When Teratoma Masquerades: A Rare Case of Intrapleural Mature Cystic Teratoma Mimicking Tuberculous Empyema.

Teratomas are germ cell tumours generally gonadal in origin and very rare, arising from extra gonadal tissue. The most common extragonadal teratomas are mediastinal, and the majority are benign. We report a case of a 49-year-old lady with recurrent right complex pleural effusion occurring a month after the completion of treatment for tuberculous empyema.

Unusual Presentation of Cryptogenic Organising Pneumonia as a Focal Lung Mass: A Case Report and Literature Review.

Organising pneumonia (OP) is a distinct pathological pattern characterised by the presence of granulation tissue buds composed of fibroblasts and myofibroblasts embedded in a loose connective tissue matrix within the distal pulmonary airspaces. When OP occurs without an identifiable cause or etiologic context, it is termed cryptogenic organising pneumonia (COP). The diagnosis of OP can be challenging due to its diverse clinical presentations, including the idiopathic form and various secondary forms associated with underlying diseases.

Endobronchial Leiomyoma Presenting as Post-Obstructive Pneumonia.

Endobronchial leiomyoma is a rare airway tumour. We report the case of a 30-year-old female non-smoker who presented with persistent fever and cough, ultimately diagnosed with post-obstructive pneumonia secondary to an endobronchial leiomyoma. The patient underwent a successful endobronchial cryo-resection with the resolution of symptoms.

Re-expansion pulmonary oedema: two case reports and review of the current literature.

Re-expansion pulmonary oedema (RPE) is an uncommon complication that occurs when a collapsed lung suddenly re-expands, resulting in an osmotic shift of fluid from the blood vessels into the air spaces within the lungs. This condition can develop following thoracocentesis or intercostal chest drainage. We report two cases of RPE that developed after varying volumes of pleural drainage and at different times.

Massive hemoptysis in pregnancy due to invasive pulmonary aspergillosis with pulmonary tuberculosis co-infection.

A 37-year-old woman, 25 weeks pregnant, experienced sudden massive hemoptysis. She had a background history of systemic lupus erythematosus (SLE) and past pulmonary tuberculosis (PTB). Emergency intubation was necessary, and bronchoscopy revealed blood pooling in both main bronchi, with active bleeding from the right upper lobe bronchus.

Recurrent bilateral idiopathic chylothorax: a therapeutic challenge.

Chylothorax is a rare condition caused by pleural effusion resulting from thoracic duct injury. Recurrent chylothorax is often resistant to conservative treatment and presents a clinical conundrum in its management. Here, we report a compelling case of recurrent chylothorax that persisted despite the administration of total parenteral nutrition, octreotide and thoracic duct embolisation.

Combined intrapleural alteplase and DNase therapy in complicated pleural infection arising from postsurgery oesophageal leak.

Managing a complicated pleural infection related to postsurgery can pose a clinical challenge, especially when initial interventions such as intercostal chest drain and antibiotics prove ineffective. We describe a man in his mid-60s who developed a recurrence of exudative pleural effusion caused by an oesophageal leak following laparoscopic total gastrectomy with Roux-y oesophagojejunostomy for gastric adenocarcinoma. Surgical repairs and oesophageal stenting were performed to address the oesophageal leak.

Impact of Aerobika oscillating positive expiratory pressure in improving small airway resistance, lung function, symptoms and exercise capacity in chronic obstructive pulmonary disease.

Background: Aerobika oscillating positive expiratory pressure (OPEP) device promotes airway clearance in many respiratory diseases. However, studies have yet to focus on its effectiveness in improving small airway resistance impulse oscillometry (IOS) measurement in COPD subjects. We aim to evaluate the improvement of small airway resistance ( IOS), lung function (spirometry), exercise capacity [ 6-min walking test (6MWT)], symptoms [COPD assessment test (CAT)] and severe exacerbation events among COPD subjects using Aerobika OPEP.

The benefit of indwelling pleural catheter with ambulatory pneumothorax device and autologous blood patch pleurodesis in lymphangioleiomyomatosis with persistent air leak.

We report a 35-year-old woman who presented with dyspnoea and chest pain for 1 week. High-resolution computed tomography (HRCT) thorax revealed bilateral pneumothoraces with diffuse lung cysts. Bilateral intercostal chest tubes were inserted, and there was a persistent air leak (PAL) bilaterally.

Satisfaction and tolerability using virtual reality (VR) as adjunctive treatment during flexible bronchoscopy: a randomized control trial.

Background: Patient comfort during invasive and therapeutic procedures is important. The use of virtual reality (VR) devices during flexible bronchoscopy (FB) as a method of distraction to increase patient tolerability and improve satisfaction has not been investigated. We aim to assess the satisfaction and tolerability of participants undergoing FB with or without VR.

Retrospective review comparing intrapleural fibrinolytic therapy (alteplase) and surgical intervention in complex pleural effusion.

Background: Intrapleural fibrinolytic therapy (IPFT) is one of the treatment options for complex pleural effusion. In this study, the IPFT agent used was alteplase, a tissue plasminogen activator (t-PA). This study aims to determine the difference in the outcome of patients with complex pleural effusion between IPFT and surgery in terms of radiological improvement, inflammatory parameters, length of stay, and post-intervention complications.

Prevalence and clinical characteristics of malignant lung nodules in tuberculosis endemic area in a single tertiary centre.

Background: Lung nodule management remains a challenge to clinicians, especially in endemic tuberculosis areas. Different guidelines are available with various recommendations; however, the suitability of these guidelines for the Asian population is still unclear. Our study described the prevalence of malignant lung nodules among nodules measuring 2-30 mm, the demographic and characteristics of lung nodules between benign and malignant groups, and the clinician's clinical practice in managing lung nodules.

Hydrofluorocarbons pneumonitis as a complication of inhalation injury following air-conditioning repairs.

Hydrofluorocarbon (HFC) pneumonitis is an uncommon cause of inhalation injury. HFCs are a group of chemicals predominantly used for refrigeration and cooling. A 19-year-old air-conditioning technician developed acute onset of dyspnoea and chest tightness while servicing an air conditioner in a confined space.

Modified regimen intrapleural alteplase with pulmozyme in pleural infection management: a tertiary teaching hospital experience.

Background: Current management of poorly draining complex effusions favours less invasive image-guided placement of smaller tubes and adjunctive intrapleural fibrinolysis therapy (IPFT). In MIST-2 trial, intrapleural 10 mg alteplase (t-PA) with 5 mg of pulmozyme (DNase) twice daily for 72 h were used. We aimed to assess the effectiveness and safety of a modified regimen 16 mg t-PA with 5 mg of DNase administered over 24 h in the management of complex pleural infection.

Organising pneumonia manifesting as a late-phase complication of COVID-19.

Acute COVID-19 usually lasts 4 weeks from the onset of symptoms. We report two cases of COVID-19-associated organising pneumonia (OP) occurring beyond 4 weeks from the acute onset of symptoms. Both tested positive for SARS reverse transcription-PCR 2 months before presentation with a resolution of respiratory symptoms.

Successful treatment of a complex malignant pleural effusion with 1 mg alteplase instilled through a non-draining indwelling pleural catheter.

Indwelling pleural catheter (IPC) is the treatment of choice in managing symptomatic recurrent malignant pleural effusion (MPE). Loculated effusions following insertion may occur due to infection, catheter malfunction or the inflammatory nature of MPE. Loculations may lead to ineffective drainage and make the IPC non-functional.

Disease-modifying antirheumatic drugs and organising pneumonia.

Organising pneumonia (OP) in rheumatoid arthritis (RA) may be part of pulmonary manifestation (disease related) or disease-modifying antirheumatic drugs (DMARDs) related. We report a case series of RA patients with DMARDs related OP. A 65-year-old woman developed OP 3 weeks after initiation of methotrexate (MTX).

Re-establishing indwelling pleural catheter patency with alteplase after failure of streptokinase.

Indwelling pleural catheter (IPC) has revolutionized the management of malignant pleural effusion (MPE). IPC is relatively safe, although complications can occur. We report a 53-year-old woman with stage IVA lung adenocarcinoma and recurrent MPE.

Resolution of refractory chylothorax with a combination of talc pleurodesis and CPAP.

Chylothorax is an uncommon cause of pleural effusion. Recurrent chylous effusions are often resistant to conservative treatment and many need surgical intervention. We report a 69-year-old woman with refractory idiopathic chylothorax resistant to medium-chain triglyceride diet and intermittent thoracentesis.

Indwelling pleural catheter and successful autopleurodesis of refractory inflammatory lupus effusion.

Indwelling pleural catheter (IPC) is a useful tool for refractory malignant pleural effusions (MPEs). It allows palliation by intermittent symptomatic relief of the effusion and improves quality of life. Its use in benign pleural effusions comes mainly from retrospective studies, case series, and case reports.

What happens when we treat the "Typhoid Mary" of COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was declared a pandemic on 11 March 2020. We have since seen its fast spread worldwide. A likely contributing factor was the lack of symptoms of some of the carriers, making them unaware of their risk of spreading to other more vulnerable individuals.

Silicone pneumonitis after gluteal filler: a case report and literature review.

Liquid silicone (polydimethylsiloxane) is an inert material that is commonly used for cosmetic purpose. Silicone embolization syndrome (SES) can rapidly progress to pneumonitis as a consequence of the injection of nonmedical-grade liquid silicone. We describe a case of severe silicone pneumonitis complicated with acute respiratory distress syndrome and bilateral pneumothorax secondary to silicone gluteal augmentation.