The authors report a rare case of benign lung tumor, the INTRABRONCHIAL LEIOMYOMA, of a 33-year-old male patient. Diagnosis was performed by bronchoscopy with tumor biopsy, the tumor consisted largely of smooth muscle fibers. The option for treatment, after seven years of tumor evolution, was pneumonectomy.

Keywords: Leiomyoma; Bronchi, Lung neoplasm.

Granular cell tumors are uncommon neoplasm arising from Schwann cell. They are uncommon in the respiratory tract and there are only 32 cases described with primary tracheal involvement. A case is described of a 28 year-old woman with granular cell tumor located primarily in the trachea. The tumor was treated surgically with good result.

Keywords: granular cell tumor; trachea

The authors present a 62-year-old male patient who had pulmonary nocardiosis with poor evolution. He also presented mental confusion, septic shock and a significant leukocytosis. Poor evolution happened even when sulfamethoxazole + trimethoprim replaced by ceftriaxone + clindamycin as an antibiotic therapy were used. Diagnostic methods, epidemiology and therapy of this infection are discussed and revised. The authors emphasize the importance of an early diagnosis, isolation in culture, and antibiogram examination of Nocardia ssp samples for therapeutic adapting.

Keywords: Pneumonia. Nocardia.

Human pulmonary dirofilariasis is a rare disease caused by the parasite Dirofilaria immitis. It is usually seen as a solitary pulmonary nodule that mimics lung cancer. Although this disease is considered benign, its diagnosis often requires an excisional lung biopsy. Herein we report the epidemiological, clinical and radiological features observed in seven cases of human pulmonary dirofilariasis from Florianópolis. Six of our seven patients, showed a radiological finding of pulmonary nodule and underwent excisional lung biopsy for diagnosis. In one case, the radiological image was unavailable for review. Therefore, it was not described in this work, and the diagnosis was established through transbronchial biopsy.

Keywords: Dirofilariasis. Dirofilaria immitis. Coin lesion pulmonary.

Granular cell tumor (GCT) is a term used to describe a tumor with distinctive histology, characteristic immunohistochemical profile, and peculiar ultrastructural findings. This tumor has an ample topographic distribution and its localization in the airways is considered common. The authors report on the case of a 40-year old woman who had been presenting productive cough and fever for two months and seemed normal at physical examination. Computerized tomography evidenced thickened intermediary bronchial wall and bronchoscopy showed, at this level, hyperemia and elevation of the endobronchial mucosa. Histopathological and immunohistochemical examination of the tissued established the diagnosis of GCT. The purpose of this report is to call attention to the possibility of diagnosing this kind of tumor by small endoscopic biopsies.

Keywords: Neoplasm muscle tissue. Granular cell tumor. Biopsy. Diagnosis

The authors report a case of pleural lipoma which was found incidentally in a thoracic roentgenogram. The radiographic studies were inconclusive about the nature of the lesion. The diagnosis was established by histologic study of the tumor excised by thoracotomy, after an inconclusive cytologic study obtained by transthoracic fine needle aspiration.

Keywords: Lipoma. Pleura.

Pneumatoceles usually have a benign presentation. The authors describe an uncommon case of a 3-month-old boy who had a first episode of pneumonia and left pleural effusion. At the age of 2, he had another episode of pneumonia with pneumatoceles formation. He progressed with wheezing and enlargement of the pneumatoceles, chickenpox, urinary infection, liver abscess and toxocariasis. When he was 3 years old, the patient was admitted to hospital with pneumonia, giant bilateral pneumatoceles, status asthmaticus and possible immunodeficiency. Due to a restrictive pulmonary disorder, a chest tube was placed in one of the pneumatoceles, but there was no improvement in his respiratory status. He progressed to sepsis and respiratory failure, needing mechanical ventilation. The patient was submitted to bilateral bullectomy with expansion of the collapsed lung. However, he died soon after the surgery. This was an uncommon case with pneumatoceles that evolved to respiratory failure requiring surgical intervention.

Keywords: Pneumatoceles. Bullous lung disease. Cysts. Staphyloccocal pneumonia. Ventilatory insufficiency. Bullectomy.

The hemangiopericytoma is a rare malignant neoplasia that involves the lungs in about 10% of the cases. It usually presents as a great encapsulated mass in asymptomatic patients. The treatment of choice is surgical resection. The authors present a case of malignant lung hemangiopericytoma in a 62 year-old woman, followed by discussion and review of literature.

Keywords: Hemangiopericytoma. Lung neoplasms.

A case is presented of a 36 year-old woman, with metastatic lung choriocarcinoma with atypical clinical and radiological presentation. The finding of pulmonary hypertension indicated the possibility of pulmonary thromboembolism, still, the definitive diagnosis and cause of pulmonary embolism were done in the autopsy. The authors discuss the manners of choriocarcinoma metastasis presentation, its repercussions and the latent period which may exist until it presents evidence of neoplasm.

Keywords: Choriocarcinoma. Pulmonary embolism.

A 23 female patient presented with productive cough, vomica and hair elimination in the sputum. Chest X-ray and CT showed a pulmonary abscess in the right lower lobe. The clinical treatment failed. A lobectomy was done and showed a benign lung teratoma, a very rare disease.

Keywords: Teratoma. Thoracic neoplasms.

Objective: To characterize the situation of pulmonology journals published in Latin America. Methods: A survey was conducted in a meeting sponsored by the Latin American Thoracic Society. Each journal editor presented a report and answered a questionnaire. Results: Improving information acquisition is the main motivation for pulmonology societies to edit their own journals, whereas disseminating medical knowledge and reporting experiences are the main motivations for authors to submit papers. The most common failing in the manuscripts submitted is poor compliance with the journal guidelines. Improving author-editor-reviewer relationships would be the best strategy for improving the quality of manuscripts. Suggestions for improving Latin American journals included the following: promoting professionalism in editorial tasks; encouraging manuscript reviewers to be more meticulous; and embracing international norms for editing medical journals. The following major problems were reported: a lack of regular, appropriate periodicity of issues; a shortage of original papers that are considered 'milestones' in the specialty; a low rejection rate for submitted papers; a high turnover of editors. Conclusion: Based on our findings, we can make the following recommendations: although many journals are available in electronic form, they should also be maintained in print form; each journal should divulge its subscription fee, even if it is included in the annual society membership dues; although each Latin American country might decide to publish its own pulmonology journal, the feasibility of publishing a multinational Latin American pulmonology journal should be explored.

Keywords: Periodicals; Manuscripts; Latin America; Respiratory tract diseases.

Microsporidiosis is a rapidly emerging protozoon infection that has been reported predominantly in severely immunosuppressed persons with acquired immunodeficiency syndrome (AIDS). Since the first case of human microsporidian infection was reported in 1956, over 400 cases have been documented. The initial description of microsporidian infection in AIDS patients occurred in 1985. Five genera have been identified as the agents of microsporidiosis in immunocompromised persons (Enterocytozoon, Encephalitozoon, Septata, Pleistophora and Nosema). Respiratory tract infection due to microsporidia is associated almost exclusively with disseminated disease produced by members of the genera Encephalitozoon and Septata. Metronidazole and albendazole were recently reported to be responsible for clinical improvement of patients. The authors reported a case of a woman with AIDS and respiratory symptoms related to two pulmonary pathogens: Mycobacterium tuberculosis and Encephalitozoon cuniculi, identified by polymerase chain reaction (PCR) using diagnostic primers targeting the small subunit ribosomal RNA.

Keywords: Microsporidiosis. Respiratory tract infection. Acquired immunodeficiency syndrome.

A forty year old woman, 72 hours after liposuction, complained of sudden dyspnea, fever and tachycardia. Thoracic radiography and duplex-scan of deep veins were normal. Pulmonary scintigraphy suggested thromboembolism. The patient had hypoxia, anemia and mental confusion after three days of systemic heparin. Once fat embolism syndrome was suspected, heparin infusion was stopped and corticosteroid therapy was started. After that, the patient was much better and discharged from hospital.

Keywords: Fat embolism syndrome. Pulmonary thromboembolism. Liposuction.

The authors report a case of bronchoesophageal fistula found unsuspectedly in bronchoscopy. The radiological findings were compatible and etiologic confirmation was established by histopathological studies.

Keywords: Bronchoesophageal fistula. AIDS.

Objective: To describe the results of a seven years experience using home oxygen therapy in children with hypoxemia and chronic lung disease. Patients and methods: This is a retrospective and descriptive study carried out at Hospital da Criança Santo Antônio - Porto Alegre-RS, Southern Brazil. The characteristics of the children on home oxygen therapy from January/93 to January/00 were analyzed. Results: Out of the 40 patients studied, 29 (72.5%) were males. At the beginning of home oxygen therapy, the age of the patients ranged from two months to 13 years and six months (mean: 24.8; median: 13), and 18 of them (45%) were less than one year old. The most frequent diseases were: obliterative bronchiolitis (31 cases; 77.5%); chronic obstructive lung disease with aspiration pneumonia (three cases); hypogammaglobulinaemia (two cases); suppurative lung disease (two cases), alveolar proteinosis (one case) and tuberculosis (one case). The length of the last hospitalization before home oxygen therapy was started ranged from nine to 240 days (mean: 63.7 days; median: 50 days). Most of the patients (30; 75%) received oxygen from a concentrator and the remainder from a cylinder. Mean oxygen therapy length ranged from 27 to 1,620 days (median: 392.5 days). There were five deaths from complications of the basic disease and one from accidental removal of the tracheostomy tube. Oxygen use could be discontinued in 19 patients - 15 with obliterative bronchiolitis, two with chronic aspiration pneumonia, one with tuberculosis and one with alveolar proteinosis. Conclusion: Although oxygen was needed for long periods, evolution was satisfactory in most children. Home oxygen for oxygen-dependent is an alternative treatment that allows an early discharge and a quick return to home life.

Keywords: Oxygen inahalation therapy. Anoxemia. Lung obstructive diseases. Home treatment.

We present the case of a 60-year-old female patient who had been in menopause for 14 years and presented a pulmonary nodule on chest X-ray diagnosed in the postoperative follow-up evaluation of breast cancer. The patient had a history of mastectomy and ipsilateral axillary lymphadenectomy for invasive ductal breast carcinoma, as well as of hormone therapy, chemotherapy, and adjuvant radiotherapy. After thoracoscopic nodulectomy, the frozen section analysis revealed a pulmonary hamartoma. Recent studies show that 75% of patients who undergo surgery for pulmonary nodules after a curative mastectomy for breast cancer present lung metastases, 11.5% present primary lung cancer, and 13.5% present benign lesions, including hamartoma.

Keywords: Hamartoma; Breast neoplasms; Lung neoplasms; Neoplasm metastasis.

A case of polycystic hydatid disease with radiological manifestations that mimicked pulmonary metastatic lesions is reported. The patient, from Brasília, DF, was admitted to the Brasilia University Hospital in February 1996, with a six-month history of unproductive cough, progressive dyspnea, thoracic pain and an episode of hemoptysis. Besides the pulmonary lesions, a CT scan showed hypodense lesions and calcifications in the right lobe of the liver. Repeated examinations of the sputum and bronchoalveolar lavage revealed no malignant cells. An open lung biopsy was then performed and allowed the authors to recognize the helminthic nature of the disease. Protoscolices, probably of Echinococcus vogeli, were found in tissue sections. The source of infection was supposed to be some hunting dog lodged in a kennel kept by the patient. Administration of albendazole brought no significant improvement to the pulmonary lesions, after one year of treatment not yet interrupted.

Keywords: Polycystic hydatid disease. Polycystic echinococcosis. Neotropical echinococcosis. Echinococcus vogeli.