Lung India : official organ of Indian Chest Society
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Amyloidosis is a spectrum of diseases, in which various proteins which are usual components of plasma are deposited as insoluble beta-pleated sheets extracellularly, disrupting function of various organs. Amyloid light-chain amyloidosis occurs due to the deposition of proteins, derived from immunoglobulin light chains, routinely manifesting with multisystem involvement. ⋯ We hereby report two cases of pulmonary amyloidosis, one being a case of diffuse alveolar septal pulmonary amyloidosis, which is an extremely rare pattern of involvement, with a very poor prognosis, and the other one being tracheobronchial pattern of involvement, which usually results due to the localized deposition of amyloid in the tracheobronchial tree. Knowledge about pulmonary amyloidosis is important due to its poor prognosis and nonspecific findings in CT chest.
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Asthma is a chronic disease of the airways affecting a large number of people across the globe. Uncontrolled asthma poses an emotional as well as the physical burden on patients and results in a great economic burden. "Exacerbation-prone phenotype" asthmatics are a cluster of patients who may suffer from more frequent and severe exacerbations than other asthmatics. ⋯ Caring for the patient with "exacerbation-prone asthma" needs participation from both the doctor as well as the patient. Self-management, improving knowledge about the disease, control of comorbidities, and a stepwise approach with the use of a single inhaler maintenance and reliever therapy in patients with severe asthma could help in delivering better care for the "exacerbation-prone phenotype" of asthmatics.
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Few studies have reported on the utility of ultrathin bronchoscopes (UTBs) for performing radial probe endobronchial ultrasound (EBUS). Herein, we describe our experience with UTB and conventional bronchoscope (CB) for performing radial EBUS. ⋯ Despite smaller lesions, radial EBUS performed with the UTB was found to have similar efficacy to that performed with the CB. More lesions could be visualized endobronchially using the UTB making it an attractive alternative for performing radial EBUS.
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A 43-year-old female with a medical history of renal stones, hypertension, diabetes mellitus Type 2, and depression presented to her urologist with bilateral flank pain. She complained of worsening exertional dyspnea over the last several months with recent weight gain. She also endorsed night sweats and intermittent, scant hemoptysis over the past year. ⋯ Physical examination was unremarkable. Computed tomography scan of abdomen and pelvis demonstrated bilateral nonobstructing renal stones and a 1.8 cm × 1.7 cm nodular opacity in the right lower lobe of the lung, not present on previous scan 1 year prior. Surgical wedge resection was performed and subsequent pathologic examination demonstrated a 1.2 cm × 0.6 cm × 0.5 cm soft, gelatinous well-demarcated mass in the right lower lobe wedge specimen without gross evidence of necrosis or hemorrhage confirming colloid adenocarcinoma of the lung.
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A 69-year old bed-bound woman presented with chest pain and diaphoresis. Diagnostic imaging led to the diagnosis of bilateral extensive pulmonary emboli extending into all segmental branches. ⋯ Repeat evaluation after 33 hours revealed improvement of right ventricular size and function. EKOS catheters are useful for administration of fibrinolytics in pulmonary embolism.