Nihon Kyōbu Shikkan Gakkai zasshi
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A 52-year-old man was admitted to our hospital with chief complaints of fever, general fatigue, and weight loss. A chest roentgenogram showed hyperinflation and many small nodular shadows in both lung fields. A chest CT scan showed centrilobular shadows distributed equally over all lung fields. ⋯ Steroid therapy was started. The patient's symptoms rapidly disappeared and a chest roentgenogram showed remarkable improvement. We believe this was a very peculiar case of sarcoidosis: the patient had systemic symptoms only, and roentgenographic examinations showed hyperinflation and centrilobular shadows distributed over all lung fields.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1997
Case Reports[Massive hemoptysis in a patient with a tuberculous thoracic aneurysm].
A 91-year-old man with a history of pulmonary tuberculosis 20 years earlier came to our hospital because of hemoptysis in May 1993. A chest X-ray film showed infiltrative shadows in the left first arch of the cardiac silhouette, and sputum cultures were positive for Mycobacterium tuberculosis. Despite treatment with antituberculosis drugs, chest X-ray films revealed gradual progression, and he had occasional hemoptysis. ⋯ Sudden and massive hemoptysis occurred in January 1994. At autopsy, the wall of the aneurysm and the surrounding tissue were found to have histological changes characteristic of tuberculosis. Tuberculous thoracic aneurysms are quite rare, but may develop in patients with tuberculosis in other areas.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1997
Case Reports[Acute eosinophilic pneumonia induced by cigarette smoke].
An 18-year-old man was admitted to our hospital because of a dry cough and high fever of acute onset. A chest radiograph revealed diffuse bilateral infiltrates, mainly in peripheral lung zones. Laboratory data showed hypoxemia and leukocytosis, and no eosinophilia. ⋯ Therefore, a challenge test was done in which the patient smoked cigarettes. By 15 hours after the challenge, he had become severely hypoxemic and by 21 hours after the challenge his pulmonary function had decreased. In this patient, smoking cigarettes appeared to have induced acute eosinophilic pneumonia.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1997
Case Reports[Two patients with pulmonary hemorrhage associated with myeloperoxidase-antineutrophil cytoplasmic antibody].
We encountered two patients with pulmonary hemorrhage who had high levels of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA). Patient 1 was a 69-year-old woman. Both were admitted to our hospital complaining of hemoptysis. ⋯ Patients with pulmonary-renal vasculitic syndrome who have MPO-ANCA may be given a diagnosis of MPA. Therefore, we diagnosed MPA in these two patients. Testing for ANCA may be useful in patients with pulmonary hemorrhage and renal involvement.
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Nihon Kyobu Shikkan Gakkai Zasshi · Jan 1997
[Clinicopathological findings in 5 patients with acute eosinophilic pneumonia].
We studied 5 patients with acute eosinophilic pneumonia. Radiologic findings were Kerley's lines and pleural effusion on chest X-ray films, and interlobular septa on chest CT scans. Examination of transbronchial lung biopsy specimens revealed infiltration of eosinophils and lymphocytes into alveolar walls and edema of alveolar walls, interlobular septa, and perivascular connective tissue. ⋯ It also contained basophils and mast cells, which were not seen in fluid from normal subjects. Fluid from patients with chronic eosinophilic pneumonia had significantly fewer basophils than did fluid from those with acute eosinophilic pneumonia (p < 0.01). These findings suggest that release of chemical mediators from basophils plays a key role in interstitial edema in acute eosinophilic pneumonia.