Respiratory Medicine Case Reports最新文献_第3页

Severe pulmonary disease as a driver of dynamic left ventricular outflow tract obstruction in stress cardiomyopathy 严重肺部疾病是应激性心肌病左心室流出道梗阻的驱动因素

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-08-14 DOI: 10.1016/j.rmcr.2026.102473

Alexis Magre, Srujan Kancharla, Gianpiero Paletta, Naveen Tyagi

{"title":"Severe pulmonary disease as a driver of dynamic left ventricular outflow tract obstruction in stress cardiomyopathy","authors":"Alexis Magre, Srujan Kancharla, Gianpiero Paletta, Naveen Tyagi","doi":"10.1016/j.rmcr.2026.102473","DOIUrl":"10.1016/j.rmcr.2026.102473","url":null,"abstract":"<div><h3>Background</h3><div>Dynamic left ventricular outflow tract obstruction (LVOTO) is a recognized complication of stress cardiomyopathy and can mimic hypertrophic obstructive cardiomyopathy (HOCM) even in the absence of structural hypertrophy. In critically ill patients with severe pulmonary disease, preload, afterload, and contractility can be altered which may exacerbate obstruction.</div></div><div><h3>Case presentation</h3><div>A 76-year-old woman with interstitial lung disease and microscopic polyangiitis receiving immunosuppressive therapy presented with progressive dyspnea and shock. Transthoracic echocardiography demonstrated systolic anterior motion (SAM) of the mitral valve and a dynamic LVOT gradient which increased with Valsalva maneuver. Coronary angiography showed no obstructive coronary artery disease. Cardiac magnetic resonance imaging demonstrated normal left ventricular wall thickness with hypokinesis of the mid-to-apical segments suggestive of stress cardiomyopathy. Her clinical course was complicated by COVID-19 pneumonia, recurrent shock, mechanical ventilation, and progressive right ventricular dysfunction. Repeat echocardiography demonstrated persistent dynamic obstructive physiology despite the absence of structural cardiac disease. Treatment required careful preload optimization, vasopressor selection, and respiratory support, as interventions commonly used for shock and pulmonary edema risked worsening LVOTO.</div></div><div><h3>Conclusion</h3><div>This case highlights stress cardiomyopathy complicated by dynamic LVOTO presenting with pseudo-HOCM physiology. Clinical complications of severe pulmonary disease, respiratory failure, and right ventricular dysfunction likely amplified the preload-dependent obstruction and contributed to refractory hemodynamic instability. Due to standard shock therapies paradoxically worsening obstruction, early echocardiographic recognition and physiology-guided management are critical in this population.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"63 ","pages":"Article 102473"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148777189","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}

引用次数: 0

A silent invader: Invasive pulmonary aspergillosis in an immunocompetent host 一个沉默的入侵者：侵袭性肺曲霉病在免疫正常的宿主

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-04-27 DOI: 10.1016/j.rmcr.2026.102425

Harshith Reddy Beeravolu, Babaji Ghewade, Vivek Alone, Rashmika Mummaneni, Poonam Avinash Patil

{"title":"A silent invader: Invasive pulmonary aspergillosis in an immunocompetent host","authors":"Harshith Reddy Beeravolu, Babaji Ghewade, Vivek Alone, Rashmika Mummaneni, Poonam Avinash Patil","doi":"10.1016/j.rmcr.2026.102425","DOIUrl":"10.1016/j.rmcr.2026.102425","url":null,"abstract":"<div><div>Invasive pulmonary aspergillosis (IPA) is a fulminant fungal infection that predominantly occurs in immunocompromised patients; however, it may occasionally be encountered in immunocompetent individuals, often leading to diagnostic delay and unfavorable outcomes. We describe a case of invasive pulmonary aspergillosis (IPA) in an immunocompetent woman in her mid-20s who presented with productive cough, hemoptysis, low-grade fever, and pleuritic chest pain, closely resembling pulmonary tuberculosis at initial evaluation. While the chest x-ray was normal, high-resolution computed tomography of the chest demonstrated a characteristic halo sign in the right middle lobe. Further evaluation with bronchoscopy and bronchoalveolar lavage revealed a markedly elevated galactomannan index, and fungal culture grew <em>Aspergillus flavus</em>. Hence the patient was initiated on oral voriconazole in accordance with Infectious Diseases Society of America guidelines, resulting in complete clinico-radiological resolution. In immunocompetent patients with persistent respiratory symptoms and suggestive imaging results, this report emphasizes the significance of maintaining a high index of suspicion for IPA. It also emphasizes the importance of early intervention in the form of bronchoscopic evaluation and prompt antifungal therapy in achieving favorable outcomes.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"61 ","pages":"Article 102425"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803238","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}

引用次数: 0

Severe psoriasis as an immune-related adverse event after long-term atezolizumab therapy for pulmonary large-cell neuroendocrine carcinoma: A case report 严重银屑病作为肺部大细胞神经内分泌癌长期阿特唑单抗治疗后的免疫相关不良事件：1例报告

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-04-21 DOI: 10.1016/j.rmcr.2026.102421

Chisa Murayama , Yasuyuki Ikezawa , Chihiro Shiiya , Yoshitaka Oda , Masafumi Ikezawa , Akihiro Matsunaga , Kosuke Tsuji , Tetsuaki Shoji , Megumi Furuta , Yuta Takashima , Hidenori Kitai , Jun Sakakibara-Konishi , Satoshi Konno

{"title":"Severe psoriasis as an immune-related adverse event after long-term atezolizumab therapy for pulmonary large-cell neuroendocrine carcinoma: A case report","authors":"Chisa Murayama , Yasuyuki Ikezawa , Chihiro Shiiya , Yoshitaka Oda , Masafumi Ikezawa , Akihiro Matsunaga , Kosuke Tsuji , Tetsuaki Shoji , Megumi Furuta , Yuta Takashima , Hidenori Kitai , Jun Sakakibara-Konishi , Satoshi Konno","doi":"10.1016/j.rmcr.2026.102421","DOIUrl":"10.1016/j.rmcr.2026.102421","url":null,"abstract":"<div><div>Immune checkpoint inhibitors, such as atezolizumab, have become integral to the treatment of various malignancies and have significantly improved clinical outcomes by enhancing host antitumor immune responses. However, with their expanding clinical use, immune-related adverse events (irAEs) have been increasingly recognized. These events may involve any organ system and pose new challenges in patient management. Most irAEs occur within the first few months following treatment initiation; however, they may also develop unexpectedly after prolonged periods of stable therapy. Late-onset irAEs are generally mild to moderate in severity, although a subset can progress to severe forms. Dermatological toxicities are the most frequently observed irAEs. Although most cutaneous reactions are mild and manageable, severe skin toxicities, although relatively uncommon, can substantially impair patients’ quality of life and may necessitate treatment modification or discontinuation. Psoriasis is a recognized cutaneous irAE that may present either as a de novo disease in patients without a history of psoriasis or as an exacerbation of pre-existing psoriasis. This case report describes a rare presentation of severe psoriasis that developed following long-term atezolizumab therapy and improved following treatment with oral prednisolone in 61-year-old man with pulmonary large-cell neuroendocrine carcinoma.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"61 ","pages":"Article 102421"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147750220","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}

引用次数: 0

Severe pulmonary vein stenosis presenting with infection-like pulmonary findings after radiofrequency ablation for atrial fibrillation: A case report 心房颤动射频消融后严重肺静脉狭窄表现为感染样肺部表现：1例报告

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-08-27 DOI: 10.1016/j.rmcr.2026.102495

Qingdi Du, Zongsheng Tian, Jiahao Wang, Xueliang Xu

{"title":"Severe pulmonary vein stenosis presenting with infection-like pulmonary findings after radiofrequency ablation for atrial fibrillation: A case report","authors":"Qingdi Du, Zongsheng Tian, Jiahao Wang, Xueliang Xu","doi":"10.1016/j.rmcr.2026.102495","DOIUrl":"10.1016/j.rmcr.2026.102495","url":null,"abstract":"<div><div>We report a case of severe pulmonary vein stenosis(PVS) with complete pulmonary vein occlusion(PVO) after radiofrequency ablation for atrial fibrillation(AF). A 51-year-old man presented to the respiratory department with chest tightness, dyspnea, and chest pain. Early chest computed tomography (CT) revealed inflammatory changes in the left lung and bilateral pleural effusions, and the patient responded poorly to antibiotic therapy. He had undergone radiofrequency catheter ablation for AF 5 months prior. On admission, inflammatory markers were not significantly elevated, procalcitonin was negative, and bronchoalveolar lavage fluid (BALF) culture and metagenomic next-generation sequencing (mNGS) revealed no definitive pathogenic infection. Subsequent cardiac CTA showed non-visualization of the left inferior pulmonary vein and stenosis of the left superior pulmonary vein near the left atrium, leading to a diagnosis of post-ablation pulmonary vein occlusion and stenosis. The patient underwent pulmonary vein stenting at another hospital, with follow-up CTA demonstrating restored opacification distal to the stents without intraluminal filling defects. This case highlights the need for prompt evaluation of pulmonary vein patency when focal pulmonary infection-like changes, chest pain, or pleural effusion occur after atrial fibrillation ablation when infection is not confirmed.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"63 ","pages":"Article 102495"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148934600","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}

引用次数: 0

Progressive unilobar cavitating lung disease despite medical therapy: Diagnostic limitations and definitive surgical management 进行性单叶空化肺疾病，尽管药物治疗：诊断局限性和明确的外科治疗。

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-05-23 DOI: 10.1016/j.rmcr.2026.102432

Hafiz Gulzeb Kamil , Elizabeth Finn , Shilajit Ghosh , Christos Kosmidis , Badis Al Harbawi , Mohammed Haris

{"title":"Progressive unilobar cavitating lung disease despite medical therapy: Diagnostic limitations and definitive surgical management","authors":"Hafiz Gulzeb Kamil , Elizabeth Finn , Shilajit Ghosh , Christos Kosmidis , Badis Al Harbawi , Mohammed Haris","doi":"10.1016/j.rmcr.2026.102432","DOIUrl":"10.1016/j.rmcr.2026.102432","url":null,"abstract":"<div><div>Cavitating lung lesions are a common radiological finding with a broad differential diagnosis, including infectious, malignant and inflammatory causes. Management of infective lesion is often challenging, particularly when disease progresses despite appropriate medical therapy. We report a case of progressive, unilobar cavitating lung disease in a 59-year-old man related to <em>Aspergillus</em> colonization and <em>Streptococcus constellatus</em> infection, despite prolonged optimal antibacterial and antifungal treatment. Initial bronchoscopic investigations identified <em>Aspergillus</em> hyphae, but repeated conventional microbiological sampling failed to detect the underlying bacterial pathogen. Serial imaging demonstrated persistent progressive cavitation coalescing into large fluid-filled abscess confined to upper lobe, prompting surgical intervention. The bacterial pathogen was only identified after lobectomy, with cultures confirming <em>S. constellatus</em>. This case highlights the limitations of standard diagnostic techniques, the importance of recognising failure of medical therapy and the role of timely thoracic surgical resection in achieving definitive source control in anatomically localised infective cavitating lung disease.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"62 ","pages":"Article 102432"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152186","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}

引用次数: 0

Palliative pneumonectomy for incurable sarcoma metastasis 姑息性全肺切除术治疗无法治愈的肉瘤转移

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-05-14 DOI: 10.1016/j.rmcr.2026.102423

Thermutis Djanie , Alexander Schalk , Thomas Fabian

引用次数: 0

Endobronchial tuberculosis with atypical radiological images and features in association with long-term use of inhaled corticosteroid for bronchial asthma: lessons from the case and literature review 长期使用吸入皮质类固醇治疗支气管哮喘与不典型影像学表现和特征相关的支气管内结核：病例和文献回顾的经验教训

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-03-21 DOI: 10.1016/j.rmcr.2026.102414

Saori Ikeda, Yukio Hosomi

{"title":"Endobronchial tuberculosis with atypical radiological images and features in association with long-term use of inhaled corticosteroid for bronchial asthma: lessons from the case and literature review","authors":"Saori Ikeda, Yukio Hosomi","doi":"10.1016/j.rmcr.2026.102414","DOIUrl":"10.1016/j.rmcr.2026.102414","url":null,"abstract":"<div><div>A 57-year-old man presented with endobronchial tuberculosis (EBTB). He had a history of using inhaled corticosteroids (ICS) for years since asthma was diagnosed during childhood. The present case was remarkable in that ICS alone may have affected the onset and progression of the EBTB. In addition, diagnosing the patient's condition apparently was challenging because he had atypical epidemiology, diagnostic imaging findings, and sites of occurrence for tuberculosis.</div><div>The CT images revealed no cavitation, which is reported to be relatively specific and typical for tuberculosis. And then, it demonstrated mixed shadows indicating consolidation in the lower lobe and tree-in-bud, which are not specific. And the patient had no other risk factors of tuberculosis but prolonged ICS use. Tuberculosis was also cited as the differential diagnosis based on the chronic clinical course, bronchial wall calcification, and the tree-in-bud sign on imaging, not being highly suspected overall. To understand the clinical condition, we performed bronchoscopy. As a result, EBTB and pulmonary tuberculosis were diagnosed.</div><div>Even when findings are largely atypical for tuberculosis, it should be strongly considered in the differential diagnosis when any typical elements, which are sometimes not specific, are encountered. It is also because EBTB is reported to be extremely transmissible owing to its high rate of bacterial shedding. Moreover, the recognition of the risk of reactivation especially in patients with asthma using ICS will also be important in the future although the possibility that ICS can affect it has been discussed for a long time.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"61 ","pages":"Article 102414"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554103","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}

引用次数: 0

Intralobar pulmonary sequestration in situs inversus: A rare presentation with recurrent hemoptysis 肺叶内反位肺隔离：复发性咯血的罕见表现

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-03-21 DOI: 10.1016/j.rmcr.2026.102406

Nawras Ibrahim , Rahaf Jereisat , Melissa Korb , Maher Dahdel

{"title":"Intralobar pulmonary sequestration in situs inversus: A rare presentation with recurrent hemoptysis","authors":"Nawras Ibrahim , Rahaf Jereisat , Melissa Korb , Maher Dahdel","doi":"10.1016/j.rmcr.2026.102406","DOIUrl":"10.1016/j.rmcr.2026.102406","url":null,"abstract":"<div><h3>Background</h3><div>Bronchopulmonary sequestration (BPS) is a rare congenital malformation of lung tissue characterized by the absence of normal bronchial connection and systemic arterial supply [1,2]. Situs inversus totalis (SIT) is an independent congenital anomaly in which thoracic and abdominal organs are reversed in mirror-image fashion [4]. The coexistence of BPS and SIT is exceedingly rare [9].</div></div><div><h3>Case presentation</h3><div>We present a 51-year-old woman with SIT and BPS who developed massive hemoptysis. She had undergone prior embolization for intralobar sequestration (ILS) three years earlier. CT angiography revealed ILS in the medial left upper lobe (anatomic right middle lobe) with aberrant supply from the left phrenic artery. Emergent embolization achieved temporary control, but recurrent bleeding necessitated thoracotomy, wedge resection, and subsequent lobectomy.</div></div><div><h3>Conclusion</h3><div>This case highlights the diagnostic and therapeutic challenges of ILS in SIT. Embolization provided temporary control, but definitive management was achieved with surgical resection [6,8]. Clinicians should be aware of the potential for recurrent hemoptysis in ILS with complex vascular anatomy, especially in patients with SIT.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"61 ","pages":"Article 102406"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147554105","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}

引用次数: 0

Subcutaneous apomorphine-induced pneumonitis: An uncommon pulmonary adverse event 阿帕吗啡诱发的皮下肺炎：一种罕见的肺部不良事件。

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-06-04 DOI: 10.1016/j.rmcr.2026.102446

Enrique Barrueco-Otero, Vanesa Hidalgo-Sierra, Patricia Torres Piñero, Isabel González Fernández, Laura Gil Pintor, María Bartol Sánchez, María Jesús Corbi Cobo-Losey, Carlos Montilla, Miguel Ángel Hernández-Mezquita

{"title":"Subcutaneous apomorphine-induced pneumonitis: An uncommon pulmonary adverse event","authors":"Enrique Barrueco-Otero, Vanesa Hidalgo-Sierra, Patricia Torres Piñero, Isabel González Fernández, Laura Gil Pintor, María Bartol Sánchez, María Jesús Corbi Cobo-Losey, Carlos Montilla, Miguel Ángel Hernández-Mezquita","doi":"10.1016/j.rmcr.2026.102446","DOIUrl":"10.1016/j.rmcr.2026.102446","url":null,"abstract":"<div><h3>Introduction</h3><div>Apomorphine is a potent dopaminergic agonist widely used in the management of motor fluctuations in advanced Parkinson's disease. Although generally well tolerated, rare pulmonary adverse drug reactions (ADRs) may occur. We report a case of probable apomorphine-induced pneumonitis associated with subcutaneous administration.</div></div><div><h3>Case presentation</h3><div>A 62-year-old Caucasian male with multiple comorbidities presented to the emergency department with headache, non-productive cough, central chest pain, fever, and dyspnea over the past 48 hours <strong>(</strong>3 weeks after initiation of subcutaneous apomorphin). Chest X-ray revealed bilateral hilar infiltrates and basal consolidation. CT scan showed organizing pneumonia (OP)-like pattern. Extensive microbiological evaluation of bronchoalveolar lavage and bronchial aspirate samples, including bacterial, fungal, mycobacterial, viral, and atypical pathogen testing, was negative. Lack of response to broad-spectrum antibiotics raised the suspicion of drug-induced pneumonitis due to subcutaneous apomorphine. Antibiotics were discontinued, and corticosteroid therapy (methylprednisolone 40 mg/day) was initiated with gradual tapering resulted in rapid clinical improvement and complete radiological resolution within one month.</div></div><div><h3>Conclusion</h3><div>The temporal relationship between apomorphine initiation and symptom onset, compatible clinical and radiological findings, extensive microbiological exclusion of infectious causes, and favorable response after drug withdrawal and corticosteroid therapy supported the diagnosis of probable apomorphine-induced pneumonitis.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"62 ","pages":"Article 102446"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347250","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}

引用次数: 0

Bilateral giant progressive massive fibrosis mimicking lung cancer in a rubber factory worker: A rare presentation 橡胶工厂工人的双侧巨大进行性巨大纤维化模拟肺癌：罕见的表现。

IF 0.7

Respiratory Medicine Case Reports Pub Date : 2026-01-01 Epub Date: 2026-07-07 DOI: 10.1016/j.rmcr.2026.102460

Itsna Arifatuz Zulfiyah, Irmi Syafaah, Resti Yudhawati Meliana, Fierly Hayati, Priangga Adi Wiratama, Wiwin Is Effendi, Garinda Alma Duta, Faradila Nur Aini

{"title":"Bilateral giant progressive massive fibrosis mimicking lung cancer in a rubber factory worker: A rare presentation","authors":"Itsna Arifatuz Zulfiyah, Irmi Syafaah, Resti Yudhawati Meliana, Fierly Hayati, Priangga Adi Wiratama, Wiwin Is Effendi, Garinda Alma Duta, Faradila Nur Aini","doi":"10.1016/j.rmcr.2026.102460","DOIUrl":"10.1016/j.rmcr.2026.102460","url":null,"abstract":"<div><h3>Background</h3><div>Silicosis is typically associated with high-risk industries like mining, making its occurrence in the rubber manufacturing sector exceptionally rare. The advanced form, progressive massive fibrosis (PMF), presents a significant diagnostic challenge as it frequently mimics lung malignancy radiologically and tuberculosis histopathologically.</div></div><div><h3>Case presentation</h3><div>A 51-year-old female rubber factory worker with a 23-year history of exposure to talc-based anti-adherent powder presented with dyspnea and bilateral upper lobe masses, initially suspected to be lung cancer. Six years prior, she had been misdiagnosed and treated for tuberculosis based on the presence of giant cells in a lung biopsy. In the current admission, contrast-enhanced CT revealed large, non-enhancing masses accompanied by characteristic eggshell calcifications in the mediastinal lymph nodes, suggesting a non-malignant etiology. The definitive diagnosis was established through the integration of pathology and polarized light microscopy. A retrospective review of the previous biopsy reclassified the giant cells from the Langhans type to foreign body giant cells, while polarized light microscopy revealed birefringent polyhedral silica particles dispersed within the fibrous tissue.</div></div><div><h3>Conclusion</h3><div>This case highlights the diagnostic hazards of overlooking occupational history in low-risk sectors. Progressive massive fibrosis presents a dual diagnostic pitfall by radiologically mimicking malignancy and histopathologically mimicking tuberculosis.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"63 ","pages":"Article 102460"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498327","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}

引用次数: 0