A case of numerous atypical adenomatous hyperplasia diagnosed by a video-assisted thoracoscopic lung biopsy

A 46-year-old male was referred to our hospital due to abnormal opacities on chest X-rays. High-resolution CT disclosed focal ground glass attenuation counting up to more than one hundred throughout both lung fields. A wedge-shaped excision by a video-assisted thoracoscopic lung biopsy revealed numerous atypical adenomatous hyperplasia. Although not all the focal ground glass attenuation areas on high-resolution CT were identified as being adenomatous hyperplasia pathologically, so far, a case with adenomatous hyperplasia has not been previously reported

Differential effects of human neutrophil peptide-1 on growth factor and interleukin-8 production by human lung fibroblasts and epithelial cells.

alpha-Defensins, antimicrobial peptides produced mainly by neutrophils, have been reported to be associated with a wide variety of lung diseases, including idiopathic pulmonary fibrosis (IPF), cystic fibrosis (CF), and diffuse panbronchiolitis (DPB). In each disease, alpha-defensins are located in different areas, such as around the alveolar septa in IPF and around the airways in CF and DPB, suggesting that alpha-defensins play different roles. Meanwhile, growth factors are known to contribute to IPF, CF, and DPB. alpha-Defensins are known to induce interleukin (IL)-8 in airway epithelial cells, but the effects of alpha-defensins on the release of growth factors from various components in the lung have not been sufficiently investigated. In the present study, the in vitro effects of human neutrophil peptide (HNP)-1 (a subtype of alpha-defensin) on the expressions of IL-8 and growth factors in lung fibroblasts, bronchial epithelial cells, and alveolar epithelial cells were examined. HNP-1 mainly enhanced the expression of IL-8 in epithelial cells, whereas it enhanced transforming growth factor-beta and vascular endothelial growth factor expressions in lung fibroblasts. These results suggest that alpha-defensins play different roles in the pathogenesis of IPF, CF, and DPB according to the location in the lung where the alpha-defensins are mainly produced

HSP47 in lung fibroblasts is a predictor of survival in fibrotic nonspecific interstitial pneumonia.

BACKGROUND: The histopathologic pattern is currently the most important prognostic marker for idiopathic interstitial pneumonia (IIP). However, more highly sensitive markers are now required. Heat shock protein (HSP) 47, a collagen-specific molecular chaperone, is involved in the processing and/or secretion of procollagens, and it has been demonstrated that HSP47 expression is significantly higher in the lung specimens of idiopathic UIP than in UIP associated with collagen vascular diseases (CVD). However, its expression in nonspecific interstitial pneumonia (NSIP), the other common pathological pattern of IIP, has not been well investigated. Therefore, the association between lung fibroblast HSP47 expression and prognosis in fibrotic NSIP was evaluated. METHODS: Surgical lung biopsy specimens of 63 patients [idiopathic fibrotic NSIP=19, fibrotic NSIP associated with CVD=9, idiopathic UIP=26, and UIP associated with CVD=9] were reviewed, and a score for lung fibroblast HSP47 expression was assigned. These patients\u27 clinical features and survival were also analyzed. RESULTS: There was no significant difference in HSP47 expression between idiopathic fibrotic NSIP and fibrotic NSIP associated with CVD. The idiopathic fibrotic NSIP patients with higher HSP47 expression levels in their lung specimens had a poorer prognosis than patients with lower HSP47 expression levels. CONCLUSIONS: The present results suggest that lung fibroblast HSP47 expression may be a useful new prognostic marker for idiopathic fibrotic nonspecific interstitial pneumonia

Effects of doxycycline on production of growth factors and matrix metalloproteinases in pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is characterized by progressive fibrosis and a poor prognosis. Alveolar epithelial cells (AECs) are considered to play important roles by releasing growth factors and matrix metalloproteinases (MMPs) and by being involved in epithelial mesenchymal transition in IPF. Doxycycline hydrochloride (DOXY), an inhibitor of MMPs, attenuates pulmonary fibrosis in models and in patients with IPF; however, the mechanism of this action remains obscure

A Case of Pseudoangiomatous Stromal Hyperplasia of the Breast Presenting with Chest Pain

Pseudoangiomatous stromal hyperplasia is a rare, benign, breast disease characterized by dense, collagenous proliferation of mammary stroma, forming interanastomosing capillary-like spaces. Previously reported cases presented with a palpable breast mass or continuous breast enlargement, or were unexpectedly detected on mammography or ultrasonography. However, cases presenting only with pain as the initial symptom have not been reported. In this report, we describe a case of pseudoangiomatous stromal hyperplasia that presented with intermittent dull chest pain. A 2.6 x 1.1 cm, well-defined, hypoechoic mass was noted in the breast on ultrasonography, and an excisional biopsy was performed. On pathology, the tumor showed stromal hyperplasia and vessel-like slit structures. Immunohistochemical staining for vimentin, CD34, CD31, and Factor VIII-related antigen was compatible with pseudoangiomatous stromal hyperplasia. The dull chest pain disappeared after the excision. Pseudoangiomatous stromal hyperplasia is often described as painless. However, chest pain could also be an initial symptom

Drug-induced Eosinophilic Pneumonia with Pulmonary Alveolar Hemorrhage Caused by Benzbromarone

A 51-year-old man was admitted to our hospital with cough, hemosputum, dyspnea and chest pain. Chest high-resolution computed tomography (HRCT) revealed diffuse ground-glass opacities in both lungs with peripheral predominance. Bronchoalveolar lavage fluid was fresh-bloody and analysis indicated an increase in the eosinophil proportion. Benzbromarone-induced lymphocyte stimulation test was positive. Therefore, the patient was diagnosed as having drug-induced eosinophilic pneumonia with pulmonary alveolar hemorrhage caused by benzbromarone. After discontinuation of benzbromarone and administration of corticosteroids, chest HRCT images and respiratory manifestation improved. Here, we report this rare case of benzbromarone-induced eosinophilic pneumonia with pulmonary alveolar hemorrhage

Importance of Controlling Drug-resistant Pseudomonas aeruginosa Infection: Experience from Lung Transplantation in a Cystic Fibrosis Case

Cystic fibrosis (CF) is rare in Japan. We encountered a CF case with drug-resistant Pseudomonas aeruginosa infection and successfully performed lung transplant from living related donors. A combination of betalactams and aminoglycosides for drug-resistant P. aeruginosa infection was administered before lung transplantation. Intravenous colistin was also used immediately before and after transplant surgery. Gram staining of respiratory specimens was performed every day after surgery and it was useful in monitoring infection status. Strict monitoring of infections by the Gram staining and culture of respiratory specimens is considered to be effective in preventing lower respiratory infection in lung transplantation