Respiratory failure in a cancer patient: pulmonary thrombotic microangiopathy.

The hypoxic patient with a normal chest X-ray can be a diagnostic challenge. This case illustrates the rational diagnostic process and describes a relatively rare but important complication of cancer metastasis. Thrombotic microangiopathy, like lymphangitis carcinomatosa, may cause respiratory failure and is a poor prognostic finding.

Resolution without treatment of granulomatous pneumonitis due to intravesical BCG for bladder cancer.

Granulomatous pneumonitis is a well-recognised complication of intravesical BCG therapy. The mechanism is sometimes thought to be 'hypersensitivity' rather than infection as in most cases mycobacteria are not cultured. Despite this it is usually treated with antituberculous chemotherapy with or without corticosteroid.