1/8. Treatment of bronchorrhea by corticosteroids in a case of bronchioloalveolar carcinoma producing CA19-9.A case of gastrointestinal cancer-associated antigen (CA19-9)-positive bronchioloalveolar carcinoma accompanied by bronchorrhea and respiratory failure successfully treated with corticosteroids is reported. The patient was treated with pulse methylprednisolone at a dose of 1,000 mg/day for three days, followed by oral prednisolone (60 mg/day). Within 2 days, the sputum volume decreased from >100 ml/day to 20 ml/day and it was finally controlled to 0-10 ml/day. The reduction in the sputum volume was associated with alleviation of dyspnea and hypoxemia. The levels of CA19-9 in the serum and the sputum were extremely high and an immunocytochemical study showed that the tumor cells were stained by CA19-9 antibody. This case demonstrates the therapeutic value of corticosteroids in the treatment of bronchorrhea in subjects with bronchioloalveolar carcinoma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/8. Fulminant invasive pulmonary aspergillosis in immunocompetent patients--a two-case report.Two cases of invasive aspergillosis (IA) in immunocompetent patients with a fulminant fatal outcome are reported. Both patients were elderly and had a history of chronic lung disease treated with prolonged inhaled corticosteroids and a short course of systemic corticosteroids. They presented with dyspnea and fever, their respiratory function deteriorated rapidly, and they died 7 days after admission. aspergillus fumigatus was cultured from respiratory samples. IA was confirmed in one case by necropsy that showed diffuse bilateral necrotizing pneumonitis and myocarditis. In the other case, IA diagnosis was established by thoracic CT scan plus detection of Aspergillus antigen in two blood samples. These two cases demonstrate that short-term corticosteroid therapy in immunocompetent patients with underlying chronic lung conditions is a risk factor for IA, and that its evolution can be fulminant.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/8. Allergic bronchopulmonary fungal disease caused by saccharomyces cerevisiae.We describe a patient who presented with dry cough, low-grade fever, and focal patchy shadow of pulmonary infiltrates. Remarkably, the prospective etiological agent, saccharomyces cerevisiae was purely and repeatedly cultured from her sputum. Allergic bronchopulmonary mycosis (ABPM) was diagnosed based on clinical, serological, and pathological criteria. Although the patient described here satisfied only three of the criteria, the conclusion that the allergic bronchopulmonary disease in our case was induced by S. cerevisiae was made based on the following evidence: 1) S. cerevisiae was repeatedly isolated from the patient's sputum, 2) anti-S. cerevisiae antibody was detected in her serum, and 3) bronchoprovocation test to S. cerevisiae antigen was positive. We present here a case of allergic bronchopulmonary fungal disease caused by S. cerevisiae antigen.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
4/8. Bronchocentric granulomatosis associated with influenza-A virus infection.Bronchocentric granulomatosis is an unusual pathologic entity that is characterized by a necrotizing granulomatous inflammation surrounding the airways. The diagnosis is usually made retrospectively, after histopathologic examination of an open-lung biopsy or resection of a pulmonary lesion. Although the aetiology has not been fully elucidated, the current pathogenetic mechanism is considered to be an immunologic reaction against endobronchial antigens, since most patients exhibit signs of bronchial asthma, eosinophilia and allergic bronchopulmonary aspergillosis. However, non-asthmatic patients may develop bronchocentric granulomatosis without signs for endobronchial fungal infections, but probably as a consequence of other pulmonary infections. An 80-year-old female patient presented with high fever and bilateral pulmonary infiltrates and nodules. After extensive investigations and open-lung biopsy, the diagnosis bronchocentric granulomatosis was established that was possibly associated with an influenza-A virus infection. Treatment consisted of immunosuppressive drugs (prednisone and cyclophosphamide), which led to complete clinical and radiological recovery.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/8. Mucoid impaction: a localized form of allergic bronchopulmonary aspergillosis.Mucoid impaction is defined as the obstruction of proximal bronchi by mucous plugs and exudates. There are striking similarities between patients with mucoid impaction and those with allergic bronchopulmonary aspergillosis (ABPA), often referred to as "mucoid microimpaction." We evaluated three patients with mucoid impaction for diagnostic criteria of ABPA and human leukocyte antigen type. We found that certain human leukocyte antigen types were common among mucoid impaction patients and those with ABPA. It is possible that patients with mucoid impaction could represent a localized form of ABPA.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
6/8. Antigen-induced enhancement of bronchial reactivity.bronchial hyperreactivity as determined by the airway response to methacholine was evaluated pre- and post-antigen challenge in three patients with specific antigen sensitivity. No significant change in pulmonary function was noticed after inhalation of antigen alone. However, transient but significant increase in methacholine responsiveness followed the antigen challenge. The studies indicate a need for a nonspecific inhalation challenge following a negative antigen challenge when clinically indicated.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
7/8. Case report. Disseminated sporotrichosis presenting as sarcoidosis: electron microscopic and immunologic studies.A 50-year-old black man with constitutional symptoms, cutaneous nodules, and bilateral hilar adenopathy was found to have non-caseating granulomata on bronchial biopsy. He was treated with corticosteroids for sarcoidosis. Within five months he was found to have disseminated sporotrichosis. Electron microscopy revealed mycelial forms of S. schenckii in superficial lesions and yeast forms from deep tissue sites: no novel forms were seen. blood mononuclear cell studies revealed hyperactive suppressor cells with respect to non-specific T cell targets and the antigen specific target. Examination of the initial biopsy material after digestion with diastase before PAS staining revealed budding yeast consistent with S. schenckii. This case emphasizes the need for careful histopathologic examination of clinical material before a diagnosis of sarcoidosis is made, and reveals an immunologic abnormality which may account for the patient's anergic state and susceptibility to S. schenckii infection.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/8. Histopathological and immunohistochemical studies of acquired tracheobronchomalacia: an autopsy case report.A 72-year-old patient was reported to have 'saber-sheath-type' acquired tracheobronchomalacia after irradiation therapy for laryngeal cancer. The pathogenetic features of this case were demonstrated immunohistopathologically using CD68, HLA-DR, UCHL1, L26 and Ki-67 antibodies. The principal features were (a) selective destruction of the cartilage with Ki-67 stainability from the trachea to the segmental bronchi with inflammatory infiltrations of predominant T lymphocytes (UCHL1-positive) and activated macrophages (CD68-positive with marked HLA class II antigen) and (b) replacement by collagen fibers through the affected lesion. The tissues, except for the cartilage in the airway tract, were preserved without marked change, including the membranous portion. The cartilage at organs other than the airway showed no changes. We first clarified the immunohistopathology of tracheobronchomalacia. We proposed that the characteristic cell-mediated immunity against cartilage with T lymphocytes and activated macrophages in the pathogenetic features may be related to a cancer-healing tendency.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |