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Biomedical subjects

Manabu Komiyama

Publications and source records attributed to Manabu Komiyama.

3 recordsLinked to original sources

[A case of AIDS-complicated lung infection mimicking acute eosinophilic pneumonia].

A 34-year-old man was admitted with dyspnea and low grade fever. Chest radiograph and computed tomography (CT) showed bilateral, ground glass opacities and perihilar consolidation. Bronchoalveolar lavage (BAL) was performed. The percentage of eosinophils in the BAL fluid (BALF) was elevated (20.5%). BALF smear and culture showed normal flora. Acute eosinophilic pneumonia was diagnosed and steroid therapy was performed. Afterwards he was transferred to our hospital. The HIV antibody was positive and peripheral blood CD-4 positive lymphocytes decreased to 10/microl, cytomegalovirus (CMV) antigenemia was positive and beta-D-glucan increased. CMV infection and pneumocystis pneumonia (PCP) complicated with AIDS was diagnosed. Trimethoprim/sulfamethoxazole, ganciclovir, and antifungal drugs were administered, but he suffered pneumothorax on the 18th day after admission and died. Histopathologic findings from an autopsy lung specimen revealed CMV infection and PCP. It is known that the percentage of eosinophils in the BALF increases in some cases of PCP complicated with AIDS. We emphasize that it is necessary to consider PCP when the percentage of eosinophils in the BALF increase.

Acquired Immunodeficiency Syndrome↗

[A case of pseudo-meigs syndrome due to ovarian clear cell adenocarcinoma].

A 59-year-old woman was admitted with dyspnea. A chest X-ray film revealed a large amount of pleural effusion at the both sides. No malignant cells were found in bilateral pleural effusions. Computed tomography (CT) of the abdomen showed a huge mass of the right ovary with a small amount of ascites, suggesting a diagnosis of Meigs syndrome. The ovarian mass and the neighboring organs, including the uterus and the greater omentum, were surgically removed, and then both the bilateral pleural effusion and ascites disappeared after the surgery. The histopathological examination revealed that the mass was clear cell adenocarcinoma of the ovary (stage IIc), indicating that the disease was pseudo-Meigs Syndrome. This is the second report of pseudo-Meigs Syndrome caused by clear cell adenocarcinoma of the ovary in Japan.

Adenocarcinoma, Clear Cell↗

[Lymphangioleiomyomatosis (LAM) causing chylothorax].

A 28-year-old woman was admitted to our hospital complaining of chest pain and dyspnea. Chest radiographs showed left pleural effusion. The effused fluid obtained by thoracocentesis was milky, and so chylothorax was diagnosed. A high-resolution chest CT (HRCT) scan demonstrated diffuse multiple cystic lesions, which were undetectable by conventional CT. An abdominal CT scan showed a retroperitoneal tumor. Since the effusion was resistant to conservative therapy, we performed clipping of the thoracic duct under the diaphragm. Since the effusion disappeared after continuous aspiration, 10 KE of OK-432 was administered into the pleural cavity, and the chylorrhea disappeared. The clinical diagnosis, based on the biopsy of the abdominal tumor, was lymphangioleiomyomatosis. Chylothorax developing from lymphangioleiomyomatosis is rare in Japan. However, we must consider the possibility of lymphangioleiomyomatosis in patients with chylothorax, and always perform chest HRCT.

Adult↗