ABSTRACT
Central airway obstruction can result from various benign and malignant conditions, and often requires prompt palliation. The efficacies of a variety of bronchoscopic techniques for the treatment of central airway obstruction such as electrocautery, laser, brachytherapy, argon plasma coagulation and cryotherapy have been established. An insulation-tipped diathermic knife-2 (IT knife-2) was initially introduced for gastrointestinal endoscopic submucosal dissection and has been used globally as a safe and effective instrument. However, its use has not been reported for the treatment of endotracheal or endobronchial lesions. Here, we report the case of central airway obstruction in a 65-year-old male due to malignancy and a 52-year-old-female with post-radiation bronchial stenosis that were treated successfully with the IT-knife-2 via flexible bronchoscopy.
Subject(s)
Aged , Humans , Male , Airway Obstruction , Argon Plasma Coagulation , Brachytherapy , Bronchoscopy , Constriction, Pathologic , Cryotherapy , Electrocoagulation , Lung NeoplasmsABSTRACT
Immunoglobulin G4 (IgG4)-related disease is a newly recognized condition characterized by fibroinflammatory lesions with dense lymphoplasmacytic infiltration, storiform-type fibrosis and obliterative phlebitis. The pathogenesis is not fully understood but multiple immune-mediated mechanisms are believed to contribute. This rare disease can involve various organs and pleural involvement is even rarer. We report a case of IgG4-related disease involving pleura. A 66-year-old man presented with cough and sputum production for a week. Chest radiography revealed consolidation and a pleural mass at right hemithorax. Treatment with antibiotics resolved the consolidation and respiratory symptoms disappeared, but the pleural mass was unchanged. Video-assisted thoracoscopic surgery was performed. Histopathology revealed dense lymphoplasmacytic infiltration and storiform fibrosis with numerous IgG4-bearing plasma cells. The serum IgG4 level was also elevated. Further examination ruled out the involvement of any other organ. The patient was discharged without further treatment and there is no evidence of recurrence to date.
Subject(s)
Aged , Humans , Anti-Bacterial Agents , Autoimmune Diseases , Cough , Fibrosis , Immunoglobulin G , Immunoglobulins , Phlebitis , Plasma Cells , Pleura , Pleural Neoplasms , Radiography , Rare Diseases , Recurrence , Sputum , Thoracic Surgery, Video-Assisted , ThoraxABSTRACT
Amiodarone is one of the most commonly prescribed antiarrhythmic drug for almost all atrial or ventricular arrythmias. Amiodarone-induced pulmonary toxicity (APT) was first described in 1980 and has potentially serious side effects that are believed to develop in 5% of patients. In general, APT occurs only when high amiodarone doses are used for a long time. However, during short-term therapy of amiodarone, APT is rarely reported. In this report, we describe a case of amiodarone-induced pulmonary toxicity after a short course of amiodarone therapy for atrial fibrillation.