Type 1 fibrinous plastic bronchitis (PB) is rare in adults, especially following massive hemothorax. A 62-year-old smoker developed extensive fibrinous bronchial casts after thoracoscopic evacuation of a massive right hemothorax (6,500 mL) with hemorrhagic shock, massive transfusion, and consumptive coagulopathy. Bronchoscopy on postoperative day 4 revealed branching casts in the segmental bronchi. Repeated mechanical extraction, saline lavage, and viscoelastic-guided correction of coagulopathy, without the use of intrabronchial fibrinolytics, led to resolution. Histopathology confirmed Type 1 inflammatory PB. Massive hemorrhage may trigger Type 1 PB through airway epithelial injury, a procoagulant milieu, and neutrophilic inflammation. Prompt bronchoscopic clearance with targeted hemostatic correction may be key when fibrinolysis is deferred because of bleeding risk.

Primary malignant melanoma of the trachea is an exceptionally rare tumor that may cause life-threatening airway obstruction. This report presents a rare case of primary tracheal malignant melanoma successfully managed by rigid bronchoscopy. A 58-year-old man presented with dyspnea, cough, and inspiratory stridor. Computed tomography revealed a severely obstructive intraluminal tracheal mass. Rigid bronchoscopy demonstrated a vascular polypoid lesion obstructing approximately 85% of the tracheal lumen. Mechanical debulking, argon plasma coagulation, and cryotherapy were performed with therapeutic intent, achieving complete airway recanalization and immediate clinical improvement. Histopathologic examination confirmed malignant melanoma with positivity for S-100, Melan-A, and HMB-45. Dermatologic, ophthalmologic, and radiologic evaluations excluded another primary tumor site or distant metastasis, supporting the diagnosis of primary tracheal malignant melanoma. No complications, recurrence, or disease progression were observed during the 12-month follow-up period. This case highlights the importance of interventional bronchoscopy in rare central airway tumors.

We report a rare case of an asymptomatic intrapulmonary foreign body (FB) coexisting with a benign neoplasm in a 29-year-old nonsmoking woman. The patient presented with nonspecific back pain without respiratory symptoms or a history of trauma. Chest CT incidentally revealed a 4.0-cm linear metallic density (2,761 HU) and a 5-mm subsolid nodule in the right lower lobe. Preoperative hookwire localization followed by video-assisted thoracoscopic surgery (VATS) enabled successful en bloc resection. A 4.0-cm sewing needle was extracted intact. Histopathology confirmed organizing pneumonia with chronic foreign body reaction and, notably, a benign bronchiolar adenoma adjacent to the FB. To our knowledge, this is the first reported coexistence of an occult intrapulmonary sewing needle and bronchiolar adenoma. Although the spatial proximity raises etiologic questions, the absence of histologic transition suggests a coincidental relationship. VATS with histopathologic correlation was essential for definitive diagnosis and management.

Hydatid disease is a parasitic infection caused by Echinococcus species. It is endemic in certain regions of the world and most commonly affects the liver and lungs, although cysts may develop in various organs. Intrathoracic extrapulmonary involvement is rare, and vertebral localization within this region is exceedingly uncommon. In spinal hydatid disease, in which neurologic symptoms may be prominent, surgical intervention remains the most effective treatment. Herein, we present the case of a 22-year-old patient treated for an intrathoracic extrapulmonary vertebral hydatid cyst, along with a review of the relevant literature.

Rhabdomyosarcoma is the most common soft tissue sarcoma. It shows skeletal muscle differentiation and mainly affects children. Thoracic involvement is rare, and pulmonary involvement is exceptional. We report the case of a 49-year-old patient who was asymptomatic except for grade II dyspnea of 40 days’ duration and presented to the emergency department after the spontaneous expectoration of a tumor bud during a coughing episode. Chest radiography revealed an opacified left hemithorax with signs of volume loss. Thoracic CT showed a left pulmonary tumor measuring 103 × 100 × 115 mm and invading the left main bronchus, the left upper lobar pulmonary artery, and both left pulmonary veins. Histopathologic examination of the expectorated tumor fragment revealed proliferation of round cells with massive necrosis. Immunohistochemical analysis supported the diagnosis of pulmonary botryoid rhabdomyosarcoma. We present this case along with a review of the literature on pulmonary involvement in adult rhabdomyosarcoma.

Lymphoproliferative lung diseases may occur secondary to Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) through hematogenous spread or invasion of the hila from mediastinal lymph nodes. In rare cases, they may present as primary pulmonary lymphoma (PPL), defined as a clonal lymphoid proliferation limited to the lungs and bronchi, with no extrapulmonary disease at diagnosis or during the subsequent three months of follow-up. The most frequent subtype is mucosa-associated lymphoid tissue (MALT) lymphoma, which arises from pulmonary mucosal lymphoid tissue. PPL typically progresses slowly and may be discovered incidentally on imaging. Radiologic findings may resemble pneumonia or lung cancer; therefore, PPL should be considered when pneumonia is unresponsive to treatment. In this case report, we describe a patient presenting with dyspnea, a central right lung lesion, mediastinal lymphadenopathy, and multiple bilateral pulmonary nodules. As bronchoscopic evaluation was non-diagnostic, transthoracic biopsy confirmed the diagnosis of PPL.

Mucormycosis is an uncommon but life-threatening fungal infection typically seen in immunocompromised hosts. It has rarely been reported following exertional heat stroke (EHS). We describe a fatal case of rhino-orbital-cerebral and pulmonary mucormycosis in a 59-year-old man recovering from EHS. Despite initial stabilization, he developed necrotic facial lesions and respiratory failure. Mucor spp were isolated from tissue and bronchoalveolar lavage (BAL) cultures. He died on day 14 despite liposomal amphotericin B therapy. This rare case of mucormycosis following EHS highlights the potential role of heat-induced immune dysfunction in predisposing patients to opportunistic fungal infections. Clinicians should maintain a high index of suspicion for mucormycosis in EHS patients with unexplained fever or tissue necrosis.

Mycobacterium simiae is a slow-growing nontuberculous mycobacterial species with intrinsic resistance to conventional antituberculosis agents and is capable of causing pulmonary and/or extrapulmonary infections. The incidence and severity of disease are increased particularly in immunosuppressed individuals. In this young incarcerated patient, during the etiologic evaluation of pneumonia, sputum smears were negative for acid-fast bacilli; however, M. simiae was isolated from two separate sputum mycobacterial cultures. The patient demonstrated clinical and radiologic improvement with nonspecific antibiotic therapy.

Endobronchial tuberculosis (EBTB) is a rare form of tuberculosis. Although its clinical, laboratory, microbiologic, and treatment characteristics are similar to those of other forms of tuberculosis, EBTB differs in that bronchoscopy plays a central role in diagnosis and, particularly in untreated cases, it may lead to serious airway complications such as bronchial stenosis. This case report describes a 57-year-old female patient with risk factors for lung cancer who was diagnosed with EBTB during advanced diagnostic evaluation. The case is presented to draw attention to the diagnosis, treatment, and management of this rare form of tuberculosis.

Talcosis is a fibrotic lung disease that results from the inhalation of talc. It can occur in various occupational settings, such as mining and industrial work. In talcosis, the typical finding on high-resolution computed tomography (HRCT) is diffuse centrilobular micronodules. A patient with no history of smoking who worked in the lamination department of an automotive glass factory presented with shortness of breath. The patient’s chest radiograph showed increased bilateral reticulonodular densities and large opacities in the upper zones of both lungs. Based on a comprehensive evaluation of the patient’s occupational history, clinical presentation, and imaging findings, talc pneumoconiosis was considered the most likely diagnosis. In progressive fibrotic occupational lung diseases such as this, for which there is generally no specific treatment, the usual approach is to control the factors that contribute to disease development.

It is a common belief among clinicians that corticosteroid therapy is an etiologic factor in peptic ulcer disease and its complications. However, this belief is based largely on older studies, and many clinicians avoid using these agents in such patients. Nevertheless, complex clinical situations may arise in which both indications for and concerns about corticosteroid use coexist. Although corticosteroids are often considered risky or relatively contraindicated in patients with peptic ulcers, they may be indicated in the treatment of acute respiratory distress syndrome (ARDS). Here, we report a case of extrapulmonary ARDS secondary to peptic ulcer perforation that was successfully treated with corticosteroids. The patient received methylprednisolone at a dose of 1 mg/kg/day and was successfully treated and discharged without complications. Because of the widespread belief that corticosteroid therapy is contraindicated in peptic ulcer disease, few recent studies have addressed this issue. This case may renew interest in the presumed ulcerogenic effects of corticosteroids in peptic ulcer disease and its complications, thereby encouraging further research.

Anomalous systemic arterial supply to the left lower lobe is a rare congenital pulmonary vascular anomaly in which normally developed lung parenchyma with intact bronchial communication receives blood directly from a systemic artery rather than from the pulmonary arterial circulation. We report the case of a 35-year-old man who presented with mild hemoptysis and palpitations. CT and MR angiography revealed a 10-mm aberrant systemic artery arising from the descending thoracic aorta and supplying the basal segments of the left lower lobe, with normal pulmonary venous drainage and no dysplastic parenchyma. In the absence of pulmonary hypertension or a significant shunt, conservative management with follow-up was chosen. During one year of follow-up, the patient remained asymptomatic without radiologic progression. This case underscores the critical role of multidetector CT and MR angiography in accurately differentiating this entity from pulmonary sequestration and highlights that noninvasive diagnosis can support safe conservative management in appropriately selected patients.