Case Reports in Pulmonology最新文献

{"title":"Incidentally Detected Pulmonary Carcinoid Tumorlet With Coexisting Carcinoid Tumorlet in the Mediastinal Lymph Node in a Patient With Lung Cancer.","authors":"Bhavesh Mohan Lal, Michella K Whisman, Matthew A Steliga, Konstantinos Arnaoutakis","doi":"10.1155/crpu/9910270","DOIUrl":"10.1155/crpu/9910270","url":null,"abstract":"<p><p>Pulmonary carcinoid tumorlets are a cluster of neuroendocrine cells in the lung, which invade the basement membrane and are less than 5 mm in size. While similar to carcinoid tumors in all regards, they are differentiated from carcinoid tumors purely based on their size. They are generally considered benign, but lymph nodal involvement has been described in the past. It is unclear if lymph nodal involvement is due to metastasis to the lymph node or synchronous de novo proliferation of neuroendocrine cells in the lymph node as well. Here, we describe a patient with adenocarcinoma of the lung who was incidentally detected to have a pulmonary carcinoid tumorlet and a carcinoid tumorlet in the mediastinal lymph node.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"9910270"},"PeriodicalIF":0.0,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978093","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":"Warfarin-Induced Pulmonary Hemorrhage: A Rare and Life-Threatening Complication in the Resource-Limited Setting of Gaza.","authors":"Abdallah Abu Shammala, Majed Jaber, Bilal Irfan, Alaa Owda, Abdallah Herzallah","doi":"10.1155/crpu/8866411","DOIUrl":"10.1155/crpu/8866411","url":null,"abstract":"<p><p>Warfarin is widely prescribed for the prevention of thromboembolic events but carries a well-known risk of bleeding complications. While gastrointestinal and intracranial hemorrhages remain among the more frequent sites, pulmonary hemorrhage is an exceedingly rare case presentation and can be particularly catastrophic. We report the case of a 57-year-old male in Gaza with an extensive medical history of past hospitalization, who presented with severe ecchymosis, with his condition progressing to life-threatening pulmonary hemorrhage. This case occurred amid an active Israeli military assault in November 2024 in the European Gaza Hospital in Khan Yunis, at a time when diagnostic modalities had become limited or completely destroyed and healthcare resources were in severe shortage. The patient was treated with supportive measures, including mechanical ventilation and warfarin reversal using vitamin K and fresh frozen plasma. His anticoagulation regimen was changed to rivaroxaban. This case underlines the difficulties in diagnosing and managing rare but critical hemorrhagic complications in conflict-affected regions and emphasizes the urgency for clinicians to be vigilantly monitoring international normalized ratio values to conduct timely interventions.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"8866411"},"PeriodicalIF":0.0,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978066","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":"Visual Recovery Following Linezolid Cessation in an MDR-TB Patient: Detailed Case Analysis.","authors":"Yovil Bagas Wiyana, Isnin Anang Marhana, Gatot Suhartono, Andreas Haryono","doi":"10.1155/crpu/9939815","DOIUrl":"10.1155/crpu/9939815","url":null,"abstract":"<p><p>Multidrug-resistant tuberculosis (MDR-TB) is characterized by resistance to at least isoniazid and rifampicin. Linezolid is an antibiotic used for drug-resistant Gram-positive bacteria and is a treatment option for MDR-TB. However, its use is associated with optic neuropathy, presenting as acute worsening and bilateral vision loss, typically within 4 months of therapy. A 47-year-old male with MDR-TB relapsed during the sixth month of an individualized treatment regimen at Dr. Soetomo General Academic Hospital, Surabaya. The patient presented with weakness and anemia, receiving a regimen including levofloxacin (750 mg), linezolid (600 mg), clofazimine (100 mg), and cycloserine (500 mg). In the ninth month, the patient developed visual disturbances, initially suspected to be caused by an intracranial tumor. Despite various examinations and treatments, there was no improvement until linezolid was discontinued. The patient's visual complaints gradually improved following the cessation of linezolid therapy. This case underscores the potential for linezolid to cause optic neuropathy during prolonged treatment for MDR-TB. Detailed ophthalmologic examinations, including optical coherence tomography (OCT) and magnetic resonance imaging (MRI), confirmed optic neuropathy without intracranial pathology. Despite high-dose steroid therapy, the patient's vision improved only after 1 month since discontinuing linezolid. This highlights the importance of monitoring for ocular toxicity in patients undergoing long-term linezolid therapy and suggests that timely intervention can prevent permanent visual impairment. The case demonstrates the reversible nature of linezolid-induced optic neuropathy upon drug cessation and emphasizes the need for regular ophthalmologic assessments in patients receiving prolonged linezolid treatment. This report contributes to the understanding of the adverse effects of linezolid and underscores the importance of vigilant monitoring and alternative therapeutic strategies for MDR-TB.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"9939815"},"PeriodicalIF":0.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776862","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":"Familial Mediterranean Fever as a Cause of Recurrent Pleurisy in a Child With Crohn's Disease: A Case Report.","authors":"Ola Alhalabi, Khaled Abouhazima, Fatima Al Maadid, Ahmed Abushahin","doi":"10.1155/crpu/9412773","DOIUrl":"10.1155/crpu/9412773","url":null,"abstract":"<p><p><b>Introduction:</b> Familial Mediterranean fever (FMF) and Crohn's disease (CD) are chronic autoinflammatory disorders that share similar clinical and biological features. Both disorders are characterized by chronic and relapsing symptoms. In some cases, FMF can coexist with CD, which makes diagnosis and treatment challenging. <b>Case Presentation:</b> A 9-year-old Egyptian child was diagnosed with CD at the age of 5, based on clinical symptoms and endoscopic histopathologic findings. Initially, the patient responded well to biological therapy (anti-TNF<i>α</i>), showing improvements in symptoms along with declines in inflammatory markers and fecal calprotectin levels. At the age of 7, the child began experiencing frequent episodes of fever accompanied by pleuritic chest pain. Right-sided pleural effusion was identified on repeated chest X-rays. The patient was diagnosed with recurrent acute bacterial pneumonia due to immune suppression and was managed with multiple courses of oral antibiotics. During the last presentation, in one of these episodes, further investigation was pursued due to a lack of response to antibiotics, indicated by persistently elevated inflammatory markers (CRP, ESR) and nonresolving mild right-sided pleural effusion. FMF was suspected based on the patient's clinical presentation and chest imaging. A detailed family history revealed a positive FMF diagnosis in a first-degree cousin. Genetic testing was performed, which revealed two heterozygous pathogenic mutations that support the FMF diagnosis. Treatment with colchicine prevented further episodes. The patient continued to receive follow-up care from the GI team for CD and was maintained on adalimumab. <b>Conclusions:</b> FMF should be considered for children with CD who exhibit pulmonary symptoms that do not respond to CD treatment.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"9412773"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735256","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":"Unmasking Hidden Mediastinal Involvement in Papillary Thyroid Carcinoma: A Case Report on the Diagnostic Utilization of EBUS-TBNA.","authors":"Albatol N Rashed, Khalid S Alokla, Ali F Alfayez, Luai Sallout","doi":"10.1155/crpu/1770801","DOIUrl":"10.1155/crpu/1770801","url":null,"abstract":"<p><p>The global incidence of thyroid cancer is on the rise, with papillary thyroid carcinoma (PTC) accounting for approximately 80% of all cases. The incidence of mediastinal lymph node metastases in papillary thyroid cancer ranges from 0.7% to 27%. This case report details the diagnosis of a young man with papillary thyroid cancer, where the diagnosis was confirmed using endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) of the mediastinal lymph nodes. EBUS-TBNA, recognized for its minimal invasiveness and high diagnostic yield, facilitated the precise evaluation and staging of mediastinal involvement. This method played a key role in identifying metastatic involvement in a case where traditional imaging and diagnostic approaches may have been insufficient. The case underscores the utility of EBUS-TBNA in managing thyroid cancer metastases, particularly in assessing rare sites of metastatic spread, and highlights the importance of this technique in the comprehensive diagnostic evaluation of thyroid cancer patients with suspected mediastinal lymph node involvement.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"1770801"},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187484","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":"Primary Lung Adenocarcinoma Manifesting as Bilateral Reticulonodular Infiltrates: A Case Report.","authors":"Geran Maule, Qusai Alqudah, Mohamed Ismail, Ryan Fox, Ajaypal Gill, Luis Javier","doi":"10.1155/crpu/6678388","DOIUrl":"10.1155/crpu/6678388","url":null,"abstract":"<p><p>A 52-year-old female with a history of gastroesophageal reflux disease (GERD), hypertension (HTN), and supraventricular tachycardia (SVT) status postablation presented with progressive dyspnea and diffuse bilateral infiltrates on imaging. Symptoms began following exposure to a chicken farm, initially as a dry cough, evolving despite treatment with antibiotics, albuterol, and methylprednisolone. Emergency department CT imaging demonstrated bilateral linear, reticular, and nodular infiltrates. A negative infectious workup prompted bronchoscopy, confirming lung adenocarcinoma via immunohistochemical staining despite no significant smoking history, international travel, or other exposures. Brain MRI identified a solitary 7-mm enhancing lesion, guiding subsequent oncologic management. This case underscores the complexity of diagnosing atypical pulmonary symptoms and advocates for early bronchoscopic evaluation in suspected malignancies, particularly with pertinent family history.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"6678388"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310805","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 Subtle Presentation of Pharyngitis and Pneumonia: Lemierre Syndrome.","authors":"Federico Bellini, Valentino Allocca, Laura Aspidistria, Marco Farinatti, Ippolito Guzzinati, Marta Maria Daniele, Serena Casanova, Francesca Gasparini, Mara Nalin, Sara Saturni, Gian Luca Casoni","doi":"10.1155/crpu/6371331","DOIUrl":"https://doi.org/10.1155/crpu/6371331","url":null,"abstract":"<p><p>Lemierre syndrome (LS) is a rare condition with an estimated incidence of 1-10/1,000,000 per year defined as a complication of an oral and nasopharyngeal infection with secondary septicemia leading to septic emboli and internal jugular vein thrombosis. This syndrome was first described by Andre' Lemierre in 1936, before the development of antibiotics. In the preantibiotic era, it was a common condition and it was often characterized by a fatal course within 7-15 days with a mortality rate that could reach up to 80% of cases. After the development of antibiotic therapies, the incidence of LS rapidly declined, and nowadays, it is also known as \"the forgotten disease,\" but the mortality risk remains high (5%) especially in case of diagnostic delay and inappropriate therapies. We presented a case of a 23-year-old who was referred to our hospital for worsening dyspnea associated with high fever following a pharyngitis in order to raise awareness about this severe rare disease. Long-term outcomes are usually good if proper treatment is started with no delay. The mainstays of treatment for the pulmonary and vascular aspects are antibiotic treatment with or without anticoagulation and chest-tube drainage.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"6371331"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055577","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":"Delayed-Onset Hemothorax Following Cough-Induced Rib Fracture.","authors":"Katrina Villegas Md, Arielle Aiken Md, Mohammed Halabiya Md, Mourad Ismail Md","doi":"10.1155/crpu/7977884","DOIUrl":"https://doi.org/10.1155/crpu/7977884","url":null,"abstract":"<p><p>Hemothorax, the accumulation of blood in the pleural space, is most frequently linked to chest trauma but can occasionally result from nontraumatic causes such as persistent or forceful coughing. Cough-induced rib fractures are rare, with an even less frequent association with hemothorax. We describe a case involving a 57-year-old male who presented with a worsening cough and left-sided pleuritic chest pain despite prior antibiotic and symptomatic treatment. Initial imaging revealed a minimally displaced 10th rib fracture, left-sided atelectasis, and trace pleural effusion. During his hospital stay, he developed acute respiratory distress and increased chest pain, with repeat imaging revealing a large left-sided hemothorax. Chest tube placement drained 1100 mL of blood, supporting the diagnosis of hemothorax, as evidenced by clinical presentation and imaging, despite the absence of fluid analysis. The patient's condition improved following the intervention, and he was discharged in stable condition without recurrence of hemothorax on follow-up imaging. This case highlights the rare association between cough-induced traumatic rib fractures and delayed development of hemothorax. While rib fractures typically result from blunt trauma, they can also occur from stress or repetitive coughing. Complications such as hemothorax are uncommon but potentially life-threatening. The interval development of hemothorax, as seen in this patient, underscores the importance of serial monitoring in cases of rib fractures with ongoing symptoms. Clinicians should maintain a high index of suspicion for hemothorax in patients presenting with rib fractures and persistent cough, particularly in the context of worsening respiratory symptoms or pleuritic chest pain. Early recognition and timely intervention are critical to optimizing outcomes and mitigating the risks of rapid clinical deterioration.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"7977884"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007982","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 Unwelcome Guest: <i>Strongyloides stercoralis</i> Hyperinfection in a Patient With Steroid-Dependent Asthma-COPD Overlap Syndrome (ACOS)-A Case Report and Review of Literature.","authors":"Rafael Miret, Jose M Acosta-Rullan, Alfredo Toll, Grayson Honeycutt, Manjot Malhi, Christian Almanzar Zorrilla, Raiko Diaz, Mauricio Danckers, Daniel Zapata","doi":"10.1155/crpu/3204304","DOIUrl":"10.1155/crpu/3204304","url":null,"abstract":"<p><p><i>Strongyloides stercoralis</i> is a soil-transmitted roundworm nematode estimated to affect over 600 million people worldwide. Hyperinfection syndrome (HS) has been described in immunosuppressed patients. Our case highlights a rare manifestation of HS due to <i>Strongyloides stercoralis</i> causing acute respiratory failure in an asthma-COPD overlap syndrome (ACOS) patient on chronic corticosteroid therapy. A 63-year-old woman with diabetes, chronic obstructive pulmonary disorder due to chronic cigarette smoking, and severe asthma on chronic prednisone therapy presented with recurrent intractable abdominal pain and shortness of breath. The patient underwent esophagogastroduodenoscopy (EGD) showing friable mucosa returning positive for <i>Strongyloides stercoralis</i> infection. The patient deteriorated with progressive acute hypoxic respiratory failure and acute metabolic encephalopathy requiring invasive mechanical ventilation. Dual antiparasitic therapy with ivermectin and albendazole was initiated, and the patient was treated for septic shock. The patient was successfully extubated and was discharged from the hospital to a rehabilitation center without steroid therapy. Due to the classic transmission and life cycle of the filiform larvae, the lungs are target organs in HS. The mortality of <i>Strongyloides</i> HS ranges from 85% to 100% when untreated. HS due to <i>Strongyloides stercoralis</i> carries a high risk for disseminated infection in patients with chronic steroids. High index of suspicion, tissue sample, and prompt institution of target therapy institutions are key for a successful clinical outcome.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"3204304"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721689","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":"Diffuse Alveolar Hemorrhage Associated With Anti-PL-7 Antisynthetase Syndrome: A Case Report.","authors":"Paul Shiu, Shannon Iriza, Steven Templeton","doi":"10.1155/crpu/3715449","DOIUrl":"10.1155/crpu/3715449","url":null,"abstract":"<p><p><b>Background:</b> Diffuse alveolar hemorrhage (DAH) is a potentially life-threatening condition which can present with hemoptysis, diffuse alveolar infiltrates, anemia, and hypoxic respiratory failure. Antisynthetase syndrome (AS) is a rare autoimmune disorder most often characterized by nonerosive arthritis, proximal muscle weakness with elevated muscle enzymes, Raynaud's phenomenon, hyperkeratosis of the digits (mechanic's hands), and interstitial lung disease. According to large population studies, AS has an annual incidence of 0.56 per 100,000 persons and prevalence of 9 per 100,000. The most common autoantibody is anti-aminoacyl-transfer RNA synthetase for histidine (anti-Jo-1) with a reported prevalence of 20%-30%, whereas anti-Pl-7 (for threonine) accounts for less than 5% of all autoimmune myositis. Specific myositis autoantibodies determine clinical phenotype. PL-7 is characterized by interstitial lung disease, myositis, and arthritis. Autoimmune myositis, specifically AS, is a rare cause of DAH. Herein, we describe the first reported case of PL-7-associated AS with DAH. <b>Case Presentation:</b> A 41-year-old female presented with worsening shortness of breath and hemoptysis. Laboratory studies included a hemoglobin of 10.5 g/dL, mildly elevated liver enzymes, and a creatine phosphokinase (CPK) of nearly 4000 U/L. CT of the chest showed diffuse ground glass opacities bilaterally. Serial aliquots of the bronchoalveolar lavage (BAL) fluid revealed progressively hemorrhagic return and histopathologic analysis consistent with DAH. Other concurrent causes of DAH were ruled out. <b>Conclusion:</b> Although rare, AS should be considered a cause of DAH, particularly in patients presenting with symptoms of muscle weakness and arthritis or with evidence of mechanic's hands.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"3715449"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048610","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}