ABSTRACT
A spontaneous tracheal rupture is rare and life-threatening. We postulate that long-term steroid administration is an under-reported risk factor. We present a case of an impending spontaneous tracheal rupture in a 51-year-old female with a significant medical history of systemic lupus erythematosus and interstitial lung disease, and a drug history of chronic steroid intake for 9 months. An impending tracheal rupture was diagnosed by computed tomography, which prompted surgery. A right thoracotomy, followed by a posterior tracheal repair via an intercostal muscle flap, was done, with venovenous extracorporeal membrane oxygenation support throughout the operation.
ABSTRACT
Multifocal micronodular pneumocyte hyperplasia (MMPH) is the lesser known pulmonary manifestation of tuberous sclerosis. It manifests radiologically as diffuse small ground-glass and solid nodules. Accurate diagnosis is essential as it can be mistaken for miliary tuberculosis or malignant lesions which necessitates specific treatment. Constellation of radiological features such as multicentric disease at onset and stability over time can help to distinguish MMPH from its differentials. Histologically, MMPH is characterized by hamartomatous proliferation of type II pneumocytes with a lack of high nuclear to cytoplasmic ratio. MMPH confers a benign prognosis unlike its differentials. Therefore, accurate diagnosis is paramount in ensuring appropriate care is delivered. Here, we describe the radiological and histological features of MMPH in a patient with genetically proven tuberous sclerosis complex and co-existing lymphangioleiomyomatosis.
ABSTRACT
Pulmonary sclerosing pneumocytoma is a rare tumour with 23 cases reported to have metastasis to lymph nodes, but to date, only 6 had involved mediastinal nodal stations. Our patient was a 40-year-old Asian female with a 2.5 cm nodule in her right lower lobe. Positron-emission tomography suggested no nodal disease; but after resection, the intra-lobular, hilar and subcarinal nodes were all found to be involved. As prognosis of this rare disease is uncertain, we aim to report our findings against available literature and similar cases.
