{"title":"肺胸膜癌并发过敏性支气管肺霉菌病的罕见病例。","authors":"Yoshihiro Okada, Kazuhiro Sakaguchi, Kazuya Tanimura, Kazuhide Horimoto, Takeshi Kawaguchi, Masatsugu Hamaji, Maiko Takeda, Shigeto Hontsu, Shigeo Muro","doi":"10.1002/rcr2.1439","DOIUrl":null,"url":null,"abstract":"<p><p>A 72-year-old man with productive cough and wheezing was referred to our institution for a growing mass shadow and central bronchiectasis in the right lower lobe on computed tomography. Based on the symptoms, elevated Aspergillus-specific immunoglobulin E levels, and radiological findings, allergic bronchopulmonary mycosis (ABPM) was suspected according to the Japanese clinical diagnostic criteria. The patient refused bronchoscopic examination, and oral prednisolone (0.5 mg/kg/day) improved the symptoms; however, the mass shadow continued to grow. Subsequently, bronchoscopy revealed mucus plugs and an endobronchial tumour with a whitish surface. The tumour was surgically resected, and the pathological diagnosis was a coexistence of ABPM and pulmonary pleomorphic carcinoma. To the best of our knowledge, this is the first case of ABPM developing at the site of pulmonary pleomorphic carcinoma. Careful bronchoscopic examinations and histopathological evaluations of the surgical specimen led to a prompt and accurate diagnosis.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 7","pages":"e01439"},"PeriodicalIF":0.8000,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263916/pdf/","citationCount":"0","resultStr":"{\"title\":\"A rare case of allergic bronchopulmonary mycosis complicating pulmonary pleomorphic carcinoma.\",\"authors\":\"Yoshihiro Okada, Kazuhiro Sakaguchi, Kazuya Tanimura, Kazuhide Horimoto, Takeshi Kawaguchi, Masatsugu Hamaji, Maiko Takeda, Shigeto Hontsu, Shigeo Muro\",\"doi\":\"10.1002/rcr2.1439\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>A 72-year-old man with productive cough and wheezing was referred to our institution for a growing mass shadow and central bronchiectasis in the right lower lobe on computed tomography. Based on the symptoms, elevated Aspergillus-specific immunoglobulin E levels, and radiological findings, allergic bronchopulmonary mycosis (ABPM) was suspected according to the Japanese clinical diagnostic criteria. The patient refused bronchoscopic examination, and oral prednisolone (0.5 mg/kg/day) improved the symptoms; however, the mass shadow continued to grow. Subsequently, bronchoscopy revealed mucus plugs and an endobronchial tumour with a whitish surface. The tumour was surgically resected, and the pathological diagnosis was a coexistence of ABPM and pulmonary pleomorphic carcinoma. To the best of our knowledge, this is the first case of ABPM developing at the site of pulmonary pleomorphic carcinoma. Careful bronchoscopic examinations and histopathological evaluations of the surgical specimen led to a prompt and accurate diagnosis.</p>\",\"PeriodicalId\":45846,\"journal\":{\"name\":\"Respirology Case Reports\",\"volume\":\"12 7\",\"pages\":\"e01439\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-07-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11263916/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respirology Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/rcr2.1439\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respirology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/rcr2.1439","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
一名 72 岁的男性因咳嗽、气喘,右下叶肿块影不断增大并伴有中央支气管扩张,经计算机断层扫描转诊至我院。根据症状、曲霉菌特异性免疫球蛋白 E 水平升高和放射学检查结果,按照日本临床诊断标准,怀疑为过敏性支气管肺霉菌病(ABPM)。患者拒绝支气管镜检查,口服泼尼松龙(0.5 毫克/千克/天)后症状有所改善,但肿块阴影仍在继续扩大。随后,支气管镜检查发现了粘液栓和表面发白的支气管内肿瘤。肿瘤被手术切除,病理诊断为 ABPM 和肺胸膜癌并存。据我们所知,这是首例在肺胸膜癌部位发生 ABPM 的病例。对手术标本进行仔细的支气管镜检查和组织病理学评估后,我们迅速做出了准确诊断。
A rare case of allergic bronchopulmonary mycosis complicating pulmonary pleomorphic carcinoma.
A 72-year-old man with productive cough and wheezing was referred to our institution for a growing mass shadow and central bronchiectasis in the right lower lobe on computed tomography. Based on the symptoms, elevated Aspergillus-specific immunoglobulin E levels, and radiological findings, allergic bronchopulmonary mycosis (ABPM) was suspected according to the Japanese clinical diagnostic criteria. The patient refused bronchoscopic examination, and oral prednisolone (0.5 mg/kg/day) improved the symptoms; however, the mass shadow continued to grow. Subsequently, bronchoscopy revealed mucus plugs and an endobronchial tumour with a whitish surface. The tumour was surgically resected, and the pathological diagnosis was a coexistence of ABPM and pulmonary pleomorphic carcinoma. To the best of our knowledge, this is the first case of ABPM developing at the site of pulmonary pleomorphic carcinoma. Careful bronchoscopic examinations and histopathological evaluations of the surgical specimen led to a prompt and accurate diagnosis.
期刊介绍:
Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.