Oda, Yoshifumi Hirata, Isao Kataoka, Kazuharu Suda, Aya Isomura, Junji Shibahara, Yutaka Suzuki","doi":"10.1002/rcr2.70725","DOIUrl":"10.1002/rcr2.70725","url":null,"abstract":"<p><p>Myoepitheliomas of the respiratory organs are extremely rare. We report a case of endobronchial myoepithelioma in a 43-year-old woman presenting to hospital with a cough. Chest computed tomography (CT) showed consolidation in the lingular segment of her left upper lobe. She was initially diagnosed as having pneumonia and treated with antibiotics, but her symptoms persisted. We then performed diagnostic bronchoscopy and observed a smooth, elevated lesion obstructing the lingular bronchus. Positron emission tomography/CT revealed a nodule in the lingular bronchus of the left upper lobe with fluorodeoxyglucose (FDG) uptake, while the consolidation had disappeared. Left upper lobectomy was performed, and on the basis of the pathological findings including immunostaining, she was finally diagnosed as having myoepithelioma. There has been no recurrence during an 18-month follow-up. Although myoepithelioma is a rare disease, it should be considered in the differential diagnosis of nodules with FDG uptake.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70725"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714044","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 of Primary Pulmonary Meningioma With Slow Enlargement Over a 9-Year Period.","authors":"Kazuki Sugata, Yoshitaka Tanaka, Hiroki Katsushima, Yoshio Tsunezuka","doi":"10.1002/rcr2.70716","DOIUrl":"10.1002/rcr2.70716","url":null,"abstract":"<p><p>Primary pulmonary meningioma (PPM) is an extremely rare benign tumour with a long-term natural history that remains elusive. A 69-year-old asymptomatic male who had never smoked presented with an 11-mm smooth nodule in the left lower lobe. Serial chest radiographs revealed slow, continuous growth over 9 years (from 2 to 11 mm; tumour doubling time [TDT]: 1.2 years). The patient underwent partial thoracoscopic resection. Histopathology indicated a whorled pattern of spindle cells with a low Ki-67 index (~1%), indicating a WHO grade 1 meningioma, despite atypical negativity for epithelial membrane antigen. Brain magnetic resonance imaging ruled out the presence of intracranial lesions. No postoperative recurrence was noted at 6 months postoperatively. This case highlights that Grade 1 PPM could lead to long-term progressive growth. The established WHO grading system might be correlated with the PPM growth rate, warranting further case accumulation.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70716"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714022","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":"Rapid Progressive Dendriform Pulmonary Ossification due to Eosinophilic Pneumonia.","authors":"Koharu Harada, Takunori Ogawa, Ryosuke Nagaoka, Hiromi Edo, Hiroaki Sugiura, Taiki Nozaki, Yoshifumi Kimizuka","doi":"10.1002/rcr2.70699","DOIUrl":"10.1002/rcr2.70699","url":null,"abstract":"<p><p>A 55-year-old man with idiopathic eosinophilic pneumonia developed rapidly progressive dendriform pulmonary ossification with branching pulmonary calcifications on CT. Corticosteroid treatment improved both pulmonary consolidations and calcified lesions, suggesting that acute or immature pulmonary calcification may be reversible.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70699"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726079","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 : 2026-08-11eCollection Date: 2026-08-01DOI: 10.1002/rcr2.70724
Shijie Yang, Shaoling Li, Wenwen Sun, Ye Gu, Li Yang
{"title":"Primary Tracheal Rosai-Dorfman Disease Coexisting With Active Pulmonary Tuberculosis.","authors":"Shijie Yang, Shaoling Li, Wenwen Sun, Ye Gu, Li Yang","doi":"10.1002/rcr2.70724","DOIUrl":"10.1002/rcr2.70724","url":null,"abstract":"<p><p>Rosai-Dorfman disease (RDD) rarely involves the trachea, and active pulmonary tuberculosis (TB) has not been reported with tracheal RDD. A 35-year-old woman presented with progressive cough, wheezing, and shortness of breath for 1 month. Chest CT revealed a tracheal mass causing > 90% airway narrowing and left lung nodules suggestive of TB. Emergency bronchoscopic resection using high-frequency electrocautery relieved the obstruction. Histopathology showed emperipolesis and immunohistochemistry was consistent with RDD. Bronchial aspirate was positive for <i>Mycobacterium tuberculosis</i> complex by culture and GeneXpert, without rifampicin resistance. Standard anti-TB therapy was given. Two-month CT and one-year follow-up bronchoscopy and CT showed a patent airway without recurrence. The patient remained symptom-free with no other organ involvement. This is the first report of primary tracheal RDD coexisting with active pulmonary TB. Bronchoscopic resection combined with anti-TB therapy achieved durable disease control at 1 year.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"14 8","pages":"e70724"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714081","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}