RT Journal Article
SR Electronic
A1 Plasek, Jiri
A1 Dvorackova, Jana
A1 Jahoda, Jan
A1 Trulikova, Kristina
A1 Mokosova, Radka
A1 Danek, Tomas
A1 Hrabovsky, Vladimir
A1 Martinek, Arnost
T1 ACUTE INTERSTITIAL PNEUMONIA (HAMMAN-RICH SYNDROME) IN IDIOPATHIC PULMONARY FIBROSIS AND BRONCHOALVEOLAR CARCINOMA: A CASE REPORT
JF Biomedical papers
YR 2011
VO 155
IS 4
SP 403
OP 407
DO 10.5507/bp.2011.039
UL https://biomed.papers.upol.cz/artkey/bio-201104-0014.php
AB Aim: Acute interstitial pneumonia is characterized by rapid progressive dyspnoea degenerating into respiratory failure requiring mechanical ventilation. Acute interstitial pneumonia (AIP) and idiopathic pulmonary fibrosis (IPF) are separate clinic/pathological entities although overlap may be present. It is well-known that patients with IPF have increased risk of lung carcinoma; Adenocarcinoma in connection with IPF is less common. Moreover the subtype of adenocarcinoma, diffuse bronchoalveolar carcinoma has not yet been described.
Case report: We report the case of 45 yr old former hockey player with increased bilateral reticular shadowing on chest radiograph, dyspnoea, velcro-like crackles, restrictive respiratory disease and mixed high-resolution computed tomography finding. During brief in-patient treatment the patient developed acute respiratory failure accompanied by multiorgan failure and disseminated coagulopathy. Deterioration of the microcirculation was followed by loss of peripheral vascular resistance, which was irreversible even with normalization of the blood gases achieved by extracorporeal membrane oxygenation. At autopsy, bronchoalveolar carcinoma in usual interstitial pneumonia (UIP) combined with areas of alveolar damage with hyaline membranes was found.
Conclusion: This case alerts clinicians to unusual idiopathic pulmonary fibrosis manifestations and its complications. Close collaboration between clinicians, pathologists and laboratory physicians is highly recommended for early diagnosis and appropriate treatment.