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Inappropriate Therapy of Subcutaneous Implantable Cardioverter-Defibrillator Induced by an Electrical Bath. 电浴诱发皮下植入式心律转复除颤器不当治疗1例。
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-03-17 DOI: 10.2169/internalmedicine.6607-25
Motohiro Shingu, Tatsuya Nishikawa, Ryouta Yoshioka, Go Nakano, Atsushi Iseki, Tatsuya Matsubara, Yuya Oga, Hibiki Kadohara, Yuto Osumi, Kenta Ishibashi, Mana Hiraishi, Mitsuo Kinugasa, Yasutaka Hirayama, Koichi Tamita
{"title":"Inappropriate Therapy of Subcutaneous Implantable Cardioverter-Defibrillator Induced by an Electrical Bath.","authors":"Motohiro Shingu, Tatsuya Nishikawa, Ryouta Yoshioka, Go Nakano, Atsushi Iseki, Tatsuya Matsubara, Yuya Oga, Hibiki Kadohara, Yuto Osumi, Kenta Ishibashi, Mana Hiraishi, Mitsuo Kinugasa, Yasutaka Hirayama, Koichi Tamita","doi":"10.2169/internalmedicine.6607-25","DOIUrl":"10.2169/internalmedicine.6607-25","url":null,"abstract":"<p><p>We describe the case of a 73-year-old man who had a subcutaneous implantable cardioverter-defibrillator (S-ICD) implanted for the secondary prevention of ventricular fibrillation. He received inappropriate shock therapy for S-ICD while using a Japanese electric bath (denki buro). The records of S-ICDs obtained by device interrogation showed that inappropriate therapy was induced by electric waves in the bath. S-ICDs might be more sensitive than transvenous ICD because of the nature of the anatomic position of the electrode. Patients should therefore be carefully educated regarding the risk of inappropriate S-ICD therapy induced by the use of electric baths.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2705-2709"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483156","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
Favorable Response to Chemotherapy with Durvalumab Plus Tremelimumab in Two Cases of KRAS G12C-positive Pulmonary Sarcomatoid Carcinoma. Durvalumab联合Tremelimumab化疗在2例KRAS g12c阳性肺肉瘤样癌中的良好反应：1例报告
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-03-17 DOI: 10.2169/internalmedicine.6660-25
Takeru Ichikawa, Kenichiro Kudo, Yuki Takigawa, Tomoya Osedo, Yuto Sasano, Toki Kitano, Jun Nishimura, Hiromi Watanabe, Ken Sato, Keiichi Fujiwara
{"title":"Favorable Response to Chemotherapy with Durvalumab Plus Tremelimumab in Two Cases of KRAS G12C-positive Pulmonary Sarcomatoid Carcinoma.","authors":"Takeru Ichikawa, Kenichiro Kudo, Yuki Takigawa, Tomoya Osedo, Yuto Sasano, Toki Kitano, Jun Nishimura, Hiromi Watanabe, Ken Sato, Keiichi Fujiwara","doi":"10.2169/internalmedicine.6660-25","DOIUrl":"10.2169/internalmedicine.6660-25","url":null,"abstract":"<p><p>Pulmonary sarcomatoid carcinoma (PSC) and Kirsten rat sarcoma viral oncogene homologue (KRAS) mutations are poor prognostic factors in non-small cell lung cancer. We report two cases of metastatic KRAS G12C-positive PSC in men (aged 69 and 66 years). Both patients were treated with chemotherapy combined with durvalumab and tremelimumab (POSEIDON regimen). They thereafter achieved excellent clinical outcomes, including complete and partial responses, with sustained benefits. The POSEIDON regimen may represent a potent therapeutic option for this rare patient population with multiple negative prognostic factors.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2726-2731"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483118","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
The Prevalence and Clinical Characteristics of Atrial Fibrillation and Reflux Esophagitis Among Individuals Undergoing Health Checkups. 健康体检人群中房颤和反流性食管炎的患病率和临床特征
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 DOI: 10.2169/internalmedicine.8127-26
Kyoichi Adachi, Norihisa Ishimura, Yuko Miki, Kanako Kishi, Utae Sakamoto, Eiko Okimoto, Yuko Matsubara, Madoka Furuta, Nobuhide Watanabe, Shunji Ishihara
{"title":"The Prevalence and Clinical Characteristics of Atrial Fibrillation and Reflux Esophagitis Among Individuals Undergoing Health Checkups.","authors":"Kyoichi Adachi, Norihisa Ishimura, Yuko Miki, Kanako Kishi, Utae Sakamoto, Eiko Okimoto, Yuko Matsubara, Madoka Furuta, Nobuhide Watanabe, Shunji Ishihara","doi":"10.2169/internalmedicine.8127-26","DOIUrl":"https://doi.org/10.2169/internalmedicine.8127-26","url":null,"abstract":"<p><p>Objective　To examine the association between atrial fibrillation (AF) and reflux esophagitis (RE).Methods　A total of 5,205 adults (3,262 men, 1,943 women; mean age, 54.9±9.8 years) who underwent esophagogastroduodenoscopy (EGD) as part of a routine health checkup were enrolled in this study. AF was defined as AF detected on electrocardiography during the checkup and/or a documented history of the condition. RE was assessed endoscopically according to the Los Angeles classification. The smoking history, habitual alcohol consumption, and use of acid-suppressive agents were also assessed.Results　AF was observed in 36 participants (0.7%). Compared with those without AF, participants with AF were more likely to be male, older, have a higher body mass index, and have a history of smoking and acid-suppressive agent use. After excluding participants receiving acid-suppressive medications, RE was significantly more prevalent in patients with AF than in those without AF (39.1% vs. 22.0%, p=0.049). The prevalence of AF was 0.9% among patients with RE and 0.4% among those without RE. However, multiple logistic regression analysis indicated that RE was not independently associated with AF after adjusting for sex, age, and other clinical factors.Conclusion　AF may be associated with RE in individuals undergoing routine health checkups. However, this association was attenuated after adjustment for sex, age, and other clinical factors, suggesting that it may be largely explained by shared confounding factors.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187821","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
Endoscopic Submucosal Dissection as a Diagnostic and Minimally Invasive Therapeutic Excision Modality for Primary Anorectal Malignant Melanoma. 内镜下粘膜夹层作为诊断和微创治疗原发性肛肠恶性黑色素瘤的切除方式。
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-02-10 DOI: 10.2169/internalmedicine.6841-25
Yusaku Yokotani, Hiroaki Kitae, Kyoka Ozawa, Mika Mazaki, Hoshu Kurebayashi, Koki Yamamoto
{"title":"Endoscopic Submucosal Dissection as a Diagnostic and Minimally Invasive Therapeutic Excision Modality for Primary Anorectal Malignant Melanoma.","authors":"Yusaku Yokotani, Hiroaki Kitae, Kyoka Ozawa, Mika Mazaki, Hoshu Kurebayashi, Koki Yamamoto","doi":"10.2169/internalmedicine.6841-25","DOIUrl":"10.2169/internalmedicine.6841-25","url":null,"abstract":"<p><p>Primary anorectal malignant melanoma is a rare mucosal malignancy with nonspecific symptoms, frequent misdiagnoses, delayed treatment, and the lack of an established standard therapeutic strategy are the reasons for a poor prognosis. Diagnostic challenges are further compounded by the low rate of preoperative histological confirmation, especially for amelanotic lesions. Given its poor prognosis, performing a less invasive resection is crucial. We herein report the case of an 82-year-old male patient who underwent endoscopic submucosal dissection as a total biopsy and was treated with immune checkpoint inhibitors as adjuvant therapy.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2690-2694"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168215","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
Double Mutations in the FLNA and MYH11 Genes Causing Familial Thoracic Aortic Aneurysm and Dissection: A Report of Two Cases. FLNA和MYH11基因双突变导致家族性胸主动脉瘤和夹层：附2例报告
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-02-24 DOI: 10.2169/internalmedicine.6761-25
Nobuhiro Ogasawara, Wakana Sato, Hiroko Morisaki, Hiroyuki Watanabe
{"title":"Double Mutations in the FLNA and MYH11 Genes Causing Familial Thoracic Aortic Aneurysm and Dissection: A Report of Two Cases.","authors":"Nobuhiro Ogasawara, Wakana Sato, Hiroko Morisaki, Hiroyuki Watanabe","doi":"10.2169/internalmedicine.6761-25","DOIUrl":"10.2169/internalmedicine.6761-25","url":null,"abstract":"<p><p>In some cases, familial thoracic aortic aneurysm and dissection is caused by multiple gene mutations. A 36-year-old woman (Patient 1) experienced acute aortic dissection requiring emergency surgery. Eight years later, her child (Patient 2) was diagnosed with an aortic aneurysm, and head magnetic resonance imaging revealed periventricular nodular heterotopia, thus prompting genetic testing to identify possible mutations in the FLNA and MYH11 genes. Subsequently, Patient 1 underwent genetic testing, which revealed the same mutations. Double mutations in FLNA and MYH11 can lead to aortic aneurysms and aortic dissection, while often manifesting at a young age.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2700-2704"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147278153","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 Aplastic Anemia Concurrent with Lymphoplasmacytic Lymphoma/Waldenström's Macroglobulinemia. 严重再生障碍性贫血并发淋巴浆细胞性淋巴瘤/Waldenström巨球蛋白血症1例报告。
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-03-10 DOI: 10.2169/internalmedicine.6790-25
Takehiro Okuda, Yuta Hanyu, Hana Mineshige, Yuta Inoue, Maki Sakurada, Masashi Matsui, Naomi Katsuki, Makoto Iwasaki, June Takeda, Junya Kanda, Yasuhito Nannya, Seishi Ogawa, Akifumi Takaori-Kondo, Yasuko Miyahara, Mitsuru Itoh
{"title":"Severe Aplastic Anemia Concurrent with Lymphoplasmacytic Lymphoma/Waldenström's Macroglobulinemia.","authors":"Takehiro Okuda, Yuta Hanyu, Hana Mineshige, Yuta Inoue, Maki Sakurada, Masashi Matsui, Naomi Katsuki, Makoto Iwasaki, June Takeda, Junya Kanda, Yasuhito Nannya, Seishi Ogawa, Akifumi Takaori-Kondo, Yasuko Miyahara, Mitsuru Itoh","doi":"10.2169/internalmedicine.6790-25","DOIUrl":"10.2169/internalmedicine.6790-25","url":null,"abstract":"<p><p>A 79-year-old female presented with progressive dyspnea. A bone marrow biopsy revealed hypoplastic marrow with abnormal lymphoid cells. A genetic analysis revealed a MYD88 p.V204F mutation, supporting the diagnosis of lymphoplasmacytic lymphoma/Waldenström's macroglobulinemia (LPL/WM). Additional evaluations established a concomitant diagnosis of aplastic anemia (AA). Treatment prioritized AA with cyclosporine and eltrombopag. Subsequently, the LPL/WM was treated with rituximab monotherapy. This sequential treatment resulted in a symptomatic improvement. Although AA is a diagnosis of exclusion, its coexistence with lymphoma is rare. This case highlights the diagnostic and therapeutic complexity of AA and LPL/WM overlap and suggests that prioritizing the treatment of AA may lead to better outcomes.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2743-2749"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439040","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
Atypical Subacute Thyroiditis without Thyroid Dysfunction: A Report of Two Cases. 不典型亚急性甲状腺炎伴甲状腺功能障碍2例报告。
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-03-03 DOI: 10.2169/internalmedicine.7012-25
Yuji Nagayama, Seigo Tachibana, Takashi Fukuda, Hiroyuki Yamashita
{"title":"Atypical Subacute Thyroiditis without Thyroid Dysfunction: A Report of Two Cases.","authors":"Yuji Nagayama, Seigo Tachibana, Takashi Fukuda, Hiroyuki Yamashita","doi":"10.2169/internalmedicine.7012-25","DOIUrl":"10.2169/internalmedicine.7012-25","url":null,"abstract":"<p><p>Subacute thyroiditis (SAT) is a painful inflammation of the thyroid that causes transient thyrotoxicosis, followed by hypothyroidism and an eventual recovery. We report two atypical cases of SAT that presented with anterior neck pain, tender thyroid nodules, elevated inflammatory markers, and characteristic ultrasound findings, all suggestive of SAT, but who remained euthyroid throughout their courses. The serum thyroglobulin level increased in one case. These cases demonstrate rare euthyroid presentations of SAT despite not meeting the current diagnostic criteria for SAT established by the Japan Thyroid Association, and underscore that normal thyroid function tests do not exclude this diagnosis.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2710-2714"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147358567","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
Pulmonary Cryptococcosis Mimicking Lung Metastasis in a Patient with Pancreatic Cancer: A Case Report and Review of the Literature. 胰腺癌患者肺隐球菌病伴肺转移一例报告及文献复习。
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 Epub Date: 2026-03-17 DOI: 10.2169/internalmedicine.6722-25
Kaho Uesugi, Reiko Yamada, Yoshifumi Nakamura, Yasuaki Shimada, Minako Urata, Takamitsu Tanaka, Kenji Nose, Tetsuro Miwata, Hayato Nakagawa
{"title":"Pulmonary Cryptococcosis Mimicking Lung Metastasis in a Patient with Pancreatic Cancer: A Case Report and Review of the Literature.","authors":"Kaho Uesugi, Reiko Yamada, Yoshifumi Nakamura, Yasuaki Shimada, Minako Urata, Takamitsu Tanaka, Kenji Nose, Tetsuro Miwata, Hayato Nakagawa","doi":"10.2169/internalmedicine.6722-25","DOIUrl":"10.2169/internalmedicine.6722-25","url":null,"abstract":"<p><p>Pulmonary cryptococcosis is a fungal infection that mimics metastatic lung tumors. A man with pancreatic head cancer and liver metastases harboring a germline BRCA2 mutation received FOLFOX chemotherapy. Despite a favorable response from the primary tumor and a decline in the CA19-9 levels, a rapidly enlarging solitary pulmonary nodule appeared. Because of the discordance between the response of the primary tumor and the lung nodule, thoracoscopic partial lung resection was performed for a definitive diagnosis, which confirmed pulmonary cryptococcosis. Postoperatively, fluconazole was administered without recurrence and systemic chemotherapy was resumed. Early histopathological confirmation is crucial to make an accurate diagnosis and select the appropriate management.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":"2738-2742"},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483092","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
Accelerated Systemic Atherosclerosis Following Immune-Related Adverse Events in a Patient with Primary Thoracic Melanoma: A Case of Sequential Coronary and Peripheral Revascularization. 原发性胸部黑色素瘤患者免疫相关不良事件后加速全身性动脉粥样硬化：顺序冠状动脉和外周血管重建术一例
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 DOI: 10.2169/internalmedicine.8340-26
Tomoaki Nishikawa, Akinori Higaki, Saki Mori, Toru Miyoshi, Shoichiro Yamamoto, Osamu Yamaguchi
{"title":"Accelerated Systemic Atherosclerosis Following Immune-Related Adverse Events in a Patient with Primary Thoracic Melanoma: A Case of Sequential Coronary and Peripheral Revascularization.","authors":"Tomoaki Nishikawa, Akinori Higaki, Saki Mori, Toru Miyoshi, Shoichiro Yamamoto, Osamu Yamaguchi","doi":"10.2169/internalmedicine.8340-26","DOIUrl":"https://doi.org/10.2169/internalmedicine.8340-26","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) improve survival in advanced melanoma, but they may accelerate atherosclerosis, particularly in patients with immune-related adverse events (irAEs). A 64-year-old man with stage IV BRAF-wild-type primary thoracic melanoma achieved complete remission after nivolumab plus ipilimumab, but he later developed grade 3 immune-related hepatitis, requiring treatment discontinuation. Three and a half years later, symptomatic peripheral artery disease required revascularization, followed by severe coronary artery disease requiring percutaneous coronary intervention one year later. This case suggests that severe irAEs may be associated with accelerated systemic atherosclerosis, highlighting the importance of long-term cardiovascular surveillance following ICI therapy.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187799","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
Dynamic Bronchoscopic Evolution of a Cobblestone-like Appearance in COVID-19-associated Pulmonary Aspergillosis: A Case Report. covid -19相关肺曲霉病鹅卵石样外观的动态支气管镜演变：1例报告
IF 1.1
Internal medicine (Tokyo, Japan) Pub Date : 2026-10-15 DOI: 10.2169/internalmedicine.7958-26
Toshihide Ishida, Nobuhiro Fujishima, Yoshio Satonaga, Marimu Yamanaka, Shota Omori, Ryuichi Takenaka, Ryuzo Abe, Kazuhiro Kawamura, Tsutomu Daa, Kosaku Komiya
{"title":"Dynamic Bronchoscopic Evolution of a Cobblestone-like Appearance in COVID-19-associated Pulmonary Aspergillosis: A Case Report.","authors":"Toshihide Ishida, Nobuhiro Fujishima, Yoshio Satonaga, Marimu Yamanaka, Shota Omori, Ryuichi Takenaka, Ryuzo Abe, Kazuhiro Kawamura, Tsutomu Daa, Kosaku Komiya","doi":"10.2169/internalmedicine.7958-26","DOIUrl":"https://doi.org/10.2169/internalmedicine.7958-26","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is associated with high mortality and diagnostic difficulties. We report a fatal case of CAPA with a distinctive cobblestone-like tracheobronchial appearance observed during bronchoscopy. A patient receiving maintenance hemodialysis for chronic kidney disease was admitted with severe COVID-19. Bronchoscopy revealed multiple white tracheobronchial plaques, suggestive of an invasive Aspergillus infection. Despite antifungal therapy, respiratory failure progressed, and repeat bronchoscopy revealed worsening cobblestone-like lesions. The patient died despite receiving intensive treatment. Autopsy confirmed Aspergillus hyphal invasion, corresponding to the bronchoscopic findings, highlighting a rare but diagnostically important airway manifestation of CAPA.</p>","PeriodicalId":520650,"journal":{"name":"Internal medicine (Tokyo, Japan)","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187808","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
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