The Journal of the Japan Society for Respiratory Endoscopy
Online ISSN : 2186-0149
Print ISSN : 0287-2137
ISSN-L : 0287-2137
Volume 35 , Issue 3
Showing 1-50 articles out of 210 articles from the selected issue
  • Type: Cover
    2013 Volume 35 Issue 3 Pages Cover1-
    Published: May 25, 2013
    Released: October 29, 2016
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  • Type: Appendix
    2013 Volume 35 Issue 3 Pages App1-
    Published: May 25, 2013
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  • Type: Appendix
    2013 Volume 35 Issue 3 Pages App2-
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  • Type: Appendix
    2013 Volume 35 Issue 3 Pages App3-
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 2-
    Published: May 25, 2013
    Released: October 29, 2016
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  • Type: Appendix
    2013 Volume 35 Issue 3 Pages 3-
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 4-5
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 6-14
    Published: May 25, 2013
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 15-17
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 18-22
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 23-26
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 27-29
    Published: May 25, 2013
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  • [in Japanese], [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 30-34
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 35-38
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 39-42
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 43-48
    Published: May 25, 2013
    Released: October 29, 2016
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  • Type: Appendix
    2013 Volume 35 Issue 3 Pages App4-
    Published: May 25, 2013
    Released: October 29, 2016
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  • Type: Index
    2013 Volume 35 Issue 3 Pages Toc1-
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  • Type: Index
    2013 Volume 35 Issue 3 Pages Toc2-
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 241-242
    Published: May 25, 2013
    Released: October 29, 2016
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  • Fumihiro Asano, Motoi Aoe, Yoshinobu Ohsaki, Yoshinori Okada, Shinji S ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 243-251
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 252-
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 253-
    Published: May 25, 2013
    Released: October 29, 2016
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  • Shozaburo Yamaguchi, Takayuki Kaburagi, Risa Shimada, Norihiro Haraguc ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 254-258
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Although thoracoscopy under local anesthesia is widely used, the appropriate time for removal of the chest tube after this procedure is unknown. We prospectively studied patient toleration of chest tube removal on the same day as diagnostic thoracoscopy under local anesthesia (hereinafter called "same-day removal"). Method. The study was conducted on 30 patients with pleurisy who were determined to require thoracoscopy for further evaluation and who were aged 20-79, had a percutaneous oxygen saturation of ≥90%, pleural effusion less than half the thoracic cavity, and were judged by a pulmonologist on a previous examination to be candidate to undergo same-day removal. After the patient underwent thoracoscopy with local anesthesia, the indwelling chest tube was removed on the same day. We evaluated the surgical success rate of same-day removal, time to chest tube removal, reasons for failure of same-day removal, and complications and the incidence of pleural effusion within 1 month of the procedure. Results. From August 2009 through February 2011, we enrolled 30 consecutive patients. One of these 30 patients was excluded due to cancellation of thoracoscopy, 2 other patients were excluded because it was thought that pleurodesis was necessary at the time of thoracoscopy. And the remaining 27 patients were studied. Among these 27 patients, 13 had cancerous pleurisy, 6 had tuberculous pleurisy, 1 had chronic empyema, 1 had reactive pleurisy, and 6 had nonspecific pleurisy. Same-day removal, which averaged 5.4 hours, was successful in 26 patients (96%). Patients unsuitable for same-day removal included 1 patient who suffered pneumothorax in the contralateral lung. Complications such as subcutaneous emphysema and pneumothorax occurred, and 2 patients required removal of pleural effusion within 1 month of the procedure. Conclusion. As long as patients are chosen appropriately, same-day removal is considered to be adequately tolerable.
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  • Kazuya Tone, Kazushi Yoshida, Kyuto Odashima, Masamichi Takagi, Kazuyo ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 259-264
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Tracheobronchomalacia cause functional tracheal/bronchial stenosis. However, recently, a new criterion, excessive dynamic airway collapse (EDAC), has been proposed. There are still few reports on EDAC. Case. A 50-year-old woman could not move due to dyspnea, and was brought to our hospital by ambulance. Abdominal computed tomography (CT) revealed a giant ovarian tumor. This tumor was considered to be an etiological factor for respiratory failure and ventilation disorder. Emergency surgery was performed. As weaning from the ventilator was difficult after surgery, bronchoscopy was conducted. The tracheal mucosa was normal, but the trachea showed crescent-like stenosis. Complete occlusion was observed on coughing. There were no changes in the tracheal cartilage area, and the membranous area relaxation on expiration was adjacent to the anterior wall of the trachea, leading to a diagnosis of EDAC. While maintaining the PEEP at 8 cm H_2O, artificial respiration was switched to CPAP therapy with non-invasive positive pressure ventilation to achieve weaning from the ventilator. The respiratory state stabilized. Conclusion. When withdrawal from control with a ventilator is difficult, bronchoscopy should be performed, considering the possibility of EDAC.
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  • Takashi Oki, Tomoko Kobayashi, Tsukasa Hataoka, Tadataka Sekiyama, Yos ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 265-270
    Published: May 25, 2013
    Released: October 29, 2016
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    Case. A 66-year-old woman had been treated with propylthiouracil (PTU) for hyperthyroidism since the age of 52. She was admitted because of a productive-cough and infiltrative shadows in the right lower lobe on chest X-ray and CT images. The serum level of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) was very high (9400 EU). PTU was discontinued, and fiberoptic bronchoscopy was performed. The bronchoalveolar lavage fluid was not bloody, but contained Pasteurella multocida. The histopathological examination of the biopsy specimen obtained by a transbronchial lung biopsy revealed non-necrotizing vasculitis and an organizing pneumonia pattern. PTU induced pneumonia with vasculitis was diagnosed and she was treated with antibiotics with no administration of PTU. Although the high titer of serum MPO-ANCA persisted, her symptoms and chest radiograph findings gradually improved. Conclusion. While pulmonary alveolar hemorrhage with ANCA associated vasculitis caused by PTU have been reported, there have been few reports of lung injury induced by PTU. This report presented a case of PTU-associated lung injury. We discussed the pathological findings and the involvement of an infection.
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  • Masaki Kawamura, Chiaki Endo, Akira Sakurada, Yoshinori Okada, Yasushi ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 271-276
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Postoperative bronchial stump fistula and pyothorax are difficult to manage. Recently various bronchoscopic interventions have been reported. Case 1. A 72-year-old man developed a pyopneumothorax after right lower lobectomy and wedge resection of middle lobe. Bronchoscopy showed a bronchial fistula 3 mm in diameter at the right lower bronchial stump. Polidocanol was bronchoscopically injected to the fistula but it was ineffective. Polyglycolic acid sheet with fibrin glue was inserted into the fistula over and over, and finally air-leakage stopped. This patient is free from relapse of pyopneumothorax 26 months after the bronchoscopic intervention. Case 2. A 67-year-old man developed pyothorax after left lower lobectomy and thoracic curettage was performed. Bronchoscopy revealed necrosis of the left lower bronchial stump and micro fistula. The bronchoscopic intervention with polyglycolic acid sheet and fibrin glue resulted in the closure of the fistula. This patient died of meningitis carcinomatosa 9 months after the intervention without relapse of pyothorax. Conclusion. Bronchoscopic intervention for bronchial stump fistula with polyglycolic acid sheet and fibrin glue is simple and effective method.
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  • Rei Kobayashi, Masahiro Kaji, Shou Horiuchi, Naofumi Miyahara, Yumi Hi ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 277-280
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Bevacizumab (Bev) is an effective cytotoxic agent for non-small cell lung cancer (NSCLC). Tumor cavitation sometimes occurs due to chemotherapy by Bev. Case. Left lower lobectomy was performed for a 71-year-old woman with NSCLC 5 years previously. However, multiple pulmonary metastases and left hilar lymph nodes metastasis was diagnosed and then chemotherapy was started 2 years previously. Tumor cavity formation was recognized, after the patient received chemotherapy with CBDCA + PEM + Bev 2 months before the present report. Necrotic tumor cells then obstructed the left main bronchus, resulting in sudden respiratory failure. Conclusion. We should be aware of the possibility of airway occlusion caused by necrotic tumor cells when we treat the patients with central lung cancer by Bev.
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  • Yumi Hino, Masahiro Kaji, Sho Horiuchi, Naofumi Miyahara, Rei Kobayash ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 281-284
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. We report a case of surgery for mucoepidermoid carcinoma associated with recurrent obstructive pneumonia. Case. A 39-year-old woman was referred to our hospital for a tumor that was detected in the left lung by computed tomography performed because of pneumonia. The tumor appeared to be a mass lesion protruding into the lumen of the posterior basal segmental bronchus (Blo). Although bronchoscopy was performed, no definitive diagnosis was obtained. Thus, surgery was performed for both diagnosis and treatment. The intraoperative frozen section pathological diagnosis was mucoepidermoid carcinoma. Because it was a low-grade malignant tumor, left basal segmentectomy and lymphadenectomy were performed. Conclusion. Mucoepidermoid carcinoma, which is relatively rare, is likely to be associated with obstructive pneumonia due to the characteristics of the tumor. It should be noted that a mass lesion may be a factor in some cases of pneumonia, as shown in our case. We also consider that, in case of a low-grade malignant tumor, limited surgery is well indicated and should be actively considered.
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  • Atsushi Yamanaka, Nobuyuki Ono, Daisuke Himeji
    Type: Article
    2013 Volume 35 Issue 3 Pages 285-290
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Bronchopulmonary actinomycosis associated with a foreign body is rare. Case. A 77-year-old man suffered from pneumonia repeatedly in the right upper lobe over a long period. A chest CT scan showed partial collapse and an infiltrative shadow in the right S^3. Soft tissue shadow associated with a partially calcified lesion in the right B^3 bronchus was recognized. Bronchoscopy revealed a granulomatous lesion associated with a brownish-yellow structure in the proximal right B^3 bronchus. Cytologic examination of the brushing sample from this lesion revealed Actinomyces. The granulomatous lesion improved after administration of ampicillin for 6 weeks. The structure in the right B^3 bronchus was removed by bronchoscopic biopsy forceps, and it was found to be a foreign body, a bone fragment. Accordingly we diagnosed bronchopulmonary actinomycosis induced by bone fragment aspiration. The patient has been asymptomatic since removal of the foreign body. Conclusion. This was a rare case of bronchopulmonary actinomycosis associated with an endobronchial foreign body. It is very difficult to make a diagnosis of actinomycosis because Actinomyces is one of the indigenous oral bacteria and its cultivation is very difficult. The possibility of an endobronchial foreign body should be suspected in patients with bronchopulmonary actinomycosis.
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  • Takeshi Orihashi, Chiharu Yoshii, Kanako Hara, Takaaki Ogoshi, Tsutomu ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 291-295
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Anomalous bronchi are divided into supernumerary bronchi and displaced bronchi. Displacement of a lobar bronchus is unusual, especially cases in which the right upper lobe bronchus is displaced into the right middle lobe bronchus. Case. A 75-year-old man complained of high fever and cough in August, 2011. Although he was treated by antibiotics in another hospital, but since his symptoms did not improved, he was referred to our hospital. Chest CT showed consolidation with an air bronchograms in the right upper and middle lobe bronchi, and also in the left S^5 segment. 3D-CT and fiberoptic bronchoscopy revealed that the right upper lobe bronchus bifurcated from the right middle lobe bronchus, therefore we diagnosed this case as a displaced bronchus. There was no anomaly in other organs or in the pulmonary arteries. Transbronchial lung biopsy through the displaced right upper bronchus revealed a histologic pattern consistent with cryptogenic organizing pneumonia. Treatment with corticosteroids reduced clinical symptoms rapidly and improved imaging findings. There was no relapse of infection and organizing pneumonia after that time. Conclusion. We reported a case of displaced right upper bronchus bifurcating from the right middle lobe bronchus accompanied by cryptogenic organizing pneumonia. In this case, there was no previous history of pneumonia, therefore we concluded that there was no relationship between the anomalous bronchus and the organizing pneumonia.
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  • Yoko Kida, Toshihiko Kaneda, Masahiro Kaneko, Hiroshi Fujii, Hiromi To ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 296-299
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Congenital bronchial atresia is rare. Case. An asymptomatic 25-year-old woman who had no remarkable medical history was referred to our hospital because of abnormal shadows on chest X-ray detected on a routine health check-up. Chest CT showed mucoid impaction in left B3 and a low attenuation area in the left upper lobe. Although we could not detect a bronchial atresia by bronchoscopy, 3D chest CT using multiplanar reconstruction and the volume rendering method revealed a bronchial atresia of left B^3. Ventilation lung scintigram (^<81m>Kr) and perfusion lung scintigram (^<99m>Tc-MAA) showed matched segmental defects of left upper lobe. She had no history of recurrent infectious diseases from birth. We diagnosed congenital bronchial atresia. Conclusion. Congenital bronchial atresia is a rare disease, but it is important to recognize it as one of the differential diagnoses for asymptomatic young people with abnormal chest shadows. If the diagnosis of a congenital bronchial atresia by bronchoscopy is difficult, 3D-CT is a noninvasive and very useful method.
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  • Keita Takeda, Satoshi Shiono, Toshimasa Okazaki, Masami Abiko, Toru Sa ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 300-304
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Castleman's disease is uncommon. Case. A 64-year-old man presented with a mediastinal tumor in the anterotracheal region on chest CT. Contrast-enhanced CT revealed a 48-mm hypervascular tumor. PET/CT revealed FDG accumulation by the tumor. EBUS-TBNA of the tumor did not yield a conclusive diagnosis. As the tumor gradually grew, we diagnosed possible malignant mediastinal tumor was made, and surgery was performed. Histopathologically, it was diagnosed as a hyaline vascular type of Castleman's disease. Conclusion. We describe a case of Castleman's disease that was difficult to diagnose.
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  • Kiyoshi Kanno, Masaya Akai, Tomohiro Kato, Toshihiko Tada, Kizuku Wata ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 305-309
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. Paragonimiasis is a parasitic disease caused by Paragonimus westermani, which is transmitted by the consumption of raw or undercooked freshwater crabs, such as Eriocheir japonica and Geothelphusa dehaani, or boar meat. Case. A 54-year-old woman was referred to our department because of left-sided pleural effusion. Fibrin deposits in the thoracic cavity were thoracoscopically removed under local anesthesia, followed by chest-tube drainage which led to resolution of the effusion, with no recurrence; however, the patient was referred to our department again 9 months later because of pleural effusion on the right side associated with a right pneumothorax. Peripheral blood examination revealed an increased eosinophil count and elevation of the serum IgE level, and chest CT revealed pleura-based nodules extending to the right upper and lower lobes. Parasite-specific antibody responses were examined based on the patient's history of habitual boar meat consumption, and Paragonimus westermani infection was diagnosed. Fibrin deposits in the thoracic cavity were thoracoscopically removed under local anesthesia, followed by drainage of the pleural effusion and oral administration of praziquantel, an antiparasitic drug. There was no recurrence of the pleural effusion, and the parasite-specific antibody titers also decreased following treatment. Conclusion. The condition in this patient was thought to be caused by migration of the parasite from the initial location in the left lung to the right thoracic cavity.
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  • Hiroyuki Minemura, Hiroshi Yokouchi, Ken-ichiro Hirai, Satoko Sekine, ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 310-314
    Published: May 25, 2013
    Released: October 29, 2016
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    Case. A 57-year-old woman was referred to our hospital because of stridor, dyspnea on effort, and sensations of chest and back oppression. Chest computed tomography (CT) showed right hilar lymphadenopathy (#118). EBUS-TBNA was performed. Tissue specimens obtained by EBUS-TBNA revealed lymphoid follicle-like structure. Frozen specimens obtained by redo EBUS-TBNA later demonstrated IgH gene rearrangement and fusion of IgH-BCL2. Given the results of immunohistochemistry as well as the gene analysis, this case was diagnosed as follicular lymphoma. Conclusion. Accurate diagnosis of lymphoma requires identification of subtypes for subsequent treatment strategies. Thus, it is necessary to make optimal arrangements in advance for obtaining specimens from lesions suspected to be lymphoma by EBUS-TBNA.
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  • Katsutoshi Ando, Kouichi Sato, Kazuhisa Takahashi
    Type: Article
    2013 Volume 35 Issue 3 Pages 315-320
    Published: May 25, 2013
    Released: October 29, 2016
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    Background. PR3-ANCA is a highly specific marker for granulomatosis with polyangiitis (GPA). Because of its high diagnostic value, the diagnosis in GPA patients with MPO-ANCA-positive or PR3-ANCA-negative is occasionally laborious. Case. A 75-year-old man was admitted with fever, cough and zygomatic pain. Computed tomography (CT) of the chest and magnetic resonance imaging (MRI) of the paranasal sinus demonstrated the segmental consolidation containing an air bronchogram in the right middle lobe bronchus and mucosal swelling in the left maxillary sinus, respectively. Laboratory data included MPO-ANCA was elevated (287 EU), but negative for PR3-ANCA. Bronchoscopy demonstrated multiple ulcerative lesions in the trachea and bronchi. Tissue specimens obtained from lung and paranasal mucous membranes resulted in the detection multinucleated giant cells which suggested GPA. Although we could not detect typical findings such as palisading granuloma, urinalysis showed proteinuria and hematuria, indicating affected kidneys besides upper and lower respiratory lesions. Hence, we finally diagnosed GPA for typical clinical and bronchoscopic findings. After initiation of prednisolone, cyclophosphamide and sulfamethoxazole trimethoprim, his clinical and imaging findings dramatically improved. Conclusion. Bronchoscopy enabled diagnosis and initiation of treatment for shortly after onset. We should consider the bronchoscopy early in patients whose GPA is suspected.
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  • Daisuke Taniyama, Shuko Tsujimura, Fumio Sakamaki
    Type: Article
    2013 Volume 35 Issue 3 Pages 321-325
    Published: May 25, 2013
    Released: October 29, 2016
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    Case. A 55-year-old man presented with sudden onset of chest discomfort followed by cough and hemoptysis. He had only one previous episode of hemoptysis. Seventeen years earlier, without any other symptoms. On the admission day, a dynamic computed tomography (CT) of the chest showed no abnormal pulmonary lesions, but there was a mass contrast effect in the right lung hilar region, suggesting a connection between the right bronchial artery and the pulmonary artery. Bronchoscopy revealed bleeding from the right lower lobe. The right bronchial arteriogram showed a connection between the right bronchial artery and the pulmonary artery. A diagnosis of idiopathic bronchial artery-pulmonary artery fistula (BPAF) was made because of no other obvious findings on CT. The patient underwent bronchial artery embolization (BAE) to stop the hemoptysis and was discharged. However, he had hemoptysis again 4 and 6 months later. The right bronchial arteriogram showed reperfusion at the BAE site. BAE was again performed, and he was discharged. Conclusion. Although BPAF is extremely rare, it should be considered as a cause of repeated hemoptysis.
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 326-
    Published: May 25, 2013
    Released: October 29, 2016
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    Type: Article
    2013 Volume 35 Issue 3 Pages 326-
    Published: May 25, 2013
    Released: October 29, 2016
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    Type: Article
    2013 Volume 35 Issue 3 Pages 326-327
    Published: May 25, 2013
    Released: October 29, 2016
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    Type: Article
    2013 Volume 35 Issue 3 Pages 327-
    Published: May 25, 2013
    Released: October 29, 2016
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    Type: Article
    2013 Volume 35 Issue 3 Pages 327-328
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 328-
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 328-
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 328-
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 328-329
    Published: May 25, 2013
    Released: October 29, 2016
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  • [in Japanese]
    Type: Article
    2013 Volume 35 Issue 3 Pages 329-
    Published: May 25, 2013
    Released: October 29, 2016
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    Download PDF (257K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 329-
    Published: May 25, 2013
    Released: October 29, 2016
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    Download PDF (257K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 329-
    Published: May 25, 2013
    Released: October 29, 2016
    JOURNALS FREE ACCESS
    Download PDF (257K)
  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    Type: Article
    2013 Volume 35 Issue 3 Pages 329-
    Published: May 25, 2013
    Released: October 29, 2016
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