Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: a case report and review of the literature

Abstract Background Primary spontaneous pneumothorax is a common disorder occurring in young adults without underlying lung disease. Although tobacco smoking is a well-documented risk factor for spontaneous pneumothorax, an association between electronic cigarette use (that is, vaping) and spontaneous pneumothorax has not been noted. We report a case of spontaneous pneumothoraces correlated with vaping. Case presentation An 18-year-old Caucasian man presented twice with recurrent right-sided spontaneous pneumothoraces within 2 weeks. He reported a history of vaping just prior to both episodes. Diagnostic testing was notable for a right-sided spontaneous pneumothorax on chest X-ray and computed tomography scan. His symptoms improved following insertion of a chest tube and drainage of air on each occasion. In the 2-week follow-up visit for the recurrent episode, he was asymptomatic and reported that he was no longer using electronic cigarettes. Conclusions Providers and patients should be aware of the potential risk of spontaneous pneumothorax associated with electronic cigarettes.

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Lingual Dystonia Treated with Botulinum Toxin - A Case Report

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v24i2.152 ◽

1970 ◽

Vol 24 (2) ◽

pp. 75-78

Author(s):

MA Hayee ◽

QD Mohammad ◽

H Rahman ◽

M Hakim ◽

SM Kibria

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin A ◽

Botulinum Toxin Type A ◽

Botulinum Toxin Type ◽

X Ray ◽

Medical College ◽

Lingual Dystonia ◽

History Of ◽

Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

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Urinothorax Caused by Xanthogranulomatous Pyelonephritis

Case Reports in Pulmonology ◽

10.1155/2018/7976839 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Waiel Abusnina ◽

Hazim Bukamur ◽

Zeynep Koc ◽

Fauzi Najar ◽

Nancy Munn ◽

...

Keyword(s):

Urinary Tract ◽

Obstructive Uropathy ◽

Xanthogranulomatous Pyelonephritis ◽

Robot Assisted ◽

Rare Form ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Tract Infections

Xanthogranulomatous pyelonephritis is a rare form of chronic pyelonephritis that generally afflicts middle-aged women with a history of recurrent urinary tract infections. Its pathogenesis generally involves calculus obstructive uropathy and its histopathology is characterized by replacement of the renal parenchyma with lipid filled macrophages. This often manifests as an enlarged, nonfunctioning kidney that may be complicated by abscess or fistula. This case details the first reported case of xanthogranulomatous pyelonephritis complicated by urinothorax, which resolved on follow-up chest X-ray after robot-assisted nephrectomy.

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Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.817 ◽

2019 ◽

Vol 7 (19) ◽

pp. 3262-3264

Author(s):

Taher Felemban ◽

Abdullah Ashi ◽

Abdullah Sindi ◽

Mohannad Rajab ◽

Zuhair Al Jehani

Keyword(s):

Laryngeal Carcinoma ◽

Incidental Finding ◽

Chain Reaction ◽

Rare Presentation ◽

Case Presentation ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Polymerase Chain ◽

Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

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Unilateral Right Exophthalmia Revealing Systemic Sarcoidosis: A Case Report and a Review of the Literature

EMJ Respiratory ◽

10.33590/emjresp/19-00088 ◽

2019 ◽

Author(s):

Sophia Bania

Keyword(s):

Ct Scan ◽

Exceptional Case ◽

Mediastinal Lymphadenopathy ◽

Case Presentation ◽

X Ray ◽

Caseous Necrosis ◽

History Of ◽

Chest X Ray ◽

Systemic Sarcoidosis

Background: Sarcoidosis is only revealed in 3% of the cases among Caucasians by ophthalmic damage and, when it does, it presupposes that the visceral impairment has remained silent so far. In this article, the exceptional case of a patient with systemic sarcoidosis revealed by unilateral exophthalmia is reported. Case presentation: The patient is a female with no history of substantial pathology. She had a unilateral right exophthalmia and ptosis evolving over 3 years. A dyspnea and dry cough were also reported with a duration of 1 year. The chest X-ray and CT scan revealed bilateral hilar opacities and mediastinal lymphadenopathy that lead to the suspicion of sarcoidosis. The cerebro-orbital CT scan led to the classification of the patient’s exophthalmia as Grade I and eliminated the possibility of other aetiologies. The mediastinoscopy indicated a granulomatous adenitis with no caseous necrosis, which allowed the diagnosis of a mediastinopulmonary sarcoidosis. Discussion and conclusion: The diagnostic approach to exophthalmia should involve a systematic search for sarcoidosis, although this aetiology remains exceptional.

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CT abdomen only for active surveillance in patient with stage I germ cell tumor.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e17064 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e17064-e17064

Author(s):

Hamed Ahmadi ◽

Anne K. Schuckman ◽

Sumeet Bhanvadia ◽

Hooman Djaladat ◽

Siamak Daneshmand

Keyword(s):

Ct Scan ◽

Tumor Markers ◽

Active Surveillance ◽

Physical Exam ◽

Stage I ◽

Clinical Recurrence ◽

X Ray ◽

History Of ◽

Chest X Ray

e17064 Background: Surveillance of stage I GCTs includes periodic imaging of chest, abdomen and pelvis. Currently the AUA guidelines recommends CT scan of the abdomen with or without the pelvis as well as chest x ray during active surveillance for these patients. Efforts to modify the surveillance protocols aim to minimize radiation exposure in this young patient population. Per our institutional protocol, we limit cross sectional imaging to CT of the abdomen only during surveillance of stage I disease. Here we report our outcomes to determine whether any recurrence was missed or delayed based on this protocol. Methods: All patient with clinical stage I GCT who have been under active surveillance and completed at least 2 year follow up at our institution were selected using our institutional testis cancer database. Clinical and demographic information were reviewed including recurrence pattern and tumor marker status at time of recurrence. Results: A total of 89 patients who had complete follow up information in the database were included in the study. 49/89 (55%) patients had non-seminoma or mixed GCT histology. 5/89 (5%) patients had history of cryptorchidism and 16/89 (18%) patients had history of inguinal surgery. 14/89 (15%) had relapse at a median of 6.8 months. Recurrence was first detected on surveillance imaging (Imaging recurrence) in 11/14 (78%), by rising tumor markers (marker recurrence) in 2/14 (14%), and on physical exam (clinical recurrence) in 1/14 (7%) patients. Of patients with marker or clinical recurrence, only one had evidence of retroperitoneal recurrence which was detectable by CT abdomen and the other two had lung metastasis detected by chest X ray. Only one patient with imaging recurrence had pelvic lymphadenopathy which was large enough to be seen on CT abdomen. Conclusions: CT scan of the abdomen only in combination with chest imaging, tumor markers and physical exam detected 100% of recurrences in this series. CT pelvis can be safely omitted during active surveillance of stage I GCT. Future modification in guidelines for surveillance protocols of stage I GCT may be warranted with further mounting evidence.

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Bilateral spontaneous chylothorax presenting as a left-sided neck mass

BMJ Case Reports ◽

10.1136/bcr-2020-240320 ◽

2021 ◽

Vol 14 (4) ◽

pp. e240320

Author(s):

Sarah Akbar ◽

Rajeev Advani ◽

Rohini Aggarwal

Keyword(s):

Soft Tissues ◽

Anterior Chest Wall ◽

Neck Mass ◽

Ct Scans ◽

X Ray ◽

Low Fat Diet ◽

History Of ◽

Chest X Ray ◽

Inflammatory Changes

A previously well 36-year-old woman presented with a 2-day history of a tender left-sided neck mass associated with left-sided otalgia and odynophagia. On examination, there was a diffuse, tender swelling of the left anterior triangle of the neck with extension onto the anterior chest wall. Ultrasound and CT scans of the neck revealed extensive inflammatory changes in the soft tissues of the neck and a chest X-ray showed blunting of both costophrenic angles. A diagnostic pleural aspiration was subsequently performed and yielded chyle. The patient was commenced on total parenteral nutrition and placed on a low-fat diet; symptoms completely resolved within 5 days, and at follow-up at 6 weeks, there were no further episodes or complications. Bilateral spontaneous chylothorax is a rarely reported phenomenon in the literature; it has been reported in females following the possibility of minor physical exercise such as stretching or hyperextension of the neck.

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An Unusual Histology for a Lung Nodule: A Case Report of Primary Pulmonary Paraganglioma

Frontiers in Surgery ◽

10.3389/fsurg.2021.688236 ◽

2021 ◽

Vol 8 ◽

Author(s):

Alessandra Mazzucco ◽

Eleonora Poirè ◽

Andrea Leporati ◽

Matteo Chiari ◽

Laura Moneghini ◽

...

Keyword(s):

Clinical Presentation ◽

Histopathological Examination ◽

Incidental Finding ◽

Lung Nodule ◽

Pulmonary Tissue ◽

Case Presentation ◽

X Ray ◽

Asymptomatic Patients ◽

Chest X Ray

Introduction: Primary pulmonary paraganglioma is a rare tumor with few cases reported in literature and unspecific clinical presentation.Case Presentation: A 49-year-old woman presented to our department with an incidental finding of a pulmonary mass at chest X-ray and no associated clinical symptom. The CT scan and the FDG-PET showed mild uptake of contrast, but a definitive diagnosis was only possible after surgery through histopathological examination.Conclusion: Paragangliomas originating in the pulmonary tissue are generally non-functioning masses discovered incidentally in otherwise asymptomatic patients. Surgery appears to be the best treatment option, with only radiologic follow-up necessary afterwards.

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"Stray" achalasia: From gastroenterologist to pulmonologist and back

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1602085o ◽

2016 ◽

Vol 144 (1-2) ◽

pp. 85-89

Author(s):

Dusanka Obradovic ◽

Biljana Joves-Sevic ◽

Milos Stojanovic ◽

Miroslav Ilic ◽

Igor Ivanov

Keyword(s):

Correct Diagnosis ◽

Gastrointestinal Symptoms ◽

Computed Tomography Scan ◽

X Ray ◽

Chest X Ray ◽

Pulmonary Infiltration ◽

Fluid Levels ◽

Tomography Scan ◽

Frequent Presence

Introduction. Achalasia is a rare esophageal disorder which, due to frequent presence of both respiratory and gastrointestinal symptoms, can initially be referred either to pulmonologist or gastroenterologist. Case Outline. A 50-year-old patient was initially referred to gastroenterologist with the following symptoms: nausea, vomiting, occasional hiccups, weight loss, chest pain, dysphonia, and dry cough. After chest X-ray, the patient was referred to pulmonologist with differential diagnosis for pulmonary infiltration and thoracic aortic aneurysm. Pulmonologist interpreted chest X-ray as showing paratracheal mediastinal enlargement with air-fluid levels, thus suspecting achalasia. Computed tomography scan of the thorax with per os contrast showed extremely dilated esophagus with food stasis. The patient was then referred to thoracic surgeon, who ordered additional diagnostics (esophageal passage with contrast, esophagomanometry, esophagogastroduodenoscopy), and finally performed Heller myotomy. Postoperatively there were no complications, and the patient was symptom free during the follow-up. Conclusion. Although achalasia can also result in respiratory symptoms, fastidious anamnesis and accurate radiological interpretation are essential for the correct diagnosis.

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Digital Clubbing and Hodgkin Disease in Children: A Case Report and Review of Literature

Journal of Pediatrics Review ◽

10.32598/jpr.9.3.786.1 ◽

2021 ◽

Vol 9 (3) ◽

pp. 239-246

Author(s):

Hossein Karami ◽

◽

Amir Mohammad Beyzaee ◽

Farzad Masiha ◽

Maryam Ghasemi ◽

...

Keyword(s):

Mediastinal Lymph Node ◽

Lymph Node Biopsy ◽

Hodgkin Disease ◽

Hypertrophic Osteoarthropathy ◽

Case Presentation ◽

Digital Clubbing ◽

Night Sweats ◽

History Of ◽

Chest X Ray ◽

Tomography Scan

Introduction: Digital clubbing (hypertrophic osteoarthropathy) as the initial presentation of lymphoma is rarely reported, particularly in children. In this study, we report a patient with intrathoracic Hodgkin Disease (HD) and digital clubbing as the first presentation, and we will review the literature regarding the same condition. Case Presentation: A 10-year-old boy presented with a 2-month history of cough, mild dyspnea, and night sweats, with prominent digital clubbing. A chest x-ray and a computed tomography scan of the chest showed multiple mediastinal masses. A mediastinal lymph node biopsy was done. Pathologic examination was indicative of nodular sclerosis HD. Conclusions: In patients with digital clubbing, intrathoracic malignancies should be considered a differential diagnosis and must be ruled out by precise examination and paraclinical help.

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Retention of Bovie scratch pad radio-opaque marker during VATS pleurodesis

10.21203/rs.3.rs-215426/v1 ◽

2021 ◽

Author(s):

Deena Akras ◽

Daniel Raymond ◽

Rami Akhrass ◽

Sudish Murhty

Keyword(s):

Foreign Body ◽

Spontaneous Pneumothorax ◽

Surgical Intervention ◽

Low Cost ◽

Ease Of Use ◽

Case Presentation ◽

X Ray ◽

Retained Foreign Body ◽

Chest X Ray ◽

Chest Ct Scan

Abstract Background: Surgical intervention for spontaneous pneumothorax typically includes mechanical pleurodesis that frequently utilizes a bovie scratch pad given its universal presence, low cost and ease of use. The pad is folded on itself after dividing it in half, allowing easier passage through the smaller incisions. This case is reported to raise awareness that dividing the scratch pad may allow the embedded radio-opaque marker to fall out and become retained as a foreign body.Case presentation: The patient is a 41 year-old female who presented with shortness of breath secondary to spontaneous pneumothorax. Chest CT scan showed apical blebs. The patient underwent video assisted thorascopic surgery (VATS) with bleb resection and mechanical pleurodesis using a divided and folded bovie scratch pad. Postoperative chest x-ray showed a retained foreign body. Reoperation confirmed this to be the radio-opaque marker of the scratch pad and was removed. The patient did well and was discharge the following day.Conclusion: Dividing the bovie scratch pad may damage and “weaken” the product allowing the radio- opaque marker to fall out during its use for pleurodesis and should be discouraged. Recommendation is made of using the scratch pad as a whole and not dividing it.

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