Sarcomatoid Carcinoma of the Lung: A Rare and Unfortunate Disease

Pulmonary sarcomatoid carcinoma (PSC) is an extremely rare malignancy with a poor overall survival rate. Sarcomatoid tumors (SC) can arise out of many organs in the body and are generally rare but primary PSC’s are among the rarest. Of all lung tumors, PSC’s represent less than 1%. Our case presents a male with a past medical history of chronic obstructive pulmonary disease (COPD) who presents with a pleural effusion secondary to PSC.

Download Full-text

Spontaneous spinal extradural haematoma presenting with chest pain: a case report and literature review

Acute Medicine Journal ◽

10.52964/amja.0387 ◽

2010 ◽

Vol 9 (2) ◽

pp. 76-79

Author(s):

Jessica M Skilling ◽

◽

Nicola M Tempest ◽

Ahmed H Abdelhafiz ◽

◽

...

Keyword(s):

Atrial Fibrillation ◽

Chronic Obstructive Pulmonary Disease ◽

Back Pain ◽

Case Report ◽

Abrupt Onset ◽

Chronic Obstructive ◽

Extradural Haematoma ◽

Past Medical History ◽

Obstructive Pulmonary Disease ◽

History Of

An 85 year old lady was admitted to hospital after experiencing an abrupt onset of right sided chest and mid thoracic back pain. This pain was exacerbated by movement and coughing but not by inspiration. There was no history of recent injury. Her past medical history included atrial fibrillation (AF), aortic stenosis, hypertension and chronic obstructive pulmonary disease. Medication on admission included bendrof lumethiazide 2.5mg od, digoxin 125 mcg od, doxazosin 4mg od, enalapril 20mg od, warfarin and salbutamol and seretide inhalers. Prior to the onset of the pain she had been independently mobile with a stick.

Download Full-text

Case Report: Pulmonary sarcomatoid carcinoma in a female patient from Nepal

F1000Research ◽

10.12688/f1000research.55187.1 ◽

2021 ◽

Vol 10 ◽

pp. 723

Author(s):

Anirudra Devkota ◽

Amrit Paudel ◽

Simit Sapkota ◽

Subash Pandit ◽

Aashish Baniya

Keyword(s):

Ct Scan ◽

Sarcomatoid Carcinoma ◽

Lower Lobe ◽

Small Cell ◽

Chronic Obstructive ◽

Shortness Of Breath ◽

Small Cell Lung ◽

Dismal Prognosis ◽

History Of ◽

Pulmonary Sarcomatoid Carcinoma

Sarcomatoid carcinoma of the lung is an uncommon subtype of non-small-cell lung cancer (NSCLC). Even in the early stages, pulmonary sarcomatoid carcinoma (PSC) has a dismal prognosis when compared to other kinds of NSCLC with a mean survival of 9–12 months and a five-year survival rate of around 20%. We present the case of a 68-year-old woman with a two-month history of shortness of breath and cough. Initial computed tomography (CT) scan showed features of interstitial lung disease with chronic obstructive airway changes. After 34 months, the patient’s condition worsened with newer complaints of sore throat and hemoptysis. A repeat CT scan showed a ∼49x38x59mm size lesion in the superior segment of the left lower lobe. A core needle biopsy was performed, which revealed tumor cells consisting of irregular tubules and sarcomatoid components. The patient was started on chemotherapy. Unfortunately, she succumbed to her disease. Our case highlights the aggressiveness of PSC.

Download Full-text

Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽

10.3390/healthcare9010053 ◽

2021 ◽

Vol 9 (1) ◽

pp. 53

Author(s):

Jun Horie ◽

Koichiro Takahashi ◽

Shuuichi Shiranita ◽

Kunihiko Anami ◽

Shinichiro Hayashi

Keyword(s):

Gait Speed ◽

Pulmonary Rehabilitation ◽

Exercise Tolerance ◽

Respiratory Illness ◽

Forced Expiratory Volume ◽

Walking Distance ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

St George's Respiratory Questionnaire ◽

History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

Download Full-text

Imaging in alpha-1 antitrypsin deficiency: a window into the disease

Therapeutic Advances in Chronic Disease ◽

10.1177/20406223211024523 ◽

2021 ◽

Vol 12_suppl ◽

pp. 204062232110245

Author(s):

Yuh-Chin Tony Huang ◽

Marion Wencker ◽

Bastiaan Driehuys

Keyword(s):

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Essential Information ◽

Plain Chest Radiograph ◽

Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin Deficiency ◽

History Of ◽

Detailed Assessment ◽

Alpha 1 Antitrypsin ◽

Magnetic Resonance Imaging Mri

Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.

Download Full-text

Association between Chronic Obstructive Pulmonary Disease and Ménière’s Disease: A Nested Case–Control Study Using a National Health Screening Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094536 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4536

Author(s):

So-Young Kim ◽

Chang-Ho Lee ◽

Dae-Myoung Yoo ◽

Chan-Yang Min ◽

Hyo-Geun Choi

Keyword(s):

Meniere’S Disease ◽

Menière’S Disease ◽

Chronic Obstructive ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Obstructive Pulmonary Disease ◽

Region Of Residence ◽

History Of ◽

Ménière's Disease

This study explored the relation between Ménière’s disease and chronic obstructive pulmonary disease (COPD). The ≥40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort was included. In total, 7734 Ménière’s disease patients and 30,936 control participants were enrolled. Control participants were matched for age, sex, income, and region of residence with Ménière’s disease participants. The odds of having Ménière’s disease given a history of COPD were analyzed using conditional logistic regression. Subgroup analyses were conducted according to age, sex, income, and region of residence. The odds of having Ménière’s disease were found to be 1.18-fold higher with a history of COPD than with no history of COPD (95% confidence intervals (CI) = 1.06–1.32, E-value (CI) = 1.64 (1.31)). The ≥60 years old, male, low-income, and rural subgroups showed increased odds of developing Ménière’s disease when a history of COPD was reported. A history of COPD was associated with an increased risk of Ménière’s disease in the adult population.

Download Full-text

Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

Canadian Respiratory Journal ◽

10.1155/2015/306720 ◽

2015 ◽

Vol 22 (4) ◽

pp. 209-214 ◽

Cited By ~ 5

Author(s):

Chantal Robitaille ◽

Esther Dajczman ◽

Andrew M Hirsch ◽

David Small ◽

Pierre Ernst ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Screening Program ◽

Tertiary Care ◽

Airflow Obstruction ◽

University Hospital ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Targeted Screening ◽

History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

Download Full-text

High prevalence of undiagnosed COPD among patients evaluated for suspected myocardial ischaemia

Open Heart ◽

10.1136/openhrt-2018-000848 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000848 ◽

Cited By ~ 1

Author(s):

Andreas Jönsson ◽

Artur Fedorowski ◽

Gunnar Engström ◽

Per Wollmer ◽

Viktor Hamrefors

Keyword(s):

Myocardial Ischaemia ◽

Chronic Obstructive Lung Disease ◽

Chronic Obstructive ◽

Clinical Factors ◽

Obstructive Pulmonary Disease ◽

Presenting Symptoms ◽

High Prevalence ◽

History Of ◽

Artery Disease ◽

Global Initiative

ObjectiveChronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are leading causes of global morbidity and mortality. Despite the well-known comorbidity between COPD and CAD, the presence of COPD may be overlooked in patients undergoing coronary evaluation. We aimed to assess the prevalence of undiagnosed COPD among outpatients evaluated due to suspected myocardial ischemia.MethodsAmong 500 outpatients who were referred to myocardial perfusion imaging due to suspected stable myocardial ischaemia, 433 patients performed spirometry. Of these, a total of 400 subjects (age 66 years; 45% women) had no previous COPD diagnosis and were included in the current study. We compared the prevalence of previously undiagnosed COPD according to spirometry criteria from The Global Initiative for Chronic Obstructive Lung Disease (GOLD) or lower limit of normal (LLN) and reversible myocardial ischaemia according to symptoms and clinical factors.ResultsA total of 134 (GOLD criteria; 33.5 %) or 46 patients (LLN criteria; 11.5%) had previously undiagnosed COPD, whereas 55 patients (13.8 %) had reversible myocardial ischaemia. The presenting symptoms (chest discomfort, dyspnoea) did not differ between COPD, myocardial ischaemia and normal findings. Except for smoking, no clinical factors were consistently associated with previously undiagnosed COPD.ConclusionsAmong middle-aged outpatients evaluated due to suspected myocardial ischaemia, previously undiagnosed COPD is at least as common as reversible myocardial ischaemia and the presenting symptoms do not differentiate between these entities. Patients going through a coronary ischaemia evaluation should be additionally tested for COPD, especially if there is a positive history of smoking.

Download Full-text

Aspiração de Corpo Estranho no Idoso

Acta Médica Portuguesa ◽

10.20344/amp.6986 ◽

2016 ◽

Vol 29 (5) ◽

pp. 340

Author(s):

Cátia Oliveira Matos ◽

Manuel Mário Sousa

Keyword(s):

Oral Intake ◽

The Elderly ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Clinical Suspicion ◽

Chronic Obstructive ◽

History Taking ◽

Therapeutic Procedure ◽

Obstructive Pulmonary Disease ◽

History Of

Foreign body aspiration is common in children and in the elderly, who may present with subtle symptoms. Clinical suspicion is crucial and bronchoscopy is the main diagnostic and therapeutic procedure available. This is the case of a man, 78 years old, with a history of chronic obstructive pulmonary disease, who presented with respiratory distress following oral intake of tablets. History taking and physical examination raised suspicion. The diagnosis was confirmed with flexible bronchoscopy and rigid bronchoscopy was carried out for treatment. The patient’s condition is stable and he is under investigations for dysphagia.

Download Full-text