scholarly journals Atypical Sjögrenʼs Syndrome Initially Presenting as Lymphocytic Interstitial Pneumonitis followed by Immune Thrombocytopenia

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Maham Mehmood ◽  
Abhishrut Jog ◽  
Masooma Niazi ◽  
Arlene Tieng ◽  
Giovanni Franchin
Keyword(s):  
Computed Tomography ◽  
Platelet Count ◽  
Interstitial Pneumonitis ◽  
Immune Thrombocytopenia ◽  
Lower Lobe ◽  
Empiric Antibiotic Therapy ◽  
Rare Presentation ◽  
Chest Computed Tomography ◽  
Extraglandular Manifestations ◽  
Breath Sounds

Background. Sjögrenʼs syndrome is an autoimmune disease characterized primarily by decreased exocrine gland function leading to eye and mouth dryness. Extraglandular manifestations occur less frequently. Case Report. A 74-year-old man with hypertension was admitted with productive cough and fever. On physical examination, he had bilateral lower lung decreased breath sounds. A chest radiograph showed bibasilar patchy infiltrate. Laboratory studies revealed hemoglobin of 11.9 g/dL, white blood cell count of 16,000/uL, and platelet count of 250,000/uL. Empiric antibiotic therapy was begun for suspected community acquired pneumonia, and then he was discharged home. However, his cough recurred. Chest computed tomography demonstrated adenopathy throughout the mediastinum and multiple ill-defined patchy groundglass opacities with a lower lobe prominence. He underwent a transbronchial biopsy to rule out malignancy; however, it showed lymphocytic interstitial pneumonitis. Antinuclear antibody was 1 : 80 homogeneous, and anti-SSA antibody was 6.3 AI (normal <1.0 AI). The patient was treated with prednisone 20 mg/day with marked improvement in his symptoms. Repeat chest computed tomography showed decreased groundglass opacities and decreased mediastinal lymph nodes. After more than a year, he was readmitted due to petechiae on his buccal mucosa and a platelet count of 2000/μL. The patient was started on prednisone 80 mg/d and intravenous immunoglobulin 80 g/d for 2 consecutive days. The platelet count eventually increased to 244,000/μL. Conclusion. We report a rare presentation of Sjogrenʼs syndrome manifesting as acute lymphocytic interstitial pneumonitis and followed by immune thrombocytopenia. Both extraglandular manifestations responded well to corticosteroid therapy.

scholarly journals Bronchial Leech Infestation in a 15-Year-Old Female

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mohammad Ashkan Moslehi ◽  
Mohammad Hadi Imanieh ◽  
Ali Adib
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Young Children ◽  
Lower Lobe ◽  
Foreign Body Aspiration ◽  
Ground Glass ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

Foreign body aspiration (FBA) is a common incidence in young children. Leeches are rarely reported as FBA at any age. This study describes a 15-year-old female who presented with hemoptysis, hematemesis, coughs, melena, and anemia seven months prior to admission. Chest X-ray showed a round hyperdensity in the right lower lobe. A chest computed tomography (CT) demonstrated an area of consolidation and surrounding ground glass opacities in the right lower lobe. Hematological investigations revealed anemia. Finally, bronchoscopy was performed and a 5 cm leech was found within the rightB7-8bronchus and removed by forceps and a Dormia basket.

Adenocarcinoma in pulmonary sequestration

2011 ◽  
Vol 19 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Lukman Lawal ◽  
Dimitrios Mikroulis ◽  
Savvas Eleftheriadis ◽  
Panagiotis Karros ◽  
Ioannis Bougioukas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Fluid Level ◽  
Male Smoker ◽  
Recurrent Pneumonia ◽  
Chest Computed Tomography ◽  
Lower Lobectomy ◽  
Intralobar Sequestration

A 67-year-old male smoker presented with hemoptysis and recurrent pneumonia. Chest computed tomography showed an emphysematous cyst and air-fluid level cavities in the left lower lobe. A left lower lobectomy was performed. The intraoperative finding was intralobar sequestration. Histopathology revealed adenocarcinoma within the sequestrated lobe. Only 8 cases of lung cancer and sequestration have been reported since 1963.

scholarly journals High aspartate aminotransferase to alanine aminotransferase ratio on admission as risk factor for poor prognosis in COVID-19 patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cheng Qin ◽  
Yingxin Wei ◽  
Xiaoyu Lyu ◽  
Bangbo Zhao ◽  
Yunlu Feng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Factor ◽  
Platelet Count ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Poor Prognosis ◽  
Independent Risk Factor ◽  
Chest Computed Tomography ◽  
Severity Scores ◽  
Laboratory Results

Abstract This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Death was regarded as poor prognosis in this study. Of 567 patients, 200 (35.3%) had AST/ALT ≥ 1.38. Of the 200 patients, older age (median age 60 years), myalgia (64 [32%] cases), fatigue (91 [45.5%] cases), some comorbidities and outcomes were significantly different from patients with AST/ALT < 1.38. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR 0.995, 95% CI [0.992–0.998]) and hemoglobin (OR 0.984, 95% CI [0.972–0.995]) were independently associated with AST/ALT ≥ 1.38 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR 99.9, 95% CI [2.1–4280.5]). In subsequent monitoring, both survivors and non-survivors showed decreased AST/ALT ratio during hospitalization. In conclusion, high AST/ALT ratio might be the indication of worse status and outcomes in COVID-19 patients.

scholarly journals High Aspartate Aminotransferase to Alanine Aminotransferase Ratio on Admission as Risk Factor for Poor Prognosis in COVID-19 Patients

2020 ◽  
Author(s):  
Cheng Qin ◽  
Yingxin Wei ◽  
Xiaoyu Lyu ◽  
Bangbo Zhao ◽  
Yunlu Feng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Factor ◽  
Platelet Count ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Poor Prognosis ◽  
Independent Risk Factor ◽  
Chest Computed Tomography ◽  
Severity Scores ◽  
Laboratory Results

Abstract This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Poor prognosis included death and transfer to other hospitals due to deterioration. Of 567 patients, 56 (9.9%) had AST/ALT ≥ 2. Of the 56 patients, older age (median age 65.5 years), fatigue (29 [51.8%] cases), comorbidities (33 [58.9%] cases) and outcomes were significantly different from patients with AST/ALT < 2. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR = 0.989, 95% CI [0.983-0.996]) were independently associated with AST/ALT ≥ 2 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR = 22.02, 95% CI [1.84-263.2]), especially in patients with AST levels > 40 U/L. In subsequent monitoring, the AST/ALT ratio was decreased in both patients with AST/ALT < 2 or ≥ 2 on admission. COVID-19 patients who are older, or have fatigue, comorbidities are more likely to have AST/ALT ≥ 2 on admission, which might be the indication of worse status and outcomes.

scholarly journals Uniportal video-assisted thoracic surgery and perioperative pirfenidone for lung cancer and idiopathic pulmonary fibrosis: a case report

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110169
Author(s):  
Ayae Saiki ◽  
Teruaki Mizobuchi ◽  
Kaoru Nagato ◽  
Fumihiro Ishibashi ◽  
Junichi Tsuyusaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Primary Lung Cancer ◽  
Lung Cancer Surgery ◽  
Lower Lobe ◽  
Chest Computed Tomography ◽  
Video Assisted ◽  
Acute Exacerbations

Patients with idiopathic pulmonary fibrosis (IPF) occasionally experience acute exacerbations after surgery for lung cancer. Several recent studies have revealed a prophylactic effect of perioperative pirfenidone treatment on postoperative acute exacerbations of IPF in patients with lung cancer. A 75-year-old woman consulted with her pulmonologist because of an IPF shadow detected by follow-up chest computed tomography 2 months after surgical treatment of biliary cancer. Another 7 months later, chest computed tomography showed a 23- × 14-mm nodule located in the right lower lobe with high accumulation of fluorodeoxyglucose detected by positron emission tomography, resulting in a radiological diagnosis of primary lung cancer with IPF. We administered perioperative pirfenidone treatment followed by right lower lobectomy using uniportal video-assisted thoracoscopic surgery after attaining a pathological diagnosis of adenocarcinoma. The patient developed no acute exacerbations of IPF during the postoperative period, and she had no recurrence of lung cancer for 15 months after surgery. We successfully used a combination of perioperative antifibrotic medication and minimally invasive surgery after lung cancer surgery in a patient with IPF.

scholarly journals Successful management of acquired left bronchial stenosis caused by massive atelectasis

2019 ◽  
Vol 7 ◽  
pp. 2050313X1983817
Author(s):  
Jun Miyahara ◽  
Taku Ohhashi ◽  
Hideyuki Nakashima ◽  
Hiroshi Sugiura ◽  
Shigeru Ohki
Keyword(s):  
Computed Tomography ◽  
Respiratory Failure ◽  
Gastroesophageal Reflux ◽  
Conservative Management ◽  
Lower Lobe ◽  
Male Infant ◽  
Chest Physiotherapy ◽  
Bronchial Stenosis ◽  
Successful Management ◽  
Chest Computed Tomography

Acquired bronchial stenosis is rare in children, usually caused by infection or traumatic granuloma due to chronic intubation. A case of severe acquired left bronchial stenosis successfully treated by conservative management for gastroesophageal reflux and atelectasis is reported. A male infant born at 24 weeks’ gestation, weighing 461 g, presented with massive atelectasis of the left lower lobe and severe left bronchial stenosis, based on chest computed tomography performed for the evaluation of respiratory failure at the age of 8 months. He responded well to the placement of a duodenal tube for gastroesophageal reflux and chest physiotherapy, reducing the symptoms of atelectasis and successfully managing the left bronchial stenosis. Acquired bronchial stenosis could be caused by bronchial shift due to atelectasis, and it can be cured by conservative management. In cases of acquired bronchial stenosis with massive atelectasis, it is important to consider atelectasis as a potential cause of the acquired bronchial stenosis.

scholarly journals A case of an endobronchial metastasis from an endometrial carcinoma

2019 ◽  
Vol 7 ◽  
pp. 2050313X1882390
Author(s):  
Chan-Hee Lee ◽  
Hyun Jung Kim ◽  
Chi-Heum Cho ◽  
IlSeon Hwang
Keyword(s):  
Computed Tomography ◽  
Endometrial Carcinoma ◽  
Lower Lobe ◽  
Serous Carcinoma ◽  
Lobe Bronchus ◽  
Chest Computed Tomography ◽  
Endobronchial Metastasis ◽  
Positron Emission ◽  
Lung Malignancy ◽  
The Right

A 73-year-old woman was referred to the pulmonology department for abnormal findings on chest computed tomography. She had undergone a laparoscopic staging operation including a hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic node and para-aortic node dissection, and concurrent chemo-radiation therapy for endometrial serous carcinoma stage IIIc cancer 15 months earlier. A follow-up chest computed tomography after the chemotherapy showed that the right lower lobe bronchus was obstructed, and it was necessary to differentiate a primary lung malignancy from a metastasis and secretion. A positron emission tomography revealed an intense hypermetabolic nodule in the right lower lobe bronchus and diffuse hypometabolism of the right lower lobe lung. Bronchoscopy revealed a tumor mass obstructing the right lower lobe bronchus, and an endobronchial biopsy confirmed a metastatic serous carcinoma from the endometrium. We described an endobronchial metastasis from an endometrial carcinoma with various diagnostic images and histology. To the best of our knowledge, this is the first report of an endobronchial metastasis from an endometrial carcinoma in Korea.

scholarly journals Chest computed tomography (CT) scan findings in patients with COVID-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Mohammad Karimian ◽  
Milad Azami
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Meta Analysis ◽  
Lower Lobe ◽  
Chest Ct ◽  
Transformation Rule ◽  
Cochrane Library ◽  
Final Report ◽  
Chest Computed Tomography ◽  
Chest Ct Scan

AbstractObjectivesNumerous cases of pneumonia of caused by coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. Chest computed tomography (CT) scan is highly important in the diagnosis and follow-up of lung disease treatment. The present meta-analysis was performed to evaluate chest CT findings in COVID-19 patients.Materials and MethodsAll research steps were taken according to the MOOSE protocol and the final report was based on PRISMA guidelines. Each stage of the study was conducted by two independent authors. We searched the Web of Science, Ovid, Science Direct, Scopus, EMBASE, PubMed/Medline, Cochrane Library, EBSCO, CINAHL and Google scholar databases. The search was conducted on March 20, 2020. Grey literature was searched at medrxiv website. All analyses were performed using Comprehensive Meta-Analysis. The adapted Newcastle Ottawa Scale was used to evaluate the risk of bias. We registered this review at PROSPERO (registration number: CRD42019127858).ResultsFinally, 40 eligible studies with 4,183 patients with COVID-19 were used for meta- analysis. The rate of positive chest CT scan in patients with COVID-19 was 94.5% (95%CI: 91.7-96.3). Bilateral lung involvement, pure ground-glass opacity (GGO), mixed (GGO pulse consolidation or reticular), consolidation, reticular, and presence of nodule findings in chest CT scan of COVID-19 pneumonia patients were respectively estimated to be 79.1% (95% CI: 70.8- 85.5), 64.9% (95%CI: 54.1-74.4), 49.2% (95%CI: 35.7-62.8), 30.3% (95%CI: 19.6-43.6), 17.0% (95%CI: 3.9-50.9) and 16.6% (95%CI: 13.6-20.2). The distribution of lung lesions in patients with COVID-19 pneumonia was peripheral (70.0% [95%CI: 57.8-79.9]), central (3.9% [95%CI: 1.4-10.6]), and peripheral and central (31.1% [95%CI: 19.5-45.8]). The most common pulmonary lobes involved were right lower lobe (86.5% [95%CI: 57.7-96.8]) and left lower lobe (81.0% [95%CI: 50.5-94.7]).ConclusionOur study showed that chest CT scan has little weakness in diagnosis of COVID-19 combined to personal history, clinical symptoms, and initial laboratory findings, and may therefore serve as a standard method for diagnosis of COVID-19 based on its features and transformation rule, before initial RT-PCR screening.

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