Thyroglobulin gene mutation with cold nodule on thyroid scintigraphy.

Thyroglobulin gene mutation is a rare cause of congenital hypothyroidism, but thyroglobulin gene mutations are thought to be associated with thyroid cancer development. A 21-year-old Japanese man treated with levothyroxine for congenital hypothyroidism had an enlarged thyroid gland with undetectable serum thyroglobulin despite elevated serum TSH level. The patient was diagnosed with thyroglobulin gene mutation, with compound heterozygosity for Gly304Cys missense mutation and Arg432X nonsense mutation.

Toxic multinodular goiter with low radioactive iodine uptake.

A 74-year-old woman was referred to our hospital for goiter and persistent thyrotoxicosis. She had no signs of ophthalmopathy. She was not taking thyroid hormone.

[A case of idiopathic pulmonary alveolar proteinosis with multiple localized ground-glass opacities].

A 58-year-old Japanese female consulted our staff with multiple localized ground-glass opacities in chest CT. She underwent video assisted thoracoscopic surgery for diagnosis. Histopathologic finding from surgery specimen in one of ground-glass opacities revealed bronchioloalveolar carcinoma.

[A case of cystic bronchial typical carcinoid].

A 53-year-old man was admitted with a nodular lesion on chest radiograph. Chest CT scan showed a cystic nodule in right S4 which gradually enlarged during follow-up without therapy. Two years after the first examination, we performed middle lobectomy using video assisted thoracoscopy.

[A case of Wegener's granulomatosis without PR3-ANCA at relapse].

A 49-year-old man was admitted to our hospital with fever. His chest radiograph showed some nodules in the right upper and lower lung fields. The cytoplasmic-antineutrophil cytoplasmic antibody test was positive, and histopathologic biopsy of a small nasal polyps yielded a diagnosis of Wegener's granulomatosis.

[Case of allergic bronchopulmonary aspergillosis triggered by relocation of residence].

A 22-year-old woman has been treated with inhaled corticosteroid for bronchial asthma. Her family moved house to Toyama prefecture in March 2003, and she was enrolled in our hospital. Her chest radiograph on first medical examination showed the right upper lobe infiltration.

[Hypopituitarism caused by hypothalamic metastasis of lung cancer].

A 40-year-old man was admitted due to thirst, general malaise, and swollen cervical lymph nodes. Cervical lymph node biopsy revealed moderately differentiated adenocarcinoma, and he was diagnosed lung cancer with hypothalamic metastasis. We gave him chemotherapy and hypothalamic irradiation.

[Central diabetes insipidus caused by pituitary metastasis of lung cancer].

A 53-year-old man admitted for thirst, polyposia, and polyuria. Large cell lung cancer T3N2M1 (Stage IV), and central diabetes insipidus caused by pituitary metastasis of lung cancer, were diagnosed. We gave him desmopressin acetate, and chemotherapy with paclitaxel and carboplatin.

[A case of hypersensitivity pneumonitis caused by Lyophyllum karst].

A 52-year-old woman who has worked at factory to check pack Lyophyllum karst for six years consulted another doctor for dry cough as common cold. After a month, low grade fever, dyspnea on effort, and productive cough brought her to our hospital. Her chest radiographs showed multiple small nodular shadows and ground glass opacities in entire lung fields.

[Pulmonary septic emboli in a patient with right-side infectious endocarditis].

An 18-year-old woman afflicted with ventricular septal defect was admitted for high fever and dyspnea. She had undergone no surgical repair. Chest CT showed numerous nodular opacities in both lungs.

[X-ray-negative endobronchial tuberculosis with persistent irritating cough that resulted in unpredicted mass infection].

A 24-year-old woman was referred to another hospital because of a barking cough, but her chest radiograph showed no abnormality. Although she had been diagnosed as having other diseases and had been given medical treatment, the barking cough continued. Abnormalities of the chest radiograph appeared 11 months later, and endobronchial tuberculosis was diagnosed from the clinical history, chest CT and a sputum smear positive for acid-fast bacilli.

[Diffuse alveolar damage after inhalation of zinc oxide fumes].

A 57-year-old man with a 37-year occupational history of welding was admitted for high fever and dyspnea after inhalation of zinc oxide fumes during a period of welding without a protective mask. Chest radiography and CT showed bilateral diffuse ground-glass opacities, and blood gas analysis revealed that PaO2 was 48.1 torr in room air.