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A case of pleural and pericardium amyloidosis with effusion associated with multiple myeloma relapse. 一例与多发性骨髓瘤复发相关的胸膜和心包淀粉样变性伴有渗出的病例。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-31 eCollection Date: 2024-08-01 DOI: 10.1002/rcr2.1445
Naoya Ishibashi, Takafumi Sugawara, Yugo Ashino, Ryuga Yabe, Ryo Nonomura, Yutaka Oshima, Takanobu Sasaki

An 80-year-old man with a history of Bence-Jones potein (BJP) λ-type multiple myeloma (MM), which had been in remission for 16 years, was examined for shortness of breath and was found to have bilateral pleural and pericardial effusions. A pleural fluid test and a pleural biopsy under local anaesthesia performed by a previous physician failed to make the diagnosis. Despite diuretic therapy, his condition necessitated frequent thoracentesis. The patient was referred to our hospital and thoracoscopic pleural and pericardial biopsies performed under general anaesthesia revealed λ-type AL amyloidosis, indicating a relapse of MM. Despite drug therapy for MM, the patient died from aspiration pneumonia. The case underscores the importance of considering amyloidosis in differential diagnoses for refractory effusions, especially in patients with a history of MM, even after long-term remission.

一名80岁的老人曾患本斯-琼斯波亭(Bence-Jones potein,BJP)λ型多发性骨髓瘤(MM),已缓解16年。之前的一名医生在局部麻醉下进行了胸腔积液检查和胸膜活检,但未能确诊。尽管接受了利尿剂治疗,但他的病情仍需要频繁进行胸腔穿刺。患者被转诊到我院,在全身麻醉下进行的胸腔镜胸膜和心包活检发现了λ型AL淀粉样变性,表明MM复发。尽管对 MM 进行了药物治疗,但患者还是死于吸入性肺炎。该病例强调了在难治性积液的鉴别诊断中考虑淀粉样变性的重要性,尤其是在有 MM 病史的患者中,即使长期缓解后也应考虑淀粉样变性。
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引用次数: 0
Pleuroparenchymal sarcoidosis: A rare manifestation mimicking metastatic lung cancer. 胸膜下肉样瘤病:模仿转移性肺癌的罕见表现。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-30 eCollection Date: 2024-08-01 DOI: 10.1002/rcr2.1438
Eugene Gan, Chee Kiang Tay

A 66-year-old male from Myanmar presented with 3 months of cough and constitutional symptoms. He was an ex-tobacco user with no significant medical or exposure history. Chest x-ray showed ill-defined bilateral opacities and a left pleural effusion. Chest CT revealed two right lower lobe masses, and a moderate-sized left pleural effusion. PET-CT demonstrated hypermetabolic uptake in the thickened nodular pleura, pericardium, and hilar/mediastinal lymph nodes. EBUS-TBNA of the right lower paratracheal node and TBLB of the right lower lobe mass yielded epithelioid granulomas comprising multinucleated giant cells, epithelioid histiocytes and lymphoplasmacytic cells. Thoracoscopy revealed hard, whitish mass-like parietal pleural plaques, and pleural biopsy revealed identical histopathologic results. His symptoms resolved quickly after commencing prednisolone 25 mg daily. Chest CT at 6 months demonstrated near complete resolution of the parenchymal masses and pleural effusion. We highlight this unique case of pleuroparenchymal sarcoidosis mimicking metastatic lung cancer in a tuberculosis-endemic region.

一名来自缅甸的 66 岁男性因咳嗽和全身症状就诊 3 个月。他以前吸烟,没有明显的病史或接触史。胸部 X 光片显示双侧不明不白的肺不张和左侧胸腔积液。胸部 CT 显示两个右下叶肿块和一个中等大小的左胸腔积液。PET-CT 显示增厚的结节性胸膜、心包和腹腔/纵隔淋巴结有高代谢摄取。气管旁右下结节的 EBUS-TBNA 和右下叶肿块的 TBLB 发现了由多核巨细胞、上皮样组织细胞和淋巴浆细胞组成的上皮样肉芽肿。胸腔镜检查发现了坚硬的白色块状胸膜顶膜斑块,胸膜活检显示了相同的组织病理学结果。在开始使用每天 25 毫克的泼尼松龙后,他的症状很快得到缓解。6 个月后的胸部 CT 显示,实质肿块和胸腔积液几乎完全消退。我们重点介绍这例在结核病流行地区发生的模仿转移性肺癌的胸膜实质肉样瘤病。
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引用次数: 0
Selective bronchial occlusion for acquired bronchobiliary fistula caused by treatment of hepatocellular carcinoma: A case series. 选择性支气管闭塞术治疗肝癌引起的后天性支气管胆道瘘:病例系列。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-30 eCollection Date: 2024-08-01 DOI: 10.1002/rcr2.1440
Bi Zhao, Rui Chen Huang, Yang Xia, Yuchao Dong, Haidong Huang, Lijun Zhao, Wei Zhang

Acquired bronchobiliary fistula (ABBF) is very rare among the complications that occur in patients with hepatocellular carcinoma (HCC) after treatment. Although surgery and drainage have been the main methods for treating ABBF for a long time, they are not entirely suitable for patients with refractory ABBF resulting from HCC therapy. In this study, we present four cases of ABBF caused by HCC treatment, who were treated using selective bronchial occlusion (SBO). Among the 4 patients with ABBF treated with SBO, 3 cases successfully blocked ABBF with SBO, and the treatment success rate was 75%. All successfully treated patients reported disappearance of symptoms of bilioptysis and cough was alleviated. No life-threatening adverse reactions were reported following SBO intervention, and no deaths occurred. We believe that the use of video bronchoscopy to place a self-made silicone plug in the bronchus to treat refractory ABBF is a feasible palliative treatment, which can significantly improve the condition of ABBF patients.

获得性支气管胆管瘘(ABBF)是肝细胞癌(HCC)患者治疗后出现的并发症中非常罕见的一种。虽然长期以来手术和引流一直是治疗 ABBF 的主要方法,但它们并不完全适用于 HCC 治疗导致的难治性 ABBF 患者。在本研究中,我们介绍了四例因 HCC 治疗导致的 ABBF 患者,他们均接受了选择性支气管闭塞(SBO)治疗。在采用 SBO 治疗的 4 例 ABBF 患者中,3 例成功阻断了 ABBF,治疗成功率为 75%。所有成功治疗的患者均表示胆汁栓塞症状消失,咳嗽减轻。SBO 介入治疗后未出现危及生命的不良反应,也没有死亡病例。我们认为,使用视频支气管镜将自制的硅胶塞置入支气管治疗难治性 ABBF 是一种可行的姑息治疗方法,可显著改善 ABBF 患者的病情。
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引用次数: 0
IgG4-related pleural disease diagnosed by thoracoscopic pleural biopsy: A case report. 通过胸腔镜胸膜活检确诊的 IgG4 相关胸膜疾病:病例报告。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-30 eCollection Date: 2024-08-01 DOI: 10.1002/rcr2.1442
Azusa Miyoshi, Hideki Katsura, Tomohiro Akaba, Mitsuko Kondo, Etsuko Tagaya

Here we report a rare case of immunoglobulin G4 (IgG4)-related pleural disease diagnosed using a thoracoscopic pleural biopsy. A 66-year-old man was admitted to our hospital with right-dominant bilateral pleural effusions and gradually worsening dyspnoea. Chest radiographs revealed right-dominant pleural effusions, while chest computed tomography showed bilateral pleural effusions without parenchymal lesions. Although the bilateral pleural effusions were exudative with an increased number of lymphocytes, the definitive diagnosis was initially elusive. High IgG4 levels in the serum and pleural effusions were observed. A pathological evaluation of a right pleural biopsy specimen collected via video-assisted thoracoscopic surgery showed fibrosis-associated lymphoplasmacytic infiltration, 45-60 IgG4-positive plasma cells per high-power field, and an IgG4/immunoglobulin G ratio of 40%. Consequently, the patient was diagnosed with IgG4-related pleural disease. The bilateral pleural effusions improved after corticosteroid therapy.

我们在此报告一例罕见的免疫球蛋白 G4(IgG4)相关胸膜疾病病例,该病例是通过胸腔镜胸膜活检确诊的。一名 66 岁的男性因右侧双侧胸腔积液和逐渐加重的呼吸困难入住我院。胸片显示右侧胸腔积液,胸部计算机断层扫描显示双侧胸腔积液,但无实质病变。虽然双侧胸腔积液呈渗出性,且淋巴细胞数量增多,但起初无法明确诊断。血清和胸腔积液中的 IgG4 水平很高。通过视频辅助胸腔镜手术采集的右侧胸膜活检标本的病理评估显示,纤维化相关淋巴浆细胞浸润,每个高倍视野有 45-60 个 IgG4 阳性浆细胞,IgG4/免疫球蛋白 G 的比率为 40%。因此,患者被诊断为 IgG4 相关性胸膜疾病。经过皮质类固醇治疗后,双侧胸腔积液有所好转。
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引用次数: 0
A rare case of allergic bronchopulmonary mycosis complicating pulmonary pleomorphic carcinoma. 肺胸膜癌并发过敏性支气管肺霉菌病的罕见病例。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-23 eCollection Date: 2024-07-01 DOI: 10.1002/rcr2.1439
Yoshihiro Okada, Kazuhiro Sakaguchi, Kazuya Tanimura, Kazuhide Horimoto, Takeshi Kawaguchi, Masatsugu Hamaji, Maiko Takeda, Shigeto Hontsu, Shigeo Muro

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.

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。
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引用次数: 0
Transbronchial lung cryobiopsy under real-time radial EBUS: First report on a novel twist of the classical technique. 实时径向 EBUS 下的经支气管肺冷冻活组织检查:经典技术新变革的首份报告。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-22 eCollection Date: 2024-07-01 DOI: 10.1002/rcr2.1435
Nektarios Anagnostopoulos, Simone Petrarulo, Claudia Ravaglia, Alessandra Dubini, Sara Piciucchi, Grigoris Stratakos, Venerino Poletti

Transbronchial lung cryobiopsy (TBLC) is a relatively new technique for obtaining lung biopsies, known for being the least invasive method while offering a high diagnostic yield, a favourable safety profile, and a significant reduction in morbidity, mortality, and hospital stay length compared to surgical lung biopsy. Radial-EBUS (r-EBUS) represent a cornerstone modality for accessing 'invisible' peripheral pulmonary lesions. However, a major drawback of these techniques is the lack of 'real-time' visualization of the biopsy being obtained. In this case report, we present a young woman who was referred to us with a cough, haemoptysis, and a non-resolving lung consolidation. She underwent TBLC under real-time rEBUS guidance. This clinical case demonstrates that, in specific clinical scenarios, TBLC with real-time rEBUS is an excellent diagnostic tool.

经支气管肺冷冻活检(TBLC)是一种相对较新的肺活检技术,因其创伤最小、诊断率高、安全性好以及与外科肺活检相比可显著降低发病率、死亡率和住院时间而闻名。径向-EBUS(r-EBUS)是检查 "看不见 "的肺部外周病变的基础方法。然而,这些技术的一个主要缺点是无法 "实时 "观察活检结果。在本病例报告中,我们介绍了一位因咳嗽、咯血和肺部合并症未缓解而转诊至我院的年轻女性。她在实时 rEBUS 引导下接受了 TBLC 检查。该临床病例表明,在特定的临床情况下,实时 rEBUS 引导下的 TBLC 是一种极佳的诊断工具。
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引用次数: 0
Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus in a healthy pregnant woman after being infected with influenza A: A case report for early warning. 一名健康孕妇感染甲型流感后由耐甲氧西林金黄色葡萄球菌引发的社区获得性坏死性肺炎:一份用于预警的病例报告。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-22 eCollection Date: 2024-07-01 DOI: 10.1002/rcr2.1396
Hoa Do Thanh, Duc Vu Anh, Ghi Nguyen Hai, Duong Le Xuan

A previously healthy woman, 5 weeks pregnant, was admitted to the intensive care unit in critical condition for septic shock and acute respiratory distress syndrome due to methicillin-resistant Staphylococcus aureus (MRSA) after being infected with Influenza for 3 days. The patient in this case suffered from severe sequelae due to necrotizing pneumonia and later died on the 20th day after admission. We would like to remind clinicians to be aware of this rare but serious diagnosis. The key is to begin appropriate treatment immediately because MRSA necrotizing pneumonia is mediated by toxins and once the toxins are released they cannot be limited by antibiotic treatments. Necrotizing pneumonia related to MRSA should be considered in young patients with pneumonia, sepsis, and neutropenia following seasonal influenza infection with rapidly progressive symptoms.

一名怀孕 5 周的健康孕妇在感染流感 3 天后,因耐甲氧西林金黄色葡萄球菌(MRSA)引起的脓毒性休克和急性呼吸窘迫综合征而被送入重症监护室,情况十分危急。该病例中的患者因坏死性肺炎导致严重后遗症,后于入院后第 20 天死亡。我们希望提醒临床医生注意这种罕见但严重的诊断。关键是要立即开始适当的治疗,因为 MRSA 坏死性肺炎是由毒素介导的,一旦毒素释放出来,抗生素治疗就无法限制其作用。季节性流感感染后出现肺炎、败血症和中性粒细胞减少且症状进展迅速的年轻患者应考虑与 MRSA 相关的坏死性肺炎。
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引用次数: 0
A rare occurrence of paragonimiasis accompanied by cryptococcal pneumonia. 一种罕见的伴有隐球菌肺炎的副猪嗜血杆菌病。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-19 eCollection Date: 2024-07-01 DOI: 10.1002/rcr2.1424
Hwan Jin Lee, Jun Hyung Park, Ae Ri Ahn, Jae Seok Jeong, Yong Chul Lee

Pulmonary paragonimiasis may be accompanied by a rare infectious disease, such as cryptococcal pneumonia. To our knowledge, this is the first case ever reported in the English literature.

肺副银屑病可能伴有一种罕见的传染病,如隐球菌肺炎。据我们所知,这是英文文献中首次报道的病例。
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引用次数: 0
Diffuse pleural metastasis from atypical meningioma. 非典型脑膜瘤弥漫性胸膜转移。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-17 eCollection Date: 2024-07-01 DOI: 10.1002/rcr2.1430
Alma Rose Devasia, Surya Krishnan, S Swathi Krishna, Aravind Perathur, Jyotsna Yesodharan, Keechilat Pavithran

Meningioma is the most common benign primary brain tumour and does not usually metastasise. We report the case of a 69-year-old male patient with a history of meningioma who presented respiratory symptoms. He was found to have diffuse pleural metastasis from meningioma, which occurred 10 years after surgical management of recurrent meningioma. This case study provides insights into the clinical profile, workup and management of metastatic meningioma.

脑膜瘤是最常见的良性原发性脑肿瘤,通常不会转移。我们报告了一例有脑膜瘤病史的 69 岁男性患者,他出现了呼吸道症状。在对复发性脑膜瘤进行手术治疗 10 年后,他被发现患有脑膜瘤弥漫性胸膜转移。本病例研究有助于深入了解转移性脑膜瘤的临床特征、检查和治疗。
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引用次数: 0
Allergic bronchopulmonary mycosis in Schizophyllum commune with positive Aspergillus-specific IgE antibodies: A case report. 五味子过敏性支气管肺霉菌病,曲霉菌特异性 IgE 抗体阳性:病例报告。
IF 0.8 Q4 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-07-01 DOI: 10.1002/rcr2.1433
Hiroshi Takahashi, Masamitsu Hamakawa, Tadashi Ishida, Akira Watanabe

Schizophyllum commune is the third most common causative fungus of allergic bronchopulmonary mycosis(ABPM). Two-thirds of ABPM caused by S. commune can be positive for Aspergillus fumigatus-specific IgE, which can be difficult to diagnose. Our patient presented to our hospital with wet cough for 3 months and chest pain for 3 days. Blood tests showed IgE 1522 IU/mL, eosinophils 688/mm3, A. fumigatus -specific IgE 2.24 UA/mL, and chest computed tomography showed high-attenuation mucus. Bronchoscopy showed mucus plugs and speculum examination showed filamentous fungi, but various culture tests did not detect A. fumigatus, Asp f 1-specific IgE was negative, and S. commune was detected in the culture of bronchial washing. Since he was positive for S. commune-specific IgE and IgG, he diagnosed ABPM caused by S. commune. These findings demonstrate the importance of identifying the causative fungus in ABPM by detailed examination.

木霉菌(Schizophyllum commune)是过敏性支气管肺霉菌病(ABPM)的第三大常见致病真菌。三分之二由赤霉菌引起的过敏性支气管肺真菌病可出现曲霉菌特异性 IgE 阳性,因此很难诊断。患者因湿咳 3 个月和胸痛 3 天来我院就诊。血液检查显示 IgE 1522 IU/mL,嗜酸性粒细胞 688/mm3,曲霉菌特异性 IgE 2.24 UA/mL,胸部计算机断层扫描显示高浓度粘液。支气管镜检查显示有粘液栓,窥器检查显示有丝状真菌,但各种培养试验均未检测到烟曲霉,Asp f 1 特异性 IgE 为阴性,支气管冲洗培养液中检测到 S. commune。由于他的沙门氏菌特异性 IgE 和 IgG 阳性,他诊断为沙门氏菌引起的 ABPM。这些发现表明,通过详细检查确定 ABPM 的致病真菌非常重要。
{"title":"Allergic bronchopulmonary mycosis in <i>Schizophyllum commune</i> with positive <i>Aspergillus</i>-specific IgE antibodies: A case report.","authors":"Hiroshi Takahashi, Masamitsu Hamakawa, Tadashi Ishida, Akira Watanabe","doi":"10.1002/rcr2.1433","DOIUrl":"10.1002/rcr2.1433","url":null,"abstract":"<p><p><i>Schizophyllum commune</i> is the third most common causative fungus of allergic bronchopulmonary mycosis(ABPM). Two-thirds of ABPM caused by <i>S. commune</i> can be positive for <i>Aspergillus fumigatus</i>-specific IgE, which can be difficult to diagnose. Our patient presented to our hospital with wet cough for 3 months and chest pain for 3 days. Blood tests showed IgE 1522 IU/mL, eosinophils 688/mm<sup>3</sup>, <i>A. fumigatus</i> -specific IgE 2.24 UA/mL, and chest computed tomography showed high-attenuation mucus. Bronchoscopy showed mucus plugs and speculum examination showed filamentous fungi, but various culture tests did not detect <i>A. fumigatus</i>, Asp f 1-specific IgE was negative, and <i>S. commune</i> was detected in the culture of bronchial washing. Since he was positive for <i>S. commune</i>-specific IgE and IgG, he diagnosed ABPM caused by <i>S. commune</i>. These findings demonstrate the importance of identifying the causative fungus in ABPM by detailed examination.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Respirology Case Reports
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