Respiratory Medicine Case Reports最新文献

{"title":"A rare case of a giant pulmonary solitary fibrous tumor: Diagnostic and therapeutic challenges in the absence of malignancy","authors":"Nouman Aziz ,&nbsp;Waseem Nabi ,&nbsp;Sukhrob Makhkamov ,&nbsp;Yasmine Elsherif ,&nbsp;Adnan Bhat ,&nbsp;Sonu Sahni","doi":"10.1016/j.rmcr.2025.102191","DOIUrl":"10.1016/j.rmcr.2025.102191","url":null,"abstract":"<div><h3>Background</h3><div>Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms predominantly arising from the pleura but occasionally occurring in extrapleural locations. Pulmonary parenchymal SFTs of extreme size are exceedingly uncommon and present diagnostic and therapeutic challenges.</div></div><div><h3>Case presentation</h3><div>We report the case of a 60-year-old female with a 14 x 12 × 23 cm pulmonary SFT presenting with a two-week history of productive cough and significant weight loss. Imaging revealed a massive heterogeneous mass in the left lower lobe, compressing lung parenchyma, causing pleural effusion and atelectasis, and raising concerns for metastatic spread to the liver and spleen. Histological examination confirmed the diagnosis of SFT, with spindle-cell morphology and positive immunohistochemical staining for CD34 and STAT6. Despite the tumor's size and compressive effects, histopathology showed no necrosis, pleomorphism, or high mitotic activity, indicative of a non-aggressive phenotype. The patient underwent successful surgical resection via thoracotomy and is under long-term follow-up.</div></div><div><h3>Discussion</h3><div>This case highlights the unique diagnostic complexity of SFTs, particularly with tumors of exceptional size. While larger SFTs often suggest malignant potential, the absence of typical markers of malignancy in this case emphasizes the unpredictable behavior of these tumors. Imaging and immunohistochemical evaluation are critical for diagnosis, and surgical resection remains the cornerstone of management.</div></div><div><h3>Conclusion</h3><div>This rare case underscores the importance of thorough diagnostic evaluation and surgical management in addressing giant pulmonary SFTs. Despite their potential for malignant transformation, careful histopathological analysis and multidisciplinary collaboration can guide optimal treatment and long-term surveillance for these unpredictable tumors.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"55 ","pages":"Article 102191"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685860","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":"Idiopathic CD4 lymphocytopenia: An uncommon but fatal cause of Pneumocystis pneumonia","authors":"Julia Schearer ,&nbsp;Christopher Merrick","doi":"10.1016/j.rmcr.2025.102177","DOIUrl":"10.1016/j.rmcr.2025.102177","url":null,"abstract":"<div><div><em>Pneumocystis</em> pneumonia (PCP) is a fungal infection with primary occurrence in immunocompromised individuals by the etiologic agent <em>Pneumocystis jirovecii</em>. In those without previously identified risk factors, maintaining an index of suspicion for this diagnosis with search for underlying immunosuppressive cause is of utmost importance. Here, we present a case of fatal PCP in a patient without a known history of immunocompromise subsequently diagnosed with idiopathic CD4 lymphocytopenia (ICL) with an absolute CD4⁺ T-cell count of 7 cells/uL.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"54 ","pages":"Article 102177"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349530","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":"Dendriform pulmonary ossification in military combat veterans: A case series","authors":"Jeremy T. Hua ,&nbsp;Carlyne D. Cool ,&nbsp;Tami J. Bang ,&nbsp;Silpa D. Krefft ,&nbsp;Richard C. Kraus ,&nbsp;Cecile S. Rose","doi":"10.1016/j.rmcr.2024.102156","DOIUrl":"10.1016/j.rmcr.2024.102156","url":null,"abstract":"<div><div>Dendriform pulmonary ossification (DPO) is a rare condition characterized by mature bone formation in the lung. DPO has been linked to various conditions, but little is known about the link between DPO and hazardous airborne exposures. We queried research databases of military personnel evaluated for deployment-related respiratory diseases at two occupational pulmonary medicine clinics (Colorado, USA) for diagnoses of DPO, and summarized demographics, Gulf War military deployment history, medical history, and pulmonary function testing. Chest imaging was independently reviewed and scored by a thoracic radiologist, and all cases had undergone lung tissue biopsy. We identified five male combat veterans with DPO, median age 49 years [range: 32–64]. All had deployed to Southwest Asia or Afghanistan during the First or Second Gulf War, and all reported frequent, intense exposure to diesel exhaust, burn pit emissions, and sandstorms. Lung physiology was abnormal in all cases. The most prevalent chest imaging and histopathology findings were airway-centric injury, inflammation, and retained particulate matter, suggesting substantial hazardous exposure during military deployment. This case series of a rare lung disease from the only two contemporary Colorado clinics serving previously deployed veterans highlights a potential link between airborne hazards and lung injury leading to DPO. A high index of clinical suspicion combined with a detailed occupational history may reveal additional exposure-related associations with DPO. Access to large medical databases of military veterans with linkage to exposure histories may further elucidate risk factors for lung injury with ossification, paving the way for targeted prevention.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"53 ","pages":"Article 102156"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061332","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":"Intuitive stent simulation with internal cavity airway models created by a consumer-grade three-dimensional printer: A case series","authors":"Naoya Kitamura ,&nbsp;Toshihiro Ojima ,&nbsp;Yoshifumi Shimada ,&nbsp;Keitaro Tanabe ,&nbsp;Ryo Yokoyama ,&nbsp;Naru Kitade ,&nbsp;Koichiro Shimoyama ,&nbsp;Tomoshi Tsuchiya","doi":"10.1016/j.rmcr.2025.102167","DOIUrl":"10.1016/j.rmcr.2025.102167","url":null,"abstract":"<div><div>Airway stenting, which can cause life-threatening complications, requires advanced techniques as well as safe and reliable procedures. Learning effective techniques and accurately identifying and simulating malignant airway stenosis before the procedure are crucial. However, traditional methods that use three-dimensional (3D) computed tomography images displayed on two-dimensional screens have limitations in accurately visualizing and simulating airway conditions. To address these issues, this study presents the creation of 3D airway models using a consumer-grade 3D printer. These cost-effective and time-efficient models replicate the airway lumen, allowing precise stent placement simulations and enhancing the learning process of airway stenting techniques. In a case series of five patients with malignant airway stenosis, these models facilitated effective stent placement, enhanced the understanding of airway anatomy, and contributed to procedural success. This study's findings suggest that the use of 3D airway models has substantial potential for broader clinical applications in airway stenting. However, evidence for the widespread adoption of this technology is insufficient, and further research is needed.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"53 ","pages":"Article 102167"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123635","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 melanoma metastasis. A rare relapse","authors":"Anastasios Palamidas ,&nbsp;Bouros Dimosthenis","doi":"10.1016/j.rmcr.2025.102222","DOIUrl":"10.1016/j.rmcr.2025.102222","url":null,"abstract":"<div><div>Melanomas are skin derived malignant tumors exhibiting extreme diversity during disease progression in terms of time and site of metastasis. This is a rare case of a 68 year old, former smoker male, with a history of a cutaneous head melanoma which was treated 20 years ago. He presented with dyspnea and mild hemoptysis. On examination a solid mass found at the right lower lobe. Bronchoscopy performed and biopsies taken revealing endobronchial metastatic melanoma. Tissue genomics revealed two rare mutations. Finally patient received a doublet of immunotherapy and targeted therapy regiments. To the best of our knowledge this is a rare case of endobronchial metastasis 20 years after the treatment of the primary site. After so many years elapsed it is difficult to make a differential diagnosis between metastasis and a second primary endobronchial melanoma. Surgery and bronchoscopic modalities are promising only if they can be combined with immunotherapy and targeted therapies which are the game changers regarding the treatment of the disease.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"55 ","pages":"Article 102222"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges in differentiating mediastinal tuberculosis from mediastinal tumors: A case report","authors":"Aida,&nbsp;Noni Novisari Soeroso,&nbsp;Herani Mutia Riandini","doi":"10.1016/j.rmcr.2024.102152","DOIUrl":"10.1016/j.rmcr.2024.102152","url":null,"abstract":"<div><div>Mediastinal tuberculosis poses significant diagnostic challenges due to its nonspecific clinical and radiological features, particularly in high TB incidence regions like Indonesia. Here, we present the case of A 17-year-old male, initially diagnosed with a mediastinal tumor, was later confirmed to have mediastinal tuberculosis (TB). Despite normal lab results, imaging revealed a right parahilar mass. Bronchoscopy indicated bronchial stenosis, and VATS converted to thoracotomy confirmed TB. The patient improved significantly after six months of anti-tuberculosis therapy (ATT). Managing mediastinal tumors and tuberculosis requires tailored surgical interventions like thoracotomy or VATS, emphasizing the need for accurate preoperative diagnoses. This case underscores the importance of comprehensive diagnostic evaluation, including histopathological and microbiological tests, to distinguish TB from other mediastinal pathologies and ensure appropriate treatment.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"53 ","pages":"Article 102152"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985582","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 unique case of extranodal marginal zone lymphoma with synchronous pulmonary and dermatologic manifestations","authors":"Carlo Arevalo ,&nbsp;Fernando Camacho ,&nbsp;Joseph Modrak","doi":"10.1016/j.rmcr.2024.102153","DOIUrl":"10.1016/j.rmcr.2024.102153","url":null,"abstract":"<div><div>An 89-year-old male with a medical history of non-ischemic cardiomyopathy was initially admitted with acute hypoxic respiratory failure attributed to heart failure exacerbation. Aside from progressive dyspnea, a non-pruritic, non-painful rash and constitutional symptoms were reported. Initial work-up was remarkable for normocytic anemia, lymphopenia, mild hypercalcemia, and elevated inflammatory markers. Despite aggressive diuresis, his respiratory distress worsened requiring up-titration of supplemental oxygen (6–8L/min). Subsequent chest CT showed diffuse, ill-defined areas of consolidation and ground-glass opacities (GGOs) with areas of solid and ground-glass nodularity. Rheumatologic work-up was remarkable for mildly elevated ANA titer of 1:60, and positive anti-centromere antibody of 1.8 AI (normal range 0–0.9 AI). Infectious work-up was negative. Due to high oxygen requirements, tissue sampling was obtained by skin biopsy instead of bronchoscopy. After biopsy testing, prednisone 60 mg was started with posterior clinical and radiographic improvement. Biopsy results revealed cutaneous MZL. Follow-up PET scan showed persistent but improved diffuse GGOs and nodular opacities. Given the clinical presentation, imaging and skin biopsy results, the diagnosis was compatible with EMZL with synchronous pulmonary and skin manifestations. Empiric treatment with Rituximab and steroid taper was planned. At 6-month follow-up, the patient reported clinical and respiratory improvement.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"53 ","pages":"Article 102153"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016107","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 acute respiratory distress syndrome due to chlorine gas inhalation: Rapid progression with favorable ICU outcome","authors":"Dung Thai Pham ,&nbsp;Bang Ngoc Dao ,&nbsp;Dung Tien Nguyen ,&nbsp;Ba Van Dang ,&nbsp;Dung Tien Le ,&nbsp;Hung Manh Do ,&nbsp;Loc Tich Hoang ,&nbsp;Minh Tuan Ngo ,&nbsp;Duong Minh Vu","doi":"10.1016/j.rmcr.2024.102148","DOIUrl":"10.1016/j.rmcr.2024.102148","url":null,"abstract":"<div><div>Acute respiratory distress syndrome (ARDS) secondary to chlorine gas inhalation is a rare yet critical condition that can lead to severe respiratory failure if not managed promptly. This case report presents a 43-year-old male who developed ARDS after accidental exposure to chlorine gas during pool maintenance. The patient's condition deteriorated rapidly, with symptoms progressing to acute pulmonary edema and severe hypoxemia, requiring immediate transfer to the intensive care unit (ICU). Initial treatment included non-invasive ventilation, but the patient soon required tracheal intubation and mechanical ventilation. Despite the rapid disease progression, the patient responded well to aggressive ICU management, including oxygen therapy, mechanical ventilation, and pharmacological support. Remarkably, within seven days, the patient fully recovered and was discharged in stable condition. This case highlights the potential for a good prognosis in ARDS due to chlorine gas inhalation compared to other etiologies, emphasizing the importance of timely intervention and specialized care in the ICU.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"53 ","pages":"Article 102148"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933475","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":"Hereditary transthyretin amyloidosis incidentally diagnosed by video-associated lung surgery for lung cancer: A case report","authors":"Katsuhiro Itogawa ,&nbsp;Shintaro Sato ,&nbsp;Hideaki Yamakawa ,&nbsp;Keiichi Akasaka ,&nbsp;Masako Amano ,&nbsp;Akiko Adachi ,&nbsp;Hidekazu Matsushima","doi":"10.1016/j.rmcr.2025.102170","DOIUrl":"10.1016/j.rmcr.2025.102170","url":null,"abstract":"<div><div>Pulmonary involvement associated with transthyretin amyloidosis is a relatively uncommon presentation among many systemic symptoms. However, in recent times, several definitive treatments have been newly approved, thus the importance of diagnosing previously overlooked cases has been increasing. This report describes an incidentally diagnosed case with a pulmonary lesion. A 76-year-old male with a history of obstructive sleep apnea syndrome, bilateral carpal tunnel syndrome, and lumbar canal stenosis was presented with a 25mm right lower lobe nodule identified through a computed tomography conducted at an outpatient clinic. Lung cancer was suspected and the following thoracoscopic segmentectomy revealed a diagnosis of adenocarcinoma in situ. In addition, further pathological investigation of the background lung tissue revealed deposition of amyloid transthyretin (TTR), although no radiological findings suggestive of pulmonary amyloidosis were present. A genetic mutation screening test revealed pathological TTR gene mutation of heterozygous Tyr114His (p.Tyr134His). Thus, the diagnosis of hereditary transthyretin amyloidosis was made, and the subsequent investigation identified familial amyloid polyneuropathy. Finally, treatment with vutrisiran, a small interfering RNA (siRNA) targeting the TTR gene, was successfully initiated. Physicians need to be aware that unidentified amyloidosis may be diagnosed incidentally from a biopsied or resected specimen for another purpose. Diagnosing systemic amyloidosis that may otherwise be overlooked would enable patients to receive benefits from the definitive therapy.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"53 ","pages":"Article 102170"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155576","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":"Adult granulosa cell tumor with rare pulmonary presentation","authors":"Mark G. Evans ,&nbsp;Anthony Crymes ,&nbsp;Adam Bedeir ,&nbsp;David R. Braxton ,&nbsp;Matthew J. Oberley ,&nbsp;Robert T. Muldoon","doi":"10.1016/j.rmcr.2025.102185","DOIUrl":"10.1016/j.rmcr.2025.102185","url":null,"abstract":"<div><div>Adult granulosa cell tumor (GCT) is an uncommon sex cord-stromal neoplasm of the ovary. It typically demonstrates locoregional spread, and disease outside of the pelvis as metastasis is uncommon. Only a rare case of primary thoracic adult GCT has been documented, and here we describe another occurrence with unusual pulmonary presentation, thereby expanding the anatomic distribution across which adult GCT could potentially arise.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"54 ","pages":"Article 102185"},"PeriodicalIF":0.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520344","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}