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Author(s):  
Carmine Guarino ◽  
Ilaria Pedicelli ◽  
Francesco Perna ◽  
Valentina Di Spirito ◽  
Giuseppe Fiorentino ◽  
...  

A 59-year-old female ex-smoker with 40 pack year smoking history and a 5-year current e-cigarette (EC) use history, presented with progressive dyspnea on exertion and daily cough for 2 months. A CT scan showed a consolidation area with air bronchogram in the middle lobe and non-calcific bilateral nodules, which could be attributed to community-acquired pneumonia. The patient was treated with empiric antibiotics and systemic steroids for 10 days. Infectious, neoplastic and autoimmune pathologies were excluded, whereas a broncho-alveolar lavage revealed an accumulation of lipids in the cytoplasm of the alveolar macrophages. Despite the recommendation of vaping cessation, the patient continued to use EC. A new CT exam, carried out after 18 months, showed reversed halo sign (RHS), patchy ground-glass opacity (GGO), pleuro-parenchymal bands, and indeed perilobular pattern, suggestive of organizing pneumonia (OP). The final diagnosis was E-cigarette, or vaping, product use Associated Lung Injury (EVALI)- related OP.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanyi Gan ◽  
Liang Xia ◽  
Yushang Yang ◽  
Qiang Pu ◽  
Lunxu Liu

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.


2021 ◽  
Vol 19 (10) ◽  
pp. 549-549
Author(s):  
Xiang Shi ◽  
Lei Wang
Keyword(s):  

Author(s):  
Chiboub M ◽  
◽  
Kammoun I ◽  
Gharbi R ◽  
Kammoun H ◽  
...  

Ectopic Cushing syndrome (ECS) is difficult to diagnose and has a poor prognosis. We report a case of a 44-year-old male who was admitted for clinical suspicion of Cushing’s syndrome. The investigations confirmed the diagnosis of ECS. No tumor was detected in preliminary imaging tests. Then, the octreoscan showed a fixation in a suspect lung node in the middle lobe. The patient was treated initially with medical drugs, he underwent a right middle lobectomy, and yet histopathology did not reveal any nodule. However, the outcome was the healing of our patient. We reviewed published articles to access new diagnostic techniques or advantages in the treatment regimen and a prognosis of ECS. Keywords: ectopic cushing’s syndrome; paraneoplastic syndromes; lung cancer.


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