Respirology Case Reports最新文献

{"title":"Miliary sarcoidosis.","authors":"Atif Saleem Siddiqui","doi":"10.1002/rcr2.1448","DOIUrl":"10.1002/rcr2.1448","url":null,"abstract":"<p><p>Miliary patterns on chest imaging of the lung can be associated with sarcoidosis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01448"},"PeriodicalIF":0.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898618","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":"Acute pulmonary thromboembolism with high-density emboli in the pulmonary artery detected on non-enhanced computed tomography.","authors":"Shimpei Kajie, Kentaro Nakamura, Tomohiro Moriya, Tomoyuki Ogata, Takaaki Yamashita","doi":"10.1002/rcr2.1447","DOIUrl":"10.1002/rcr2.1447","url":null,"abstract":"<p><p>The presence of high-density emboli in the pulmonary artery on non-enhanced computed tomography (CT) has high diagnostic performance for acute central pulmonary thromboembolism. Acute pulmonary thromboembolism is usually diagnosed by contrast-enhanced CT. However, it may be possible to achieve early diagnosis by identifying characteristic findings on non-enhanced CT.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01447"},"PeriodicalIF":0.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898617","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":"The Pneumothorax And Symptom Evaluation (PASE) study: Bendopnoea in patients with pneumothorax.","authors":"Bianca M Iacopetta, Michaela Donaghy, Chloe Charlesworth, Carolyn J Peddle-McIntyre, Ai Ling Tan, Y C Gary Lee","doi":"10.1002/rcr2.1443","DOIUrl":"10.1002/rcr2.1443","url":null,"abstract":"<p><strong>Background: </strong>Pneumothorax can cause distressing breathlessness, however the effect of the accumulated air in the pleural space and its association with diaphragmatic function and symptoms of breathlessness is not well understood. Bendopnoea is an evolving clinical symptom that has been demonstrated as clinically useful in some heart and lung conditions. Whether bendopnoea is present in patients with pneumothorax, and its potential clinical usefulness has not yet been investigated. The PASE study is a pilot study to explore the incidence and clinical relevance of bendopnoea in patients with pneumothorax and may provide better understanding of pneumothorax related dyspnoea.</p><p><strong>Methods: </strong>PASE is a prospective study. Eligible patients are assessed at baseline (pre air drainage/lung reinflation) and in patients whose pneumothorax resolves once the lung has re-expanded (post conservative management or air drainage procedure). Outcome measures include the incidence of bendopnoea, correlation of the associated symptoms (pain and breathlessness) to the severity of bendopnoea and the size of pneumothorax; and correlation with clinical outcome (i.e., response to air drainage/lung reinflation). The study will recruit 50 participants.</p><p><strong>Discussion: </strong>This is the first study to explore bendopnoea in patients with pneumothorax. The presence and significance of bendopnoea in relation to clinical and physiological parameters in patients with pneumothorax requires investigation. The findings of this study may further current understanding of dyspnoea related pneumothorax.</p><p><strong>Trial registration: </strong><b><i>Name of the registry</i>:</b> Australia New Zealand Clinical Trial Registry <b><i>Trial registration number</i></b> : ACTRN12623001109695p. <b><i>URL of the trial registry record for this trial</i></b> : https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386631&isReview=true <b><i>Date of registration</i></b> : Registered on 24 October 2023. <b><i>Funding of the trial</i></b> : This study has not received grant support. The study is sponsored by the Institute for Respiratory Health, a not-for-profit organisation. <b><i>Name and contact information for the trial sponsor</i></b> : Mr Bi Lam; Finance manager. Level 2, 6 Verdun Street, Nedlands, WA 6009. <b><i>Role of sponsor</i></b> : The funder is not involved in the planning of the study, gathering, analysing, and interpreting the data, or in preparing the manuscript. <b><i>Protocol version</i></b> : 1.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01443"},"PeriodicalIF":0.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898562","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 double-blind randomized controlled trial of N-acetylcysteine (NAC) for the treatment of acute exacerbation of chronic obstructive pulmonary disease.","authors":"Wang Chung Kwok, Shung Kay Samuel Chan, Ka Yan Chiang, Chung Man James Ho","doi":"10.1002/rcr2.1449","DOIUrl":"10.1002/rcr2.1449","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with acute exacerbation (AECOPD) being a common sequalae which negatively impact health status, rates of hospitalization and readmission, and disease progression. N-acetylcysteine (NAC) has been studied in COPD in both stable state and acute exacerbations, which has been shown to have small beneficial effects in stable COPD, as well as AECOPD. Yet, there has been lack of study with well-designed protocol to assess the role of NAC in more objective outcomes in AECOPD.</p><p><strong>Methods: </strong>This is a double-blind randomized controlled trial. Patients will be randomized in 1:1 ratio to receive oral NAC at 600 mg twice daily or placebo twice daily with standard of care. Partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂) and the ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO₂/FiO₂) will be measured on days 1 and 7. The following will be measure at baseline and on day 4 and 7: Forced expiratory volume in one second (FEV₁), 24-hour sputum volume, oxygen saturation (SaO₂), end-tidal CO₂, Leicester Cough Questionnaire (LCQ) score, COPD Assessment Test (CAT) score, grading of wheeze and grade of dyspnoea; blood inflammatory markers (leucocyte count, neutrophil count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and high sensitivity CRP (hs-CRP)). Patients will be randomized to oral NAC at 600 mg twice daily or placebo for 7 days. The main outcome measures include: The difference in PaO₂ on day 7. Secondary outcome: Change in following parameters on day 4/7 from baseline: FEV₁, sputum volume, CAT score, LCQ score, SaO₂, grade of wheeze; mMRC Dyspnoea Scale, end-tidal CO₂, blood inflammatory marker, change in PaO₂/FiO₂ ratio from baseline to day 7, PaCO₂ on day 7, 28 and 90 days' mortality, time to wean off supplemental oxygen, length of stay.Primary and secondary outcomes will be compared among the two treatment groups with two-sample <i>t</i>-test.</p><p><strong>Discussion: </strong>We hypothesize that NAC use in COPD exacerbation can provide benefits in clinical and laboratory parameters.</p><p><strong>Trial registration: </strong><b><i>Name of the registry</i></b> : ClinicalTrials.gov <b><i>Trial registration number</i></b> : NCT05706402. <b><i>URL of the trial registry record for this trial</i></b> : https://classic.clinicaltrials.gov/ct2/show/NCT05706402 <b><i>Date of registration</i></b> : Registered on 11th January 2023 <b><i>Funding of the trial</i></b> : The Health and Medical Research Fund (HMRF). <b><i>Name and contact information for the trial sponsor</i></b> : Wang Chung Kwok, Clinical Assistant Professor, Honorary Associate Consultant, Queen Mary Hospital, The University of Hong Kong, Hong Kong. <b><","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01449"},"PeriodicalIF":0.8,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898616","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":"Bronchoscopic retrieval of an aspirated tooth following high-speed motor vehicle accident.","authors":"Hamza Azam, Peter Wu","doi":"10.1002/rcr2.1444","DOIUrl":"10.1002/rcr2.1444","url":null,"abstract":"<p><p>A 28-year-old man aspirated a tooth into his right lower lobe bronchus following a high-speed motor vehicle accident. Initial retrieval attempts failed with a flexible bronchoscope, but a cryoprobe successfully dislodged and retrieved the tooth. Cryoprobe should be considered for bronchoscopic foreign body removal when conventional methods are unsuccessful.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01444"},"PeriodicalIF":0.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861184","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":"Granular cell tumour-A case of recurrent pneumonia due to an endobronchial lesion.","authors":"Alwyn Mathew, Ahmad Al-Tanjy, Yazan Abdeen","doi":"10.1002/rcr2.1436","DOIUrl":"10.1002/rcr2.1436","url":null,"abstract":"<p><p>Granular cell tumours are rare, mostly benign masses that arise from Schwann cells. Their pathophysiology is poorly understood, but the lesions are often seen in the breast, tongue, and skin. In this case report, we discuss a 34-year-old patient with recurrent pneumonia. The patient had several comorbidities, and was intubated due to respiratory distress and eventually placed on tracheostomy. During the procedure, she was noted to have a right middle lobe endobronchial lesion. It was excised and identified as a granular cell tumour. The patient was later weaned off the ventilator and discharged without any complications.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01436"},"PeriodicalIF":0.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11291553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876261","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 pleural and pericardium amyloidosis with effusion associated with multiple myeloma relapse.","authors":"Naoya Ishibashi, Takafumi Sugawara, Yugo Ashino, Ryuga Yabe, Ryo Nonomura, Yutaka Oshima, Takanobu Sasaki","doi":"10.1002/rcr2.1445","DOIUrl":"10.1002/rcr2.1445","url":null,"abstract":"<p><p>An 80-year-old man with a history of Bence-Jones potein (BJP) λ-type multiple myeloma (MM), which had been in remission for 16 years, was examined for shortness of breath and was found to have bilateral pleural and pericardial effusions. A pleural fluid test and a pleural biopsy under local anaesthesia performed by a previous physician failed to make the diagnosis. Despite diuretic therapy, his condition necessitated frequent thoracentesis. The patient was referred to our hospital and thoracoscopic pleural and pericardial biopsies performed under general anaesthesia revealed λ-type AL amyloidosis, indicating a relapse of MM. Despite drug therapy for MM, the patient died from aspiration pneumonia. The case underscores the importance of considering amyloidosis in differential diagnoses for refractory effusions, especially in patients with a history of MM, even after long-term remission.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01445"},"PeriodicalIF":0.8,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861183","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":"Pleuroparenchymal sarcoidosis: A rare manifestation mimicking metastatic lung cancer.","authors":"Eugene Gan, Chee Kiang Tay","doi":"10.1002/rcr2.1438","DOIUrl":"10.1002/rcr2.1438","url":null,"abstract":"<p><p>A 66-year-old male from Myanmar presented with 3 months of cough and constitutional symptoms. He was an ex-tobacco user with no significant medical or exposure history. Chest x-ray showed ill-defined bilateral opacities and a left pleural effusion. Chest CT revealed two right lower lobe masses, and a moderate-sized left pleural effusion. PET-CT demonstrated hypermetabolic uptake in the thickened nodular pleura, pericardium, and hilar/mediastinal lymph nodes. EBUS-TBNA of the right lower paratracheal node and TBLB of the right lower lobe mass yielded epithelioid granulomas comprising multinucleated giant cells, epithelioid histiocytes and lymphoplasmacytic cells. Thoracoscopy revealed hard, whitish mass-like parietal pleural plaques, and pleural biopsy revealed identical histopathologic results. His symptoms resolved quickly after commencing prednisolone 25 mg daily. Chest CT at 6 months demonstrated near complete resolution of the parenchymal masses and pleural effusion. We highlight this unique case of pleuroparenchymal sarcoidosis mimicking metastatic lung cancer in a tuberculosis-endemic region.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01438"},"PeriodicalIF":0.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861196","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":"Selective bronchial occlusion for acquired bronchobiliary fistula caused by treatment of hepatocellular carcinoma: A case series.","authors":"Bi Zhao, Rui Chen Huang, Yang Xia, Yuchao Dong, Haidong Huang, Lijun Zhao, Wei Zhang","doi":"10.1002/rcr2.1440","DOIUrl":"10.1002/rcr2.1440","url":null,"abstract":"<p><p>Acquired bronchobiliary fistula (ABBF) is very rare among the complications that occur in patients with hepatocellular carcinoma (HCC) after treatment. Although surgery and drainage have been the main methods for treating ABBF for a long time, they are not entirely suitable for patients with refractory ABBF resulting from HCC therapy. In this study, we present four cases of ABBF caused by HCC treatment, who were treated using selective bronchial occlusion (SBO). Among the 4 patients with ABBF treated with SBO, 3 cases successfully blocked ABBF with SBO, and the treatment success rate was 75%. All successfully treated patients reported disappearance of symptoms of bilioptysis and cough was alleviated. No life-threatening adverse reactions were reported following SBO intervention, and no deaths occurred. We believe that the use of video bronchoscopy to place a self-made silicone plug in the bronchus to treat refractory ABBF is a feasible palliative treatment, which can significantly improve the condition of ABBF patients.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01440"},"PeriodicalIF":0.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861197","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":"IgG4-related pleural disease diagnosed by thoracoscopic pleural biopsy: A case report.","authors":"Azusa Miyoshi, Hideki Katsura, Tomohiro Akaba, Mitsuko Kondo, Etsuko Tagaya","doi":"10.1002/rcr2.1442","DOIUrl":"10.1002/rcr2.1442","url":null,"abstract":"<p><p>Here we report a rare case of immunoglobulin G4 (IgG4)-related pleural disease diagnosed using a thoracoscopic pleural biopsy. A 66-year-old man was admitted to our hospital with right-dominant bilateral pleural effusions and gradually worsening dyspnoea. Chest radiographs revealed right-dominant pleural effusions, while chest computed tomography showed bilateral pleural effusions without parenchymal lesions. Although the bilateral pleural effusions were exudative with an increased number of lymphocytes, the definitive diagnosis was initially elusive. High IgG4 levels in the serum and pleural effusions were observed. A pathological evaluation of a right pleural biopsy specimen collected via video-assisted thoracoscopic surgery showed fibrosis-associated lymphoplasmacytic infiltration, 45-60 IgG4-positive plasma cells per high-power field, and an IgG4/immunoglobulin G ratio of 40%. Consequently, the patient was diagnosed with IgG4-related pleural disease. The bilateral pleural effusions improved after corticosteroid therapy.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 8","pages":"e01442"},"PeriodicalIF":0.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861185","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}