Metastatic Pulmonary Calcification With Coexisting Nonspecific Interstitial Pneumonia: A Case Report

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S52-S52
Author(s):  
Arati Inamdar ◽  
Rajiv Pulinthanathu
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Interstitial Pneumonia ◽  
Clinical Symptoms ◽  
Ground Glass ◽  
Rapid Progression ◽  
Pulmonary Calcification ◽  
Nonspecific Interstitial Pneumonia ◽  
The Right ◽  
Metastatic Pulmonary Calcification

Abstract Patients with underlying chronic kidney disease (CKD) often have elevated serum calcium and parathyroid hormones due to compromised kidney function. We present a case of a 63-year-old female nonsmoker with surgical history of three renal transplants (at age 47, 51, and 58) along with thyroidectomy and parathyroidectomy who came to the emergency department with complaint of persistent dry cough and shortness of breath for the last 2 months. The patient had been on immunosuppressive drugs, tacrolimus, prednisolone, and mycophenolic acid since her first renal transplant as well as on cinacalcet after parathyroidectomy (at age 54). Initial computed tomography (CT) scan demonstrated ground-glass opacities in bilateral upper lobes while bronchoscopy revealed few inflammatory cells without any fungi or bacteria. Repeat CT scan performed 5 days later due to rapid progression of her clinical symptoms showed worsening of ground-glass opacities in bilateral upper lobes and new nodules in right middle and lower lung lobes. The wedge lung biopsy revealed metastatic pulmonary calcification (MPC) in the right upper lobe while nonspecific interstitial pneumonia (NISP) in the right lower lobe confirmed the coexistence of two different pathological processes most likely complicating the patient’s clinical symptoms. Despite comprehensive medical therapy, patient’s symptoms have been progressively worsening and she is currently undergoing evaluation for both renal and lung transplants. Our case report not only presents a rare case of MPC coexisting with NSIP but also sheds light on the associated morbidity due to pulmonary diseases in CKD patients.

scholarly journals Gejala Klinis dan Pemeriksaan Penunjang pada Neonatus Terinfeksi COVID-19

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jason Rampengan ◽  
Johnny Rompis ◽  
Valentine Umboh
Keyword(s):  
Cohort Study ◽  
Case Report ◽  
Literature Review ◽  
Observational Study ◽  
Ct Scan ◽  
Clinical Symptoms ◽  
Ground Glass Opacity ◽  
Google Scholar ◽  
Ground Glass ◽  
Laboratory Examinations

Abstract: COVID-19 is spreading at an extremely rapid rate and can affect all age groups, albeit, information about clinical symptoms and laboratory examinations of COVID-19 I in neonates is still quite limited. This study was aimed to determine the clinical symptoms, radiographic examinations especially CT-scans, and laboratory tests that could appear in neonates suffering from COVID-19. This was a literature review study using three databases, namely Pubmed, Clinical Key, and Google Scholar. The keywords used were Covid-19 / SARS-CoV-2 AND Neonatus AND sign and symptoms AND laboratory. The selection based on inclusion and exclusion criteria, obtained 15 case report studies, three retrospective studies, one observational study, and one cohort study. The review revealed that the most frequent clinical features that appeared were fever (54.8%), dyspnoea (35.4%), and cough (29%). Meanwhile, for CT-Scan radiographs, there were 14 of 31 neonates (45.2%) did not show any abnormalities or normal. The most frequent abnormal image was ground glass opacity (GGO) (29%). Among laboratory examinations, lymphopenia was the most common abnormality (32.2%). Moreover, leukocytosis, leukopenia, thrombocytopenia, increased PCT, AST, etc. could also occur. Of all the reviewed literatures, there were no death cases of neonates died due to COVID-19. In conclusion, fever, dyspnea, cough, and lymphopenia are the most common findings as well as GGO in the CT-Scan radiograph.Keywords: COVID-19, neonates Abstrak: COVID-19 menyebar dengan sangat pesat dan dapat menjangkiti semua kelompok usia namun informasi mengenai gejala klinis dan pemeriksaan laboratorium terhadap kelompok neonatus masih terbatas. Penelitian ini bertujuan untuk mengetahui gambaran klinis, pemeriksaan radiografi khususnya CT-Scan, dan pemeriksaan laboratorium yang bisa muncul pada neonatus dengan COVID-19. Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu Pubmed, Clinical Key, dan Google Scholar. Kata kunci yang digunakan yaitu Covid-19/ SARS-CoV-2 AND Neonatus AND sign and symptom AND laboratory. Hasil seleksi berdasarkan kriteria inklusi dan ekslusi mendapatkan 15 penelitian case report, tiga retrospective study, satu observational study, dan satu cohort study. Hasil kajian menunjukkan bahwa gambaran klinis yang paling sering muncul ialah demam (54,8%), sesak (35,4%), dan batuk (29%). Pemeriksaan radiografi CT-Scan, neonatus yang tidak menunjukkan kelainan (normal) terdapat pada 14 dari 31 neonatus diamati (45,2%), sedangkan kelainan yang sering muncul ialah ground glass opacity/GGO (29%). Pada pemeriksaan laboratorium, limfopenia merupakan kelainan tersering (32,2%), sedangkan leukositosis, leukopenia, trombositopenia, peningkatan PCT, AST, dll juga bisa terjadi. Dari semua literatur yang dikaji, tidak ditemukan kasus kematian neonatus akibat COVID-19. Simpulan penelitian ini ialah gambaran klinis yang paling sering muncul pada neonatus ialah demam, sesak, dan batuk, limfopenia, dan GGO pada CT-Scan.Kata kunci: COVID-19, neonatus

scholarly journals A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Victoria Blackabey ◽  
Olivia Kenyon ◽  
Rishi Talwar
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Clinical Symptoms ◽  
Symptomatic Relief ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Unusual Presentation ◽  
Sinus Surgery ◽  
Cancer Management ◽  
The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

scholarly journals Virilization in a Girl with Adrenocortical Adenoma: A Case Report

2013 ◽  
Vol 6 (2) ◽  
pp. 70-72
Author(s):  
Tahniyah Haq ◽  
SM Ashrafuzzaman ◽  
Zafar A Latif
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Adrenal Gland ◽  
Ct Scan ◽  
Dehydroepiandrosterone Sulfate ◽  
Adrenocortical Adenoma ◽  
Adrenal Carcinoma ◽  
Mass Size ◽  
The Right ◽  
Androgen Levels

We present a case of Cushing’s syndrome and virilization in a 15 year old girl which was suspected to be due to an adrenal carcinoma. She presented with features of virilization in addition to those of hypercortisilism. Her high androgen levels especially dehydroepiandrosterone sulfate (DHEAS) were also in favor of an adrenal carcinoma. An unenhanced computerized tomography (CT) scan showed a mass (size: 5.3 cm) in the right adrenal gland with a soft tissue intensity of more than 10 HU which was suggestive of adrenal carcinoma. But, histopathology of the resected mass revealed a benign adrenocortical adenoma. DOI: http://dx.doi.org/10.3329/imcj.v6i2.14736 Ibrahim Med. Coll. J. 2012; 6(2): 70-72

Surviving a Self-inflicted Transorbital Pen Intrusion to the Cerebellum: Case Report

2021 ◽  
Author(s):  
David Breuskin ◽  
Ralf Ketter ◽  
Joachim Oertel
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Foreign Bodies ◽  
Routine Procedure ◽  
Low Velocity ◽  
Foreign Objects ◽  
Surgical Exposure ◽  
The Right ◽  
The Brain ◽  
Do So

Abstract Background Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy. Methods We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain. The authors recall the incident and the technique of the pen removal. Results Large surgical exposure of the pen trajectory was considered too traumatic. Therefore, we opted to remove the pen and have an immediate postoperative computed tomography (CT) scan. Due to its fragility, the pen case could only be removed with a screwdriver, inserted into the case. Post-op CT scan showed a small bleeding in the right peduncular region, which was treated conservatively. The patient was transferred back to intensive care unit and woken up the next day. She lost visual function on her right eye, but suffered from no further neurologic deficit. Conclusion Surgical management of removal of intracranial foreign bodies is no routine procedure. Although some would favor a large surgical exposure, we could not think of an approach to do so without maximum surgical efforts. We opted for a minimal surgical procedure with immediate CT scan and achieved an optimal result. We find this case to be worth considering when deciding on a strategy in the future.

scholarly journals Video-Assisted Thoracoscopic Lung Biopsy as a Possible Cause of Acute Interstitial Pneumonia in a Patient with Nonspecific Interstitial Pneumonia

2004 ◽  
Vol 11 (6) ◽  
pp. 437-440 ◽  
Author(s):  
D Jeffrey Moore ◽  
Colm P McParland ◽  
Martin J Bullock ◽  
Yannick Cartier ◽  
Paul Hernandez
Keyword(s):  
Case Report ◽  
Interstitial Pneumonia ◽  
Lung Biopsy ◽  
Diffuse Alveolar Damage ◽  
Usual Interstitial Pneumonia ◽  
High Resolution Computed Tomography ◽  
Present Case Report ◽  
Video Assisted ◽  
Acute Interstitial Pneumonia ◽  
Nonspecific Interstitial Pneumonia

The present case report describes a 44-year-old woman who presented with dyspnea due to diffuse interstitial lung disease. High-resolution computed tomography showed features of usual interstitial pneumonia, but the lung biopsy obtained by video-assisted thoracoscopy was consistent with a histological pattern of nonspecific interstitial pneumonia. Following the procedure, the patient developed progressive respiratory distress and died on postoperative day 13 with a clinical picture of acute interstitial pneumonia. The autopsy showed evidence of diffuse alveolar damage superimposed on the background pattern of nonspecific interstitial pneumonia. The present case report supports the notion that patients with a variety of subtypes of idiopathic interstitial pneumonias may be at risk of exacerbation of their underlying disease following thoracic procedures, including video-assisted thoracoscopic lung biopsy.

scholarly journals Vallecular cyst in an infant with stridor: a case report

2018 ◽  
Vol 6 (1) ◽  
pp. 58-62
Author(s):  
Nabin Lageju ◽  
Rajendra Prasad Sharma Guragain
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Cystic Lesion ◽  
Failure To Thrive ◽  
Surgical Excision ◽  
Infants And Children ◽  
Solid Component ◽  
Feeding Difficulties ◽  
The Right ◽  
In Infants And Children

Background and Objectives: Vallecular cysts are rare and generally asymptomatic. In infants and children they present with stridor, feeding difficulties, failure to thrive. Treatment is surgical excision with cautery or laser.Presentation of Case: We discuss the clinical, radiological presentation of a 7 months old child with vallecular cyst which was surgically treated with deroofing and marsupialisation with elecrocautery. There was no recurrence even up 2 years of follow-up.Discussion: Flexible nasopharyngolaryngoscopic examination was done which showed present of swelling in the left vallecula pushing the epiglottis posteriorly and to the right with narrowed normal endolarynx. Radiological investigations with CT scan showed cystic lesion noted in left side of neck with no septation and solid component. The lesion was extending to ipsilateral vallecula and paraglottic region with narrowing of endolarynx.Conclusion: Vallecular cyst is rare cause of noisy breathing in infants and children. In adults it is usually asymptomatic. Treatment of choice is marsupialization with electrocautery or laser.

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