A case of central neurogenic hyperventilation without tachypnoea
Central neurogenic hyperventilation (CNH) is a rare condition. Primary central nervous system lymphoma (PCNSL) is the most common cause of CNH and is usually accompanied by tachypnoea. Here, we present a rare case of PCNSL ‐induced CNH in a 60‐year‐old man without tachypnoea. Central neurogenic hyperventilation (CNH) is a rare condition, with 37 cases reported in the literature to date. The underlying mechanisms remain unclear. Primary central nervous system lymphoma (PCNSL) is the most common cause of CNH, with 17 cases reported so far. Among these, CNH was usually accompanied by tachypnoea. Only two cases, includin...
Source: Respirology Case Reports - July 16, 2019 Category: Respiratory Medicine Authors: Saori Murata, Saeko Takahashi, Hisako Kunieda, Koichi Oki, Morio Nakamura Tags: Case Report Source Type: research

Active pulmonary tuberculosis presenting with acute respiratory failure
We report the clinical course of four patients with active pulmonary tuberculosis presenting with acute respiratory failure who were treated successfully. Four patients with active pulmonary tuberculosis (PTB) presenting with respiratory failure are reported here. Bronchogenic PTB, simulating an acute febrile illness or diffuse interstitial lung disease with short duration of symptoms, as a cause of acute respiratory failure is less recognized. If diagnosed and treated early, it has good prognosis. Three of the four patients presented here had an acute presentation with fever, dyspnoea, and hypoxemia with diffuse infiltrat...
Source: Respirology Case Reports - July 16, 2019 Category: Respiratory Medicine Authors: Satish Chandra Kilaru, Sudhir Prasad, Hemanth Kilaru, Raghavender Reddy Anneela, Ashfaq Hasan, Eshwar Chandra Nandury Tags: Case Series Source Type: research

Neurofibromatosis type 1 ‐associated malignant peripheral nerve sheath tumour carcinomatous pleurisy: an autopsy case
We report a rare autopsy case of neurofibromatosis type 1 ‐associated malignant peripheral nerve sheath tumor carcinomatous pleurisy with giant intrathoracic meningoceles. A 57 ‐year‐old man with neurofibromatosis type 1 (NF‐1) and intrathoracic meningoceles was admitted to hospital after presenting with neck pain and progressive dyspnoea. On admission, a chest computed tomography scan demonstrated right pleural effusion, neck tumour, intrathoracic meningoceles, and rib metastasis. The myelography showed no transportation between the intrathoracic meningoceles and pleural cavity. As a result, these radiological fin...
Source: Respirology Case Reports - July 16, 2019 Category: Respiratory Medicine Authors: Marie Furukawa, Hiroki Ota, Yasuhiko Nakamura, Yasuhiro Nihonyanagi, Naobumi Tochigi, Sakae Homma Tags: Case Report Source Type: research

Allergic bronchopulmonary aspergillosis complicated by eosinophilic chronic rhinosinusitis successfully treated with mepolizumab
Mepolizumab, an anti ‐interleukin‐5 monoclonal antibody, remarkably improved the pulmonary infiltrations of allergic bronchopulmonary aspergillosis. A 67 ‐year‐old woman was admitted to our hospital because of frequent asthma attacks and refractory chronic rhinosinusitis. She was diagnosed with allergic bronchopulmonary aspergillosis (ABPA) concomitant with eosinophilic chronic rhinosinusitis (ECRS) on the basis of peripheral blood eosinophilia, precipitating antibodies againstAspergillus fumigatus, elevated total serum IgE, pulmonary infiltration, central bronchiectasis, mucoid impaction, and bilateral rhinosinusi...
Source: Respirology Case Reports - July 16, 2019 Category: Respiratory Medicine Authors: Nobuhiro Matsumoto, Takafumi Shigekusa, Ayako Matsuo, Hironobu Tsubouchi, Shigehisa Yanagi, Masamitsu Nakazato Tags: Case Report Source Type: research

Endobronchial one ‐way valve for persistent air leak and lung volume reduction
We describe a 66‐year‐old man with severe chronic obstructive pulmonary disease (COPD) who faile d assessments for BLVR because of the inability to perform the carbon monoxide diffusion test but subsequently had EBV deployed to his right upper lobe bronchi for persistent air leak complicating a spontaneous pneumothorax. Afterwards, there was subjective improvement in breathlessness, exercise ca pacity, and reduced frequency of exacerbations requiring hospitalization. Lung function parameters showed marked improvement. This case suggests that patients with compatible spirometric lung volume and computed tomography findi...
Source: Respirology Case Reports - July 15, 2019 Category: Respiratory Medicine Authors: Wai Cho Yu, Hau Chung Kwok, Yu Hong Chan, Man Ying Ho, Ming Chiu Chan, Yiu Cheong Yeung Tags: Case Report Source Type: research

Pneumocystis jirovecii in a patient on dose ‐dense chemotherapy for early breast cancer
We present a fatal case ofPneumocystis jirovecii pneumonia —a rare and under‐recognized complication—in an otherwise well patient undergoing a dose‐dense adjuvant chemotherapy following surgery for EBC. A 70 ‐year‐old woman underwent adjuvant chemotherapy with dose‐dense doxorubicin and cyclophosphamide for early breast cancer. After her fourth cycle of chemotherapy, she developed severe fatigue and cough with rapid‐onset hypoxic respiratory failure. Investigations demonstrated extensive bilater al consolidation with positive bronchial washings forPneumocystis jirovecii by polymerase chain reaction ...
Source: Respirology Case Reports - July 5, 2019 Category: Respiratory Medicine Authors: Chloe Khoo, Jenny Gilchrist, Jonathan Philip Williamson, Miriam Paul, Richard Kefford Tags: Case Report Source Type: research

Non ‐small cell lung cancer with mesenchymal–epithelial transition gene exon 14 skipping mutation treated with crizotinib
We report the case of an 85 ‐year‐old man who was surgically diagnosed with lung adenocarcinoma (pT2aN1M0 stage IIA). He was administered platinum combination chemotherapy as first‐line treatment for lung cancer recurrence. The patient's pleural fluid sample was obtained and analysed using a next‐generation sequencer, which demonstrated the presence of mesenchymal–epithelial transition gene (MET) exon 14 skipping mutations. As the patient developed progressive disease after receiving first‐line chemotherapy, crizotinib was administered as the second‐line treatment. The treatment was effective, and the pat...
Source: Respirology Case Reports - July 5, 2019 Category: Respiratory Medicine Authors: Seigo Katakura, Nobuaki Kobayashi, Kohei Somekawa, Nami Masumoto, Makoto Kudo, Takeshi Kaneko Tags: Case Report Source Type: research

Tracheobronchial calcification on bronchoscopy in a patient with end stage renal failure: an unusual cause of chronic cough
In this report, we describe a 64 ‐year‐old female with a history of inadequate peritoneal dialysis who presented with severe and persistent chronic cough. Extensive white nodular tracheobronchial mucosal changes were identified on bronchoscopy despite the absence of corresponding abnormalities on CT imaging. We believe that the bronchoscopic findings represent a highly unusual presentation of metastatic pulmonary calcification and an unusual cause of chronic cough amongst patients with end‐stage renal failure. Pulmonary calcification can develop as a complication of end ‐stage renal failure. Most patients are asymp...
Source: Respirology Case Reports - July 4, 2019 Category: Respiratory Medicine Authors: Alice Sawka, April Crawford, Chen Au Peh, Phan Nguyen Tags: Case Report Source Type: research

Very low ‐dose intrapleural tPA for indwelling pleural catheter‐associated symptomatic fluid loculation
This case report describes the successful use of 0.5  mg (the lowest reported dose) of tissue plasminogen activator in a patient with significant bleeding risks whose indwelling pleural catheter was complicated by symptomatic loculation. Indwelling pleural catheters (IPCs) are effective management options for malignant pleural effusion. Symptomatic fluid loculation is a recognized complication of IPC use and is usually managed with intrapleural instillation of fibrinolytic drugs, such as tissue plasminogen activator (tPA). A previous multicentre observational study showed significant heterogeneity among centres in t...
Source: Respirology Case Reports - July 3, 2019 Category: Respiratory Medicine Authors: Norris Si Hao Lan, Sona Vekaria, Calvinjit Sidhu, Yun Chor Gary Lee Tags: Case Report Source Type: research

Syncope due to tracheal adenoid cystic carcinoma
We report the case of a 34 ‐year‐old male who presented with syncope secondary to a large adenoid cystic carcinoma (ACC) of the distal trachea. Tracheal tumours comprise a small proportion of respiratory tract neoplasm, accounting for only about 2% of airway malignancies. Syncope as a presenting symptom is exceedingly rar e. We present a case of a 34 ‐year‐old male who presented with syncope secondary to a large adenoid cystic carcinoma (ACC) of the distal trachea. A computed tomography and flexible bronchoscopy showed almost complete occlusion of the distal trachea. Resection with curative intent was performed, bu...
Source: Respirology Case Reports - July 2, 2019 Category: Respiratory Medicine Authors: Eva Marianne Theresa Bots, Abraham Christoffel van Wyk, Jacques Teran Janson, Riegardt Wagenaar, Gerald Paris, Coenraad Frederik Nicolaas Koegelenberg Tags: Case Report Source Type: research

Pulmonary nocardiosis caused by Nocardia exalbida mimicking lung cancer
We report a rare case of pulmonary nocardiosis caused byNocardia exalbida with CT findings of a mass and lymph node enlargement, requiring differentiation from lung cancer and that was difficult to diagnose. Nocardiosis is an uncommon infection caused byNocardia species, but it can often occur in immunocompromised patients. As computed tomography (CT) findings of pulmonary nocardiosis, consolidation, masses, and nodules are often found, but lymph node enlargement is infrequent.Nocardia exalbida was first isolated in 2006, and there are still few reports on this microorganism. We report a case of pulmonary nocardiosis cause...
Source: Respirology Case Reports - July 1, 2019 Category: Respiratory Medicine Authors: Chika Miyaoka, Keitaro Nakamoto, Tatsuya Shirai, Maki Miyamoto, Yuka Sasaki, Ken Ohta Tags: Case Report Source Type: research

Corrigendum
Respirology Case Reports, Volume 7, Issue 7, October 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - June 26, 2019 Category: Respiratory Medicine Tags: Corrigendum Source Type: research

Issue Information
Respirology Case Reports, Volume 7, Issue 7, October 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - June 24, 2019 Category: Respiratory Medicine Tags: Issue Information Source Type: research

Exertion during a hypoxia altitude simulation test helps identify potential cardiac decompensation
We present the novel case of a 64 ‐year‐old female with a history of chronic thromboembolic pulmonary arterial hypertension and moderate bronchiectasis who experienced right ventricular failure during a clinically indicated flight simulation. While the subject recorded acceptable oxygenation during the simulation in resting cond itions, echocardiography demonstrated underlying cardiopulmonary limitation that significantly worsened with mild exercise. A 64 ‐year‐old female with a history of chronic thromboembolic pulmonary arterial hypertension (CTEPH), moderate airway obstruction (forced expiratory volume in 1 seco...
Source: Respirology Case Reports - June 24, 2019 Category: Respiratory Medicine Authors: Leigh Seccombe, Matthew Peters, Claude Farah Tags: Case Report Source Type: research

Effect of bevacizumab on brain radiation necrosis in anaplastic lymphoma kinase ‐positive lung cancer
We assessed four anaplastic lymphoma kinase (ALK) ‐positive non‐small cell lung cancer (NSCLC) patients who were treated with ALK‐tyrosine kinase inhibitors (TKIs). They developed brain radiation necrosis and brain oedema after stereotactic irradiation. Here, we report the efficacy and safety of bevacizumab given in combination with ALK‐TKI s for brain radiation necrosis in ALK‐positive NSCLC. Central nervous system (CNS) metastases from anaplastic lymphoma kinase (ALK) ‐positive lung cancer often results in failure of ALK‐tyrosine kinase inhibitor (TKI) therapy. Patients with uncontrolled CNS metastases rece...
Source: Respirology Case Reports - June 24, 2019 Category: Respiratory Medicine Authors: Kengo Tanigawa, Keiko Mizuno, Yusuke Kamenohara, Taiji Unoki, Shunsuke Misono, Hiromasa Inoue Tags: Case Series Source Type: research

Successful salvage surgery following multimodal therapy in a patient who harboured ALK ‐rearranged advanced lung adenocarcinoma with multiple organ metastases
This case report highlights that multidisciplinary treatment planning is critical for stage IIIb –IV non‐small cell lung cancer (NSCLC) patients in the era of highly effective treatments, including chemotherapy, molecular targeted therapy, and immunotherapy, which may demonstrate treatment‐free remission (TFR) even in highly selected advanced lung cancer patients with poly‐metastases, a nd we need more information about the association between each genetic alteration and the significance of salvage surgery. The prognosis of stage IVb non ‐small cell lung cancer (NSCLC) patients with multiple distant metastase...
Source: Respirology Case Reports - June 24, 2019 Category: Respiratory Medicine Authors: Yoshitsugu Horio, Tetsuya Mizuno, Yukinori Sakao, Yoshitaka Inaba, Yasushi Yatabe, Toyoaki Hida Tags: Case Report Source Type: research

Nasal mask average volume ‐assured pressure support in an infant with congenital central hypoventilation syndrome
We present the case of a 10 ‐month‐old female infant with congenital central hypoventilation syndrome who was initiated exclusively on non‐invasive ventilation using conventional nasal mask BPAP with average volume assured pressure support (AVAPS) and provide polysomnographic evidence of improved gas exchange on the AVAP S feature. Congenital central hypoventilation syndrome (CCHS) is a rare disorder characterized by alveolar hypoventilation and autonomic dysregulation secondary to mutations of thePHOX 2B genes. Treatment consists of assisted ventilation using positive pressure ventilators via tracheostomy, bi ‐lev...
Source: Respirology Case Reports - June 22, 2019 Category: Respiratory Medicine Authors: Vishal Saddi, Arthur Teng, Ganesh Thambipillay, Hugh Allen, Sonia Pithers, Colin Sullivan Tags: Case Report Source Type: research

Pneumothorax in neuromuscular disease associated with lung volume recruitment and mechanical insufflation ‐exsufflation
A 25 ‐year‐old male with Duchenne muscular dystrophy and a 73‐year‐old male with motor neurone disease both presented with chest pain and increasing dyspnoea following routine mechanical insufflation‐exsufflation or lung volume recruitment, on a background of long‐term non‐invasive ventilat ion. In each case, chest radiograph revealed a pneumothorax which resolved with intercostal catheter insertion and cessation of routine lung volume recruitment. This rare but serious complication highlights the need for careful risk/benefit analysis by clinicians prescribing these therapies. A 25 ‐year‐old male with Du...
Source: Respirology Case Reports - June 13, 2019 Category: Respiratory Medicine Authors: Luke Andrew McDonald, David John Berlowitz, Mark Erskine Howard, Linda Rautela, Caroline Chao, Nicole Sheers Tags: Invited Case Report Source Type: research

Corrigendum
Respirology Case Reports, Volume 7, Issue 6, August 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - June 12, 2019 Category: Respiratory Medicine Tags: Corrigendum Source Type: research

Recurrent lung nodules as a presentation of ventricular septal defect ‐related endocarditis
We present a patient with a known ventricular septal defect presenting with recurrent fevers associated with migratory lung nodules following a “low‐risk” dental procedure without antibiotic prophylaxis. The unusual presentation delayed the diagnosis of the migratory lung lesions as septic pulmonary emboli and consequentially the diagnosis of ventricular septal defect related infective endocarditis. The patient made an uneventful reco very following antibiotic therapy and surgical intervention. (Source: Respirology Case Reports)
Source: Respirology Case Reports - June 1, 2019 Category: Respiratory Medicine Authors: Adam Trytell, Jonathan Darby, Matthew Conron, Andrew Newcomb, Andrew Burns Tags: Case Report Source Type: research

Pulmonary alveolar proteinosis with upper ‐lobe predominance in a non‐smoking female
This report would add PAP to the list of differential diagnosis for upper‐lung ground‐glass opaciti es. A review on the relevant literature is also included in the discussion. (Source: Respirology Case Reports)
Source: Respirology Case Reports - May 29, 2019 Category: Respiratory Medicine Authors: Hong ‐Ping Er, Chung‐Ta Lee, Tang‐Hsiu Huang Tags: Case Report Source Type: research

Issue Information
Respirology Case Reports, Volume 7, Issue 6, August 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - May 22, 2019 Category: Respiratory Medicine Tags: Issue Information Source Type: research

Spontaneous cerebrospinal fluid rhinorrhoea and aspiration pneumonitis following initiation of continuous positive airway pressure treatment for obstructive sleep apnoea
In this report, we describe a 53 ‐year‐old woman with severe OSA who, while being evaluated for possible intracranial hypertension, developed spontaneous CSF rhinorrhoea and CSF aspiration pneumonitis as a complication of CPAP therapy. Magnetic resonance imaging confirmed fluid tracks at the skull base, and a nasal swab demonst rated positive β2‐transferrin. Computer tomography (CT) chest showed findings consistent with CSF aspiration pneumonitis. Resolution of both CSF leak and pneumonitis were noted following treatment with azetozolamide and curative endoscopic trans‐nasal surgery along with ventriculoperito...
Source: Respirology Case Reports - May 20, 2019 Category: Respiratory Medicine Authors: Sanjiwika Lalanjani Wasgewatta, Nathan Manning, Michael Redmond, Diane Howard, Subash Shanthakumar Heraganahally Tags: Case Report Source Type: research

Pulmonary endometriosis: a rare cause of hydropneumothorax
We present a rare case of catamenial hydropneumothorax confirmed through a pleural biopsy. Pulmonary involvement in endometriosis is well described in the literature but asymptomatic significant hydropneumothorax is considered an unusual presentation. It classically coincides with a menstrual cycle and can be a cause of recurrent disease. We present a young lady who was found to have an incidental asymptomatic right hydropneumothorax on a pre ‐employment health screen. She comes from an endemic area of tuberculosis, thus we pursued several diagnostic tests to rule it out. A diagnosis of catamenial hydropneumothorax was r...
Source: Respirology Case Reports - May 20, 2019 Category: Respiratory Medicine Authors: Husam Alzayer Tags: Case Report Source Type: research

Multiple primary lung adenocarcinomas pre ‐operatively diagnosed by discordant epidermal growth factor receptor mutations
We describe a case of simultaneous multiple bilateral lung adenocarcinomas diagnosed by discordant epidermal growth factor receptor mutations in transbronchial lung biopsy specimens that led to a successful radical surgery. A 49 ‐year‐old woman with an abnormal shadow on her chest X‐ray visited our hospital. Chest computed tomography revealed a 13‐mm diameter nodule in S9 on the right and a 47‐mm diameter mass in segment (S) 1 + 2 on the left. She underwent transbronchial biopsy, which revealed that both tumou rs had the same histology of papillary adenocarcinoma. The indications of radical surgery ...
Source: Respirology Case Reports - May 20, 2019 Category: Respiratory Medicine Authors: Yuki Katayama, Sayaka Kawai, Aya Miyagawa ‐Hayashino, Yoshizumi Takemura Tags: Case Report Source Type: research

Multiple fungus balls in a patient with chronic pulmonary aspergillosis
We present an atypical but very educational case of a 76 year ‐old man with interstitial lung disease diagnosed with chronic pulmonary aspergillosis who presented with multiple fungus balls in the right lower lobe. Key messageTypically, radiological examination in chronic pulmonary aspergillosis reveals cavities with fungus balls within the upper lobes. This case showed that multiple fungus balls can also be present in the lower lobes. (Source: Respirology Case Reports)
Source: Respirology Case Reports - May 19, 2019 Category: Respiratory Medicine Authors: Keitaro Nakamoto, Yuka Sasaki, Takashi Uchiyama, Ken Ohta Tags: Clinical Image Source Type: research

Acute shortness of breath due to reoccurrence of an intrapericardial bronchogenic cyst
A 71 ‐year‐old woman presented with dysphagia and acute shortness of breath. Surgical history included a prior thoracotomy overseas for a bronchogenic mesothelial cyst 19 years before. Computed tomography demonstrated a mass within the posterior mediastinum. A median sternotomy was performed, and a fter removal of the cyst, repair of the left atrium and pulmonary vessels was undertaken due to the invading nature of the cyst. Irrespective of the method of approach in redo surgery, complete resection must be performed in order to minimize the chance of recurrence, relieve symptoms, eliminate ris k of infection, an...
Source: Respirology Case Reports - May 17, 2019 Category: Respiratory Medicine Authors: Damian Gimpel, Joseph Conway, Felicity Meikle, Zaw Lin, David John McCormack, Adam El ‐Gamel Tags: Case Report Source Type: research

Bronchiectasis in the setting of aplasia of the epiglottis
We report a case of bronchiectasis in the setting of congenital aplasia of the epiglottis, secondary to early ‐life aspiration events in a 2‐year‐old male with recurrent lower respiratory track infections. Aplasia of the epiglottis is a rare airway abnormality requiring airway and feeding interventions. We report a case of bronchiectasis in the setting of congenital aplasia of the epiglottis, secondary to early ‐life aspiration events. Compensatory mechanisms for airway protection likely develop later in life. (Source: Respirology Case Reports)
Source: Respirology Case Reports - May 1, 2019 Category: Respiratory Medicine Authors: Puwakdandawe Weerasinghe, Rahul Thomas, Brent Masters, Nitin Kapur Tags: Case Report Source Type: research

An unusual endobronchial lesion: expanding the differential diagnosis
Here, we report a case of a 73 ‐year‐old male who presented to the hospital after a motor vehicle collision, with incidentally found pulmonary nodule and kidney mass. He was eventually diagnosed with high‐grade synovial sarcoma, one of only seven cases to date of primary endobronchial synovial sarcoma that have been reporte d. A review of the cases and literature is carried out. Synovial sarcoma is a rare tumour, accounting for approximately 2.5 –10% of all soft tissue sarcomas. In the thorax, it most often presents as a large, homogenous mass and, most commonly, is the result of extrathoracic tumour metastasis...
Source: Respirology Case Reports - April 19, 2019 Category: Respiratory Medicine Authors: Rachel Leonard, Charles Schultz, Sarah Hadique Tags: Case Report Source Type: research

Mycobacterium shimoidei, a rare non ‐tuberculous mycobacteria pathogen identified by matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry
This study reports onMycobacterium shimoidei infection in an immunosuppressed 61 ‐year‐old male with a background of emphysema. His chief complaint was haemoptysis. Chest computed tomography showed a large, thin‐walled cavitary lesion in the upper right lobe. Although NTM were identified in two separate expectorated sputum samples, DNA–DNA hybridization (DDH) failed to i dentify the species.M. shimoidei was finally identified using matrix ‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS). Following antimicrobial agent susceptibility tests, treatment with clarithromyci...
Source: Respirology Case Reports - April 17, 2019 Category: Respiratory Medicine Authors: Hiroaki Nagano Tags: Case Report Source Type: research

A rare epidermal growth factor receptor H773L/V774M compound mutation in advanced non ‐small‐cell lung cancer with poor response to epidermal growth factor receptor tyrosine kinase inhibitor
Here, we report a case of advanced non ‐small‐cell lung cancer with a rare epidermal growth factor receptor (EGFR) exon 20 H773L/V774M compound mutation, which demonstrated poor clinical response to afatinib, a second‐generation EGFR‐TKI with pan‐human EGFR blocking activity. The anti‐cancer treatment was shifted to platinum‐ based chemotherapy, which resulted in a partial response. Uncommon mutations account for 10 –15% of epidermal growth factor receptor (EGFR) mutations in patients with non‐small‐cell lung cancer. Afatinib is currently the most efficient EGFR‐tyrosine kinase inhibitor (TKI) aga...
Source: Respirology Case Reports - April 10, 2019 Category: Respiratory Medicine Authors: Lun ‐Che Chen, Jin‐Yuan Shih, Chong‐Jen Yu, Ching‐Yao Yang Tags: Case Report Source Type: research

Transoesophageal ultrasound ‐guided bronchoscopic aspiration of a superior mediastinal tumour using the BF‐UC290F instrument
We report a case with a superior mediastinal mass diagnosed via endoscopic, ultrasound‐guided, bronchoscopic fine‐needle aspiration using the BF‐UC290F. A 46 ‐year‐old male with a superior mediastinal mass presented with a one‐month history of hoarseness and chest pain and was referred to our hospital. Although endobronchial, ultrasound‐guided, transbronchial needle aspiration (EBUS‐TBNA) was initially performed, we could not obtain an adequate specimen because of his severe cough and an inadequate EBUS view. During the same endoscopic session, we performed endoscopic, ultrasound‐guided, bronchoscopic fin...
Source: Respirology Case Reports - April 10, 2019 Category: Respiratory Medicine Authors: Daisuke Minami, Yuki Takigawa, Hiroe Kayatani, Ken Sato, Keiichi Fujiwara, Takuo Shibayama Tags: Case Report Source Type: research

Dyspnoea and restrictive lung disease due to mediastinal and pleural lipomatosis in morbid obesity
We report a case of large volume mediastinal and pleural lipomatosis causing significant dyspnoea in an obese individual. This is a rare complication of obesity and should be considered in obese patients when other causes of dyspnoea have been excluded. Dyspnoea in obese patients can be multifactorial and complex. Mediastinal and pleural lipomatosis can be associated with obesity and is usually considered asymptomatic and benign. We report an obese 39 ‐year‐old man who presented with progressive dyspnoea, where in addition to obstructive sleep apnoea and obesity hypoventilation syndrome, was found to have massive media...
Source: Respirology Case Reports - April 9, 2019 Category: Respiratory Medicine Authors: Jen Yuh Lim, Kim A. McAnulty, Catherina L. Chang Tags: Case Report Source Type: research

Severe mediastinitis over a month after endobronchial ultrasound ‐guided transbronchial needle aspiration
Mediastinitis is a concerning acute or subacute complication of endobronchial ultrasound ‐guided transbronchial needle aspiration (EBUS‐TBNA). The median time of mediastinitis onset is approximately 12 days after EBUS‐TBNA. Here we present the first report, to the best of our knowledge, of mediastinitis occurring over a month after EBUS‐TBNA in two patients. Although endobronchial ultrasound ‐guided transbronchial needle aspiration (EBUS‐TBNA) has been reported to be a minimally invasive and relatively safe procedure, mediastinitis is a serious complication related to the procedure. The median time of mediastin...
Source: Respirology Case Reports - April 9, 2019 Category: Respiratory Medicine Authors: Kana Kurokawa, Tetsuhiko Asao, Ryo Ko, Tetsutaro Nagaoka, Kenji Suzuki, Kazuhisa Takahashi Tags: Case Report Source Type: research

Phlegmasia cerulea dolens: a rare cause of shock
We present a case of extensive bilateral lower extremity deep vein thrombosis associated with an inferior vena cava filter, which rapidly progressed to PCD and refractory shock. Phelgmasia cerulea dolens (PCD) is a rare cause of shock that can complicate deep venous thrombosis and carries a high risk of mortality. We present a case of extensive bilateral lower extremity deep vein thrombosis associated with an inferior vena cava filter which rapidly progressed to PCD and refractory shock. (Source: Respirology Case Reports)
Source: Respirology Case Reports - April 8, 2019 Category: Respiratory Medicine Authors: Christopher Bob Lewis, Matthew Kevin Hensley, Julie Elizabeth Barrett, Steven Burke Van Norman, Alexander Stuart Taylor, Jeffrey Craig Horowitz Tags: Case Report Source Type: research

Tension hydrothorax secondary to small cell lung cancer
Tension hydrothorax is uncommon and a malignant aetiology is rare. Here we present a case of malignant tension hydrothorax secondary to small cell lung cancer and highlight management strategies to prevent the life ‐threatening complication of re‐expansion pulmonary oedema. Malignant tension hydrothorax is rare. Here we present a malignant tension hydrothorax secondary to small cell lung cancer (SCLC). To our knowledge, this is the first report of this entity. Briefly, a 53 ‐year‐old male smoker presented in acute distress after months of fatigue, shortness of breath, and weight loss. On examination his heart rate ...
Source: Respirology Case Reports - April 6, 2019 Category: Respiratory Medicine Authors: Eleah Danielle Porter, David John Finley, Joseph David Phillips Tags: Case Report Source Type: research

Mediastinal emphysema after long ‐distance flight with ketoacidosis and underlying diabetes mellitus type 1
We present a 21 ‐year‐old female with diabetes mellitus type 1 diagnosed with SPM which improved after four days with conservative treatment. A 21 ‐year old female with diabetes mellitus type 1 presented to our hospital's emergency department having suffered from shortness of breath, mild chest pain, and vomiting following her arrival after a long‐distance flight two days earlier. Symptoms had since subsided and physical examination was no rmal. Blood analysis revealed increased D‐dimers and diabetic ketoacidosis. Computed tomography (CT) examination excluded pulmonary embolism but demonstrated significant medias...
Source: Respirology Case Reports - April 5, 2019 Category: Respiratory Medicine Authors: Gracia Lana Ardila Pardo, Wolfgang Michael K übler, Martin Witzenrath, Jörg‐Wilhelm Oestmann Tags: Case Report Source Type: research

A case of pulmonary lymphoproliferative disorder presenting rapidly progressive respiratory failure
A 72 ‐year‐old woman presented with acute onset of shortness of breath and fatigue over several days, and was found to be in acute respiratory failure. Computed tomography of the chest revealed massive ground‐glass opacity and partial crazy‐paving appearance with multiple nodules across all the l obes of the lung and a large mass in the right lower lobe. She was diagnosed with B‐cell lymphoma and the abnormal lung shadow was considered to be a result of a pulmonary lymphoproliferative disorder (PLD). PLD is known to present with various radiographic patterns. However, the progression of PL D is usually slow, and ...
Source: Respirology Case Reports - April 2, 2019 Category: Respiratory Medicine Authors: Kohei Fujita, Kenjiro Ishigami, Hiroyuki Tanaka, Koki Moriyoshi, Tadashi Mio Tags: Case Report Source Type: research

A 27 ‐year‐old female presented with diffuse alveolar haemorrhage due to breast angiosarcoma with lung metastasis
We report a case of a 27 ‐year‐old female with the diagnosis of primary breast angiosarcoma developing DAH. This raised our concern that angiosarcoma with lung metastasis may present with diffuse alveolar haemorrhage (DAH) and should be considered as an important fatal differential diagnosis of DAH. Angiosarcomas are rare soft ‐tissue sarcomas of endothelial cell origin and have a poor prognosis. Diffuse alveolar haemorrhage (DAH) is a syndrome characterized by the accumulation of intra‐alveolar red blood cells. However, neoplastic diseases are not commonly considered in the differential diagnosis of DAH. We report...
Source: Respirology Case Reports - March 25, 2019 Category: Respiratory Medicine Authors: Po ‐Hsin Lee, Yun‐An Chen, Pin‐Kuei Fu Tags: Case Report Source Type: research

Massive haemoptysis from right middle lobe bronchus managed by customized silicon stents
We presented an 89‐year‐old bronchiectasis patient who developed massive haemoptysis from the right middle lobe bronchus. Haemoptysis was not controlled by both pharmacological treatment and bronchial artery embolization. Two customized silicone stents with the one in the right middle lob e bronchus and another in the right intermediate bronchus were used to manage haemoptysis. One month after stents implantation, the stent inside the right intermediate bronchus was removed, another stent was left in the right middle lobe bronchus to continue occluding the bleeding passageway. Haemop tysis did not occur after silicon s...
Source: Respirology Case Reports - March 25, 2019 Category: Respiratory Medicine Authors: Weihua Xu, Hongwei Wang, Haidong He, Huiping Hu, Haihua Lu, Guozheng Li Tags: Case Report Source Type: research

Issue Information
Respirology Case Reports, Volume 7, Issue 5, July 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - March 20, 2019 Category: Respiratory Medicine Tags: Issue Information Source Type: research

Negative pressure wound therapy with instillation without open ‐window thoracostomy for empyema
Here we present the cases of two patients with refractory empyema after intrathoracic irrigation and drainage, who underwent a new treatment with negative pressure wound therapy with instillation and dwell time (NPWTi ‐d) but without open‐window thoracostomy (OWT) using the fistula of the thoracic drain. We called this treatment non‐OWT NPWTi‐d. Both the patients recovered. Non‐OWT NPWTi‐d may be a new option to treat empyema. Treatment of empyema is very challenging. The use of negative pressure wound therapy (NPWT), and NPWT with instillation and dwell time (NPWTi ‐d) for wound closure have attracted attent...
Source: Respirology Case Reports - March 19, 2019 Category: Respiratory Medicine Authors: Kayo Okamoto, Kumiko Matsumoto, Norichika Iga, Seiji Komatsu Tags: Case Report Source Type: research

Unusual presentation of Castleman's disease mimicking lung cancer
We reported a patient with a history of heavy smoking with particular image features of CD, which presented as mediastinal lymphadenopathy and peribronchovascular interstitial thickening mimicking lung cancer or sarcoidosis initially. Castleman's disease (CD) is an uncommon lymphoproliferative disorder characterized as either unicentric or multicentric presentation based on the involving sites. The most frequent presentation of CD is a solitary mediastinal mass. We reported a patient with a history of heavy smoking with particular image features of CD, which presented as mediastinal lymphadenopathy and peribronchovascular ...
Source: Respirology Case Reports - March 14, 2019 Category: Respiratory Medicine Authors: Ming ‐Tsung Chen, Shih‐Chun Lee, Chun‐Chi Lu, Chen‐Liang Tsai Tags: Case Report Source Type: research

Flexible bronchoscopy and cryoextraction for critical airway obstruction caused by an endobronchial angioleiomyoma
We describe a case presenting with central airway obstruction, safely and effectively treated with cryoextraction of the tumour using flexible bronchoscopy. (Source: Respirology Case Reports)
Source: Respirology Case Reports - March 13, 2019 Category: Respiratory Medicine Authors: Sumit Chatterji, Efrat Ofek, Tiberiu Shulimzon Tags: Clinical Image Source Type: research

Management of skin sarcoidosis with minocycline monotherapy
After approximately 1 year of the minocycline monotherapy, nearly all skin sarcoidosis lesions resolved with only light residual scars, despite the poor efficacy of the monotherapy for pulmonary sarcoidosis. Minocycline monotherapy appears to be an effective treatment modality for skin sarcoidosis. A 46 ‐year‐old woman with severe skin sarcoidosis, mainly on the back of the trunk, persisting for>15  years, was followed up without systemic treatment. In 2014, she was started on minocycline monotherapy owing to worsening of the skin sarcoid lesions. Surprisingly, after approximately 1 year of the monotherapy, n...
Source: Respirology Case Reports - March 13, 2019 Category: Respiratory Medicine Authors: Shinichi Sasaki, Motoyasu Kato, Kota Nakamura, Yukiko Namba, Osamu Nagashima, Kazuhisa Takahashi Tags: Case Report Source Type: research

Small cell lung cancer and interstitial pneumonia associated with anti ‐transcriptional intermediary factor‐1γ‐positive dermatomyositis
We report the case of a 68‐year‐old female with small cell lung cancer and interstitial pneumonia who was diagnosed fi rst with dermatomyositis positive for serum anti‐TIF‐1γ antibodies. Antibodies to transcriptional intermediary factor ‐1γ (TIF‐1γ) are strongly associated with malignancy in patients with dermatomyositis but a relatively low risk for interstitial lung disease. We report the case of a 68‐year‐old female with small cell lung cancer (SCLC) and interstitial pneumonia who was diagnosed first with dermatomyosit is positive for serum anti‐TIF‐1γ antibodies. Because inte...
Source: Respirology Case Reports - March 12, 2019 Category: Respiratory Medicine Authors: Toshio Kato, Satoru Ito, Toyonori Tsuzuki, Daisuke Watanabe, Akihito Kubo, Etsuro Yamaguchi Tags: Case Report Source Type: research

A rare case of lymphadenitis and pulmonary disease caused by Mycobacterium paraffinicum
We report a rare case of cervical lymphadenitis and pulmonary disease caused byMycobacterium paraffinicum. With over 150 species, non ‐tuberculous mycobacteria are increasingly recognized to be important human pathogens that pose diagnostic and management challenges. We report a rare case of cervical lymphadenitis and pulmonary disease caused byMycobacterium paraffinicum in a 64 ‐year‐old man who presented with three‐month history of increasing right‐sided painless neck lump. His medical history included rheumatoid arthritis, which was managed with leflunomide and methotrexate. Computed tomography scans of his ne...
Source: Respirology Case Reports - March 12, 2019 Category: Respiratory Medicine Authors: Pei Sze Carmen Tan, Ruad Perera Tags: Case Report Source Type: research

Organizing pneumonia co ‐existing with carcinoid tumour: complete resolution with bronchoscopic tumour resection
We report an unusual case of organizing pneumonia occurring as a consequence of obstruction due to a carcinoid tumour and its complete resolution by bronchoscopic relief of obstruction without the need for steroid therapy. Organizing pneumonia is a well ‐known clinical entity resulting in response to noxious stimuli causing lung injury. It is known to occur with infectious disease processes, neoplasms, post lung surgery or radiation therapy and when idiopathic, is called cryptogenic organizing pneumonia. We present an unusual case of a 48‐year‐ old woman who presented with chronic cough and progressive dyspnoea while...
Source: Respirology Case Reports - March 7, 2019 Category: Respiratory Medicine Authors: Divyansh Bajaj, Nevins Todd, Rydhwana Hossain, Karan Mahajan, Whitney Burrows, Ashutosh Sachdeva Tags: Case Report Source Type: research

Issue Information
Respirology Case Reports, Volume 7, Issue 4, May 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - February 27, 2019 Category: Respiratory Medicine Tags: Issue Information Source Type: research

Effectiveness of pulmonary vasodilators on pulmonary hypertension associated with POEMS syndrome
We report a 51 ‐year‐old woman diagnosed with PH associated with POEMS syndrome. She was started on dexamethasone and thalidomide. Although, the plasma vascular endothelial growth factor (VEGF) level decreased, systolic pulmonary artery pressure (sPAP) remained high. Auto‐peripheral blood stem cell transplan tation improved the plasma VEGF and sPAP levels. Four years later, she presented with dyspnoea on exertion, and elevated plasma VEGF and sPAP levels. Subsequently, on administering sildenafil and macitentan, the plasma VEGF and PH levels improved. Pulmonary vasodilators can be considered when PH rem ains after tr...
Source: Respirology Case Reports - February 27, 2019 Category: Respiratory Medicine Authors: Kana Ohashi, Rintaro Nishimura, Shunsuke Sugimoto, Seiichiro Sakao, Nobuhiro Tanabe, Koichiro Tatsumi Tags: Case Report Source Type: research