Transbronchial needle aspiration in severe cardiac failure patient: 'The old bull knows best'.

Conventional transbronchial needle aspiration (cTBNA) remains a basic technique that must be part of the bronchoscopists expertise. In cases where EBUS is not available, cTBNA must be kept in mind: 'the old bull knows best'.

Penetrating pulmonary injury caused by a steel rod.

In stable patients with penetrating thoracic trauma, a careful radiological assessment should be taken into account for a correct surgical management.

Uncommon anomalies of the left pulmonary artery during VATS lobectomy for lung cancer.

The key to avoid intraoperative complications due to failure in the preoperative detection of pulmonary vascular anomalies is to perform a careful hilar dissection.

Accessory V during thoracoscopic middle lobectomy: "an uncomfortable presence".

The identification of the accessory vein draining the superior segment of the right lower lobe (accessory V), during the posterior mediastinal lymph node dissection, can help avoid operative complications.

Left pulmonary artery pseudoaneurysm secondary to post-operative lung abscess.

A prompt diagnosis is mandatory to avoid fatal complications in case of pulmonary artery pseudoaneurysm.

Mediastinal malignant mesothelioma discovered in a patient with dysphagia.

A mediastinal mass in patients with a history of asbestos exposure should raise the suspicion of malignant mesothelioma.

Drainage of middle lobe vein into anomalous right lower lobe vein: management during thoracoscopic lobectomy.

Variations in pulmonary venous anatomy should not be underestimated by thoracic surgeons prior to or during major lung resections in order to avoid serious surgical complications. Here, we report a case of middle lobe vein draining into a right inferior lobar vein formed by two anomalous trunks lying on the superior surface of the common basal bronchus: in such instance, to avoid compromising the middle lobe vein drainage during a thoracoscopic right lower lobectomy, the two main tributaries of the lower lobe vein were individually identified and dissected peripherally from the anterior aspect after division of the major fissure. A careful hilar dissection and a precise surgical strategy can help surgeons perform correct procedures in presence of pulmonary vascular anomalies.