Idiopathic bronchocentric granulomatosis in an asthmatic adolescent.

Bronchocentric granulomatosis in asthmatic patients has been generally considered to be associated with allergic bronchopulmonary aspergillosis and represent a histopathologic manifestation of fungal hypersensitivity. Here we report a case of an idiopathic bronchocentric granulomatosis in a 17-year-old man with a history of asthma. He was admitted to the hospital with a fever and cough, and a chest CT scan showed peribronchial consolidation in the pulmonary parenchyma, which was unresponsive to antibiotic therapy.

Procalcitonin-guided antibiotic therapy in aspiration pneumonia and an assessment of the continuation of oral intake.

Background: Procalcitonin-guided antibiotic therapy for community-acquired pneumonia is effective and safe. However, the usefulness of procalcitonin for aspiration pneumonia and its nutrition-related outcomes are unknown.

Methods: We conducted a noninferiority randomized controlled study in patients with aspiration pneumonia who were admitted to our hospital between September 2010 and January 2012.

Intrathoracic administration of OK-432 elevates the serum procalcitonin levels.

Objective: The intrathoracic administration of OK-432, a lyophilized preparation of the heat- and penicillin-treated Su-strain of type 3, group A Streptococcus pyogenes, is performed in Japan for pleurodesis of malignant pleural effusion or pneumothorax. Persistent fever is often observed after pleurodesis. To elucidate whether procalcitonin (PCT) is useful for distinguishing between the side effects of OK-432 and infection, we measured the serum PCT levels before and after pleurodesis.

Chyloptysis after ligation of the thoracic duct.

Chyloptysis is a very rare clinical finding. We describe a 44-year-old man who presented with cough and milky-white sputum. Fiberoptic bronchoscopy revealed white sputum, which originated from the right B(6) bronchus.

[Retrospective analysis of pemetrexed plus cisplatin chemotherapy for elderly advanced non-small-cell lung cancer].

Background: The efficacy of pemetrexed(PEM)plus cisplatin(CDDP)therapy for chemotherapy-naive non-squamous cell lung cancer has been reported, but the effectiveness of such a regimen for elderly patients is unknown.

Purpose: The aim of this study is to examine the efficacy and toxicity of CDDP plus PEM therapy for elderly patients, retrospectively.

Methods: We performed a retrospective analysis of six patients 75 years old or older with non-squamous lung cancer, who underwent CDDP plus PEM therapy from June 2009 to May 2010.

[A case of Wegener's granulomatosis with orbital inflammatory pseudotumor].

An 80-year-old woman, who had been received steroid therapy to treat diffuse alveolar hemorrhage from July, 2007, was admitted because of fever, eye pain and exophthalmos on 23 July, 2008. Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) was positive, but pulmonary involvement did not recur. 67Ga scintigraphy revealed intense uptake in bilateral orbital walls and Gd-enhanced MRI indicated orbital inflammatory pseudotumor and hypertrophic pachymeningitis.

[A case of pulmonary alveolar proteinosis presenting with peripheral ground-glass opacitiy].

A 65-year-old asymptomatic nonsmoker woman was found to have bilateral ground glass opacities in subpleural areas. The bronchoalveolar lavage fluid had a light-milky appearance and transbronchial lung biopsy revealed alveolar filling with PAS-positive acellular material. The patient was given a diagnosis of pulmonary alveolar proteinosis (PAP).

[A case of multicentric Castleman's disease with metachronous pulmonary and nephric (renal) involvement].

A 52-year-old woman was referred to our hospital due to cough and sputum in January, 1996. Chest CT scans showed multiple hilar and mediastinal lymphadenopathy and laboratory tests revealed anemia, strong inflammatory reaction, polyclonal hyperimmunoglobulinemia, and an elevated interleukin-6 level. Video-assisted thoracoscopic lung biopsy revealed lymphocytic and plasmacytic infiltration around the bronchovascular band, suggesting a diagnosis of Castleman's disease, and so we began to administer steroids.

[A fatal case of pulmonary non-tuberculous mycobacteriosis with reactive AA amyloidosis].

We report a very rare fatal case of reactive AA amyloidosis following pulmonary non-tuberculous mycobacteriosis (PNTM). A 61-year-old woman with a history of PNTM since 1992, whose treatment was difficult because of liver dysfunction and drug eruption caused by antibiotics, had been hospitalized due to recurrent pulmonary bacterial infection. She complained of leg edema in January, 2000, and nephrotic syndrome was diagnosed in February.

Macroscopic and histological findings in the healing process of inhalation injury.

Although many investigators reported the diagnostic and therapeutic value of bronchoscopy in the early stage of inhalation injury, few findings in the late stage of inhalation injury have been reported. We investigated histopathological changes of in trachea and bronchi after inhalation injury. Five survivors with inhalation injury underwent bronchoscopic examinations combined with biopsies from the early stage to the late stage.

[A case of Ortner syndrome caused by primary pulmonary hypertension].

Left vocal cord palsy is a rare complication of pulmonary hypertension (also known as Ortner syndrome). Here we report a case of a patient with Ortner syndrome caused by primary pulmonary hypertension (PPH). The patient was a 28-year-old woman, who complained of persistent hoarseness and dyspnea on effort.