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

Persistent focal pulmonary opacity elucidated by transbronchial cryobiopsy: a case for larger biopsies
We describe the case of a 37 ‐year‐old woman presenting with progressive fatigue, shortness of breath, and weight loss over six months with a progressively worsening right basilar infiltrate on chest imaging in spite of antibacterial therapy. Transbronchial cryobiopsy was used to establish the diagnosis after a bronchoscopy with traditional forceps biopsies was non‐diagnostic. This case demonstrates the value of cryobiopsy as a second‐line strategy for pulmonary infiltrates when aetiology remains unclear after less invasive testing. Persistent pulmonary opacities associated with respiratory symptoms that progress d...
Source: Respirology Case Reports - February 27, 2019 Category: Respiratory Medicine Authors: Jasleen Kaur Pannu, Otis Bryant Rickman, Robert James Lentz, Joyce Evelyn Johnson, Fabien Maldonado Tags: Case Report Source Type: research

Transformation of epidermal growth factor receptor T790M mutation ‐positive adenosquamous carcinoma of the lung to small cell carcinoma and large‐cell neuroendocrine carcinoma following osimertinib therapy: an autopsy case report
Resistance mechanisms to osimertinib are of two types: epidermal growth factor receptor (EGFR) dependent, such as point mutations containing C797S, andEGFR independent, such as bypass signal pathway or histological transformation to small cell lung carcinoma (SCLC) and large ‐cell neuroendocrine carcinoma (LCNEC). Here, we report an autopsy case withEGFR T790M ‐positive adenosquamous carcinoma that transformed toEGFR T790M ‐negative SCLC and LCNEC after osimertinib therapy. A 59 ‐year‐old man with relapsed epidermal growth factor receptor (EGFR) exon 19 deletion ‐positive stage IA adenosquamous carcinoma after ...
Source: Respirology Case Reports - February 21, 2019 Category: Respiratory Medicine Authors: Shuhei Moriguchi, Hironori Uruga, Takeshi Fujii, Yoichi Yasunaga, Yui Takahashi, Kazuma Kishi Tags: Case Report Source Type: research

Bronchoscopic observation with linked colour imaging
We report two cases of the comparison of diagnosis made with linked color imaging (LCI) and conventional white ‐light imaging (WLI) on the same patients. Both mucosal inflammatory and malignant lesions were better visible with LCI in comparison to WLI. We report two cases of the comparison of diagnosis made with linked color imaging (LCI) and conventional white ‐light imaging (WLI) on the same patients. In case 1, a 75‐year‐old man in whom right upper lobectomy with mediastinal lymph node dissection was performed due to lung cancer had signs of bronchitis on postoperative day 8. The LCI demonstrated slight inflamma...
Source: Respirology Case Reports - February 14, 2019 Category: Respiratory Medicine Authors: Shinichi Yamamoto, Tomoki Shibano, Masaya Sogabe, Hideki Negishi, Sayaka Mitsuda, Shunsuke Endo Tags: Case Report Source Type: research

Successful management of pleural infection with very low dose intrapleural tissue plasminogen activator/deoxyribonuclease regime
We report a case of a complex parapneumonic effusion in a patient with coagulopathy that was successfully treated with a very low dose tissue plasminogen activator (1  mg) and deoxyribonuclease (5 mg) regime. Pleural infection managed with intrapleural therapy using a combination of 10 mg of tissue plasminogen activator (tPA) and 5 mg of deoxyribonuclease (DNase) has been shown in randomized and open ‐label studies to successfully treat>90% of patients without resorting to surgery. Potential bleeding risks, although low, and costs associated with tPA remain important concerns. No phase I studies exist fo...
Source: Respirology Case Reports - February 13, 2019 Category: Respiratory Medicine Authors: Jodi Andrea Hart, Arash Badiei, Y C Gary Lee Tags: Case Report Source Type: research

An atypical pneumonia
We describe a patient with underlying HIV presenting with progressive respiratory distress and acute renal failure. A unifying diagnosis of microscopic polyangiitis was made. Following immunosuppression induction with plasma exchange and intravenous corticosteroid and subsequent maintenance immunosuppression with intravenous cyclophosphamide in conjunction with renal replacement therapy he achieved remission. To our knowledge this is the first documented case of microscopic polyangiitis occurring in the context of underlying HIV, and raises interesting possibilities regarding the development of vasculitis in this patient. ...
Source: Respirology Case Reports - February 5, 2019 Category: Respiratory Medicine Authors: Benjamin Gerhardy Tags: Case Report Source Type: research

Lung adenocarcinoma and anti ‐transcriptional intermediary factor 1‐gamma positive dermatomyositis complicated with spontaneous oesophageal rupture
A 58 ‐year‐old man presented with a two‐month history of facial erythema and dry cough. After testing he was diagnosed with co‐occurring transcriptional intermediary factor 1‐gamma (TIF1‐γ) positive dermatomyositis (DM) and lung adenocarcinoma. He subsequently developed muscle weakness and w as administered oral prednisolone but developed TIF1‐γ positive DM‐associated oropharyngeal dysphagia complicated by spontaneous oesophageal rupture. Despite treatment, he gradually deteriorated and died from progression of chemoresistant lung cancer six months later. A 58 ‐year‐old man presented with a ...
Source: Respirology Case Reports - February 4, 2019 Category: Respiratory Medicine Authors: Takeshi Saraya, Masaki Tamura, Keisuke Kasuga, Masachika Fujiwara, Hajime Takizawa Tags: Case Report Source Type: research

Spontaneous aspiration of a long tree twig as foreign body
is extremely a rare condition. The presence of a permanent tracheal stoma in a laryngectomized patient should be considered as a predisposing factor for foreign body aspiration. Key messageSpontaneous aspiration of a long tree twig as foreign body is an extremely rare condition. The presence of a permanent tracheal stoma in a laryngectomized patient should be considered as a predisposing factor for foreign body aspiration. (Source: Respirology Case Reports)
Source: Respirology Case Reports - February 1, 2019 Category: Respiratory Medicine Authors: Kosuke Hashimoto, Kyoichi Kaira, Kunihiko Kobayashi, Yoshitake Murayama, Hiroshi Kagamu Tags: Clinical Image Source Type: research

Non ‐parallel anti‐tumour effects of pembrolizumab: a case of cardial tamponade
We present the case of a 70 ‐year‐old man with stage IV lung adenocarcinoma. He was treated with pembrolizumab, a programmed cell death‐1 inhibitor, as a first‐line therapy. After six cycles of pembrolizumab, he suddenly developed cardiac tamponade. With the exception of newly massive malignant pericardial effusion, th e other malignant lesions improved. Pembrolizumab was continued and the patient has shown a durable response for two years. We present the case of a 70 ‐year‐old man with stage IV lung adenocarcinoma. He was treated with pembrolizumab, a programmed cell death‐1 (PD‐1) inhibitor, as a first‐...
Source: Respirology Case Reports - January 31, 2019 Category: Respiratory Medicine Authors: Motoko Tachihara, Masatsugu Yamamoto, Masako Yumura, Asuka Yoshizaki, Kazuyuki Kobayashi, Yoshihiro Nishimura Tags: Case Report Source Type: research

Management of recurrent haemoptysis in malignancy with combined TISSEEL and intrabronchial valves
It is hypothesized that intrabronchial valves would stabilize the fibrin sealant and prevent expectoration or migration. Here we describe the use of combination TISSEEL and intrabronchial valves for the management of recurrent haemoptysis secondary to malignancy. This combination therapy, to the best of our knowledge, represents a novel intervention for palliative management of this condition. Management of recurrent haemoptysis poses a difficult clinical scenario. TISSEEL (Baxter Healthcare Corporation Deerfield, IL, USA) is a fibrin sealant often used in surgery to aid control of bleeding. However, when endoscopic TISSEE...
Source: Respirology Case Reports - January 31, 2019 Category: Respiratory Medicine Authors: James Di Michiel, Corinna Pan, Alvin Ing, Tajalli Saghaie Tags: Case Report Source Type: research

Pleural empyema in a patient with a perinephric abscess and diaphragmatic defect
We report a complicated case of pleural infection and perinephric abscess in a patient who presented with a large right ‐sided pleural effusion. Pleural infection as a complication of ascending urological infection is rare, and the mechanism often unclear. We report a complicated case of pleural infection and perinephric abscess in a patient who presented with a large right ‐sided pleural effusion. Pleural fluid culture yieldedMorganella morganii, an unusual pathogen in pleuro ‐pulmonary infections. Her computed tomography (CT) scan of abdomen showed a right perinephric abscess which extended into the pleural cavity....
Source: Respirology Case Reports - January 29, 2019 Category: Respiratory Medicine Authors: Pei Sze Carmen Tan, Arash Badiei, Deirdre B. Fitzgerald, Yi Jin Kuok, Y. C. Gary Lee Tags: Case Report Source Type: research

Multiple huge “cluster” and “galaxy” signs on chest radiography in a patient with pulmonary tuberculosis
In this article, we present a unique case of active pulmonary tuberculosis, with multiple huge “cluster” signs like fireworks, together with multiple “galaxy” signs. The repeated acid‐fast sputum smears and both bronchial washings were all negative forMycobacterium tuberculosis, but the acid ‐fast culture of sputum taken soon after the first bronchoscopy, and pleural fluid, turned out to be positive forM. tuberculosis at six weeks after admission. The present case clearly demonstrates that the “galaxy” and “cluster” signs are red herring signs of the low rates of isolatin...
Source: Respirology Case Reports - January 25, 2019 Category: Respiratory Medicine Authors: Miku Oda, Takeshi Saraya, Tatsuya Shirai, Narishige Ishikawa, Masachika Fujiwara, Hajime Takizawa Tags: Case Report Source Type: research

Issue Information
Respirology Case Reports, Volume 7, Issue 3, April 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - January 25, 2019 Category: Respiratory Medicine Tags: Issue Information Source Type: research

Anti ‐interleukin 5 antibody is effective for not only severe asthma and eosinophilic pneumonia but also eosinophilic bronchiolitis
There have been a few case reports of eosinophilic bronchiolitis that is characterized by radiographic findings showing diffuse bronchiolitis plus massive accumulation of eosinophils in the airways. Systemic steroid therapy has been suggested to be effective for this disorder, although the precise pathogenesis in unknown. Here, we report a case of severe asthma complicated with eosinophilic pneumonia and eosinophilic bronchiolitis, all of which were alleviated by anti ‐interleukin 5 (IL‐5) antibody. A 60 ‐year‐old female with severe bronchial asthma developed persistent dyspnoea and an abnormal lung shadow. High‐...
Source: Respirology Case Reports - December 18, 2018 Category: Respiratory Medicine Authors: Fuminori Tomyo, Naoya Sugimoto, Masashi Kawamoto, Hiroyuki Nagase, Masao Yamaguchi, Ken Ohta Tags: Case Report Source Type: research

Management of malignant carinal involvement using ‘side‐by‐side’ method of bilateral self‐expandable metallic stents
Central airway obstruction (CAO) is critical and life ‐threatening for cancer patients and is categorized as an oncological emergency that requires urgent intervention. Malignant carinal involvement is considered one of the most difficult situations among CAO, which is usually treated by rigid bronchoscopic intervention under general anaesthesia. The application of ‘side‐by‐side’ method of bilateral self‐expandable metallic stents has been reported in the management of malignant carinal involvement. This technique is useful in the treatment of patients of poor performance status who would not tolerate g...
Source: Respirology Case Reports - December 10, 2018 Category: Respiratory Medicine Authors: Takayuki Takeda, Hideki Itano, Ryo Wakasa, Masahiko Saitoh, Sorou Takeda Tags: Case Series Source Type: research

Lung spindle cell carcinoma harbouring a constitutively active epidermal growth factor receptor mutation
Lung spindle cell carcinoma is a rare lung tumour with a poor prognosis, and its standard therapy has not been established. Furthermore, little work has been performed on the genetic characteristics of lung spindle cell carcinomas. Here, we report the first case of lung spindle cell carcinoma with an epidermal growth factor receptor mutation. The patient received gefitinib as first ‐line therapy. Lung spindle cell carcinoma is a rare lung tumour with a poor prognosis, and its standard therapy has not been established. Furthermore, little work has been conducted on the genetic characteristics of lung spindle cell carcinom...
Source: Respirology Case Reports - December 10, 2018 Category: Respiratory Medicine Authors: Hiroaki Ikushima, Toshio Sakatani, Yoshio Masuda, Teppei Morikawa, Kazuhiro Usui Tags: Case Report Source Type: research

A symptomatic anterior mediastinal mass with a simultaneous Haemophilus influenzae infection
We describe a rare case of unanticipatedly delayed complete resection of a symptomatic teratoma with simultaneousHemophilus influenza infection, followed by extended rupture into the pleural, lung and bronchus. The clinical presentation, microbiology and radiology features leads to an impression of lung abscess until it was proved otherwise pathologically. Surgical resection remains the treatment of choice for mature mediastinal teratoma, and the operation itself is sometimes complicated or life ‐threatening, especially when it ruptures into adjacent vital structures. We describe a rare case of unanticipatedly delayed co...
Source: Respirology Case Reports - December 4, 2018 Category: Respiratory Medicine Authors: Hui Zen Hee, Chun ‐Ku Chen, Yi‐Chen Yeh, Chien‐Sheng Huang Tags: Case Report Source Type: research

A 17 ‐year‐old woman with a solitary, mixed squamous cell and glandular papilloma of the bronchus
Solitary endobronchial papillomas are extremely rare, accounting for only 0.38% of all lung tumours and approximately 7% of all benign epithelial and mesenchymal lung tumours. Here, we present an unexpected case of mixed papilloma in the youngest known patient to date who suffered from chest pain and bloody sputum. A 17 ‐year‐old woman was referred to our hospital due to cough on exertion and right chest pain over the previous two months, together with bloody sputum over the previous week. Chest X‐ray demonstrated a nodule measuring 3 cm in diameter in the right middle lung field. On repeated bronchoscopy, th e tumou...
Source: Respirology Case Reports - November 30, 2018 Category: Respiratory Medicine Authors: Takeshi Saraya, Masachika Fujiwara, Hirokazu Kimura, Hidefumi Takei, Hajime Takizawa Tags: Case Report Source Type: research

A case of Aspergillus and Nocardia infections after bronchial thermoplasty
We describe a case of fungal and bacterial infections that developed after BT. Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma. A 35 ‐year‐old woman with uncontrolled severe asthma despite maximal pharmacological treatment underwent BT and started coughing after the first procedure. One month later, during the second BT procedure, there were white ulcerous lesions on the right B9 bronchus. Culture of the bronchial brushing sp ecimen showedAspergillus fumigatus, for which voriconazole was started for treatment. On the third BT procedure, endobronchial mucus sampling demonstratedNocardia spp., ...
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Authors: Sachi Matsubayashi, Motoyasu Iikura, Takanori Numata, Shinyu Izumi, Haruhito Sugiyama Tags: Case Report Source Type: research

Porous diaphragm syndrome with recurrent thymoma
We report a case of porous diaphragm syndrome with recurrent thymoma that presented with massive ascites. Increasing intra ‐abdominal pressure by ascites and diaphragmatic thinning due to malnutrition by malignancies resulted in the formation of an artificial hole. Thoracentesis changed the balance of hydrostatic pressure, which initiated the influx of a large volume of ascites to the pleural cavity through a hole in the diaphragm. (Source: Respirology Case Reports)
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Authors: Takayo Ota, Yoshikazu Hasegawa, Takafumi Okabe, Akira Okimura, Masahiro Fukuoka Tags: Case Report Source Type: research

Issue Information
Respirology Case Reports, Volume 7, Issue 2, February 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Tags: Issue Information Source Type: research

Pleural anthracosis presenting with massive effusion: a rare entity
This article is about a patient with recurrent admissions for symptomatic pleural effusion. Diffuse hyperpigmentation in both parietal and visceral pleural was visualised, and biopsy demonstrated granuloma with foreign body giant cell (anthracosis). This case highlights the unusual presentation of pleural anthracosis with pleural effusion. Pleural anthracosis is rare and, in most cases, is diagnosed incidentally or at autopsy. We report a 67 ‐year‐old man with pleural anthracosis. He was initially referred for possible tuberculous pleural effusion and had recurrent admissions for symptomatic pleural effusion, which inc...
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Authors: Rayhan Amiseno, Andrea Yu ‐Lin Ban, Noraidah Masir, Lizawati Rasul Hamidi, Mohamed Faisal Abdul Hamid Tags: Case Report Source Type: research

Coexistent sarcoidosis and lymphangioleiomyomatosis in a patient with cystic lung disease
This is an interesting case of coexistent lymphangioleiomyomatosis and pulmonary sarcoidosis in a 45 ‐year‐old lady with cystic lung disease. This case highlights important clinical, radiological, and physiological features of both conditions and suggests a potential shared disease mechanism. A 45 ‐year‐old lady presented acutely with pleuritic chest pain, haemoptysis, and dyspnoea. Her background was significant for a 1.4 cm renal angiomyolipoma, and she was an ex‐smoker without any relevant family history. A computed tomography (CT) pulmonary angiogram was negative for a pulmonary emb olism but demonstrated dif...
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Authors: Sarah Cullivan, Peter De La Harpe Golden, Deirdre Doyle, Kishore Kumar Doddakula, Louise Burke, Desmond Michael Murphy Tags: Case Report Source Type: research

Diffuse pulmonary lymphangiomatosis treated with bevacizumab
We report the case of a 51 ‐year‐old man with DPL treated with 1 mg/kg bevacizumab every three weeks for 6 months. A significant improvement in lung infiltrates was seen on post‐treatment computed tomography (CT) chest with a 17.5% improvement in forced expiratory volume in one second (FEV1). The patient reported impr oved respiratory symptoms, and no significant adverse drug side effects were reported. The authors believe this is the first case of DPL to report lung function improvement [FEV1, forced vital capacity (FVC), and Diffusion Capacity for Carbon Monoxide (DLCO)] following bevacizumab therapy. (Sourc...
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Authors: Ernest Onyeforo, Adrian Barnett, Debbie Zagami, David Deller, Iain Feather Tags: Case Report Source Type: research

Pleuritis with pleural effusion due to a Bacillus megaterium infection
We report a case of a hospitalized male for a pleuritis with pleural effusion caused by aBacillus megaterium infection, a Gram ‐positive, aerobic, spore forming and rod‐shaped bacterium. To our knowledge, our case report is the first evidence of pleuritis due toB. megaterium. In the literature, up to nowB. megaterium infection has only been reported to involve eye, skin and brain. Pleural effusions may be related to pleuro ‐pulmonary or systemic disorders, including malignancy. Thoracentesis and thoracoscopy may be useful to diagnosis. In some cases, the diagnosis may be difficult and uncommon. We report the case of ...
Source: Respirology Case Reports - November 28, 2018 Category: Respiratory Medicine Authors: Ernesto Crisafulli, Ilaria Aredano, Ilaria Valzano, Barbara Burgazzi, Francesco Andrani, Alfredo Chetta Tags: Case Report Source Type: research

Evaluation of expiratory capacity with severe asthma following bronchial thermoplasty
Bronchial thermoplasty (BT) is a bronchoscopic treatment for severe asthma using thermal energy to reduce the amount of smooth muscle in the bronchial wall. In the present study, expiratory computed tomography (CT) imaging was performed before and after BT, and changes in expiratory lung capacity were measured. Use of CT for evaluation of expiratory volume may be a method for assessing the effectiveness of BT. Bronchial thermoplasty (BT) is a bronchoscopic treatment to reduce the amount of smooth muscle in the bronchial wall in patients with severe asthma. Reducing smooth muscle in the airway wall reportedly alleviates air...
Source: Respirology Case Reports - November 26, 2018 Category: Respiratory Medicine Authors: Satoru Ishii, Motoyasu Iikura, Yukiko Shimoda, Shinyu Izumi, Masayuki Hojo, Haruhito Sugiyama Tags: Case Series Source Type: research

Effectiveness of benralizumab for allergic and eosinophilic predominant asthma following negative initial results with omalizumab
We present a patient with both allergic and eosinophilic predominant asthma whose asthma symptom control and sinusitis were improved by benralizumab following negative initial results with omalizumab. A 64 ‐year‐old woman, who had presented with a 30‐year history of refractory asthma, and been treated with anti‐allergic drug therapy, inhaled corticosteroids, a long‐acting beta‐agonist, and a long‐acting muscarinic antagonist. She had been characterized as an allergic, eosinophilic asthma tic. Although omalizumab was tried initially, it was found to be insufficient. We began treatment with benralizumab. The as...
Source: Respirology Case Reports - November 21, 2018 Category: Respiratory Medicine Authors: Daisuke Minami, Hiroe Kayatani, Ken Sato, Keiichi Fujiwara, Takuo Shibayama Tags: Case Report Source Type: research

The significance of non ‐occupational asbestos exposure in women with mesothelioma
In this report we highlight three cases of mesothelioma in women with diverse environmental exposures. Malignant mesothelioma is a rare and aggressive pleural or peritoneal tumour almost always caused by exposure to asbestos fibres. Exposure to asbestos can cause malignant mesothelioma 30 –40 years after exposure. A description of sources of exposure is important for prevention and possible financial compensation. Three women with cases of histologically confirmed malignant mesothelioma diagnosed from non‐occupational asbestos exposure are described. Patients were contacted for an interview to assess their e...
Source: Respirology Case Reports - November 20, 2018 Category: Respiratory Medicine Authors: Nonhlanhla Tlotleng, Kerry Sidwell Wilson, Nisha Naicker, Coenraad FN Koegelenberg, David Rees, James Ian Phillips Tags: Case Series Source Type: research

Autoimmune pulmonary alveolar proteinosis presenting peripheral ground ‐glass opacities
Autoimmune pulmonary alveolar proteinosis should be considered in the differential diagnosis of peripheral ground glass opacities. Autoimmune pulmonary alveolar proteinosis should be considered in the differential diagnosis of peripheral ground ‐glass opacities. (Source: Respirology Case Reports)
Source: Respirology Case Reports - November 13, 2018 Category: Respiratory Medicine Authors: Keishi Sugino, Masahiro Ando, Kiyoshi Mori, Eiyasu Tsuboi Tags: Clinical Image Source Type: research

Transbronchial lung cryobiopsy: a novel confirmatory tool to diagnose asbestos ‐related pulmonary fibrosis
Transbronchial cryobiopsy appears to be an effective way of obtaining parenchymal lung samples of sufficient size to diagnose asbestosis when clinical uncertainty exists. Asbestosis is diagnosed with a combination of historical, clinical and radiological findings in the absence of another cause. Histology is required when uncertainty exists, with lung biopsy via VATs being gold standard. Transbronchial cryobiopsy is becoming increasingly popular for diagnosing interstitial lung disease and may provide sufficient lung sample to demonstrate asbestosis. A 73 year old man presented with dyspnoea on a background of rheumatoid a...
Source: Respirology Case Reports - November 9, 2018 Category: Respiratory Medicine Authors: Marta Zajaczkowska, Anthony Johnson, Luis Gallur, Joo Shin, Christopher Henderson, Jonathan Williamson Tags: Case Report Source Type: research

Gastric perforation related to concurrent use of nintedanib and ramucirumab
We report the first case of 70 ‐year‐old man taking nintedanib for his progressive idiopathic pulmonary fibrosis (IPF) and treated with ramucirumab plus docetaxel as a seventh line therapy for his pulmonary adenocarcinoma. On day15 of chemotherapy treatment cycle2, after taking nintedanib for nine days, he developed gastric p erforation. The prevalence of lung cancer in idiopathic pulmonary fibrosis (IPF) patients ranges from 9.8 to 38%. Nintedanib, a small molecule receptor tyrosine kinase inhibitor (TKI) of platelet ‐derived growth factor receptor (PDGFR), fibroblast growth factor receptor (FGFR), and vascular endo...
Source: Respirology Case Reports - November 8, 2018 Category: Respiratory Medicine Authors: Saeko Takahashi, Saori Murata, Yudai Yoshino, Yosuke Kobayashi, Morio Nakamura Tags: Case Report Source Type: research

Issue Information
Respirology Case Reports,Volume 7, Issue 1, January 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - November 1, 2018 Category: Respiratory Medicine Source Type: research

Aorto ‐pleural fistula successfully treated by one‐lung ventilation and Endobronchial Watanabe Spigots
Respirology Case Reports,Volume 7, Issue 1, January 2019. (Source: Respirology Case Reports)
Source: Respirology Case Reports - November 1, 2018 Category: Respiratory Medicine Authors: Takunori Hozumi, Koichiro Kajiura, Kei Nakamura, Haruki Taniguchi, Takao Goto, Michitaka Nasu Source Type: research

Methicillin ‐resistant Staphylococcus aureus in health‐care workers with cystic fibrosis in Sydney
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 29, 2018 Category: Respiratory Medicine Authors: Yang Song, Lucy Rebecca Keatley, Peter Gordon Middleton Source Type: research

Delayed breast cancer relapse with pleural metastasis and malignant pleural effusion after long periods of disease ‐free survival
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 27, 2018 Category: Respiratory Medicine Authors: Antony Divananth Rawindraraj, Christine Yang Zhou, Vikas Pathak Source Type: research

Hydrocarbon pneumonitis caused by the inhalation of wood preservative
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 27, 2018 Category: Respiratory Medicine Authors: Munechika Hara, Shin ‐ichiro Iwakami, Issei Sumiyoshi, Takashi Yoshida, Shinichi Sasaki, Kazuhisa Takahashi Source Type: research

Bronchobiliary fistula after radiofrequency ablation for hepatocellular carcinoma successfully treated by double drainage
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 25, 2018 Category: Respiratory Medicine Authors: Yi Chen Chang, Yu Min Lin Source Type: research

Xanthogranulomatous pyelonephritis presenting as a left ‐sided pleural effusion
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 21, 2018 Category: Respiratory Medicine Authors: Maple Huang, Reuben Sum, Sheetal Deshpande, Simon A. Joosten Source Type: research

Issue Information
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 11, 2018 Category: Respiratory Medicine Source Type: research

Shisha smoking as a possible cause of bilateral granulomatous lung lesions
Respirology Case Reports,Volume 6, Issue 9, December 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 9, 2018 Category: Respiratory Medicine Authors: Eun Ho Choe, Luke Sutherland, Christopher Hills, Jai ‐deep Sood Source Type: research

Pulmonary hernia: Case report and review of the literature
Respirology Case Reports,Volume 6, Issue 8, November 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 2, 2018 Category: Respiratory Medicine Authors: Chiara Scelfo, Chiara Longo, Marina Aiello, Giuseppina Bertorelli, Ernesto Crisafulli, Alfredo Chetta Source Type: research

Recurrent respiratory papillomatosis: the role of cidofovir
Respirology Case Reports,Volume 6, Issue 8, November 2018. (Source: Respirology Case Reports)
Source: Respirology Case Reports - October 2, 2018 Category: Respiratory Medicine Authors: Mai Ngoc Tran, Lauren Galt, Farzad Bashirzadeh Source Type: research