{"title":"Exertional Dyspnea Incidentally Diagnosed as Sarcoidosis: A Teaching Hospital Experience.","authors":"Melvina Nartey, Kofi Ulzen-Appiah","doi":"10.1155/2023/8689352","DOIUrl":"https://doi.org/10.1155/2023/8689352","url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a complex disease with nonspecific etiology and clinical presentation. Its diagnosis is often delayed due to the absence of a single specific investigation modality. A multidisciplinary approach is necessary for its diagnosis. <i>Report</i>. A 49-year-old male presented with recurrent dyspnea on exertion, easy fatigue, and chest pain after several visits to different health facilities over 5 months. A diagnosis of pulmonary sarcoidosis was made after a series of laboratory and imaging investigations were done revealing bilateral reticonodular opacifications, noncaseating granulomata, elevated serum ACE and calcium levels consistent with sarcoidosis.</p><p><strong>Conclusion: </strong>Sarcoidosis, although a rare presentation in our setting, may easily be overlooked or misdiagnosed if a holistic or multidisciplinary approach is not employed in its diagnosis. Nonspecificity of symptoms contributes to the delayed diagnosis.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2023 ","pages":"8689352"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10263012","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}
Felix Wuest, Andreas Gebhardt, Claudia Grosswendt, Sergej Griff, Antonina Zhilina, Samantha Taber, Jens Kollmeier, Torsten T Bauer
{"title":"Diffuse Alveolar Hemorrhage Associated with Epithelioid Angiosarcoma of the Lung: A Challenging Diagnosis.","authors":"Felix Wuest, Andreas Gebhardt, Claudia Grosswendt, Sergej Griff, Antonina Zhilina, Samantha Taber, Jens Kollmeier, Torsten T Bauer","doi":"10.1155/2023/5553209","DOIUrl":"https://doi.org/10.1155/2023/5553209","url":null,"abstract":"<p><p>A 68-year-old patient presented with persistent hemoptysis and weight loss. A CT scan showing diffuse bilateral ground-glass opacities and nodules was followed by bronchoscopy. While diffuse alveolar hemorrhage (DAH) could be seen, specimens obtained during bronchoscopy did not provide conclusive histological findings. The decision was made to conduct video-assisted wedge resection, after which histological examinations revealed the diagnosis of bifocal nodular manifestation of an epithelioid angiosarcoma in the lung. Being a rare entity even among sarcomas, these kinds of tumors can be primary lung tissue angiosarcomas or metastatic lesions with primaries in places like the skin, breast, and heart. Treatment usually includes chemotherapy, but prognosis remains grim. This case highlights that in DAH, uncommon causes should be considered, and sufficient probe gathering is the key to early diagnosis and treatment.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2023 ","pages":"5553209"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10289867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9706581","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}
Atulya Aman Khosla, Hollie Saunders, Scott Helgeson, Hiroshi Hikida, Nabeel Aslam, Fadi Salem, Sam Albadri, Hassan Baig
{"title":"The Utility of Bronchoscopy in Hydralazine-Induced ANCA-Associated Vasculitis.","authors":"Atulya Aman Khosla, Hollie Saunders, Scott Helgeson, Hiroshi Hikida, Nabeel Aslam, Fadi Salem, Sam Albadri, Hassan Baig","doi":"10.1155/2023/1461011","DOIUrl":"https://doi.org/10.1155/2023/1461011","url":null,"abstract":"<p><p>Hydralazine is a vasodilator used for the management of hypertension, heart failure, and hypertensive emergencies in pregnancy. It has been implicated in the causation of drug-induced lupus erythematosus (DLE) and rarely with ANCA-associated vasculitis (AAV), which may present as a pulmonary-renal syndrome and be rapidly fatal. Herein, we describe a case of hydralazine-associated AAV presenting as acute kidney injury with the use of early bronchoalveolar lavage (BAL) with serial aliquots to aid with diagnosis. Our case highlights how, in the correct clinical setting, BAL can act as a rapid diagnostic test to help guide quicker treatment to allow for better patient outcomes.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2023 ","pages":"1461011"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9395223","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 Management of Coronavirus Disease 2019-Related Respiratory Failure Using High-Flow Nasal Cannula Therapy in a Patient with Underlying Pulmonary Artery Hypertension.","authors":"Mariko Kotani, Tomoki Kohyama, Kiyoshi Moriyama, Tomoko Yorozu","doi":"10.1155/2022/1774796","DOIUrl":"https://doi.org/10.1155/2022/1774796","url":null,"abstract":"<p><p>A case involving a 50-year-old woman (height, 155 cm; weight, 79.6 kg), who was undergoing home oxygen therapy (3.5 L/min), with an oxygen saturation (SpO<sub>2</sub>) of approximately 91% due to pulmonary artery hypertension (PAH) with mixed connective tissue disease, is reported. The patient developed coronavirus disease 2019- (COVID-19-) related respiratory failure, with an SpO<sub>2</sub> of 78% on oxygen inhalation (3.5 L/min) and was admitted to the authors' hospital. In accordance with remdesivir, dexamethasone, and heparin treatment, high-flow nasal cannula (HFNC) therapy was selected to avoid intubation. At an initial HFNC setting of 70% oxygen with a flow rate of 50 L/min, SpO<sub>2</sub> improved to 92% and her subjective symptoms improved. She was weaned from HFNC on day 5 of admission (day 14 of COVID-19 onset) and discharged home on day 14 of admission. In patients with PAH, the beneficial effects of HFNC to avoid endotracheal intubation were evident in avoiding hemodynamic instability and worsening respiratory failure.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":" ","pages":"1774796"},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40477860","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}
Mia Elhidsi, Dicky Soehardiman, Agung Wibawanto, Haris Maruli, Maryastuti, Prasenohadi, Elisna Syahruddin
{"title":"Bronchoscopy Laser and Silicone Y-Stents as Emergency Airway Management in Central Airway Stenosis Due to Secondary Thyroid Carcinoma: A Case Report.","authors":"Mia Elhidsi, Dicky Soehardiman, Agung Wibawanto, Haris Maruli, Maryastuti, Prasenohadi, Elisna Syahruddin","doi":"10.1155/2022/6338073","DOIUrl":"https://doi.org/10.1155/2022/6338073","url":null,"abstract":"<p><p>Total airway obstruction in thyroid cancer is rare and has high morbidity and mortality. Airway management in such cases is challenging, especially in cases in which thyroid masses cannot be totally resected. It is important to choose the appropriate airway treatment modality. Currently, therapeutic rigid bronchoscopy procedures and endoluminal lasers, as well as airway stent insertion, are a management modality of near-total malignant airway obstruction. We report a rigid bronchoscopy procedure combined with laser and Y-stent silicone insertion in thyroid cancer with extension infiltration, as well as compression in the trachea covering the subglottic tracheal area up to the main carina and tracheo-bronchomalacia, manifesting as acute respiratory failure.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":" ","pages":"6338073"},"PeriodicalIF":0.0,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40691932","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}
Silvia Martin Bote, Maria Angeles Herrera Morueco, Beatriz Arias Arcos, Javier García Lopez, Maria Belen Lopez-Muñiz Ballesteros
{"title":"Alveolar Proteinosis in COVID-19: Clinical Case.","authors":"Silvia Martin Bote, Maria Angeles Herrera Morueco, Beatriz Arias Arcos, Javier García Lopez, Maria Belen Lopez-Muñiz Ballesteros","doi":"10.1155/2022/1842566","DOIUrl":"https://doi.org/10.1155/2022/1842566","url":null,"abstract":"<p><p>Pulmonary alveolar proteinosis (PAP) is a rare, diffuse lung disease characterized by accumulation of lipoprotein in lung surfactant in the alveolar space and terminal bronchioles, leading to impaired gas exchange and arterial hypoxemia. We present the case of a 51-year-old woman who was admitted with a diagnosis of severe SARS-CoV-2 pneumonia. Her condition did not improve with corticosteroids. A chest CT scan revealed ground-glass opacities in all lung lobes, with septal thickening. A differential diagnosis was proposed with other diseases. Bronchoscopy revealed milky bronchoalveolar lavage fluid, and staining with periodic acid-Schiff was positive, thus indicating PAP. Therefore, the patient underwent whole lung lavage, which led to clinical, radiological, and functional improvement. In the context of the COVID-19 pandemic, differential diagnosis ensures that appropriate attention is given to less prevalent entities such as PAP.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":" ","pages":"1842566"},"PeriodicalIF":0.0,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40659984","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}
Tofura Ullah, Sneh Chauhan, Joseph Friedman, Gideon Yoeli, Maximo Mora, Craig A Thurm
{"title":"Calcification in Thoracic Splenosis.","authors":"Tofura Ullah, Sneh Chauhan, Joseph Friedman, Gideon Yoeli, Maximo Mora, Craig A Thurm","doi":"10.1155/2022/9538355","DOIUrl":"https://doi.org/10.1155/2022/9538355","url":null,"abstract":"<p><p>Splenosis is a rare condition described as the implantation of ectopic splenic tissue, usually after a splenic rupture. Thoracic splenosis refers to acquired ectopic splenic tissue found within the thoracic cavity, often caused by thoracoabdominal trauma or surgery. Most cases are asymptomatic and many years may elapse before they are incidentally discovered on chest radiography or thoracic computed tomography. Splenosis is often misinterpreted as a malignancy on initial imaging. We wish to highlight a rare case of thoracic splenosis presenting with calcified and non-calcified nodules. Only two other cases of calcification have been reported in intrathoracic splenosis, neither of which provided CT images of this finding.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":" ","pages":"9538355"},"PeriodicalIF":0.0,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9578903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40660385","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}
John Omotola Ogunkoya, Marion Itohan Ogunmola, Akinwale Folarin Ogunlade, Akindele Emmanuel Ladele
{"title":"COVID-19 Vaccination Associated Bilateral Pulmonary Embolism: Cause or Coincidence.","authors":"John Omotola Ogunkoya, Marion Itohan Ogunmola, Akinwale Folarin Ogunlade, Akindele Emmanuel Ladele","doi":"10.1155/2022/9596285","DOIUrl":"https://doi.org/10.1155/2022/9596285","url":null,"abstract":"<p><strong>Background: </strong>Acute pulmonary embolism (APE) is a common cause of morbidity and mortality all over the world. Sudden onset dyspnea and chest pain are characteristic. Prior to our index case, only two previous cases of bilateral pulmonary thromboembolism were reported in black Africans and the first to be associated with COVID-19 vaccination. These cases were seen and described in middle-aged men. <i>Case Summary</i>. A 59-year-old man presented with a 2 week history of sudden onset dyspnea and a week history of productive cough. No associated chest pain or hemoptysis. No preceding history suggestive of leg pain/swelling. The patient had the booster dose of moderna (mRNA) COVID-19 vaccine a month before the onset of symptoms. There was associated anorexia, generalized body pain, joint pain, and weakness. He had reduced oxygen saturation at presentation with tachycardia. CTPA showed nearly occlusive right and left pulmonary arteries.</p><p><strong>Conclusion: </strong>Bilateral acute pulmonary embolism is rare all over the world. Its association with COVID-19 vaccine administration is even rarer. However, the clinical presentations and investigation findings are similar to the descriptions available in the literature for unilateral APE.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2022 ","pages":"9596285"},"PeriodicalIF":0.0,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498268","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}
Fernando Figueroa Rodriguez, Asfar Ghauri, Tony Abdo, Salim Daouk, Shideler Barbara, Houssein A Youness
{"title":"Navigational Bronchoscopy with Cryobiopsy for Diagnosis of ILD.","authors":"Fernando Figueroa Rodriguez, Asfar Ghauri, Tony Abdo, Salim Daouk, Shideler Barbara, Houssein A Youness","doi":"10.1155/2022/5128432","DOIUrl":"https://doi.org/10.1155/2022/5128432","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung diseases (ILDs) are a group of parenchymal pulmonary diseases in which pathologic diagnosis is essential. Although cryobiopsy has a high diagnostic yield, the complication rate remains high. <i>Case Presentation</i>. We report two cases of lung cryobiopsy guided by navigational bronchoscopy (LCB) for the diagnosis of ILD. In both cases, a CT chest angiogram (CTA) using a navigational protocol was performed. Targets were premarked and reached with the navigational system. Radial ultrasound (RU) was applied in combination with fluoroscopy guidance (FG) prior to sampling. Both patients achieved a final diagnosis; they were discharged home after procedure and no complications were noted. <i>Discussion</i>. By using a CTA with navigational guidance, we were able to perform cryobiopsy in areas with most disease activity and least vascularization.</p><p><strong>Conclusion: </strong>LCB used with navigational guidance for the diagnosis of ILD provides may be a safe and effective procedure that provides high diagnostic yield. Limitations include cost, availability, and expertise. Larger trials are needed to confirm the additional benefit.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":" ","pages":"5128432"},"PeriodicalIF":0.0,"publicationDate":"2022-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9509241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40377412","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}
Nicholas Graves, Julia Flint, Amol Sagdeo, Ayman Askari, Patrick Ball, Hana Morrissey
{"title":"Spontaneous Pneumothorax in a Patient with Systemic Lupus Erythematosus and Recent Infection with Coronavirus.","authors":"Nicholas Graves, Julia Flint, Amol Sagdeo, Ayman Askari, Patrick Ball, Hana Morrissey","doi":"10.1155/2022/9594063","DOIUrl":"https://doi.org/10.1155/2022/9594063","url":null,"abstract":"<p><p>A 50-year-old woman with a history of systemic lupus erythematosus and a recent infection with COVID-19 presented to the emergency department with acute shortness of breath twice in 10 days. She was diagnosed with myopericarditis attributed to COVID-19 infection (first admission), and chest X-ray revealed a small left-sided pneumothorax, pericardial effusion (second admission), with no mediastinal shift or other signs of tension. Computed tomography confirmed these results and revealed a few small cysts in the right lung. An echocardiogram demonstrated normal heart anatomy and filling dynamics. The patient was diagnosed with simple pneumothorax and ongoing myopericarditis managed with colchicine, ibuprofen, and low-dose prednisolone. The patient responded to treatment and was discharged. Pneumothorax association with COVID-19 is reported in a small number of publications, but the association is less clear with SLE. Our patient may have been predisposed to developing pneumothorax after COVID-19 infection due to her existing connective tissue disorder.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":" ","pages":"9594063"},"PeriodicalIF":0.0,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40335940","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}