Respiratory Medicine Case Reports最新文献

{"title":"Severe pulmonary vein stenosis presenting with infection-like pulmonary findings after radiofrequency ablation for atrial fibrillation: A case report","authors":"Qingdi Du,&nbsp;Zongsheng Tian,&nbsp;Jiahao Wang,&nbsp;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}

{"title":"Rheumatoid arthritis–associated interstitial lung disease presenting before articular manifestations: A case report","authors":"Giap Van Vu,&nbsp;Trang T. Thu Vu,&nbsp;Thuy Thanh Phan,&nbsp;Trang Thuy Mai,&nbsp;Phuong-Anh Thi Pham,&nbsp;Thinh Hoang Nguyen,&nbsp;Phuong Thu Phan","doi":"10.1016/j.rmcr.2026.102505","DOIUrl":"10.1016/j.rmcr.2026.102505","url":null,"abstract":"<div><h3>Background</h3><div>Rheumatoid arthritis–associated interstitial lung disease (RA-ILD) may precede overt articular manifestations, posing significant diagnostic and therapeutic challenges. The usual interstitial pneumonia (UIP) pattern is the most common radiologic phenotype and is associated with a poorer prognosis and a progressive fibrosing course.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"64 ","pages":"Article 102505"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149161309","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 use of dupilumab in bronchiolitis obliterans after hematopoietic stem cell transplant","authors":"May Kyaw,&nbsp;Kevin Lu,&nbsp;Douglas Conrad,&nbsp;Tiffany Tanaka,&nbsp;Jeffrey Barry","doi":"10.1016/j.rmcr.2026.102508","DOIUrl":"10.1016/j.rmcr.2026.102508","url":null,"abstract":"<div><h3>Background</h3><div>Bronchiolitis obliterans is a serious pulmonary manifestation of chronic graft-versus-host disease (cGVHD) following hematopoietic stem cell transplant (HSCT). Bronchiolitis obliterans is typically treated with a combination of inhaled steroids, azithromycin, montelukast and immunosuppressants. There are no curative treatments other than lung transplant, however, and additional therapies remain an unmet need.</div></div><div><h3>Case Presentation:</h3><div>Here we report two patients who developed bronchiolitis obliterans following HSCT. Both developed strong type 2 inflammatory markers including high eosinophil counts ≥ 1000 cells/mm³ and had history that was concerning for a possible concomitant asthma. Patient 1 had worsening symptoms after exposure to old wood during a construction project, and patient 2 had a history of asthma. Both patients were started on the anti-IL4 receptor monoclonal antibody, dupilumab, to target this type 2 inflammation. Both patients reported some symptomatic improvement but only had limited changes in their spirometry. Their courses were further complicated by multiple respiratory infections in the setting of immunosuppression for cGVHD.</div></div><div><h3>Conclusion</h3><div>These cases highlight the unmet need for treatment in the bronchiolitis obliterans space and the potential role of type 2 inflammation in their pathogenesis. Given the complex nature of these cases and the infectious risks of immunosuppression, larger studies would be needed to better assess the potential role of dupilumab in this population.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"64 ","pages":"Article 102508"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149161311","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":"Spontaneous regression of a combined large cell neuroendocrine carcinoma following bronchoscopic biopsy: A case of cytohistological discordance","authors":"Tomoyuki Kawamura,&nbsp;Shuntaro Kawabata,&nbsp;Takeshi Oishi,&nbsp;Kenji Minagi,&nbsp;Hisashi Suzuki","doi":"10.1016/j.rmcr.2026.102519","DOIUrl":"10.1016/j.rmcr.2026.102519","url":null,"abstract":"<div><div>Spontaneous regression (SR) in lung cancer is extremely rare. We report a unique case of apparent biopsy-associated SR accompanied by cytohistological diagnostic discordance in a 68-year-old man. The patient presented with a 14-mm pulmonary nodule. Bronchoscopic forceps biopsy initially yielded a diagnosis of small cell lung cancer (SCLC), whereas concurrent brush cytology suggested non-small cell lung cancer. Unexpectedly, a preoperative computed tomography scan obtained 41 days after biopsy revealed regression of the solid tumour component from 14 mm to 7 mm. The patient underwent surgical resection, and the final pathological evaluation revealed combined lung cancer comprising predominantly adenocarcinoma (95%) with a minor large-cell neuroendocrine carcinoma component (5%). The initial SCLC diagnosis was based on crush artefact within the biopsy specimen, which obscured the characteristic morphology of LCNEC. This case highlights that physical biopsy can trigger transient SR, particularly in neuroendocrine tumours; however, surgical resection remains essential to address heterogeneous disease progression. Furthermore, cytohistological discordance should alert clinicians to the possibility of combined tumours, intratumoural heterogeneity, and morphological pitfalls, ensuring appropriate multidisciplinary management.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"64 ","pages":"Article 102519"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149161379","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":"Pulmonary benign metastasizing leiomyoma presenting as advanced lung cancer: A case report","authors":"Jeffrey Medina-Medina,&nbsp;Luis Vargas-González,&nbsp;Katia Munguia-Galeano,&nbsp;Norwing García-García,&nbsp;Melvin Romero-Jarquin,&nbsp;Christian Toval-Ruiz,&nbsp;Manuel López-Urbina","doi":"10.1016/j.rmcr.2026.102500","DOIUrl":"10.1016/j.rmcr.2026.102500","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary benign metastasizing leiomyoma (PBML) is a rare extrauterine smooth muscle neoplasm that predominantly affects women with a history of uterine leiomyoma. Because its clinical and radiological manifestations frequently resemble advanced pulmonary malignancy, establishing the diagnosis remains challenging. Herein, we describe an unusual presentation characterized by a dominant pulmonary mass and diffuse bilateral pulmonary nodules, initially suggesting advanced lung cancer with intrapulmonary metastases.</div></div><div><h3>Case presentation</h3><div>We report the case of a 38-year-old woman with a previous history of total hysterectomy for symptomatic uterine leiomyomatosis who presented with progressive exertional dyspnea and persistent dry cough. Chest imaging revealed a dominant left lower lobe pulmonary mass associated with numerous bilateral pulmonary nodules, initially raising strong suspicion of advanced lung cancer with intrapulmonary metastases. Extensive microbiological and oncological investigations were unrevealing. Surgical lung biopsy demonstrated benign spindle-cell proliferation without atypia or mitotic activity, while immunohistochemistry confirmed pulmonary benign metastasizing leiomyoma. ^18F-FDG PET/CT excluded hypermetabolic extrapulmonary disease. The patient was managed conservatively with clinical and radiological surveillance and remained clinically stable with symptomatic improvement.</div></div><div><h3>Conclusion</h3><div>PBML should be considered in the differential diagnosis of women with a history of uterine leiomyoma who present with multiple pulmonary nodules or a dominant pulmonary mass. Histopathological and immunohistochemical confirmation is essential to establish the diagnosis and avoid unnecessary oncologic treatment. Conservative surveillance may represent an appropriate management strategy in selected patients with indolent disease. Given the short follow-up interval in this report, longer prospective surveillance is needed to confirm the durability of this approach.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"64 ","pages":"Article 102500"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149161381","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":"Oritavancin as rescue therapy in severe methicillin-resistant Staphylococcus aureus pneumonia: A case report","authors":"Francesco Virzì ,&nbsp;Giuseppe Giacopelli ,&nbsp;Paolo Tutone,&nbsp;Sandro Tomasello","doi":"10.1016/j.rmcr.2026.102393","DOIUrl":"10.1016/j.rmcr.2026.102393","url":null,"abstract":"<div><h3>Background</h3><div>Severe pneumonia caused by methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) represents a major therapeutic challenge due to the high risk of clinical failure and the limited efficacy of conventional antibiotics in critically ill patients.</div></div><div><h3>Case presentation</h3><div>We report the case of a 65-year-old woman with severe MRSA pneumonia, rapidly progressing to acute respiratory distress syndrome (ARDS) and apparently refractory to Linezolid and Ceftriaxone. Given the critical clinical condition, poor prognosis, and lack of alternative therapeutic options, off-label treatment with Oritavancin was initiated at a dose of 1200 mg IV infused over 3 h. Within 48 hours after administration, a marked improvement in gas exchange was observed, allowing extubation and progressive clinical recovery.</div></div><div><h3>Discussion</h3><div>Oritavancin is a long-acting lipoglycopeptide approved for Gram-positive skin and soft tissue infections, but it demonstrates effective anti-MRSA activity in non-cutaneous sites as well. This case highlights its potential role as rescue therapy in selected settings such as respiratory infections caused by resistant pathogens refractory to standard therapy.</div></div><div><h3>Conclusion</h3><div>In critical cases with failure of standard therapeutic options, Oritavancin may represent an effective and well-tolerated off-label option for the treatment of MRSA pneumonia refractory to conventional therapy, following multidisciplinary evaluation and informed consent.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"60 ","pages":"Article 102393"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147403092","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":"Disseminated tuberculosis secondary to polymicrobial co-infection following long-term immunotherapy for sarcomatoid mesothelioma: A case report","authors":"Lingyin Xia ,&nbsp;Jianning Xu ,&nbsp;Zhiqing Chen ,&nbsp;Yang Shen ,&nbsp;Yeqing Zou","doi":"10.1016/j.rmcr.2026.102367","DOIUrl":"10.1016/j.rmcr.2026.102367","url":null,"abstract":"<div><div>Malignant pleural mesothelioma (MPM), particularly its sarcomatoid subtype, is a highly aggressive sarcoma of the pleural lining with a dismal prognosis. Prolonged use of immune checkpoint inhibitors (ICIs), while improving survival in selected patients, can induce profound immunosuppression, increasing susceptibility to life-threatening opportunistic infections. This report describes a 77-year-old male with sarcomatoid MPM who developed fatal disseminated tuberculosis (TB), accompanied by concurrent Aspergillus and herpesvirus infections during extended immunotherapy. The case underscores the critical role of metagenomic next-generation sequencing (mNGS) in enabling rapid diagnosis of atypical TB reactivation in an immunocompromised host, even when conventional cultures are negative. mNGS identified co-infections with <em>Aspergillus flavus</em> and herpesviruses (HHV-5, HHV-4, HHV-1), demonstrating its superiority in polymicrobial infection detection.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"59 ","pages":"Article 102367"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078092","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":"In situ laser fenestration of Metallic covered stent for the treatment of malignant Central Airway Stenosis: A case report","authors":"Yanchao He ,&nbsp;Zhimin Hu ,&nbsp;Mingdi Wu ,&nbsp;Chunlin Mei ,&nbsp;Min Liu ,&nbsp;Yao Wang ,&nbsp;Li Wang ,&nbsp;Qiusheng Jing","doi":"10.1016/j.rmcr.2026.102371","DOIUrl":"10.1016/j.rmcr.2026.102371","url":null,"abstract":"<div><div>Malignant central airway stenosis is a life-threatening complication of respiratory malignancies. Self-expanding covered metal stents are an effective treatment, offering self-adaptability without the need for customization, making them suitable for emergency use. Y-shaped stents are preferred in most cases due to their low migration risk. However, they may cover the right upper lobe bronchus, leading to atelectasis, which requires intervention. This is the first reported case of central airway stenosis caused by bronchial metastasis from colon cancer. After placement of a Y-shaped covered stent, endobronchial modification using a YAG laser was performed to restore right upper lobe ventilation. The procedure successfully relieved the patient's dyspnea. This case provides clinical reference value, though further reports are needed to confirm its generalizability.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"59 ","pages":"Article 102371"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078091","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":"Acute tubular necrosis with secondary acute respiratory distress syndrome after organophosphate poisoning: A rare clinical case","authors":"Gudisa Bereda","doi":"10.1016/j.rmcr.2026.102366","DOIUrl":"10.1016/j.rmcr.2026.102366","url":null,"abstract":"<div><h3>Background</h3><div>Organophosphate (OP) poisoning is a potentially life-threatening condition that predominantly affects the nervous system. Acute kidney injury (AKI), particularly intrinsic acute tubular necrosis (ATN), is a rare but serious complication. Acute respiratory distress syndrome (ARDS) may further complicate severe intoxication.</div></div><div><h3>Case presentation</h3><div>A 41-year-old female intentionally ingested 48 % soluble chlorpyrifos. She developed vomiting, abdominal pain, decreased level of consciousness, oliguria, and generalized edema. On examination, she was hypotensive, tachycardic, tachypneic, and hypoxic. Laboratory investigations revealed metabolic acidosis, elevated serum creatinine (4.1 mg/dL), blood urea nitrogen (47 mg/dL), electrolyte imbalances, reduced serum cholinesterase level, and a fractional excretion of sodium (FENa) of 3 %, consistent with intrinsic renal injury. Imaging demonstrated pulmonary edema and bilaterally enlarged kidneys. She was treated with intravenous fluids, atropine infusion (0.02 mg/kg/h), pralidoxime (30 mg/kg bolus followed by 8 mg/kg/h infusion), intermittent hemodialysis for AKI, supplemental oxygen, and mechanical ventilation for ARDS. Over 84 hours, urine output improved, renal function recovered, and respiratory distress resolved. She was discharged after one week with plan for psychiatric evaluation and monthly ambulatory nephrology follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlighted a rare presentation of intrinsic ATN complicated by ARDS following OP poisoning. Early recognition and intensive supportive management of renal and respiratory complications are essential. Clinicians should consider direct OP-induced nephrotoxicity in severe poisoning to optimize outcomes.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"59 ","pages":"Article 102366"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977471","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":"Nintedanib induces rapid remission of steroid-resistant pulmonary fibrosis in an immunocompromised patient with recurrent COVID-19: A case report","authors":"Takashi Yamana,&nbsp;Risa Yoshioka,&nbsp;Yusuke Mizuhashi,&nbsp;Kasumi Tsukamoto,&nbsp;Yukiko Abe,&nbsp;Hiroaki Kodama,&nbsp;Mitsuhiro Kamimura","doi":"10.1016/j.rmcr.2025.102352","DOIUrl":"10.1016/j.rmcr.2025.102352","url":null,"abstract":"<div><div>Post-COVID-19 lung fibrosis is often treated empirically with corticosteroids; however, established therapeutic options for steroid-resistant cases are lacking. We report the case of a 53-year-old immunocompromised man, with a history of treatment for mantle cell lymphoma, who developed recurrent COVID-19 pneumonia. Despite an initial response to remdesivir and dexamethasone, he experienced six episodes of pneumonia over eight months. This resulted in progressive, steroid-resistant lung fibrosis requiring home oxygen therapy (HOT). Following hospitalization for severe respiratory failure, nintedanib was initiated. A rapid clinical improvement was observed, with decreased oxygen requirements and improved radiological findings within two weeks. After two months of nintedanib therapy, the patient's lung fibrosis had markedly resolved, and he was successfully weaned off HOT. Nintedanib may be an effective therapeutic option for progressive, steroid-resistant lung fibrosis that develops in the context of recurrent or persistent COVID-19, especially in immunocompromised patients.</div></div>","PeriodicalId":51565,"journal":{"name":"Respiratory Medicine Case Reports","volume":"59 ","pages":"Article 102352"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927121","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}