Erlotinib-Associated Acute Pneumonitis: Report of Two Cases

Two cases of erlotinib-associated acute pneumonitis are described. The first patient was started on erlotinib treatment for metastatic non-small cell lung cancer. The second patient was treated with erlotinib for metastatic adenocarcinoma of unknown origin. Both patients developed dyspnea and hypoxemia five to six days after initiation of erlotinib treatment. In both cases, computed tomography scan of the chest showed extensive bilateral ground-glass infiltrates consistent with pneumonitis. In both patients, acute pneumonitis resulted in respiratory failure requiring intubation and mechanical ventilation. Diffuse alveolar hemorrhage was excluded by bronchoscopy in both cases. Bronchoalveolar lavage cultures were negative. Erlotinib treatment was stopped and both patients were treated with corticosteroids. The first patient improved gradually and finally was discharged to a rehabilitation centre, but unfortunately the second patient died ofKlebsiellasepsis. Naranjo causality scale in both cases suggested a probable association between erlotinib and pneumonitis. Literature on erlotinib-associated pneumonitis is sparse. The clinical presentation and radiographic findings of erlotinib-associated acute pneumonitis are described.

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Non-malignant gall bladder perforation: Our experience from an institution-based retrospective analysis of 25 cases

Tropical Doctor ◽

10.1177/00494755211036593 ◽

2021 ◽

pp. 004947552110365

Author(s):

Abhijeet Kumar ◽

Nirmal Prasad Shah ◽

Narendra Pandit ◽

Suresh Prasad Sah ◽

Rakesh Kumar Gupta ◽

...

Keyword(s):

Computed Tomography ◽

Gall Bladder ◽

Clinical Presentation ◽

Gallbladder Perforation ◽

Type I ◽

Computed Tomography Scan ◽

Duration Of Hospital Stay ◽

Symptoms And Signs ◽

Tomography Scan ◽

Better Than

Gallbladder perforation still continues to perplex surgeons; 25 such patients diagnosed either pre- or intra-operatively and managed at our institute over the last 10 years period were analysed. Only eight were diagnosed pre-operatively, while a large majority (17) had a wrong initial working diagnosis. Symptoms and signs were variable. No blood investigation was specific. A computed tomography scan was generally better than ultrasound in detecting the perforation. All our cases were managed operatively with no mortality and a mean duration of hospital stay of 6.8 days. Most perforations were extra-hepatic (84%) and those of Niemeier’s type I (52.2%). Because of its varied clinical presentation, gallbladder perforation is often an intra-operative diagnosis, but early intervention carries a good outcome.

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Epidemiology, diagnosis, and assessment on non-traumatic subarachnoid haemorrhage

10.1093/med/9780199600830.003.0238 ◽

2016 ◽

Author(s):

Chethan P. Venkatasubba Rao ◽

Jose Ignacio Suarez

Keyword(s):

Subarachnoid Haemorrhage ◽

Clinical Presentation ◽

Severe Headache ◽

Cranial Computed Tomography ◽

Computed Tomography Scan ◽

Neurological Signs ◽

Grading Systems ◽

Traumatic Subarachnoid Haemorrhage ◽

Males And Females ◽

Tomography Scan

Non-traumatic subarachnoid haemorrhage (ntSAH) is a neurological emergency. Clinical presentation is usually with severe headache, with or without abnormal neurological signs on clinical examination. NtSAH affects both males and females from 30 to 70 years, and the incidence increases with age. The incidence varies widely around the world. The gender distribution also varies in different countries, although overall the incidence is higher in women than in men. The commonest cause is rupture of an intracranial aneurysm, accounting for around 80% of cases. Diagnosis is usually by finding blood in the classical subarachnoid distribution on a cranial computed tomography scan. A number of grading systems are used to classify ntSAH.

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Dacryocele in an adult presenting as facial cellulitis

Grande Medical Journal ◽

10.3126/gmj.v1i1.22412 ◽

2019 ◽

Vol 1 (1) ◽

pp. 48-51

Author(s):

Prerana Kansakar ◽

Gangadhara Sundar

Keyword(s):

Clinical Presentation ◽

Computed Tomography Scan ◽

Effective Treatment Option ◽

Silicone Tube ◽

Inferior Meatus ◽

Tender Mass ◽

Silicone Tube Intubation ◽

Painful Mass ◽

Tomography Scan ◽

Medial Canthal Tendon

A 47-year-old male presented with left sided facial cellulitis of one-week duration associated with a painful mass over the left medial canthal area. On examination, there was a firm, tender mass below the medial canthal tendon. Computed tomography scan revealed a bulky, cystic lesion at the left inferomedial orbit and medial maxilla with bony remodeling suggestive of a chronic dacryocele. The patient underwent marsupialization of the dacryocele at the inferior meatus with silicone tube intubation. His symptoms of epiphora resolved after surgery. We describe a rare clinical presentation of dacryocele in an adult and its simple, yet effective treatment option.

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Prospective Comparative Study of Integrated Positron Emission Tomography-Computed Tomography Scan Compared With Remediastinoscopy in the Assessment of Residual Mediastinal Lymph Node Disease After Induction Chemotherapy for Mediastinoscopy-Proven Stage IIIA-N2 Non–Small-Cell Lung Cancer: A Leuven Lung Cancer Group Study

Yearbook of Oncology ◽

10.1016/s1040-1741(08)70402-0 ◽

2007 ◽

Vol 2007 ◽

pp. 174-176

Author(s):

N.H. Hanna

Keyword(s):

Lung Cancer ◽

Mediastinal Lymph Node ◽

Computed Tomography Scan ◽

Small Cell Lung ◽

Stage Iiia ◽

Cancer Group ◽

Positron Emission ◽

Node Disease ◽

Prospective Comparative Study ◽

Tomography Scan

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External auditory canal paraganglioma: an atypical presentation

The Journal of Laryngology & Otology ◽

10.1017/s0022215112002162 ◽

2012 ◽

Vol 126 (12) ◽

pp. 1278-1280 ◽

Cited By ~ 4

Author(s):

N Grover ◽

F Amen ◽

A Gallimore ◽

G Brookes

Keyword(s):

Clinical Diagnosis ◽

External Auditory Canal ◽

Otitis Externa ◽

Clinical Presentation ◽

External Ear ◽

Computed Tomography Scan ◽

Low Threshold ◽

Atypical Presentations ◽

Superior Portion ◽

Tomography Scan

AbstractObjective:We present the first published description of a painful paraganglioma of the external auditory canal. Atypical histopathology made the diagnosis difficult. We discuss the potential pitfalls of clinical diagnosis and treatment of such a case.Clinical presentation:A 49-year-old woman presented with left-sided otalgia, hearing loss and tinnitus. Physical examination revealed a firm swelling arising from the superior portion of the left external auditory canal. A clinical diagnosis of otitis externa was made.Intervention:There was minimal response to medical treatment. The swelling was aspirated, leading to brisk bleeding. A tumour was suspected from the computed tomography scan, and confirmed by a biopsy. The patient underwent excision of the paraganglioma. The histopathology was atypical, making diagnosis difficult.Conclusion:Such unusual masses of the external ear should always be borne in mind, especially when dealing with atypical presentations of commonly encountered diseases. Clinicians should have a low threshold for early intervention with imaging and biopsy.

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Conjunctival metastatic adenocarcinoma of unknown origin

BMJ Case Reports ◽

10.1136/bcr-2016-214501 ◽

2016 ◽

pp. bcr2016214501 ◽

Cited By ~ 1

Author(s):

He J Li ◽

Konstantinos T Tsaousis ◽

Phillip Hoopes ◽

Nick Mamalis

Keyword(s):

Unknown Origin ◽

Metastatic Adenocarcinoma ◽

Adenocarcinoma Of Unknown Origin

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Slow-growing metastatic adenocarcinoma diagnosed via electro-navigational bronchoscopy

Proceedings of Singapore Healthcare ◽

10.1177/2010105820933308 ◽

2020 ◽

Vol 29 (3) ◽

pp. 209-211

Author(s):

Ahmad Adib Mohd Nasir ◽

Mohamed Faisal Abdul Hamid

Keyword(s):

Pulmonary Nodule ◽

Solitary Pulmonary Nodule ◽

Histopathological Examination ◽

Metastatic Adenocarcinoma ◽

Computed Tomography Scan ◽

Growth Increments ◽

Oncology Unit ◽

Slow Growing ◽

Tomography Scan

Here, we describe the case of a 67-year-old man who had been under surveillance for solitary pulmonary nodule for two years and was diagnosed with malignancy via electro-navigational bronchoscopy (ENB). Surveillance computed tomography scan of the thorax showed annual growth increments of the pulmonary nodule. In view of his Brock score showing a 35% probability of malignancy, the patient was subjected to ENB, and metastatic adenocarcinoma from the gastrointestinal tract was diagnosed. ENB was done using a machine on loan from Veran Medical Technologies. The procedure was successful, with no immediate or long-term complications. The diagnosis following histopathological examination was adenocarcinoma, and he was subsequently referred to our oncology unit for further management.

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Clinical and biological characterization of macroprolactinemia with and without prolactin-IgG complexes

Acta Endocrinologica ◽

10.1530/eje.0.1490201 ◽

2003 ◽

pp. 201-207 ◽

Cited By ~ 44

Author(s):

J De Schepper ◽

J Schiettecatte ◽

B Velkeniers ◽

Z Blumenfeld ◽

M Shteinberg ◽

...

Keyword(s):

Clinical Presentation ◽

Biological Characterization ◽

Resonance Imaging ◽

Computed Tomography Scan ◽

Heterogeneous Condition ◽

Pituitary Lesion ◽

Tomography Scan ◽

Precipitation Test

OBJECTIVE: Macroprolactinemia, which can be detected by a polyethylene glycol (PEG) precipitation test, is a clinically and biologically heterogeneous condition. In this study, we analyzed whether the clinical presentation, the hormonal findings and the in vitro lactogenic activity differed between macroprolactinemic patients with and without circulating prolactin (PRL)-IgG complexes. DESIGN: Clinical data were reviewed and additional hormonal studies were performed in 50 hyperprolactinemic patients with macroprolactinemia. METHODS: Macroprolactinemia was identified by a PRL recovery after PEG precipitation of <50%, as measured by an automated commercial immunoassay system and circulating PRL-IgG complexes by an abnormal PRL binding to anti-IgG agarose. RESULTS: PRL-IgG complexes were found in 46 patients. The origin of hyperprolactinemia in these 46 patients was idiopathic in 33 patients, while a pituitary lesion or stalk magnetic resonance imaging or computed tomography scan was detected in 13 patients found compression. Galactorrhea was found in 11 of these 46 patients, while this condition was present in three of the four patients without circulating PRL-IgG complexes. The median free PRL concentration was significantly lower in patients with PRL-IgG complexes than in the group without complexes (243 vs 969 mIU/l; P<0.005), whereas median total PRL immunoreactivity and median PRL bioactivity in the Nb2 assay were not significantly different. In patients with circulating PRL-IgG complexes, Nb2 bioassay results correlated significantly with total PRL immunoreactivity (r=0.64; P<0.0001), but not with free PRL results (r=0.24; P<0.17). CONCLUSIONS: These results indicate that PRL-IgG complexes (i) account for most cases of macroprolactinemia--as identified by PEG precipitation--in hyperprolactinemic patients presenting with a variety of diagnoses, (ii) are not associated with a specific clinical presentation, (iii) can be found in patients with diverse pituitary pathologies, and (iv) possess an in vitro lactogenic activity in the Nb2 bioassay in relation to their immunoreactivity.

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