- Lung parenchymal involvement of primary bone marrow follicular lymphoma: a rare case study. [Journal Article]
- RCRespirol Case Rep 2018; 6(3):e00302
- A 76-year-old man presented with shortness of breath. Computed tomography revealed ground-glass opacity and interlobular thickening in the right lower lobe. Blood examination showed elevated levels o...
A 76-year-old man presented with shortness of breath. Computed tomography revealed ground-glass opacity and interlobular thickening in the right lower lobe. Blood examination showed elevated levels of white blood cell count and lymphocytes. Bone marrow aspiration revealed low-grade follicular lymphoma. Histopathological examination of the surgical lung biopsy from the right lower lobe demonstrated usual interstitial pneumonia and scattered aggregation of lymphocytes with poorly formed non-necrotizing granuloma. An 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) did not show intense uptake in areas other than the right lower lobe. We concluded that the granuloma in the lung was presumed to be a sarcoid reaction associated with bone marrow follicular lymphoma, and the intense 18F-FDG uptake in the right lower lobe might have been due to a sarcoid reaction. Immunohistochemistry or other genetic examinations are important even if 18F-FDG uptake on PET-CT seems to be a false-positive because of the possibility of a sarcoid reaction.
- Non-Answered Questions in Patients with Endobronchial Valve Placement for Lung Volume Reduction. [Journal Article]
- RRespiration 2018 Feb 14
- Endoscopic lung volume reduction is a minimally invasive procedure performed to reduce the space occupied by the emphysemas' lobes. This procedure has been demonstrated to be beneficial for patients ...
Endoscopic lung volume reduction is a minimally invasive procedure performed to reduce the space occupied by the emphysemas' lobes. This procedure has been demonstrated to be beneficial for patients with advanced chronic obstructive pulmonary disease and severe hyperinflation. The use of endobronchial valves is increasing, as well as the number of reports of adverse events. The most common complications after the procedure are a pneumothorax, bleeding, infections, the need for valve removal, and valve expulsion. We have recently treated a patient who achieved immediate left upper lobe atelectasis but developed a pneumothorax on the 6th day and near-fatal kinking of the left lower lobe bronchus. This patient had asphyctic episodes probably due to a functional left pneumonectomy. We should consider this unusual complication in patients undergoing endoscopic lung volume reduction whose condition worsens after achieving complete lobar atelectasis.
- Emphysema and bronchiectasis in COPD patients with previous pulmonary tuberculosis: computed tomography features and clinical implications. [Journal Article]
- IJInt J Chron Obstruct Pulmon Dis 2018; 13:375-384
- CONCLUSIONS: COPD patients with previous PTB had unique features of bronchiectasis and emphysema on HRCT, which were associated with significant dyspnea and higher frequency of severe exacerbations. While PTB may have a local effect on bronchiectasis, its involvement in airspace damage in COPD may be extensive, probably through interactions with cigarette smoke.
- Computed tomography in adult patients with primary ciliary dyskinesia: Typical imaging findings. [Journal Article]
- PlosPLoS One 2018; 13(2):e0191457
- CONCLUSIONS: Typical imaging features in PCD include a predominance of bronchiectasis in the middle and lower lobes, severe tree in bud pattern, mucous plugging, and atelectasis. These findings may help practitioners to identify patients with bronchiectasis in whom further work-up for PCD is called for.
- [THE SYNDROME OF COMBINED PULMONARY FIBROSIS AND EMPHYSEMA - CPFE]. [Review]
- HHarefuah 2018; 157(1):28-33
- There is an increasing recognition of patients with radiologic features of both pulmonary fibrosis and emphysema. This association has enabled the description of a syndrome termed combined pulmonary ...
There is an increasing recognition of patients with radiologic features of both pulmonary fibrosis and emphysema. This association has enabled the description of a syndrome termed combined pulmonary fibrosis and emphysema (CPFE) with unique features. Patients are mostly male smokers who suffer from effort dyspnea and hypoxemia, with near-normal spirometric and lung volumes measurements, and abnormalities of gas exchange. On the computerized tomography there is upper-lobe emphysema and lower-lobe interstitial fibrosis. CPFE is frequently complicated by pulmonary hypertension, lung cancer, acute lung injury and coronary artery disease. Mortality is significant, especially in the presence of pulmonary hypertension. In this article we will review the CPFE syndrome.
- [Spontaneous clinical improvement in a COPD patient]. [Journal Article]
- NTNed Tijdschr Geneeskd 2018; 162(0):D2336
- CONCLUSIONS: Patients with severe bullous lung emphysema may benefit from resorption of large bullae. This mostly requires treatment, but resorption sometimes can be a spontaneous occurrence.
- Reimplantation of the upper lobe bronchus after lower sleeve lobectomy or bilobectomy: long-term results. [Journal Article]
- EJEur J Cardiothorac Surg 2018 Jan 17
- CONCLUSIONS: A Y-sleeve resection with reimplantation of the upper load bronchus is a technically feasible and oncologically adequate operation.
- Miliary tuberculosis with co-existing pulmonary cryptococcosis in non-HIV patient without underlying diseases: a case report. [Journal Article]
- BPBMC Pulm Med 2018 Jan 16; 18(1):6
- CONCLUSIONS: Although tuberculosis and cryptococcosis co-infection is relatively rare in immunocompromised hosts, such as those with acquired immunodeficiency syndrome, clinicians should be aware that these infections can co-exist even in non-HIV patients without underlying diseases.
- Erlotinib for coexisting typical bronchial carcinoid and advanced lung adenocarcinoma: does the epidermal growth factor receptor mutation status matter? [Journal Article]
- ADAnticancer Drugs 2018; 29(3):281-285
- Adenocarcinoma (AC) is the most common type of primary pulmonary malignancy. Lung carcinoid, however, is a rare neuroendocrine tumor. Their coexistence is extremely uncommon. We report the unique cas...
Adenocarcinoma (AC) is the most common type of primary pulmonary malignancy. Lung carcinoid, however, is a rare neuroendocrine tumor. Their coexistence is extremely uncommon. We report the unique case of synchronous advanced lung AC of the right upper lobe (stage IIIB) and typical endobronchial carcinoid tumor in the contralateral lower lobe in a 49-year-old white female who had never smoked. PET-computed tomography scan revealed a fluorine-18-fluorodeoxyglucose-avid AC lesion, whereas the carcinoid tumor was fluorine-18-fluorodeoxyglucose occult. After two lines of platinum-based combination chemotherapies and radiotherapy, the AC progressed, and oral tyrosine kinase inhibitor therapy with erlotinib was initiated in third line. On erlotinib, the AC remained stable for 50 months until disease progression, whereas the carcinoid completely regressed. Molecular testing of the rebronchoscopied AC revealed an exon 19 deletion mutation in the epidermal growth factor receptor (EGFR) gene, whereas the carcinoid was retrospectively EGFR mutation negative. The patient eventually succumbed to ileus caused by intra-abdominal spread of disease, surviving a remarkable 80 months with good performance status throughout most of the follow-up period. To the best of our knowledge, this is the first reported case of synchronous primary lung cancers with different EGFR mutation status, describing an unexpected response of an EGFR-wild-type carcinoid to third-line erlotinib.
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- Pulmonary Mycobacterium Avium-Intracellulare Complex Infection in an Infant: A Silent and Coincidental Finding. [Journal Article]
- PAPediatr Allergy Immunol Pulmonol 2017 Dec 01; 30(4):257-259
- An 11-month-old healthy infant girl was noted to have left lower lobe (LLL) opacities on chest X-ray (CXR) after developing desaturations during an elective cochlear implant surgery. Repeat CXR 10 da...
An 11-month-old healthy infant girl was noted to have left lower lobe (LLL) opacities on chest X-ray (CXR) after developing desaturations during an elective cochlear implant surgery. Repeat CXR 10 days later revealed hyperexpansion of the left lung and persistent LLL opacity. Chest computerized tomography revealed enlarged mediastinal lymph nodes, left mainstem bronchial obstruction, and nodular opacities. Bronchoscopic biopsy of the endobronchial tissue revealed multiple necrotizing granulomas and grew Mycobacterium avium-intracellulare, Streptococcus viridans, and Actinomyces odontolyticus. This case illustrates the potential for significant mediastinal lymphadenopathy, and endobronchial and parenchymal lesions caused by nontuberculous mycobacteria, which can present insidiously and without respiratory symptoms in otherwise healthy infants, despite advanced pulmonary disease.