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Tullio Valente ◽  
Giorgio Bocchini ◽  
Gaetano Rea ◽  
Marianna Paccone ◽  
Giuseppe Vitale ◽  

AbstractLipomas are the most common form of benign soft tissue tumors in humans, occurring infrequently in visceral organs. Pulmonary lipomas are seen rarely and can occur such as an endobronchial (80%) or peripheral parenchymal (20%) lesion. Less than 10 cases of lung peripheral lipoma are described in literature, none cavitated. We report the clinical case of a 51-year-old emphysematous smoker man with a peripheral intrapulmonary middle-lobe cavitating lipoma, revealed during a routine chest X-ray for emphysema, subsequently confirmed by high-resolution computed tomography (HRCT) and positron emission tomography (PET)–CT. Some hypotheses are made about the origin of cavitation. Biopsy and surgery were not done due to the fully benign nodular features at imaging. The nodule was unchanged till 2 years, last follow-up with low-dose HRCT. It is probably useful to choose a conservative approach with a follow-up, if there is a high suspicion of benignity.

2021 ◽  
Vol 57 (10) ◽  
pp. 652
Veysel Ayyildiz ◽  
Yener Aydin ◽  
Hayri Ogul

Ummu Afeera Binti Zainulabid ◽  
Muhammad Naimmuddin Bin Abdul Azih ◽  
Sasi Kumar A/L Maniyam ◽  
Azliana Binti Abd Fuaa ◽  
Mohd Radhwan Bin Abidin ◽  

Pulmonary phaeohyphomycosis is a rare infection in the lung caused by black fungi containing a cytoplasmic melanin-like pigment. A 42-year-old man with underlying retroviral disease on HAART was investigated for having constitutional symptoms. Despite undetectable viral load and a high CD4 count, he was found to have unexplained significant loss of weight and appetite over a period of 6 months. Clinical examination revealed a cachexic man with multiple inguinal lymphadenopathies. Excisional biopsy of the inguinal lymph node revealed reactive follicular hyperplasia. CT Thorax, Abdomen and Pelvis was arranged to look for occult malignancy or infection and he was found to have multiple non-enhancing subcentimeter lung nodules mainly at the lateral segment of the right middle lobe of his lung. The largest nodule measured about 0.8 x 1.5 x 0.5 (AP x W x CC), with some nodules having an irregular margin with no extension into the adjacent bronchi. Bronchoscopy was done and demonstrated a black patch at the right intermedius, lateral segment of the middle lobe which did not disappear upon bronchial flush or wash. Histopathological examination found focal areas of blackish pigment and the bronchial alveolar lavage sent for fungal culture grew Cladosporium species. The patient was treated with oral Itraconazole with marked clinical improvement. This case highlights an unusual black fungi infection in the lung that stands out not only for its rarity and it's responsiveness to treatment, but also the susceptibility of an RVD positive patient to this infection despite having suppressed viral load and normal CD4 count.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S17

2021 ◽  
Vol 2021 ◽  
Hela Kamoun ◽  
Aymen Ayari ◽  
Hadhemi Rejeb ◽  
Sarra Zairi ◽  
Hanene Smadhi ◽  

Introduction. - Paraneoplastic Cushing's syndrome is a rare cause of endogenous hypercorticism. It is caused by ectopic secretion of ACTH by a non-pituitary endocrine tumor. The aetiological biological and radiological data are often inconclusive, which creates a problem of differential diagnosis with Cushing's disease. In addition, these tumors are often small and their location is extremely variable. As a result, the difficulties of localization require the use of specific imaging techniques.Observation. - We report the observation of a 44-year-old man suffering from diabetes and high blood pressure, presenting a severe and rapidly progressive Cushing syndrome, in connection with a hypercorticism caused by an ectopic ACTH secretion. The thoracic computed tomography performed within the framework of a search for a neoplastic origin objectified a 15 mm nodule isolated at the level of the middle lobe, the scintigraphy with octreotide marked with indium-111 found a significant fixation at the level of the lung nodule. The patient had a middle lobe lobectomy. The outcome was favorable with regression of Cushing's syndrome. Pathological examination was in favor of a typical carcinoid tumor, and the immunohistochemical complement showed tumor cell positivity for ACTH, CD56, chromogranin, and synaptophysin.Conclusion. - This observation illustrates the dilemma between the need to locate an ectopic ACTH secretion and the control of aggressive and threatening Cushing's syndrome. Early use of the octreotide scintigraphy should be considered if a topographic diagnosis of the causative tumor cannot be done through conventional imaging techniques.

2021 ◽  
Vol 8 ◽  
Qiushi Wang ◽  
Chunlin Lu ◽  
Minrui Jiang ◽  
Mengxia Li ◽  
Xiao Yang ◽  

Pulmonary Sclerosing Pneumocytoma (PSP) is considered as a benign tumor, although a few cases have been reported to have multiple lesions, recurrence, and even regional lymph nodes (LNs) metastasis. Here, we report a case of PSP with atypical histologic features and malignant biological behavior, and explore its molecular genetic changes. The 23-year-old male showed a 6.5-cm pulmonary nodule in the right middle lobe (RML) and enlarged media stinal LNs. He underwent thoracoscopic RML lobectomy, systematic LNs dissection, and mediastinal lymphadenectomy. The metastases to the cervical LNs and liver were detected in a short period and then resected. Postoperative pathological examination confirmed the diagnosis of PSP in all the lesions, based on the histological characteristics and immune phenotypes. Furthermore, whole-exome sequencing identified both AKT1 E17K somatic mutation and TP53 C176Y germline mutation in this case. Thus, we presented an extremely rare case of atypical PSP with rapid recurrence and multiply metastases, which can easily be misdiagnosed as primary lung cancer. In addition, PSP-specific AKT1 E17K somatic E17K somatic mutation accompanied with TP53 C176Y germline mutation may contribute to the malignant clinical course of this tumor.

2021 ◽  
Vol 16 (1) ◽  
Yuanjun Qi ◽  
Jianbin Li ◽  
Yingjie Zhang ◽  
Qian Shao ◽  
Xijun Liu ◽  

Abstract Background This study aimed to investigate the effect of abdominal compression on tumour motion and target volume and to determine suitable planning target volume (PTV) margins for patients treated with lung stereotactic body radiotherapy (SBRT) based on four-dimensional computed tomography (4DCT). Methods Twenty-three patients diagnosed to have a peripheral pulmonary tumour were selected and divided into an all lesions group (group A), an upper middle lobe lesions group (group B), and a lower lobe lesions group (group C). Two 4DCT scans were performed in each patient, one with and one without abdominal compression. Cone beam computed tomography (CBCT) was performed before starting treatment. The gross target volumes (GTVs) were delineated and internal gross target volumes (IGTVs) were defined. IGTVs were generated using two methods: (1) the maximum intensity projections (MIPs) based on the 4DCT were reconstructed to form a single volume and defined as the IGTVMIP and (2) GTVs from all 10 phases were combined to form a single volume and defined as the IGTV10. A 5-mm, 4-mm, and 3-mm margin was added in all directions on the IGTVMIP and the volume was constructed as PTVMIP5mm, PTVMIP4mm, and PTVMIP3mm. Results There was no significant difference in the amplitude of tumour motion in the left–right, anterior–posterior, or superior-inferior direction according to whether or not abdominal compression was applied (group A, p = 0.43, 0.27, and 0.29, respectively; group B, p = 0.46, 0.15, and 0.45; group C, p = 0.79, 0.86, and 0.37; Wilcoxon test). However, the median IGTVMIP without abdominal compression was 33.67% higher than that with compression (p = 0.00), and the median IGTV10 without compression was 16.08% higher than that with compression (p = 0.00). The median proportion of the degree of inclusion of the IGTVCBCT in PTVMIP5mm, PTVMIP4mm, and PTVMIP3mm ≥ 95% was 100%, 100%, and 83.33%, respectively. Conclusions Abdominal compression was useful for reducing the size of the IGTVMIP and IGTV10 and for decreasing the PTV margins based on 4DCT. In IGTVMIP with abdominal compression, adding a 4-mm margin to account for respiration is feasible in SBRT based on 4DCT.

Breathe ◽  
2021 ◽  
Vol 17 (3) ◽  
pp. 210108
Thomas Villeneuve ◽  
Romane Fumat ◽  
Valentin Héluain ◽  
Pierre Pascal ◽  
Gavin Plat ◽  

2021 ◽  
Dennis Klug ◽  
Katharina Arnold ◽  
Eric Marois ◽  
Stephanie Blandin

Plasmodium parasites are the causative agent of malaria, a major health burden in sub- Saharan Africa. A key step in the transmission process of Plasmodium is the colonization of the salivary glands of the female Anopheles mosquito by the parasite sporozoite stage. How sporozoites recognize and invade the salivary glands is still poorly understood. Here we generated salivary gland reporter lines in the African malaria mosquito Anopheles coluzzii using salivary gland-specific promoters of the genes encoding anopheline antiplatelet protein (AAPP), the triple functional domain protein (TRIO) and saglin (SAG). The observed expression pattern of the DsRed and roGFP2 fluorescent reporters revealed lobe-specific activity of these promoters within the salivary glands, restricted either to the distal lobes or the middle lobe. We characterized four mosquito lines (AAPP-DsRed, AAPP-roGFP2, TRIO- DsRed and SAG-EGFP) in terms of localization, expression strength and onset of expression, as well as potential influences of the expressed fluorescent reporters on the infection with Plasmodium berghei and salivary gland morphology. Furthermore, using crosses with a pigmentation deficient yellow(-) mosquito line, we demonstrate that our salivary gland reporter lines represent a valuable tool to study the process of salivary gland colonization by Plasmodium parasites in live mosquitoes.

2021 ◽  
Vol 21 (1) ◽  
Seitaro Abe ◽  
Yoshinari Tanabe ◽  
Takeshi Ota ◽  
Fumio Fujimori ◽  
Akira Youkou ◽  

Abstract Background Nocardiosis is known as an opportunistic infection in immunocompromised hosts, but it occasionally has been reported in immunocompetent patient. The Nocardia exalbida is first-reported in 2006 from Japan, and a few cases of have been reported in only immunocompromised host, and the characteristic is still unclear. We herein describe the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient. Case presentation A77 -year-old Japanese man was admitted to our hospital on November 2, 2018. He was a lifelong non-smoker with no childhood history of respiratory disease. He had a medical history of dyslipidemia. One month before this admission fevers, sputum, mild cough were developed and he was evaluated in a clinic near our hospital. His diagnosis was community acquired pneumonia within his right middle lobe. He was treated with ceftriaxone 1 g/day intravenously for a week, however his symptoms relapsed a few days later. So, the physician retried ceftriaxone for another 3 days, but his symptoms did not improve. He was referred to our hospital. He was treated with sitafloxacin as an outpatient for a week, however his symptoms got worse. The chest CT showed consolidation and atelectasis in his right middle lobe. Low density area was scattered in consolidation, and right pleural effusion was observed. The patient was diagnosed with pulmonary abscess and he was admitted. Administration of piperacillin/tazobactam improved his condition. We switched antibiotics to amoxicillin/clavulanate, and he was discharged. After 2 weeks, he relapsed and was admitted again. After administration of piperacillin/tazobactam for 3 weeks, we perform bronchoscopy and Nocardia species were cultured from samples of the bronchial wash. The isolates were identified as N. exalbida using 16S rRNA gene sequencing. We prescribed Trimethoprim / Sulfamethoxazole (TMP/SMX) for 4 months. Then we switched to minocycline for renal dysfunction caused from TMP-SMX for 1 more month. After 5 months therapy, Consolidation on CT disappeared, and Nocardiosis was cured. Conclusion we reported the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient. N. exalbida infection might be associated with a good response to treatment.

2021 ◽  
Vol 14 (8) ◽  
pp. e243498
Alice Stanton ◽  
Kevin Conroy ◽  
Graham Miller

A 72-year-old female patient underwent endobronchial ultrasound and transbronchial needle aspirate sampling of mediastinal lymph nodes to investigate a middle lobe abnormality following an urgent referral. CT imaging completed the following day demonstrated a pneumomediastinum. At clinical review, the patient remained clinically stable and no intervention was required.

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