Case Reports in Pulmonology最新文献

{"title":"Pulmonary Hyalinizing Granuloma Mimicking Primary Lung Cancer: An Unusual Case Involving a Pulmonary Tumor.","authors":"Hideki Marushima,&nbsp;Hiroki Sakai,&nbsp;Reimi Yoneyama,&nbsp;Hiroyuki Kimura,&nbsp;Tomoyuki Miyazawa,&nbsp;Motohiro Chosokabe,&nbsp;Masahiro Hoshikawa,&nbsp;Koji Kojima,&nbsp;Masayuki Takagi,&nbsp;Hisashi Saji","doi":"10.1155/2020/3268608","DOIUrl":"https://doi.org/10.1155/2020/3268608","url":null,"abstract":"<p><p>Pulmonary hyalinizing granuloma is a very rare benign condition. This study describes a case involving pulmonary hyalinizing granuloma in a 76-year-old man who presented with a solitary pulmonary nodule, determined through chest radiography and computed tomography, that mimicked primary lung cancer. To establish a definitive diagnosis, tumor resection was performed with histopathological analysis indicating pulmonary hyalinizing granuloma. Radiographic findings in previously reported cases showed that most patients had well-defined margins and usually bilateral, multiple lesions. In our case; however, the solitary ill-defined tumor mimicking lung cancer is an uncommon location for this rare condition.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"3268608"},"PeriodicalIF":0.0,"publicationDate":"2020-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3268608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37664782","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":"Isolated Pauci-Immune Pulmonary Capillaritis Associated with Hydrocarbon Inhalation and Marijuana Smoking: An Unusual Case of Severe Hypoxemia.","authors":"Jason S Oh,&nbsp;Uni Wong,&nbsp;Divyansh Bajaj,&nbsp;Stella E Hines","doi":"10.1155/2020/1264859","DOIUrl":"https://doi.org/10.1155/2020/1264859","url":null,"abstract":"<p><p>We present a case report of a patient with Isolated pauci-immune pulmonary capillaritis (IPIPC). A 40-year-old male presented with acute onset severe hypoxemic respiratory failure. He had just returned home from work as a cabinetmaker, where he experienced inhalational exposure to hydrocarbons and solvents, and had smoked a marijuana cigarette. He was hypotensive, and his chest imaging showed bilateral dependent infiltrates. His hypoxemia made little improvement after conventional ventilator support and broad-spectrum antibacterial therapy and he was considered too unstable to tolerate diagnostic bronchoscopy with bronchoalveolar lavage. His laboratory evaluation initially showed microscopic hematuria which later cleared, but other tests including serologic autoimmune assessment were negative, and he did not have any traditional risk factors for vasculitis. A video-assisted thoracoscopic lung biopsy revealed diffuse alveolar hemorrhage with pulmonary capillaritis on histopathology. He was diagnosed with IPIPC and initiated on immunosuppressive therapy. He was soon liberated from mechanical ventilation and improved to hospital discharge. Diffuse alveolar hemorrhage from Goodpasture's Syndrome has manifested following inhalation of hydrocarbons and following smoking. This has not previously been reported with IPIPC. Given the lack of other findings and risk factors, his IPIPC was likely associated with occupational exposures to hydrocarbons as a cabinetmaker compounded by marijuana smoking.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"1264859"},"PeriodicalIF":0.0,"publicationDate":"2020-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1264859","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37606718","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 Case of Vaping TCH Oil Leading to Vaping Associated Pulmonary Injury: Our Approach to Its Diagnosis, Management, and Recommendations.","authors":"Anshika Singh,&nbsp;Qiuxue Tan,&nbsp;Nicole M Saccone,&nbsp;David H Lindner","doi":"10.1155/2020/6138083","DOIUrl":"https://doi.org/10.1155/2020/6138083","url":null,"abstract":"<p><p>Vaping's popularity has grown exponentially since its introduction to the US market in 2003. Its use has sky-rocketed since the unveiling of the vaping pods in 2017 which may account for the advent of the vaping related illnesses we are now seeing. Substances such as nicotine solution, tetrahydrocannabinol (THC) oil, cannabidiol (CBD) oil, and butane hash oil (BHC) packaged in cartridges available in various flavors and concentrations are aerosolized by the heating of metal coils in the e-cigarette/vaping devices. Cases from all over the country have recently been coming to light in which vaping has led to severe acute pulmonary disease or vaping-associated-pulmonary-injury (VAPI). A vast majority of the presenting patients in the reported cases have required hospitalization and intensive care, needing supplemental oxygen and even endotracheal intubation and mechanical ventilation. 98% of patients present with respiratory symptoms (dyspnea, hypoxia, chest pain, cough, hemoptysis), 81% of patients have gastrointestinal symptoms (nausea, vomiting, diarrhea, and abdominal pain), and 100% of patients have constitutional symptoms such as fever, chills, and fatigue/malaise on presentation. Although based on history and clinical presentation it is reasonable to have a high suspicion for VAPI, diagnostic workup to rule out alternative underlying causes such as infection, malignancy, or autoimmune process should be performed before establishing the diagnosis. Computed Tomography (CT) scans of the chest have predominantly shown ground-glass opacity in the lungs, often with areas of lobular or subpleural sparing. Although lung biopsies have been performed on a relatively low number of cases, lung injury patterns so far have shown acute fibrinous pneumonitis, diffuse alveolar hemorrhage, or organizing pneumonia, usually bronchiolocentric, and accompanied by bronchiolitis. Treatment plans that have led to clinical improvement in the reported cases center around high-dose systemic steroids, although there are a lack of data regarding the best regimen and the absolute need for corticosteroids. The role of antibiotics appears to be limited once infection has definitively been ruled out. We present the case of a young male who vaped THC oil and developed severe acute pulmonary injury requiring mechanical ventilation and showed a remarkable response to high dose steroid therapy with improvement in clinical symptoms and resolution of diffuse ground glass opacity on repeat HRCT scan.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"6138083"},"PeriodicalIF":0.0,"publicationDate":"2020-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6138083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37573260","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":"Cryptogenic Organizing Pneumonia with a Rare Radiographic Presentation of a Diffuse Micronodular Pattern Mimicking Miliary Lung Infiltration: A Case Report and Review of the Literature.","authors":"Jakrin Kewcharoen,&nbsp;Kittika Poonsombudlert,&nbsp;Sakda Sathirareuangchai,&nbsp;Wichit Sae-Ow,&nbsp;Hanh La,&nbsp;Narin Sriratanaviriyakul","doi":"10.1155/2020/2094625","DOIUrl":"https://doi.org/10.1155/2020/2094625","url":null,"abstract":"<p><p>We reported a case of cryptogenic organizing pneumonia (COP) presenting with an unusual diffuse micronodular pattern (DMP) mimicking miliary lung infiltration. The patient is a 66-year-old man with a past medical history of diabetes mellitus type 2 and hyperlipidemia who presented with progressive dyspnea associated with significant weight loss and night sweats for 2 weeks. Upon admission, the patient's clinical condition rapidly progressed to respiratory failure requiring mechanical ventilation. Initial Chest X-ray (CXR) showed diffuse reticulonodular infiltration mimicking miliary pattern. Chest computed tomography (CT) showed diffuse centrilobular micronodular infiltrations with features of a tree-in-bud pattern consistent with the CXR findings. He was then started on empiric antibiotics for community-acquired pneumonia and underwent a diagnostic bronchoscopy with alveolar lavage and transbronchial biopsies, which yielded negative cultures and unrevealing pathology. Tissue from CT-guided lung biopsy performed later on was also inconclusive. Due to the lack of clinical improvement, he eventually underwent surgical lung biopsy. The pathology result showed organizing pneumonia (OP) pattern with heavy lymphoplasmacytic infiltrates and numerous multinucleated giant cells. His final culture results, microbiological data and serology workup for autoimmune disease were all unremarkable. The patient was diagnosed with COP and was started on systemic corticosteroids. He displayed dramatic clinical improvement and was successfully liberated from the ventilator. Subsequent chest imaging showed resolution of the reticulonodular infiltrations. Early diagnosis for OP and ability to distinguish OP from infectious pneumonitides are critical as the majority of patients with OP respond promptly to corticosteroids. Common findings of radiographic pattern for OP are patchy air space consolidation or ground-glass opacity, yet DMP is another rare radiographic pattern that must be recognized, especially in COP. In summary, this case illustrates a rare radiographic presentation of COP. With early recognition and prompt diagnosis, proper treatment can significantly prevent morbidity and reduce mortality.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"2094625"},"PeriodicalIF":0.0,"publicationDate":"2020-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2094625","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37573258","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":"Successful Treatment for Hypercalcemia due to Cosecretion of Parathyroid Hormone-Related Protein and 1,25-Dihydroxyvitamin D₃ in Non-Small-Cell Lung Cancer: A Case Report and Literature Review.","authors":"Takunori Ogawa,&nbsp;Jun Miyata,&nbsp;Koichi Fukunaga,&nbsp;Akihiko Kawana,&nbsp;Takashi Inoue","doi":"10.1155/2020/2475725","DOIUrl":"https://doi.org/10.1155/2020/2475725","url":null,"abstract":"<p><p>Hypercalcemia of malignancy frequently manifests as paraneoplastic syndrome in patients with solid tumors. A 71-year-old man was diagnosed with stage IIIB lung squamous cell carcinoma. Laboratory examination revealed high serum calcium concentration with elevated serum parathyroid hormone-related protein (PTHrP) and 1,25-dihydroxyvitamin D₃ levels. As the patient did not respond to the initial treatment with calcitonin, extracellular fluid infusion, and chemotherapy, systemic prednisolone was administered additionally. Thus, the levels of serum calcium normalized and PTHrP and 1,25-dihydroxyvitamin D₃ decreased simultaneously. To our knowledge, this is the first case report on the successful treatment of hypercalcemia of malignancy caused by PTHrP and 1,25-dihydroxyvitamin D₃ cosecretion in a patient with lung cancer.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2020 ","pages":"2475725"},"PeriodicalIF":0.0,"publicationDate":"2020-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2475725","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37573259","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":"Hypersensitivity Pneumonitis Associated with Red-Vented Bulbul: A New Encounter of Bird Related Hypersensitivity Pneumonitis.","authors":"W D N L Amarasinghe,&nbsp;R Jayasekara,&nbsp;B D W Jayamanne,&nbsp;T D K Nalaka,&nbsp;W A D L Amarasiri,&nbsp;R Punchihewa,&nbsp;A Fernando","doi":"10.1155/2019/9572790","DOIUrl":"https://doi.org/10.1155/2019/9572790","url":null,"abstract":"<p><p>Bird related hypersensitivity pneumonitis (HP) is becoming more common than other forms of HP around the world. We present two cases of HP, associated with exposure to visiting birds which had nested within their homes in semi urban areas of Colombo, Sri Lanka. A 65-year-old female (case 1) and a 61-year-old male (case 2) presented to the chest clinic complaining of gradually progressive and persistent chronic dry cough and dyspnoea during the year 2018. Both were found to have close contact with red-vented bulbuls (Konda kurulla) in their homes for more than 6 months prior to onset of symptoms and denied any other risk exposures in detail history taking. In both patients, high-resolution computed tomography chest (HRCT) showed centrilobular nodules of ground glass density with significant lobular air trapping. Video-assisted thoracoscopic (VATs) lung biopsy of case 1 showed patchy and focal interstitial thickening with lymphocytic infiltrate, minimal fibrosis, and few noncaseating granulomata within the interstitium. Transbronchial lung biopsy of case 2 showed thickened alveolar septae with lympho-histiocytic infiltrate and occasional neutrophils and eosinopils. Both showed severe reduction in forced vital capacity (FVC) at presentation. Multidisciplinary diagnosis of HP associated with red-vented bulbuls was made. Both achieved good improvement in clinical, lung function, and radiological assessment following removal of offending antigen exposure and treatment with oral corticosteroids.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2019 ","pages":"9572790"},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/9572790","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37499597","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":"Cicatricial Organizing Pneumonia with Dendriform Pulmonary Ossification: An Unusual Cause for a Recurrent Pneumothorax.","authors":"Mnahi Bin Saeedan,&nbsp;Carol Farver,&nbsp;Atul C Mehta,&nbsp;Ruchi Yadav","doi":"10.1155/2019/2379145","DOIUrl":"https://doi.org/10.1155/2019/2379145","url":null,"abstract":"<p><p>Cicatricial organizing pneumonia is an uncommon form of organizing pneumonia, which may manifest as persisting linear opacities on computerized tomography (CT) scan mimicking a fibrosing interstitial pneumonia. It may also manifest with pulmonary ossification, which is a metaplastic bone formation within the lung tissue. The latter presentation could be either nodular or dendriform, both secondary to underlying lung disease and rarely idiopathic. Dendriform pulmonary ossification (DPO) has rarely been described as a cause of spontaneous pneumothorax. We present a case of a 55-year-old male with history of recurrent pneumothoraces and worsening dyspnea on exertion. A CT of the chest revealed progressive bilateral sub-pleural and peribronchovascular reticular opacities associated with densely ossified branching and nodular opacities. Video-assisted thoracoscopic biopsy of the lung demonstrated cicatricial organizing pneumonia with areas of marked diffuse DPO. The case highlights that dendriform pulmonary ossification arising from cicatricial organizing pneumonia should be considered in the differential diagnosis of recurrent pneumonias among patients with lower lobe sub-pleural reticular opacities. The case highlights that dendriform pulmonary ossification rarely can cause spontaneous pneumothorax and can be associated with cicatricial organizing pneumonia and reticular opacities on imaging.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2019 ","pages":"2379145"},"PeriodicalIF":0.0,"publicationDate":"2019-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/2379145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37538799","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 Case of Isolated Primary Pleural Neurofibroma in a 39-Year-Old Woman.","authors":"Kritika Krishnamurthy,&nbsp;John Alexis,&nbsp;Pukhraz Basra,&nbsp;Ana Maria Medina","doi":"10.1155/2019/6458302","DOIUrl":"https://doi.org/10.1155/2019/6458302","url":null,"abstract":"<p><p>Primary benign neurogenic neoplasms of the pleura are exceedingly rare. Neurofibromas rarely involve the pleura. A review of the literarture reveals only a single reported case of isolated pleural neurofibroma. Herein the authors describe another case of isolated primary pleural neurofibroma. A 39-year-old nonsmoker woman presented to the emergency room with complaints of progressively worsening chest pain of one month duration. A computed tomography of the chest revealed a crescent shaped, pleural based mass suspicious for a neurogenic tumor such as an intercostal schwannoma. A PET-CT skull base to midthigh failed to reveal any other masses or abnormalities. A surgical excision of the mass was performed due to the patient's intractable pain. The resected specimen consisted of an ovoid fragment of soft tissue with pale yellow, smooth and glistening cut surface. Microscopic examination revealed the tumor to be composed of spindle cells with wavy nuclei arranged haphazardly in loose collagenous and pale myxoid stroma with rare interspersed mast cells. The spindle cells were diffusely positive for S100 protein and SOX-10, and focally positive for neurofilament. In the absence of any other masses in the patient and no pertinent history, a diagnosis of primary pleural neurofibroma was made. This case emphasizes the need to consider neurofibroma in any spindle cell neoplasm of the pleura irrespective of age or singularity.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2019 ","pages":"6458302"},"PeriodicalIF":0.0,"publicationDate":"2019-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6458302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37486954","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":"Solitary Pulmonary Nodule: A Diagnostic Dilemma.","authors":"Pardeep Masuta,&nbsp;Ioana Amzuta","doi":"10.1155/2019/5242634","DOIUrl":"https://doi.org/10.1155/2019/5242634","url":null,"abstract":"<p><p>This case describes a woman with a history of tobacco abuse who presented with a dry cough and was found to have an enlarging, 4 cm right upper lobe nodule without lymphadenopathy on CT imaging of the chest. Initial biopsies of the nodule suggested follicular lymphoma, but after obtaining more tissue, the pathology was negative for malignancy and instead showed necrotizing pneumonia. She proceeded to have negative infectious serology and cultures. She had negative rheumatological testing including MPO ANCA, PR-3 ANCA, and rheumatoid factor. She did not have renal failure, hemoptysis, weight loss, arthralgia, or upper airway inflammation. She ultimately underwent a right upper lobectomy, as the nodule was enlarging on repeat imaging. The pathology of the lung showed necrotizing granulomas with giant cells and fibrosis, but lacked active vasculitis or palisading histiocytes, further obscuring the diagnosis. She was conservatively managed with intranasal steroids, cough suppressants and antihistamines given her lack of severe symptoms. The diagnosis was most consistent with granulomatosis with polyangiitis (GPA) presenting as a solitary pulmonary nodule with pathology reflecting a mild degree of disease activity. The patient may manifest further signs of the disease while being monitored clinically.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2019 ","pages":"5242634"},"PeriodicalIF":0.0,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5242634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37486953","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":"Simultaneous Association of Pulmonary Tuberculosis and Kaposi's Sarcoma in an Immunocompetent Subject: A Case Report and Literature Review.","authors":"Sofia Baina,&nbsp;Jihane Achrane,&nbsp;Jouda Benamor,&nbsp;Jamal Eddine Bourkadi","doi":"10.1155/2019/5453031","DOIUrl":"https://doi.org/10.1155/2019/5453031","url":null,"abstract":"<p><p>Kaposi's Sarcoma (KS) occurs as a pathological entity that may be classified into four different types: classic, endemic, epidemic, and iatrogenic. It can arise among HIV-positive subjects or within immunosuppression, yet exceptionally of tuberculous origin. We describe a new case report of an HIV-negative patient, manifesting Kaposi's disease in the course of tuberculosis, with the aim to assess this uncommon disorder and to outline this rare atypical association.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2019 ","pages":"5453031"},"PeriodicalIF":0.0,"publicationDate":"2019-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/5453031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684903","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}