Case Reports in Pulmonology最新文献

{"title":"Halos and Hemoptysis: A Case of Intrapulmonary Sequestration Masquerading as a Pulmonary Aspergilloma.","authors":"Faisal Masood, Anjana Murali, Claire Fishman","doi":"10.1155/crpu/4242228","DOIUrl":"10.1155/crpu/4242228","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchopulmonary sequestration (BPS) is a rare congenital malformation of the lung characterized by nonfunctional pulmonary tissue without communication to the tracheobronchial tree and with anomalous arterial supply. Intralobar sequestration (ILS), the more common form, typically presents in childhood or early adulthood.</p><p><strong>Case presentation: </strong>We describe the case of an 84-year-old woman with a history of untreated rheumatoid arthritis, coronary artery disease, and remote smoking, who presented with recurrent hemoptysis over 6 months. Initial evaluation revealed lower lobe cystic changes with an internal solid component and diffuse ground-glass opacities on chest CT, raising suspicion for fungal etiology. Serial imaging demonstrated interval progression of the cystic lesion with an enlarging solid component. The patient was treated with empiric oral antifungal therapy, but persistent hemoptysis and radiographic changes prompted surgical consultation. A left lower lobe segmentectomy was performed for definitive management. Histopathology revealed abnormal pulmonary parenchyma with dilated airspaces, mucus-filled airways, and enlarged vessels, consistent with intralobar BPS. No fungal elements or microorganisms were identified. This case appears to represent the oldest reported age at diagnosis of ILS.</p><p><strong>Conclusion: </strong>This case underscores the importance of maintaining a broad differential diagnosis for recurrent hemoptysis in elderly patients. While infection, malignancy, and autoimmune disease are common considerations, congenital anomalies such as ILS can rarely present late in life. Awareness of this possibility may help avoid diagnostic anchoring and guide appropriate multidisciplinary management.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"4242228"},"PeriodicalIF":0.0,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436882","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":"Effects of Tezepelumab in \"United Airway Disease\" (Asthma and CRSwNP).","authors":"Chiara Lupia, Giovanna Lucia Piazzetta, Daniela Pastore, Nadia Lobello, Mariaimmacolata Preianò, Emanuela Chiarella, Angelantonio Maglio, Alessandro Vatrella, Girolamo Pelaia, Corrado Pelaia","doi":"10.1155/crpu/6616379","DOIUrl":"10.1155/crpu/6616379","url":null,"abstract":"<p><p>Severe asthma is a heterogeneous disease typically characterized by inadequate symptom control, even with frequent oral corticosteroids, large doses of inhaled corticosteroids, and long-acting <i>β</i> ₂-adrenergic agonists. The latest Global Initiative for Asthma (GINA) recommendations suggest adding biological therapies at Step 5 to optimize standard treatments. Although there is a wide range of therapeutic options for T2-high asthma, unfortunately, for T2-low asthma, we still have limited therapeutic choices. Our case report refers to a 64-year-old woman with severe T2-low asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) who had already tested other standard therapies without clinical or functional benefits. She is being treated with tezepelumab (210 mg subcutaneous injection, administered every 4 weeks), an antithymic stromal lymphopoietin (TSLP) human monoclonal antibody. After the third dose, she showed significant clinical and functional benefits, which were also confirmed after 6 months of add-on biological therapy with anti-TSLP. In conclusion, this case study suggests that tezepelumab can provide rapid and effective therapeutic action in patients with severe T2-low asthma and nasal polyposis.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"6616379"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367123","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":"Mounier-Kuhn Syndrome Flare With Pleuritic Chest Pain: A Discussion of Complications and Management.","authors":"Geran Maule, Akil Augustus, Mohammad Khraisat, Jay Mehta, Elio Rodríguez Araque, Michael D Schweitzer","doi":"10.1155/crpu/7654438","DOIUrl":"10.1155/crpu/7654438","url":null,"abstract":"<p><strong>Background: </strong>Mounier-Kuhn syndrome (MKS), or tracheobronchomegaly, is a rare disorder characterized by dilation of the trachea and main bronchi due to atrophy of elastic and smooth muscle fibers. It is associated with recurrent respiratory infections, bronchiectasis, and airway collapse. Although radiological diagnosis is well established, clinical recognition remains delayed in many cases due to the disease's rarity and nonspecific presentation.</p><p><strong>Case presentation: </strong>We present a 56-year-old male with a known history of MKS who presented with pleuritic chest pain, productive cough, and constitutional symptoms. Computed tomography (CT) scans of the chest showed significant tracheobronchomegaly with posterior tracheal diverticulum and cystic bronchiectasis. Laboratory evaluation was unremarkable, and infectious and autoimmune workups were negative. The patient was treated conservatively with pulmonary hygiene, bronchodilators, and symptom-targeted therapy, leading to gradual improvement.</p><p><strong>Discussion: </strong>This case dives into a noninfectious symptomatic flare of MKS, expanding the clinical understanding of its complications. We explore the pathophysiology of pleuritic pain in this setting and review diagnostic delays, bronchiectasis-related morbidity, and therapeutic strategies. Advances in interventional pulmonology, including airway stenting and tracheobronchoplasty, offer promising outcomes in selected patients. Early identification, structured imaging assessment, and a multidisciplinary approach are key in managing this complex syndrome.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"7654438"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328130","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":"Right-Sided Bilothorax With Secondary Empyema: A Rare Thoracic Manifestation.","authors":"Aris Sudarwoko, Anna Febriani, Donny Ardika Novananda","doi":"10.1155/crpu/3080834","DOIUrl":"10.1155/crpu/3080834","url":null,"abstract":"<p><p>Bilothorax, the presence of bile in the pleural cavity, is a rare and potentially life-threatening condition. It may occur spontaneously or following hepatobiliary interventions, with right-sided involvement being most common. Patients are at substantial risk of developing empyema and require prompt drainage and intravenous antibiotic therapy. We report a 41-year-old male presenting with progressive dyspnea and bilious pleural effusion. Imaging and pleural fluid analysis confirmed right-sided bilothorax, supported by a pleural-to-serum bilirubin ratio > 1. Cultures later identified <i>Staphylococcus aureus</i>, indicating superimposed empyema. No prior hepatobiliary surgery was documented. Despite initial improvement with antibiotics and drainage, persistent pleural discharge and diaphragmatic injury warranted surgical intervention. Intraoperative findings revealed a 1 cm right hemidiaphragm defect with biliary contamination. Decortication and diaphragmatic repair using an abdominal wall fascial flap were performed. The patient showed clinical improvement postoperatively but declined follow-up and later succumbed to sepsis. This case highlights the importance of early recognition, appropriate drainage, and timely surgical management for bilothorax complicated by empyema.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"3080834"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328166","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":"Multidrug-Resistant Anal and Perianal Tuberculosis: A Case Report From the Pneumo-Phthisiology Department of Conakry University Hospital, Guinea.","authors":"Oumou Hawa Diallo, Mamadou Hawa Camara, Boubacar Djelo Diallo, Thierno Mouctar Bah, Ousmane N Namarie Camara, Aboubacar Camara, Lansana Mady Camara","doi":"10.1155/crpu/3497569","DOIUrl":"10.1155/crpu/3497569","url":null,"abstract":"<p><strong>Introduction: </strong>Multidrug-resistant (MDR) anal and perianal tuberculosis constitutes an exceptionally rare form of extrapulmonary tuberculosis. We report a case of MDR anal and perianal tuberculosis diagnosed and managed in the Pneumo-Phthisiology Department of Ignace Deen University Hospital in Conakry, Guinea.</p><p><strong>Case presentation: </strong>Mrs. M.B., a 33-year-old housewife residing in Tombolia (Conakry), with no notable medical history, presented to the General Surgery Department of Ignace Deen University Hospital on 24 February 2023 with fever, abdominal pain, constipation, and painful swelling of the anal and perianal region. Following a hemorrhoidectomy, histopathological examination of the surgical specimen initially suggested a diagnosis of diffuse large B-cell lymphoma of the anal region. Consequently, CHOP chemotherapy (Adriamycin, cyclophosphamide, vincristine, and prednisolone) was initiated on 10 March 2023 in the Hematology Department. After three cycles of chemotherapy, the patient showed no clinical improvement, with persistent anal lesions and recurrent fever. A strongly positive tuberculin skin test (15 mm) prompted referral to the Pneumo-Phthisiology Department for suspected anal tuberculosis. GeneXpert MTB/RIF testing performed on stool samples confirmed the presence of MDR <i>Mycobacterium tuberculosis</i>. A 9-month short-course second-line antituberculosis regimen was initiated. After 1 month of treatment, the patient developed abdominal pain, semiliquid diarrhea, anorexia, and abdominal distension with a positive fluid-thrill sign. The anal and perianal lesions, however, showed significant improvement.</p><p><strong>Conclusion: </strong>MDR anal and perianal tuberculosis is an uncommon manifestation of extrapulmonary tuberculosis. In regions with high tuberculosis endemicity, it should be considered in the differential diagnosis of chronic ulcerative cutaneous or mucosal lesions. Management relies primarily on second-line antituberculosis therapy to prevent complications and ensure complete recovery.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"3497569"},"PeriodicalIF":0.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291773","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 Pulmonary Marginal Zone Lymphoma Presenting With Asymptomatic Lung Consolidation.","authors":"Mohammed Al Shuraiqi, B Jayakrishnan, Mohammed Al Harrasi, Zahra Al Hajri, Radhiya Al Buraidi","doi":"10.1155/crpu/7871010","DOIUrl":"10.1155/crpu/7871010","url":null,"abstract":"<p><p>Pulmonary lymphoma is a rare condition involving the lung characterized by the abnormal proliferation of lymphoid tissue. Patients may either be asymptomatic or exhibit nonspecific clinical presentations and radiologic findings, making diagnosis challenging. Here, we describe a case of a female patient who presented to our clinic with an incidental radiological finding of pulmonary consolidation/mass. The final diagnosis of a primary pulmonary marginal zone lymphoma required a tissue diagnosis.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"7871010"},"PeriodicalIF":0.0,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12917332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272879","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":"Severe Necrotizing Community-Acquired Pneumonia and Bilateral Empyema in an Immunocompetent Patient due to <i>Fusobacterium necrophorum</i>.","authors":"Deborah Shefa, Aryan Shiari, Marina Antic, Buddhi P Hatharaliyadda, Juan Vera Gomez, David Ladin, Igor Dumic","doi":"10.1155/crpu/5505327","DOIUrl":"10.1155/crpu/5505327","url":null,"abstract":"<p><p>Necrotizing pneumonia and empyema caused by <i>Fusobacterium necrophorum</i> are uncommon. The classical presentation of Lemierre's syndrome, characterized by pharyngotonsillitis and internal jugular vein thrombosis, is not always observed, and incomplete and atypical variants can cause diagnostic uncertainty and delay in treatment. We describe the case of a previously healthy 22-year-old male athlete who developed severe necrotizing community-acquired pneumonia, bilateral empyema, and acute hypoxemic respiratory failure due to <i>F. necrophorum</i> infection, without the typical vascular thrombosis associated with Lemierre's syndrome. Blood cultures and broad-range PCR analysis of the empyema fluid confirmed the presence of <i>F. necrophorum</i>. The patient was initially treated with piperacillin-tazobactam, intravenous corticosteroids, and bilateral chest tube placement for empyema management. Treatment with piperacillin-tazobactam was complicated by drug-induced liver injury requiring antimicrobial change to ampicillin-sulbactam. The patient was discharged on oral amoxicillin-clavulanic acid and completed a total of 5 weeks of antimicrobial therapy with complete recovery. This case highlights the importance of considering <i>F. necrophorum</i> as a potential pathogen in necrotizing community-acquired pneumonia, even in immunocompetent adults, and in the absence of classic Lemierre's syndrome features. Furthermore, its novelty and contribution to the medical literature stem from the patient's presentation with bilateral empyema requiring bilateral drains, the combined blood culture and pleural fluid 16S confirmation of <i>F. necrophorum</i> infection, and the preceding steroid exposure that contributed to clinical deterioration.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"5505327"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991644","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":"Resolution of Pulmonary Inflammation and Obstruction Following Repair of Cerebrospinal Fluid Leak: A Case Report and Review of the Literature.","authors":"Ann O Birmingham, Serban A Staicu, Isaac L Schmale, Li-Xing Man","doi":"10.1155/crpu/9651572","DOIUrl":"10.1155/crpu/9651572","url":null,"abstract":"<p><strong>Objectives: </strong>Cerebrospinal fluid (CSF) rhinorrhea involves drainage of CSF through the nasal cavity due to disruption of the skull base, and pneumonitis secondary to CSF aspiration is a lesser-known complication reported. We present the case of a patient whose pulmonary symptoms and function improved after surgical CSF leak repair.</p><p><strong>Methods: </strong>This is a case report with review of the electronic medical record and literature review.</p><p><strong>Results: </strong>A 35-year-old female presented with 1 year of refractory right-sided rhinorrhea and recurrent lower respiratory infections. Nasal drainage was positive for beta-2-transferrin. Sinus CT showed a possible leakage site at the right lateral lamella of the cribriform plate. Chest CT showed upper lobe predominant ground-glass opacities. Following surgical CSF leak repair, chest CT showed resolution of ground-glass opacities and pulmonary function testing showed an increase in spirometric lung volumes.</p><p><strong>Conclusions: </strong>Aspiration pneumonitis from CSF leaks is rarely reported. Studies report resolution of ground-glass opacities on chest CT as well as clinical improvement in symptoms such as cough following surgical leak repair. Proposed mechanisms leading to aspiration pneumonitis include nasopharyngeal bacterial transit; the mechanism of persistent leak may be related to cough-induced increase in intracranial pressure leading to increased CSF flow. In patients with lower airway inflammation and obstruction as well as unexplained aspiration pneumonitis, a high index of suspicion for CSF rhinorrhea is warranted.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2026 ","pages":"9651572"},"PeriodicalIF":0.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12776594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935815","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":"Diagnostic Approach in a Rare Lung Tumor: Inflammatory Myofibroblastic Tumor.","authors":"Justine Po, Lamia Aljundi, Giselle Kim, Monika Kakol","doi":"10.1155/crpu/8877404","DOIUrl":"10.1155/crpu/8877404","url":null,"abstract":"<p><p>Diagnosis and management of inflammatory myofibroblastic tumors (IMTs) are challenging due to limited data and complications with existing techniques. We report a case of IMT in which a patient was found to have a rare near-total obstructive endobronchial tumor in the left mainstem bronchus after two unsuccessful bronchoscopy attempts-the second attempt requiring intubation due to significant bleeding, which is a common finding in IMTs. We suggest using cryorecanalization for tumor debulking to minimize the risk of bleeding during bronchoscopies and to follow up with argon plasma coagulation (APC) for safe management. The patient tolerated this procedure well with no complications and had improved symptoms, emphasizing the importance of innovative patient-tailored care to treat rare and complex lung tumors such as IMTs.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"8877404"},"PeriodicalIF":0.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879493","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":"Urinothorax and Empyema: Presentation of an Unusual Complication of a Rare Condition.","authors":"Nolan Fox, Nicholas Fox, Shourjo Chakravorty, Neeraj Sinha","doi":"10.1155/crpu/5592208","DOIUrl":"10.1155/crpu/5592208","url":null,"abstract":"<p><p>A 68-year-old male with a history of metastatic bladder cancer and urinary obstruction presented with intractable hiccups and chest pain is presented in this case. He was found to have a unilateral pleural effusion in addition to ipsilateral renal metastasis abutting the diaphragm. Imaging revealed empyema. Thoracentesis revealed positive cultures and a lack of malignant cells on cytology. Comorbid urinary obstruction and urinary tract infection suggested the rare diagnosis of an infected urinothorax. Thoracentesis also revealed pleural fluid creatinine greater than serum creatinine, meeting the most specific diagnostic criteria for urinothorax and establishing the diagnosis. Treatment aimed at evacuating the pleural space without addressing the comorbid bladder obstruction led to an unfavorable outcome in this case.</p>","PeriodicalId":52364,"journal":{"name":"Case Reports in Pulmonology","volume":"2025 ","pages":"5592208"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879430","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}