It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods  are found to be aspirated more commonly and are  usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations  are  rare in literature. In our study,  a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

Ataman K&#xf6;se

Dilek Kostak

Erol Aramagan

Asl&#x131;han Durak

Nur Sezin Se&#xe7;kin

Serdar S&#xfc;ha D&#xf6;nmez

H&#xfc;seyin Melek

Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

The case is a 48-year-old female who presented with mild dyspnea on exertion and cough with unremarkable vital signs and was found to have a large right sided pneumothorax.  She underwent small bore chest tube decompression with immediate reexpansion of the collapsed lung.  However, she rapidly developed moderate hypoxemia and radiographic evidence of reexpansion pulmonary edema (REPE) on both the treated and contralateral sides.  Within a week, she had a normal chest X-ray and was asymptomatic.  This case describes a rare complication of spontaneous pneumothorax and highlights the lack of correlation between symptoms, sequelae, and radiographic severity of pneumothorax and reexpansion pulmonary edema.  Proposed pathophysiologic mechanisms include increased production of reactive oxygen species with subsequent loss of surfactant and increased vascular permeability, and loss of vasoregulatory tone.

William E. Harner

Eric A. Crawley

Radiographically Severe but Clinically Mild Reexpansion Pulmonary Edema following Decompression of a Spontaneous Pneumothorax

Synovial sarcoma (SS) is a rare tumor originating from mesenchymal tissue and accounting for approximately 5&#x2013;10&#x25; of all soft tissue sarcomas. A rare case of primary pulmonary SS in an asymptomatic 18-year-old man admitted to our hospital for investigation of a 6 &#xd7; 6.5&#x2009;cm, oval-shaped, well-delineated pleural based peripheral mass in the left lower lobe in his thorax CT is presented. Left lower lobectomy was done. Immunohistochemically, tumor cells were positive for cytokeratin, epithelial membrane antigen (EMA), and vimentin so that the histopathological diagnosis was compatible with biphasic spindle cell type SS in the lung.

Ekrem Cengiz Seyhan

Sinem Nedime Sokucu

Gulsah Gunluoglu

Nurdan Simsek Veske

Sedat Altin

Primary Pulmonary Synovial Sarcoma: A Very Rare Presentation

A 62-year-old woman with Wolff-Parkinson-White syndrome was with recent worsening of dyspnea to New York Heart Association functional status Class III. The patient was diagnosed as having central type chronic thromboembolic pulmonary hypertension. By cardiac catheterization, her mean pulmonary artery pressure was 53 mmHg with total pulmonary resistance 2238 dynes<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.0pt;width:4px;" id="M1" height="5.4499998" version="1.1" viewBox="0 0 4 5.4499998" width="4">
	
		
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</svg>cm−5. After medical therapies with tadalafil, furosemide, ambrisentan, beraprost, and warfarin were initiated, percutaneous transluminal pulmonary angioplasty (PTPA) was performed. Following PTPA, life-threating hypoxemia resulting from postoperative reperfusion pulmonary edema developed. High-flow nasal cannula therapy (HFNC) was applied, and 100% oxygen at 50 L/min of flow was required to keep oxygenation. HFNC was continued for 3 days, and the patient was discharged on 8th postoperative day with SpO2 of 97% on 3 L/min of oxygen inhalation. Because of the simplicity of the technique, the lower cost of equipment, and remarkable patient tolerance to the treatment, we speculate that HFNC can take over the post of noninvasive ventilation as first-line therapy for patients with acute respiratory failure.

Kiyoshi Moriyama

Toru Satoh

Akira Motoyasu

Tomoki Kohyama

Mariko Kotani

Riichiro Kanai

Tadao Ando

Tomoko Yorozu

High-Flow Nasal Cannula Therapy in a Patient with Reperfusion Pulmonary Edema following Percutaneous Transluminal Pulmonary Angioplasty

Sarcoidosis is a chronic, granulomatous condition with unknown cause. Because most of the patients are free of clinical symptoms, sarcoidosis should be considered in differential diagnosis if noncaseous granuloma is noted in biopsies, performed for other reasons. With no clinical symptoms, our patient was diagnosed with sarcoidosis upon identifying noncaseous granuloma in the lymph node biopsy material collected during the laparoscopic operation, performed for gallbladder polyp.

Besir Kesici

Ahmet Burak Toros

Levent Bayraktar

Adem Dervisoglu

Sarcoidosis Incidentally Diagnosed: A Case Report

Endobronchial lipomatous polyp is a rare nonmalignant tumor of the lung. It comprises 5&#x25; of the benign lung tumor, with the majority of benign tumors being hamartoma. Lipomatous polyp often leads to endobronchial lesion, associated with postobstructive pneumonia, hemoptysis, and atelectasis. We hereby present a case and discussion of an elderly man with endobronchial lipomatous polyp, presenting as recurrent pneumonia.

Salim Surani

Karen Allen

Saherish Surani

Joseph Varon

Endobronchial Lipomatous Polyp: A Rare Benign Tumor of the Lung

Intestinal type of lung adenocarcinoma (ILADC) was initially described by Tsao and Fraser in 1991. Morphology and immunophenotype of ILADC are the same as in colorectal adenocarcinoma. Rectocolonoscopy must be performed to exclude colorectal origin of adenocarcinoma. Colorectal adenocarcinoma claimed to be genetically similar to an ILADC. Patients. We describe 24- and 26-year-old patients of both genders who went under surgery because of a lung tumor mass detected on CT scan. ILADC was diagnosed on resected lung specimens. According to positivity of Cytokeratin20, CDX-2, and Villin, respectively, and negativity of Cytokeratin7, TTF-1, Napsin-A, SurfactantB, MUC-1, and MUC-2, respectively, ILADC was diagnosed. KRAS mutation was detected in tumor tissue of the male patient. Conclusion. Rectocolonoscopy is the only relevant method for distinguishing the intestinal type of lung adenocarcinoma from metastatic colorectal carcinoma because immunohistochemistry and detection of mutation status are frequently the same in both types of adenocarcinoma. More investigations are needed for further understanding of ILADC in purpose of personalized lung carcinoma therapy particularly introducing detection of mutation status, especially in younger patients.

Jelena Stojsic

Milica Kontic

Dragan Subotic

Marko Popovic

Dragana Tomasevic

Jelena Lukic

Intestinal Type of Lung Adenocarcinoma in Younger Adults

Sarcoidosis and Crohn&#x2019;s disease are systemic granulomatous disorders affecting the lung and the intestine, respectively, with variable involvement of other organs and are seldom associated. While anti-TNF&#x3b1; is a recognized treatment of Crohn&#x2019;s disease, its usage is discussed in sarcoidosis. A 42-year-old man presented with an 11-year-long history of Crohn&#x2019;s disease; upon discovery of an abnormal chest CT scan the diagnosis of multivisceral sarcoidosis was made and, later, a treatment with an anti-TNF&#x3b1; agent, infliximab, was started, because of worsening Crohn&#x2019;s disease recurrences. CT scan demonstrated net regression of pulmonary opacities and hepatosplenic lesions. Pathologies obtained from the intestinal tract and the bronchi of the patient were, respectively, characteristic of Crohn&#x2019;s disease and sarcoidosis leading to the diagnosis of both diseases. We report a rare case of steroid resistant Crohn&#x2019;s disease associated with multivisceral sarcoidosis, treated successfully by an anti-TNF&#x3b1; agent, infliximab.

Nader Chebib

Fabrice Pi&#xe9;gay

Julie Traclet

Fran&#xe7;ois Mion

Jean-Fran&#xe7;ois Mornex

Improvement with Infliximab of a Disseminated Sarcoidosis in a Patient with Crohn&#x2019;s Disease

Rheumatoid arthritis patients are susceptible to interstitial lung disease, and joint manifestations of rheumatoid arthritis usually precede lung involvements by several years. Organizing pneumonia, as the first manifestation of rheumatoid arthritis, is extremely rare, and its clinical features remain currently unknown. We present a case and a literature review of patients who were pathologically diagnosed with organizing pneumonia first and met the diagnostic criteria of rheumatoid arthritis later. In this review, we observed the following: (1) patients with organizing pneumonia preceding rheumatoid arthritis have a high prevalence of rheumatoid factor or anticyclic citrullinated peptide antibodies; (2) almost all patients developed rheumatoid arthritis within one year after the diagnosis of organizing pneumonia. We suggest that patients with organizing pneumonia and positive for either rheumatoid factor or anticyclic citrullinated peptide antibody should be cautiously followed up regarding the development of rheumatoid arthritis, particularly during the first year after the diagnosis of organizing pneumonia.

Yoshiaki Kinoshita

Atsuhiko Sakamoto

Kouko Hidaka

Organizing Pneumonia Preceding Rheumatoid Arthritis

Vanishing lung syndrome (VLS) is a rare and distinct clinical syndrome that usually affects young men. VLS leads to severe progressive dyspnea and is characterized by extensive, asymmetric, peripheral, and predominantly upper lobe giant lung bullae. Case reports have suggested an additive role of marijuana use in the development of this disease in young male tobacco smokers. We herein report a case of a 65-year-old Hispanic male previously diagnosed with severe emphysema and acquired immune deficiency syndrome (AIDS), with a history of intravenous heroin use and active marijuana smoking who presents to the emergency department with severe progressive shortness of breath he was found to have multiple large subpleural bullae occupying more than one-third of the hemithorax on chest computerized tomography (CT), characteristic of vanishing lung syndrome. The patient was mechanically ventilated and later developed a pneumothorax requiring chest tube placement and referral for surgical bullectomy. Surgical bullectomy has shown high success rates in alleviating the debilitating symptoms and preventing the life threatening complications of this rare syndrome.  This case further emphasizes the importance of recognizing VLS in patients with severe emphysema and heavy marijuana smoking.

Basheer Tashtoush

Fernando Gonzalez-Ibarra

Roya Memarpour

Anas Hadeh

Laurence Smolley

Vanishing Lung Syndrome in a Patient with HIV Infection and Heavy Marijuana Use

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Case Reports in Pulmonology publishes case reports and case series in all areas of pulmonology, prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.

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Case Reports in Pulmonology - Table of contents 2014

title

Case Reports in Pulmonology publishes case reports and case series in all areas of pulmonology, prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.

Case Reports in Pulmonology