Ultrasound-assisted insertion of a small-diameter thoracic catheter for acute dorsal empyema.

Key Clinical Message: Ultrasound-assisted small catheter placement may be considered in cases where computed tomography guidance is unavailable, and ultrasound can identify pleural effusions clearly, even in cases where empyema is localized solely on the dorsal side.

Abstract: Thoracic catheter insertion for empyema can be challenging when the pleural effusion is localized dorsally and computed tomography guidance is unavailable. We report the case of a 40-year-old man with acute dorsal bacterial empyema who underwent successful ultrasound-assisted catheter placement in an orthopneic position.

Home high-flow nasal therapy in a patient with pleuroparenchymal fibroelastosis: A case report.

A 62-year-old man with pleuroparenchymal fibroelastosis (PPFE), who had been under observation for 19 years, was admitted due to headache, fatigue, and dyspnea. Although no acute findings were detected, his symptoms were attributed to hypercapnia and exertional hypoxemia. He had a history of pneumothorax, but chose not to undergo positive airway pressure ventilation.

Relapse rate and predictors of relapse after cessation of glucocorticoid maintenance therapy in type 1 autoimmune pancreatitis: a multicenter retrospective study.

Background: Type 1 autoimmune pancreatitis responds well to glucocorticoid therapy with a high remission rate. Moreover, glucocorticoid maintenance therapy can help prevent relapse. However, the relapse rate following cessation of long-term glucocorticoid therapy is unknown.

Diagnostic Ability and Safety of Repeated Pancreatic Juice Cytology Using an Endoscopic Nasopancreatic Drainage Catheter for Pancreatic Ductal Adenocarcinoma: A Multicenter Prospective Study.

Pathological examination is essential for the diagnosis and treatment of pancreatic ductal adenocarcinoma (PDAC). Moreover, a reliable pathological diagnosis is extremely important for improving prognosis, especially in early-stage PDAC. This study prospectively evaluated the usefulness of repeated pancreatic juice cytology (PJC) using an endoscopic nasopancreatic drainage (ENPD) catheter for the diagnosis of PDAC.

Streptococcal Toxic Shock Syndrome Caused by Streptococcus dysgalactiae subsp. equisimilis-related Empyema: A Novel Case Report.

Streptococcal toxic shock syndrome (STSS) caused by Streptococcus dysgalactiae subsp. equisimilis (SDSE)-related empyema is rare but can result in shock vitals, acute kidney injury, and extensive erythema. In the present case, a 92-year-old woman with empyema caused by SDSE developed STSS after pleural drainage and antibiotic therapy.

Medication-related osteonecrosis of the jaw leading to sepsis in a patient with rheumatoid arthritis: A case report and clinical implications.

Key Clinical Message: Chronic use of bisphosphonates, in combination with immunosuppressive therapy, increases the risk of jaw osteonecrosis. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection.

Abstract: Reports of medication-related osteonecrosis of the jaw (MRONJ) accompanied by sepsis are limited.

Primary pleural lymphoma accompanied by silicosis.

Reports of malignant lymphoma accompanied by silicosis are limited. A 93-year-old man with silicosis presented with right massive pleural effusions and was diagnosed with primary pleural lymphoma. Since there was no evidence of chronic pyothorax or Epstein-Barr virus infection, it may be due to silicosis-associated chronic inflammation.

Plasma progastrin-releasing peptide level shows different predictive profiles for treatment response by androgen receptor axis-targeted agents in patients with metastatic castration-resistant prostate cancer.

Background: The neuroendocrine (NE) pathway cannot be ignored as a mechanism for castration-resistant prostate cancer (CRPC) progression. The neuromediator, gastrin-releasing peptide (GRP) may be involved in the aberrant activation of the normal androgen receptor (AR) and increased AR variants. This study focused on plasma levels of progastrin-releasing peptide (ProGRP) and examined the treatment outcomes with androgen receptor axis-targeted (ARAT) agents.

Mucus plugs in peripheral bronchi: An unusual initial manifestation of allergic bronchopulmonary aspergillosis.

Although allergic bronchopulmonary aspergillosis can be associated with mucus plugs in the central bronchi, this association in the peripheral bronchi remains unclear. A 78-year-old woman presented with mucus plugs in both the peripheral and the central bronchi in the right lung, which evolved into consolidation with high-attenuation mucus after one month.

Venlafaxine-induced interstitial lung disease with COVID-19 pandemic-related depression.

Venlafaxine-associated pulmonary toxicity is rare, with only a few reports of pneumonitis, eosinophilic pneumonia, and asthma. We report a case of venlafaxine-induced interstitial lung disease in a patient with coronavirus disease 2019 pandemic-related depression. Chest imaging findings improved after discontinuation of venlafaxine and treatment with corticosteroids.

Tuberculous pleuroperitonitis.

An 83-year-old man was diagnosed with tuberculous pleuroperitonitis on a thoracoscopic pleural biopsy. It may be due to endogenous reactivation of the foci in the pleura and peritoneum. Thoracoscopy, which can be performed under local anesthesia, should be considered when both pleural effusion and ascites are present.

"Burgundy wine" pleural effusion: An unusual manifestation of acute bacterial empyema.

Although empyema diagnosis by thoracentesis is relatively straightforward, the pleural effusion can sometimes be bloody rather than purulent. We report a case of acute empyema with a dark-red bloody effusion, wherein multiple anaerobic bacteria were detected. Chest imaging findings improved with pleural drainage, intrapleural fibrinolytic therapy, and intravenous antibiotic treatment.

Hepatopulmonary syndrome complicated by interstitial pneumonia and obesity with normal contrast echocardiography.

Diagnosis of hepatopulmonary syndrome complicated by interstitial pneumonia and obesity is difficult because these complications can cause hypoxia. Such patients may not present with typical contrast echocardiography findings.

Metastatic mucinous tubular and spindle cell carcinoma of the kidney responding to nivolumab plus ipilimumab.

Introduction: Mucinous tubular and spindle cell carcinoma is a rare subtype of renal cell carcinoma. Little is known regarding the efficacy of systemic therapy on its metastatic form because of its rarity.

Case Presentation: We present the case of a patient with metastatic mucinous tubular and spindle cell carcinoma who achieved durable complete remission of multiple osseous metastases after undergoing cytoreductive nephrectomy followed by combination immunotherapy (ipilimumab plus nivolumab).

Complete remission of advanced lung adenocarcinoma with first-line pembrolizumab monotherapy: Two case reports.

Immune checkpoint inhibitors (ICIs) are clinically used for treating advanced lung cancer, and some patients have achieved complete remission (CR) with ICI therapy in clinical trials. However, reports summarizing the clinical courses of such patients are limited. We report two cases of lung adenocarcinoma in which CR was achieved with first-line pembrolizumab monotherapy, and the therapeutic effect was maintained after treatment completion.

Intrapulmonary lymph nodes masquerading as pleural metastasis.

Intrapulmonary lymph nodes (IPLNs) are a frequent finding of computed tomography for lung cancer and can grow without malignant findings. Linear densities extending from the nodules are a characteristic of IPLNs.

Multiple nodular opacities only involving the right middle pulmonary lobe: Unusual manifestation of tuberculosis.

Bronchoscopy should be actively performed to differentiate pulmonary tuberculosis in patients with lesions in the middle lobe, which are unaccompanied by bronchiectasis or present without obvious lesions in other lobes.

Spontaneous regression of multiple pulmonary metastases accompanied by normalization of serum immune markers following cytoreductive nephrectomy in a patient with clear-cell renal cell carcinoma.

Introduction: The spontaneous regression of metastases, which mostly occurs after surgical resection of the primary tumor, has been described in various malignancies, including renal cell carcinoma. The involvement of the host immune system is currently postulated as the underlying mechanism.

Case Presentation: We present a case of metastatic clear-cell renal cell carcinoma that achieved complete spontaneous regression of multiple pulmonary metastases preceded by normalization of serum immune markers after cytoreductive nephrectomy.

Utility of whole-body diffusion-weighted magnetic resonance imaging in the management of treatment-related neuroendocrine prostate cancer.

Introduction: Treatment-related neuroendocrine prostate cancer, a rare and aggressive malignancy that emerges during androgen deprivation therapy characterized by low serum prostate-specific antigen concentrations, is challenging to monitor because it is associated with predominantly visceral and lytic bone metastases.

Case Presentation: We describe the case of a 69-year-old man with treatment-related neuroendocrine prostate cancer in whom the treatment response could be monitored using whole-body diffusion-weighted magnetic resonance imaging in addition to serum concentrations of neuroendocrine markers. The patient responded well to platinum-based chemotherapy and achieved a complete response, as evidenced by these diagnostic modalities.

Clinical Analysis of Early-Stage Pancreatic Cancer and Proposal for a New Diagnostic Algorithm: A Multicenter Observational Study.

Early diagnosis of pancreatic ductal adenocarcinoma (PDAC) is challenging but essential for improving its poor prognosis. We established a multicenter study to clarify the clinicopathological features, and to propose new algorithm for early diagnosis of PDAC. Ninety-six patients with stage 0 and IA PDAC were enrolled from 13 high-volume centers.

Efficacy of vonoprazan 10 mg compared with 20 mg for the initial treatment in patients with erosive esophagitis: a randomized pilot study.

Background: The study aimed to investigate the efficacy of vonoprazan 10 mg compared with 20 mg in patients with erosive esophagitis.

Method: Seventy-three patients with erosive esophagitis were randomly divided into two groups either vonoprazan 20 mg (n = 37) or 10 mg (n = 36). They were administered each dose for 4 weeks as the initial treatment followed by maintenance treatment with 10 mg for 8 weeks.

Evaluation of a novel urinary antigen test kit for diagnosing Legionella pneumonia.

Objectives: The aim of this study was to evaluate the diagnostic utility of a novel test kit that could theoretically detect all serogroups of Legionella pneumophila for diagnosing Legionella pneumonia, in comparison with existing kits.

Methods: This study was conducted in 16 hospitals in Japan from April 2016 to December 2018. Three urinary antigen test kits were used: the novel kit (LAC-116), BinaxNOW Legionella (Binax), and Q-line Kyokutou Legionella (Q-line).