Internal medicine
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Thymic carcinoma (TC) is a rare malignancy with limited treatment options. Lenvatinib, a novel multitarget kinase inhibitor, has recently been used to treat advanced or metastatic thymic carcinoma that cannot be surgically removed. ⋯ We herein report an 85-year-old Japanese woman with localized unresectable thymic carcinoma who was treated with lenvatinib as induction chemotherapy before undergoing radiotherapy. Our findings suggest that lenvatinib may be a viable option for induction chemotherapy in similar clinical scenarios.
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Idiopathic inflammatory myopathies, such as dermatomyositis, are implicated as possible risk factors for venous thromboembolism. We herein report the first known case of a 50-year-old woman who presented to our hospital with a fever, chest pain, and elevated creatine kinase levels and was ultimately diagnosed with pulmonary embolism and anti-OJ antibody-positive antisynthetase myopathy. ⋯ However, only a few cases of pulmonary embolism developing before the diagnosis of inflammatory myositis have been reported. Idiopathic inflammatory myopathy should be considered as a differential diagnosis when creatine kinase levels are elevated in patients with pulmonary embolism.
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A 75-year-old man presented with cognitive decline, headaches, and ataxic gait. Magnetic resonance imaging (MRI) revealed acute infarcts in multiple brain regions, and vessel wall MRI (VW-MRI) demonstrated concentric arterial wall thickening and enhancement in some intracranial arteries, initially suggesting primary central nervous system vasculitis (PCNSV). ⋯ A skin biopsy revealed intravascular large B-cell lymphoma (IVLBCL), and autopsy revealed tumor cells in the arterial walls corresponding to the VW-MRI findings. This case highlights the risk of a misdiagnosis of PCNSV based solely on imaging findings and underscores the need for histological confirmation.
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Objective To investigate the clinical course of ulcerative colitis (UC) during pregnancy, focusing on their mutual influence. Methods We retrospectively reviewed the medical records of 58 patients with UC who had 73 pregnancies and 3 patients with newly developed UC during pregnancy. We recorded the rate of relapse of UC; the relationship between medication use and UC relapse during pregnancy; treatment for relapse; and the incidence of pregnancy, childbirth, and newborn abnormalities. ⋯ In two of the three patients with new-onset UC, UC was severe and required intensive care; however, the pregnancies continued uneventfully. Conclusion Although the progress of pregnancies complicated by UC was mostly uneventful, discontinuing medication carries the risk of UC relapse. Thus, appropriate management of medical treatments for UC during pregnancy is important.
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An anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a rare congenital vascular anomaly. We herein report a case of ABLL in a 26-year-old pregnant woman with hemoptysis. ⋯ Maternal safety was a priority, and the patient underwent thoracoscopic left lower lobectomy at 19 weeks' gestation. We concluded that the hemoptysis had been caused by an increased circulating plasma volume during pregnancy.