Mediastinal fibrosis and Hodgkin lymphoma mimicking bronchiolitis obliterans organizing pneumonia.

Bronchiolitis obliterans organizing pneumonia (BOOP) represents a kaleidoscope of concepts and morphologies, often being confused with a series of conditions, among which the most feared are Hodgkin's lymphoma and bronchioloalveolar carcinoma. We shall present the case of a 56-year-old patient, diagnosed in August 2013 with a pulmonary tumour of the right upper lobe, which was CTstaged - T4N0M0 (IIIA), who underwent a video-assisted thoracotomy for histopathological confirmation. A mediastino-pulmonary formation had been detected intraoperatively and multiple biopsies had been collected.

Giant left-sided pleuropericardial cyst, mimicking a heart disease.

Mediastinal cysts (MC) mainly have an embryonic origin, are benign and frequently discovered thanks to tomodensitometry, sometimes by magnetic resonance imaging. Rarely symptomatic, excepted in cases of very large cysts, they are mainly pleuropericardic cysts (PPC) that represent 30% of MC Surgery is commonly performed by videothoracoscopy or by video-assisted mini-thoracotomy, mainly for PPC We report the case of a 62-year-old woman, smoker (30 packs years), who is hospitalized in Constanta Pneumology Hospital in June 2011 for slight shortness of breath, sweating, pain in the left hemi thorax, minor hemoptysis, recurrent. In her medical history, there are to be noticed a blood transfusion after hysterectomy for uterine fibroma (1995), arterial hypertension (2006).

[Sternal chondrosarcoma and the complications poststernectomy].

Primary tumors of the sternum are unusual, and, of these chondrosarcoma is extremely rare. Prior cases were more frequent in men. It is the consensus that central (axial) skeletal lesions are always suspected of malignancy.

[Unilateral salpingian and ovarian TB, a rare form of extrapulmonary TB].

TB salpingitis and ovarian TB is a rare association of extrapulmonary tuberculosis, especially when the lesions are not associated with lung involvement. The correct therapy leads to the sterilization of the tuberculosis foci, although the risk of scars and adhesions is high, causing local functional disorders.

[Practical issues of transbronchial lung biopsy (TLB) in pneumology].

Method: We present a survey of 78 TLB which have been performed in Bronchology Service (during 2003-2005) for diffuse interstitial lung diseases--70 cases or located diseases--8 cases; TLB was not performed for solitary peripherally opacities because we have no radiological device with mobile arm (for good position of forceps).

Results: In 78% of cases we obtained illustrative lung tissue and in 22% of cases we prelevated just bronchial wall. Histological confirmation was obtained for 53% of cases; 47% of cases have as result lung tissue without significant modifications.

[Sequential approach in a case of tracheal hemangioma: segmental tracheal resection after Nd-YAG laser application].

Tracheal tumors of malignant or benign origin are very rare. The symptoms may mimic asthmatic crisis, dyspnea at rest or light efforts appear only when the tumor obstructs 60% of the tracheal diameter. We present the case of a 50 year old patient, ex-smoker with symptoms present 5 years before admittance with dyspnea and small hemoptysis.

[A case of tumor-like pulmonary sarcoidosis].

We present the case of a female patient age 32, with no medical history, presenting with chest pain and asthenia. Chest X-ray and CT scan revealed multiple nodular shadows in both lungs, suggesting lung metastasis. Bronchoscopy and broncho-alveolar lavage didn't reveal any malignant cells.

Cellular immune response in atypical tuberculosis diagnosed by PCR in paraffin embedded material.

The aim was to evaluate the cellular immune response in atypical tuberculosis and granulomatous inflammation consistent with tuberculosis (TBC), negative histochemically for acid-fast bacilli and analysed by PCR for Mycobacterium tuberculosis (MT) detection in paraffin-embedded tissue. Thirty six samples of differently localized atypical tuberculous lesions and granulomatous tuberculoid lesions negative for acid fast bacilli and 4 positive cases on Ziehl-Nielsen stain were analysed by PCR for MT detection and were tested immunohistochemically (IHC) for the cellular immune response in the granulomas and perigranulomatous tissue. The samples selected were: 7 pulmonary and 33 extrapulmonary specimens, especially lymph nodes.

[Pulmonary benign lymphocytic angiitis and granulomatosis--a benign lymphoproliferative condition].

BLAG--benign lymphocytic angiitis and granulomatosis is a granulomatosis disease which histologically presents a dense infiltrate of lympnoid cells that disturbes the normal alveolar architecture. Faint granuloma formation occur within the lympnoid infiltrate. A 32 years female patient was admitted for dry cough, exertional dispnea, low fever during last 11 month.

[Pulmonary tuberculosis and Kaposi syndrome in HIV positive patient].

The authors point out the case of a young woman with AIDS who presents at the same time the test HIV (+), the secondary caseoextensive bilateral pulmonary tuberculosis confirmed by the bacterial examination (bK(+) culture), the skin's and pulmonary histological manifestations of the Kaposi disease, clinically suspected, was confirmed only at the autopsy. Clinical manifestations began with skin's modifications, followed 2-3 months later by the diagnosis of a pulmonary tuberculosis, the demise decease 4-5 month after the appearance of the first skin's lesion.

[Thyroid tuberculosis--a clinical case].

We present the case of a 38-year-old male patient with tuberculosis of the thyroid; the diagnosis was established on histological examination after surgery.

Disseminated tuberculosis with gradual evolution and unusual localization.

We present a case of disseminated tuberculosis (pulmonary, skeletal and lymph nodes) accompanied by subcutaneous abscesses and with unusual localization, osteolytic lesions of the skull caused by Mycobacterium tuberculosis var. hominis. Although the patient was immunocompetent, the disease had a gradual and unexpected progression.

[Diagnostic difficulties--salvage diagnostic thoracotomies].

The authors are presenting the difficulties of diagnosis, in clearing up the etiology in two cases, where the acceptance of the exploring thoracotomy, influenced the prognostic and permitted to settle up the diagnosis. We are passing through, at this occasion, also the indications of this kind of operation.

[Pulmonary alveolar microlithiasis--a clinical case].

A new case of alveolar microlithiasis is reported, demanding for the diagnosis besides the radio-clinical investigations, complete respiratory function tests, also the pathologic proof. Authors recall the diagnostic approach and our present ignorance of the pathogenesis of this curious entity; no valid therapy is presently able to check the relentless course toward progressive respiratory failure.

[Bilateral multifocal pulmonary leiomyomatosis].

A case of diffuse primary pulmonary leiomyomatosis with a 24-years-old asymptomatic woman having a pulmonary radiological aspect of miliary dissemination 3 years after a myomectomy for sub-serous uterine fibroma. The diagnosis was established after a surgical pulmonary biopsy. The case presented certain peculiar features: a young woman; the inter-relation between pulmonary leiomyomatosis and the operated sub-serous uterine fibroma; the aggravating factor--the pregnancy; a confirmed probably hormonal cause (hyperestrogenemia); a progressive aggravating evolution.

[Goodpasture's syndrome--a case report].

A female subject case aged 64 years is presented. The history shows several hospital admissions for lung diffuse infiltrative processes, accompanied with hemoptoic sputa. These infiltrations had a regressive evolution either spontaneously or under treatment.

[New aspects of collagen formation].

New data are presented concerning the process of synthesis and secretion of collagen. The stages are described of its elaboration and biochemical transformations of collagen molecules occurring in the cell and the alterations leading to collagen fibres building-up in the extracellular spaces. Electronic microscopy of fibrogenesis study, carried out during an experimental research on lung fibrosis, has shown new aspects not yet described in the literature.

[Atypical pulmonary hydatid cyst].

An atypical form of a pulmonary hydatid cyst is described. This was a solitary super-infected pseudo-tumoral cyst and the membrane was incarcerated which has enabled us to propose as a description for this new morphological aspect of a cyst, with a filled margin of the proliferative membrane. We propose the term "Rosebud".

[Clinico-radiologic and morphopathologic aspects of mediastinal-pulmonary hemangiopericytoma].

The paper points out the diagnosis of intrathoracic hemangiopericytoma in 13 patients in the "M.Nasta" Institute of Pneumophthisiology, a seldom seen disease considered quite serious because of its malignant form and its late finding out. This is due to its non-distinctive, small number of symptoms, which has a negative influence upon the disease prognosis and evolution.

[Acute rhinopharyngitis, acute interstitial pneumonia and parieto-frontal brain abscess with H. influenzae type B].

The paper deals with a parietal frontal cerebral abscess caused by HITB biotype I in a girl aged 8 months. First a meningitis is suspected, then a tuberculous meningitis unsuccessfully treated with ampicillin, biseptol, respectively INH, rifampicin, pyrazinamide, prednisone, phenobarbital and chloramphenicol. The patient died through a central respiratory standstill on the 17th day of disease.

[Mediastinal-pulmonary lymphangioleiomyomatosis. The anatomicoclinical aspects].

The lymphangioleiomyomatosis is a rare disease which has a severe course and prognosis and occurs exclusively in females. The symptomatology is not characteristic and the radiological picture is that of a reticular and micronodular diffuse interstitial process. The morphological examination is the only which elucidates the diagnosis.