Rapid death due to pulmonary epithelioid haemangioendothelioma in several weeks: A case report.

A 49-year-old woman was admitted to our hospital because of haemoptysis for 6 days. This patient claimed no medical history except high blood sugar. Chest computed tomography (CT) showed infection and multiple nodules on both sides of the lung. Blood tests showed no obvious abnormalities. Tracheoscopy showed haemorrhagic discharge in the left upper lobe and an old thrombus obstructing the lumen in the anterior basal segment of the right lower lobe. Then, CT-guided percutaneous lung biopsy was performed. The pathological results suggested multiple nodular-like lesions in the submitted tissues, and tumour cells were round or short fusiform, forming a solid nest structure, visible mitosis, and a vascular cavity-like structure containing red blood cells. Immunohistochemistry revealed positive staining for Vimentin, Bcl-2, CD31, and CD34; negative staining for CD68, SMA, CR, and D2-40; and 40% Ki67+ positivity. Based on the earlier data, the patient was diagnosed with pulmonary epithelioid haemangioendothelioma. This patient did not receive any treatment for several reasons. Unfortunately, the patient died 8 weeks after diagnosis. In conclusion, we present a case featuring the rapid death due to PEH.

Long-term follow-up of whole lung lavage in patients with pulmonary alveolar proteinosis.

Pulmonary alveolar proteinosis (PAP) is a rare disorder characterized by intra-alveolar accumulation of lipid and proteinaceous material. While a small subset of patients with PAP spontaneously improve or even undergo disease remission, the majority of patients develop persistent or progressive disease. Numerous therapies have been used to treat PAP over the years; however, at present, whole lung lavage (WLL) remains the gold standard treatment for PAP. In the present study, data were accumulated from a cohort of patients with PAP (n=11) between 2003 and 2011 at the Wuxi People's Hospital Affiliated to Nanjing Medical University. The disease affected males and females with a ratio of 2.7:1 and all the males were current or previous smokers. The disease severity score (DSS) of the patients was mainly distributed in DSS 4 or DSS 5. All the patients underwent WLL at least once, with one patient undergoing WLLs twice and another patient three times. The clinical features, arterial blood gas and pulmonary function of the patients, were assessed prior to and following the lavage. WLL resulted in a significant improvement in symptoms, radiographic features, PaO2, D(A-a)O2 and DLCO in patients with PAP, while pulmonary ventilation function did not significantly improve. WLL appears to be an effective approach for the treatment of PAP and leads to an improvement in survival rate.

[Lung transplantation in the treatment of ventilator dependent end-stage lung diseases: report of three cases].

OBJECTIVE: To investigate the perioperative management, recipient selection of end-stage lung diseases dependent on ventilator, and the strategy of ventilator weaning. METHODS: Fifteen patients underwent lung transplantation in our hospital from 2002 to 2005. Of them, three were dependent on ventilator for 89, 120 and 107 days respectively because of end-stage pulmonary emphysema before operation. Single-lung transplantation was performed in one patient and sequential bilateral single-lung transplantations were performed in two patients without extracorporeal circulation. RESULTS: The three patients were weaned from ventilator in the sixth, eleventh and twenty second day respectively after operation. They were discharged from hospital 71 d, 41 d, and 67 d respectively after operation. They had been followed up for 22, 4, and 2 months respectively before this analysis. Their quality of life improved significantly. CONCLUSION: Lung transplantation is effective for the treatment of ventilator dependent end-stage lung diseases.