ABSTRACT
A 73-year-old woman was admitted to our hospital for treatment of vomiting. Four months previously, she had been diagnosed with lung adenocarcinoma (cT3N3M1a stage IVA) and started receiving afatinib as first-line treatment. On admission, the primary tumor had shrunk, but abdominal computed tomography revealed a new retroperitoneal lesion causing duodenal obstruction and hydronephrosis. She underwent gastrojejunostomy, and a biopsy of the peritoneum revealed adenocarcinoma. She was treated with second-line chemotherapy but developed cerebral infarction and died 104 days after admission. An autopsy revealed marked fibrosis with scattered tumor cells in the retroperitoneum. The underlying mechanism of the metastasis is discussed.
Subject(s)
Adenocarcinoma of Lung , Lung Neoplasms , Retroperitoneal Fibrosis , Retroperitoneal Neoplasms , Adenocarcinoma of Lung/drug therapy , Afatinib , Aged , Autopsy , ErbB Receptors , Female , Fibrosis , Humans , Lung Neoplasms/drug therapySubject(s)
Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium/drug effects , Pneumonia, Bacterial/microbiology , Antitubercular Agents/pharmacology , Genes, Bacterial , Genetic Heterogeneity , Humans , Microbial Sensitivity Tests , Molecular Sequence Data , Molecular Typing , Mycobacterium/genetics , Mycobacterium/isolation & purification , Mycobacterium Infections, Nontuberculous/diagnosis , Pneumonia, Bacterial/diagnosis , RNA, Ribosomal, 16S/genetics , Retrospective StudiesABSTRACT
We report a cluster of infections in four female Thai immigrants aged between 35 and 49 years who developed paragonimiasis westermani within 16 months of ingesting freshwater crabs purchased from a market in Japan. Their symptoms included cough, bloody sputum, chest pain, and dyspnea. Radiographic and CT findings comprised pleural effusion, pneumothorax, air-space consolidation, and nodular opacities. Paragonimus eggs were identified in the feces of one patient, and in the pleural effusion and the bronchoalveolar lavage fluid (BALF) of another. All diagnoses of paragonimiasis westermani were established by enzyme-linked immunosorbent assay (ELISA) of their serum. Paragonimiasis is a re-emerging disease in Japan. Moreover, since the number of immigrant patients is increasing, it is necessary to pay attention to infectious diseases resulting from their eating habits as well as imported diseases.
