Fatal congenital lobar emphysema in a puerpera: a case report and literature review

Abstract Background Congenital lobal emphysema (CLE) is a developmental lung abnormality usually diagnosed in the neonatal period and is rarely observed in adults. Adults with CLE are usually asymptomatic and only a small fraction may present with coughing, recurrent pneumonia and respiratory distress. In imaging studies, the most frequently affected lobe of CLE is the left upper lobe, followed by the right middle lobe. However, multilobar involvement with severe mediastinal shift is extremely rare. Case presentation We report a case of fatal CLE in a 28-year-old puerpera with postpartum respiratory failure. Chest computed tomography (CT) revealed emphysema of the right upper, middle and lower lobes resulting in adjacent atelectasis. Hyperinflation of the right upper lobe crossed the midline, leading to a deviation of the mediastinal structure to the left hemithorax and severe compression of the left lung. Conclusions Early and timely diagnosis of CLE with routine follow-up is necessary for patients. CLE, especially with multilobar involvement or mediastinal shift, could be life-threatening and should be promptly and aggressively treated to prevent severe complications.

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Incidental endobronchial hamartoma in a patient with enchondroma

BMJ Case Reports ◽

10.1136/bcr-2019-229670 ◽

2019 ◽

Vol 12 (9) ◽

pp. e229670

Author(s):

Arun Kadamkulam Syriac ◽

Amrit Ved Bhaskarla ◽

Mohamed Elrifai ◽

Abdul H Alraiyes

Keyword(s):

Ct Scan ◽

Argon Plasma Coagulation ◽

Argon Plasma ◽

Mesenchymal Cell ◽

Middle Lobe ◽

Endobronchial Lesion ◽

Right Middle Lobe ◽

Benign Tumours ◽

The Right

Hamartomas are the most common type of benign tumours of the lung, constituting a small portion of all lung neoplasms. Hamartomas are rare benign tumours composed of multiple mesenchymal cell lines. Two clinical types have been defined according to the location: intraparenchymal and endobronchial, more frequently the former. We present a case of endobronchial hamartoma causing significant blockage of the right middle lobe. The finding was incidental on a CT scan of the chest done for staging purposes for a large mixed lytic and sclerotic lesion that was found within the proximal-mid portion of the tibial diaphysis. The endobronchial lesion was removed by hot electrocautery snare during bronchoscopy and identified as a hamartoma. Argon plasma coagulation was applied to the lesion’s base afterwards and the patient was to follow-up in 3 months for a repeat CT scan.

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Congenital lobar emphysema mimicking as persistent pneumonia in a newborn

Clinics and Practice ◽

10.4081/cp.2011.e101 ◽

2011 ◽

Vol 1 (4) ◽

pp. 101 ◽

Cited By ~ 2

Author(s):

Sriparna Basu ◽

Aditya Kumar Gupta ◽

Ashok Kumar

Keyword(s):

Respiratory Distress ◽

Histopathological Examination ◽

Middle Lobe ◽

Congenital Lobar Emphysema ◽

Mediastinal Shift ◽

Common Causes ◽

Lobar Emphysema ◽

Female Baby ◽

The Right ◽

High Index Of Suspicion

Congenital lobar emphysema (CLE) is an uncommon congenital malformation of the lung that can present with respiratory distress in early life. We report a full term female baby who presented with intermittent bluish discoloration of the lips and extremities during crying since birth. An initial diagnosis of left sided collapse-consolidation with right-sided compensatory emphysema was made from chest xray. When no improvement was noted after intravenous antibiotic therapy for 7 days, computerized tomographic scan of thorax was done which showed emphysema of the right middle lobe with transherniation and mediastinal shift to the left. Right middle lobectomy was done and postoperative period was uneventful. Histopathological examination of the specimen confirmed the diagnosis of CLE. CLE can mimic more common causes of respiratory distress in neonatal period and needs a high index of suspicion for diagnosis. Early diagnosis and effective surgical treatment is curative.

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Characteristics of Acute Pulmonary Embolism in Patients With COVID-19 Associated Pneumonia From the City of Wuhan

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029620936772 ◽

2020 ◽

Vol 26 ◽

pp. 107602962093677 ◽

Cited By ~ 6

Author(s):

Jianpu Chen ◽

Xiang Wang ◽

Shutong Zhang ◽

Bin Lin ◽

Xiaoqing Wu ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Laboratory Data ◽

Lower Lobe ◽

Middle Lobe ◽

Imaging Characteristics ◽

Right Middle Lobe ◽

The Right ◽

D Dimer

The aim of this study was to describe clinical, imaging, and laboratory features of acute pulmonary embolism (APE) in patients with COVID-19 associated pneumonia. Patients with COVID-19 associated pneumonia who underwent a computed tomography pulmonary artery (CTPA) scan for suspected APE were retrospectively studied. Laboratory data and CTPA images were collected. Imaging characteristics were analyzed descriptively. Laboratory data were analyzed and compared between patients with and without APE. A series of 25 COVID-19 patients who underwent CTPA between January 2020 and February 2020 were enrolled. The median D-dimer level founded in these 25 patients was 6.06 μg/mL (interquartile range [IQR] 1.90-14.31 μg/mL). Ten (40%) patients with APE had a significantly higher level of D-dimer (median, 11.07 μg/mL; IQR, 7.12-21.66 vs median, 2.44 μg/mL; IQR, 1.68-8.34, respectively, P = .003), compared with the 15 (60%) patients without APE. No significant differences in other laboratory data were found between patients with and without APE. Among the 10 patients with APE, 6 (60%) had a bilateral pulmonary embolism, while 4 had a unilateral embolism. The thrombus-prone sites were the right lower lobe (70%), the left upper lobe (60%), both upper lobe (40%) and the right middle lobe (20%). The thrombus was partially or completely absorbed after anticoagulant therapy in 3 patients who underwent a follow-up CTPA. Patients with COVID-19 associated pneumonia have a risk of developing APE during the disease. When the D-dimer level abnormally increases in patients with COVID-19 pneumonia, CTPA should be performed to detect and assess the severity of APE.

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Bronchobiliary fistula: a rare postoperative complication of spilled gallstones from laparoscopic cholecystectomy

BMJ Case Reports ◽

10.1136/bcr-2021-243198 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243198

Author(s):

Nanditha Guruvaiah ◽

Janardhana Ponnatapura

Keyword(s):

Laparoscopic Cholecystectomy ◽

Bronchial Tree ◽

Middle Lobe ◽

High Morbidity ◽

Quadrant Pain ◽

Bronchobiliary Fistula ◽

Recurrent Pneumonia ◽

History Of ◽

Right Middle Lobe ◽

The Right

Bronchobiliary fistula (BBF) is defined as the abnormal connection between the biliary system and the bronchial tree, which presents clinically as an irritant cough with bilioptysis. Many conditions can lead to its development. We present a case of an acquired BBF in a 61-year-old man with a significant history of spilled gallstones from a prior laparoscopic cholecystectomy and subsequent presentation of intermittent right upper quadrant pain and recurrent pneumonia. Imaging studies revealed a liver and subdiaphragmatic abscess with right middle lobe pneumonia and a BBF traversing the right hemidiaphragm. The patient was surgically managed by takedown of fistula with drainage of the abscess and removal of spilled gallstone, followed by a resection of the right middle lobe. While previous studies indicate spilled gallstones are benign, this case demonstrates its potential for serious complications. Therefore, early diagnosis and proper management is essential as BBF has a high morbidity and mortality rate.

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Multifocal Pulmonary Granular Cell Tumor Presenting with Postobstructive Pneumonia

Case Reports in Pulmonology ◽

10.1155/2017/8513702 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Samid M. Farooqui ◽

Muhammad S. Khan ◽

Laura Adhikari ◽

Viral Doshi

Keyword(s):

Granular Cell Tumor ◽

Main Bronchus ◽

Granular Cell ◽

Middle Lobe ◽

Cell Tumor ◽

Diagnostic Challenge ◽

Right Middle Lobe ◽

The Right ◽

Lost To Follow Up

Granular cell tumor (GCT) is a neoplasm of Schwann cell origin. Its presence in the aerodigestive tract is uncommon and becomes a diagnostic challenge on initial presentation. Our case is of a 59-year-old woman who presented to the emergency department with a history of productive cough and dyspnea associated with fever and chest pain. An initial chest X-ray (CXR) showed a right middle lobe consolidation with follow-up Computed Tomography (CT) scan showing a mass in the right bronchus. Bronchoscopy revealed a polypoid, sessile granular mass in the right bronchus intermedius with multiple white lesions in trachea, left main bronchus, and right upper bronchi. Histology revealed a benign GCT. Bronchoalveolar lavage from the right middle lobe grew Streptococcus pneumoniae. Patient was treated with intravenous levofloxacin during hospital stay and discharged on a 7-day course of oral antibiotics to be followed as outpatient but was lost to follow-up. GCT can present as a polypoid tumor causing recurrent postobstructive pneumonia. Surgical resection is the most successful treatment option. The tumor is more common in third and fourth decade of life and our patient is the oldest patient, according to our knowledge, to have a GCT.

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Endometriosis of the Lung: Case Report and Literature Review

10.21203/rs.3.rs-141435/v1 ◽

2021 ◽

Author(s):

Jin Yao ◽

Hong Zheng ◽

Hui Nie ◽

Jia-jia Huang ◽

Na Tan ◽

...

Keyword(s):

Case Reports ◽

Treatment Options ◽

Middle Lobe ◽

Thoracic Drainage ◽

Pulmonary Endometriosis ◽

Lower Lung ◽

Right Middle Lobe ◽

Gynecological Disease ◽

The Right

Abstract Background: Lung endometriosis is an extremely rare gynecological disease. Literature reports suggest that most patients will show generic symptoms such as hemoptysis, pneumothorax, and hemopneumothorax, which can often result in misdiagnosis. There are case reports of 18 patients with lung endometriosis describing clinical manifestation, imaging changes, treatment and prognosis. To provide further information on this rare disease, we present a case of pulmonary endometriosis and a review of lung endometriosis.Case presentation: We report on a 19-year-old female who was admitted to hospital due to repeated menstrual hemoptysis for 3 months. Computed tomography during menstruation showed patchy high-density shadows sized approximately 0.5 cm × 0.5 cm × 0.5 cm in the right middle lobe of the lung. Following menstruation, hemoptysis and changes on CT imaging disappeared. Thoracoscopic right middle lobectomy, right lower lung repair, and closed thoracic drainage were performed. Postoperative histopathology confirmed lung endometriosis. There was no recurrence of symptoms after 6 months of follow-up. Conclusions: We review the literature on factors associated with lung endometriosis, diagnosis, and treatment options. We propose that the diagnosis for lung endometriosis should be made by comprehensively integrating patient reproductive history, clinical and imaging details as well as histopathology. Surgical resection appears to be an effective treatment for lung endometriosis.

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Endometriosis of the lung: case report and literature review

10.21203/rs.3.rs-135229/v1 ◽

2020 ◽

Author(s):

Jin Yao ◽

Hong Zheng ◽

Hui Nie ◽

Jiajia Huang ◽

Na Tan ◽

...

Keyword(s):

Case Reports ◽

Treatment Options ◽

Middle Lobe ◽

Thoracic Drainage ◽

Pulmonary Endometriosis ◽

Lower Lung ◽

Right Middle Lobe ◽

Gynecological Disease ◽

The Right

Abstract Background:Lung endometriosis is an extremely rare gynecological disease. Literature reports suggest that most patients will show generic symptoms such as hemoptysis, pneumothorax, and hemopneumothorax, which can often result in misdiagnosis. There are case reports of 18 patients with lung endometriosis describing clinical manifestation, imaging changes, treatment and prognosis. To provide further information on this rare disease, we present a case of pulmonary endometriosis and a review of lung endometriosis.Case presentation:We report on a 19-year-old female who was admitted to hospital due to repeated menstrual hemoptysis for 3 months. Computed tomography during menstruation showed patchy high-density shadows sized approximately 0.5 cm × 0.5 cm × 0.5 cm in the right middle lobe of the lung. Following menstruation, hemoptysis and changes on CT imaging disappeared. Thoracoscopic right middle lobectomy, right lower lung repair, and closed thoracic drainage were performed. Postoperative histopathology confirmed lung endometriosis. There was no recurrence of symptoms after 6 months of follow-up. Conclusions: We review the literature on factors associated with lung endometriosis, diagnosis, and treatment options. We propose that the diagnosis for lung endometriosis should be made by comprehensively integrating patient reproductive history, clinical and imaging details as well as histopathology. Surgical resection appears to be an effective treatment for lung endometriosis.

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Relationships between pulmonary function test parameters and quantitative computed tomography measurements of emphysema in subjects with chronic obstructive pulmonary disease

Acta medica Lituanica ◽

10.6001/actamedica.v24i4.3616 ◽

2018 ◽

Vol 24 (4) ◽

pp. 209-218

Author(s):

Virginija Šileikienė ◽

Marius Urbonas ◽

Mindaugas Matačiūnas ◽

Jolita Norkūnienė

Keyword(s):

Pulmonary Function ◽

Pulmonary Function Tests ◽

Left Lung ◽

Middle Lobe ◽

Quantitative Ct ◽

Ct Measurements ◽

Function Tests ◽

Test Parameters ◽

Right Middle Lobe ◽

The Right

Objective. CT is able to precisely define the pathological process in COPD. There are a number of previous articles discussing the distribution of emphysema and its connection with pulmonary function tests. However, the results obtained by the researchers are not identical. Purpose. To assess relationships between emphysema and pulmonary function test parameters in COPD patients. Materials and methods. Fifty-nine patients diagnosed to have COPD underwent chest CT examinations and pulmonary function tests. For the quantitative assessment, percentages of low attenuation volume LAV950 HU (%) of a both lungs, the right lung, the left lung, and each lobe were obtained. Quantitative CT measurements were compared with forced expiratory volume in 1 s (FEV1), the ratio of FEV1 to forced vital capacity (FEV1/FVC), the diffusing capacity for carbon monoxide (DLco) and total lung capacity (TLC). Results. Except for the right middle lobe and the right upper lobe, respectively, all the quantitative CT measurements showed weak to moderate negative correlations with diffusing capacity (DLco) (r = –0.35 to –0.61, p < 0.05) and weak positive correlations with TLC (r = 0.34 to 0.44, p < 0.05). Group analysis indicated that LAV–950 HU (%) values of both lungs, right lung, left lung, and each lobe, except for right middle lobe, were increased in patients with GOLD stages 3 and 4 of COPD compared to GOLD stages 1 and 2 (p < 0.05). Conclusion. CT measurements of emphysema are significantly related to pulmonary function tests results, particularly DLco.

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CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

Neurologico Spinale Medico Chirurgico ◽

10.15562/nsmc.v1i4.131 ◽

2019 ◽

Vol 1 (4) ◽

Author(s):

Yustinus Robby Budiman Gondowardojo ◽

Tjokorda Gde Bagus Mahadewa

Keyword(s):

Spinal Cord ◽

Left Lung ◽

Lumbar Vertebrae ◽

Compression Fracture ◽

High Mobility ◽

Early Mobilization ◽

Cord Injury ◽

Cardiothoracic Surgeon ◽

The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

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Peritoneal well-differentiated papillary mesothelioma associated with infertility in a 37-year-old woman

Journal of International Medical Research ◽

10.1177/0300060520986680 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098668

Author(s):

Bo Pang ◽

Cong Hu ◽

Qian Liu ◽

Jinyu Yu ◽

Zhentong Wei ◽

...

Keyword(s):

Benign Tumors ◽

Free Fluid ◽

Adenomatoid Tumor ◽

Cancer Antigen 125 ◽

Immunohistochemical Markers ◽

Serum Ca125 ◽

Life Threatening ◽

Well Differentiated ◽

The Right

Well-differentiated papillary mesothelioma (WDPM) is an uncommon mesothelial tumor. The lesions may be single or multiple and usually behave in a benign or indolent fashion, sometimes persisting for many years. In the present case, a 37-year-old woman had experienced primary infertility for 12 years, and a diagnostic laparoscopy was performed. Approximately 200 mL of dark red, free fluid in the pelvis and more than 10 yellow-white nodules on the surface of the right round ligament, sacrum ligament, right fallopian tube, and both sides of the uterus were found. A lesionectomy was performed and immunohistochemical markers indicated WDPM with adenomatoid tumor. The patient was monitored by computed tomography and serum CA125 (cancer antigen 125) levels for 49 months with no recurrence. WDPM and adenomatoid tumor are both benign tumors of mesothelial origin. Because of the lack of effective radical treatment, regular follow-up is sufficient. However, the effects of estrogen and progesterone on WDPM and adenomatoid tumors during ovulation or pregnancy remains unclear. Although WDPM is not life threatening, a strategy to fulfill the fertility requirements of women with this condition is a new challenge for infertility doctors.

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