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Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, United Kingdom.
We report a case of non-ST elevation myocardial infarction in a 36-year-old man with Erdheim-Chester disease (ECD). Multimodality assessment revealed acute coronary thrombus with simultaneous recurrent pulmonary embolism in spite of compliance with a direct oral anticoagulant. Prior case reports of acute myocardial infarction in this population have not outlined the role of catheter based intravascular assessment and treatment in this rare clinical entity.
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Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
Concurrent mutations in tumor protein p53 (TP53) or Kelch-like ECH-associated protein 1-nuclear factor erythroid 2-related factor 2-pathway components are linked to poor outcomes in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), but the impact of triple mutations remains unclear. We report a case of EGFR-, TP53-, and Cullin 3 (CUL3)-mutant NSCLC in a 43-year-old woman with widespread metastases at diagnosis, including those in the contralateral lung, distant lymph nodes, pericardium, liver, bones, left adrenal gland, and brain. She received osimertinib as first-line therapy, but pericardial effusion and liver metastases progressed rapidly over 3 months, and she was switched to carboplatin and pemetrexed.
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The fibroblastic sleeve is a structure potentially enveloping any intravascular device. At ultrasound scan, it typically presents as a thin layer of variably echogenic material covering the catheter surface, which usually tends to remain into the vessel after the catheter removal. However, several case reports have documented its migration toward the heart or pulmonary artery after a central venous catheter removal.
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Department of Critical Care, Hospital Universitario de La Princesa, Madrid, Spain.
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Shifa International Hospital/Shifa Tameer e Millat University, Islamabad, Pakistan.
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