Ana Castro

Dermatomiosite como primeira manifestação de uma neoplasia pulmonar

Dermatomyositis (DM) is a rare disease characterised by proximal muscle weakness and a typical cutaneous rash. The muscle biopsy shows inflammatory lesions consistent with myositis, being related to an increased risk of cancer, often considered as a paraneoplastic syndrome. The authors present a case of a 63-year-old man, with progressive proximal muscle weakness and cutaneous rash, appearing in two months. The muscle and skin biopsies were consistent with DM. Chest tomography showed a nodular image in the lingular region and bronchy biopsy confirmed the diagnosis of small cell lung carcinoma (SCLC). This clinical case intends to enhance the importance of a thorough diagnostic study in patients with DM, as it is often a paraneoplastic syndrome.

Pulmonary phaeohyphomycosis: a challenge to the clinician

To the Editor: Phaeohyphomycosis is a rare, slowly progressive infection caused by a heterogeneous group of imperfect black or dematiaceous fungi that are found in plants and soil, and contain a cytoplasmic melanin-like pigment, which appears to have aetiological significance by decreasing the susceptibility of these organisms to antifungal agents. A commonly recognised species included in this group is Cladosporium spp. [1]. Although it has been described as a pathogen in immunocompromised patients, there are no reports of lung infections caused by this agent. We present the case of a 27-year-old non-smoking female chemical engineer who worked at a cork company (quality control, smelling cork stoppers daily), without relevant medical history who was admitted to the pulmonology department (Vila Nova de Gaia-Espinho Hospital Centre, Vila Nova de Gaia, Portugal) with dry cough, malaise and low fever for the previous week. On examination, she was in a good general condition without dyspnoea or fever. The chest was clear to auscultation and there was no significant lymphadenopathy or hepatosplenomegaly. The remainder of the …

WITHDRAWN: The overall impact of COPD (CAT) and BODE index on COPD male patients: correlation?

This article has been withdrawn for editorial reasons because the journal will be published only in English. In order to avoid duplicated records, this article can be found at http://dx.doi.org/10.1016/j.rppnen.2014.02.004. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

Advanced lung adenocarcinoma in an EGFR-positive patient treated with Erlotinib for 52 months

The authors present a case of a 53-years-old non-smoker Caucasian female who was diagnosed with lung adenocarcinoma (stage IA) and underwent surgical resection in 2002. Five years later, the tumor relapsed (stage IV disease) and she initiated chemotherapy with carboplatin, gemcitabine and bevacizumab as a first-line therapy. Despite partial remission after four cycles, this regimen was discontinued due to unacceptable toxicity. In 2008, the disease progressed and the patient was started on Erlotinib as second-line treatment. The patient had a sustained partial remission which she maintains at present – 52 months after initiation of Erlotinib. Molecular testing performed on the primary lung tumor revealed an Epidermal Growth Factor Receptor (EGFR) gene mutation (deletion in exon 19).

Dyspnea and Wheezing: Still a Challenge for Pulmonologists

Schwannoma is a neurogenic tumor originating from the nerve sheath Schwann cells. Intrathoracic location is rare, and the endobronchial location is exceptional. Schwannoma is a rare tumor; the majority of lesions are benign and usually asymptomatic. The authors present a case report of a 83-year-old woman, nonsmoker, observed in the emergency department for wheezing and cough lasting for 2 months. Chest tomography showed a right hilar pulmonary mass, ill defined, with thick and irregular walls, centered on the upper lobe bronchus, which was obliterated. Fiberoptic bronchoscopy showed a necrotic mass obstructing the right upper lobe bronchus whose biopsy allowed the diagnosis of benign schwannoma. Subsequently, the patient carried tumor ablation by laser bronchoscopy, with the resolution of the respiratory symptoms. This case stands out for its rarity but also because it is an excellent example of the importance of endoscopic techniques for therapeutic purposes. Schwannoma is a benign tumor in which surgical or endoscopic intervention generally prevents local recurrence and associated clinical manifestations.