Agenesis of lung is a rare congenital disorder. We are reporting varied degree of pulmonary agenesis in two adult patients. Lung India 2008; 25 : 28-30

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A case of recurrent haemoptysis due to fibroma is described in a 55 years old male patient. Clinical examination revealed anaemia and bilateral basal crepitations. Chest X - ray showed no abnormality. Bronchoscopy revealed polypoid fibroma in left main bronchus. It was removed bonchoscopically with no recurrence during 12 months follow up.

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Splenic lesions due to tuberculosis are extremely rare in immunocompetent indi­viduals and delays in diagnosis are frequent. Here, we describe a 49-year-woman presenting with pyrexia-of-unknown origin with no evidence of any immunodefi­ciency. Computed tomography of the abdomen showed an enlarged spleen having multiple small focal hypodense lesions; the later were confirmed to be of tubercu­lous etiology on histopathological examination. She had favorable response with anti-tubercular chemotherapy. We report this case of tuberculosis spleen in an im­munocompetent individual for its rarity and to highlight the fact that these patients can be managed by medical treatment effectively.

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Tuberculous involvement of the metacarpals and phalanges is a rare presentation of extrapulmonary tuberculosis in adult. Here is a case of tubercular dactylitis in a 27 year old female presenting as discharging sinus over proximal part of third metacarpalbone of left hand.

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Analysis of OPD data of 2012 patients in a referral pulmonary clinic at Kolkata was done following a protocol-based approach. Obstructive airway diseases (COPD and asthma) were the most common (43%) problem followed by infective lung diseases (15%) including tuberculosis, bronchogenic carcinoma (8%), ILD (4%), haemopty­sis of undiagnosed etiology (4.5%), chronic cough of undiagnosed etiology (6.5%) and pleural diseases (4.6%). Other diseases like obstructive sleep apnoea, sarcoid­osis, systemic diseases with lung involvements etc., and non respiratory problems formed the rest (14.4%).

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Malignant mesothelioma is an uncommon pleural neoplasm and usually associated with inhalation exposure to asbestos. About 20% of the patients have no demon­strable exposure to asbestos. It rarely metastasizes in peripheral lymph nodes. Here is a case report of malignant pleural mesothelioma without asbestos exposure with cervical lymph node metastasis

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Objectives: To detect the site of airway obstruction in patients of emphysema by impulse oscillometry (IOS) and to compare its observatios with flow volume loop (FV loop) studies. Methods: Twenty-five patients of emphysema were subjected to both impulse os­cillometry (IOS) and conventional spirometry. The resulting impedance spectra by IOS and FV loop were utilized to identify the site of airway obstruction in each of the patients. Both methods applied were also compared for sensitivity to identify airway and specify the site of obstruction. Results: Four patients were excluded from the final analysis as their impedance spectra showed significant upper airway influence, which would have made the localization of the site of airway obstruction by IOS invalid. Both IOS and FV loop could detect airway obstruction in all 21 patients. FV loop localized the site of obstruction as combined central and peripheral airways in 15 patients (71.4%) and as peripheral in 6 (28.6%).The IOS however, revealed the presence of the predomi­nant site of obstruction peripheral in all the 21 patients, and both central and pe­ripheral obstruction in 5 patients (23.8%). Conclusions: IOS had proven to be advantageous over FV loop studies as it could identify central and peripheral airway obstruction separately and established the predominant site of obstruction.

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We report a case of a 65 year old man who presented with haemoptysis. X-ray chest PA view shows mediastinal widening suggestive of mediastinal mass. A CT scan of thorax shows a large aneurysm of ascending aorta & arch of aorta. This an­eurysm is eroding the trachea and abutting the sternum and vertebrae. The patient is VDRL reactive. Haemoptysis is a rare presentation of aortic aneu­rysm.

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Angiosarcoma is a rare malignant neoplasm of the vascular or lymphatic endothe­lium. Diffuse alveolar hemorrhage is a rare presenting manifestation of angiosar­coma. We describe a case of pulmonary metastasis of angiosarcoma who presented with diffuse alveolar hemorrhage as initial manifestation.

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Hydatid disease is caused by the larval stage of the cestode, Echinococcus granulo­sus. Man is the intermediate host in its life cycle. The most common organ involved is liver followed by lung. Although surgery remains the definitive treatment for symptomatic lesions, it is associated with considerable morbidity. Other less inva­sive treatment strategies as an adjunct to medical treatment that have been tried in various case series include percutaneous aspiration, instillation and re-aspiration of scolicidal agents (PAIR), and thoracoscopic removal of cysts located subpleurally. Here we report the case of a 58 year old gentleman with hepatic and pleuropulmo­nary hydatid disease who was subjected to medical thoracoscopy and instillation of hypertonic saline (3%), followed by medical management with albendazole with which complete resolution of the pulmonary cysts was achieved.

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