Tag Archives: pulmonary
Fiber-optic bronchoscopic image showing multiple submucosal nodules characteristically sparing posterior membranous (A). Narrow-band imaging not showing the intraepithelial capillary loop pattern with dark brown dots (B). Axial and coronal scan depicting calcifications within the tracheal lumen (C and D).

Polypoidal Trachea: A Clinician’s Predicament

A 44-year-old asymptomatic female patient with no known comorbidities was scheduled for donor kidney harvesting for her husband. During intubation, the anesthetist found multiple polypoidal lesions just below the vocal cords, studding the tracheal wall. A diagnosis of multiple tracheal papillomatosis was made, and the patient was referred to the Otorhinolaryngology Department for further evaluation. […]

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A Bad Sign: Dermatomyositis with Interstitial Lung Disease

The presence of an autoantibody explained why a patient with dermatomyositis had respiratory symptoms. A 52-year-old man presented with a 1-month history of fever and rash, and a 2-week history of muscle pain and muscle weakness, which made it difficult for him to rise from a sitting position. The patient denied being a smoker or […]

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Chest radiograph demonstrating 2 bilateral cavitating pulmonary infiltrates (A) and chest radiograph 9 months later demonstrating complete resolution of the infiltrates after immunosuppressive therapy (B).

Granulomatosis with Polyangiitis Presenting as Hypophysitis

A 20-year-old healthy woman presented to a local hospital with 3 months of headaches and fatigue and 3 weeks of intermittent fevers to 40°C. Physical examination was normal. White blood cell count was 6.1 × 109/L, hemoglobin 10 g/dL, sodium 153 mmol/L, and creatinine 0.80 mg/dL. Magnetic resonance imaging demonstrated a 2.1 × 1.8 × 0.9-cm cystic sellar lesion. Hormone testing […]

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The patient's posterior trunk was marked with pink urticarial papules and plaques.

Down the Rabbit Hole: Cutaneous Tuberculosis

The term “going down the rabbit hole,” based on Lewis Carroll’s Alice’s Adventures in Wonderland, is a metaphor for an entry into the unknown, the disorienting, or the mentally deranging. Although the case of a patient with a nonhealing ulcer did not set us on a path with these exact qualities, it did remind us that […]

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Progressive Dysphonia: Ortner Syndrome

A 68-year-old woman with known idiopathic heart failure and severe reduced ejection fraction was admitted for aggravation of dyspnea and recurrent dysphonia over the past 6 months, progressing to constant hoarseness. Vitals signs were normal. Laboratory tests showed normal hemoglobin and white blood cell count, increased levels of N-terminal pro-brain natriuretic peptide (NT-proBNP; 10574 pg/mL), […]

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man holding his chest

Advanced Therapies for Massive Pulmonary Embolism

The report by Secemsky et al1 in this issue of The American Journal of Medicine illustrates the current management of pulmonary embolism at the Massachusetts General Hospital (MGH). A Pulmonary Embolism Response Team sees all patients in whom pulmonary embolism is diagnosed by computed tomography. The team manages these patients during their hospitalization and after discharge for up […]

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