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

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

A case of human pulmonary adiaspiromycosis - the 18th from Brazil - is reported for two purposes: to contribute to the knowledge of the clinical course of the disease and to discuss the basis for using the transbronchial biopsy in demonstrating the causative organism. The patient, an 18 year old male, lived in the Paranoa village, near Brasilia, DF, where he worked in a joinery, making straw-brooms. In February 1997, he was admitted to the Brasilia University Hospital, with severe respiratory manifestations. The main symptom was a ventilatory-dependent thoracic pain. A chest roentgenogram showed a diffuse interstitial infiltrate, in both lungs, with micronodular pattern suggestive of a miliary process. No bacterial or fungal organisms could be found in the sputum or bronchial lavages of the patient. A transbronchial biopsy was then performed and the microscopic examination of the lung tissue revealed several large adioconidia. Adiaspiromycosis is believed to be a self-healing condition, since in the great majority of the so far known cases spontaneous remission of the pulmonary lesions has been the rule. Transbronchial biopsy, due to its simplicity, is indicated as the procedure of choice to demonstrate the adiaconidia of the agent in tissue sections - the only way to definitely establish the diagnosis of adiaspiromycosis.

Keywords: Adiaspiromycosis. Pulmonary mycosis. Emmonsia crescens. Emmonsia parva var crescens. Chrysosporium parvum var crescens.

A case of exuberant endobronchial tuberculosis is presented in a 29-year-old male patient, HIV negative, under endoscopic aspects before and after the institution of a specific therapy. Considering the high tuberculosis infection/disease prevalence in our environment and the potential sequelae of this kind of tuberculosis, the authors emphasize the importance of the respiratory endoscopic examination for the diagnosis, treatment, and follow-up of endobronchial lesions.

Keywords: Bacilo álcool-acidorresistente

Inflammatory pseudotumor of the lung is a rare form of benign neoplasia and is generally characterized by a solitary pulmonary nodule. The endobronchial presentation is uncommon. Conservative surgery remains the treatment of choice, and surgeons should always strive to achieve tumor-free margins due to the possibility of local recidivism. This article reports the case of a 36-year-old male patient with recurrent attacks of wheezing and cough. The patient underwent successful bronchoplasty for the resection of an endobronchial inflammatory pseudotumor.

Keywords: Granuloma, plasma cell; Coin lesion, pulmonary; Surgery.

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.

We report the case of a 74-year-old female patient diagnosed with a giant cell tumor of the sternum. The clinical and radiological presentation was indicative of a primary tumor of the sternum. The patient underwent complementary tests and surgery. The pathological examination confirmed the diagnosis. Commonly observed in the long bones of the appendicular skeleton, this type of tumor is characterized by its local aggressiveness and metastatic potential. We also review the literature on the topic.

Keywords: Sternum; Giant cell tumors; Thorax.

Objectives: The advent of massively parallel next-generation sequencing (MP-NGS) offers potential advantages over sequential molecular profiling (SMP) in the management of non-small cell lung cancer (NSCLC). This study compares the two methodologies using samples obtained through endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), focusing on actionable mutation detection, turnaround time (TAT), and clinical outcomes. Methods: A retrospective analysis was conducted on NSCLC patients who underwent EBUS-TBNA and molecular characterization between January 2020 and December 2023. SMP and MP-NGS were compared in terms of actionable mutation detection rates, TAT, and impact on overall survival (OS). Results: Among 106 patients, MP-NGS demonstrated a significantly higher detection rate of actionable mutations compared to SMP (40.9% vs. 22.2%, p=0.042). The median TAT was slightly shorter with SMP than with externally outsourced MP-NGS (17 days vs. 23 days, p=0.076). Patients diagnosed via MP-NGS were more frequently allocated to targeted therapies (44.26% vs. 22.2%, p=0.038), which may have positively influenced overall survival (672 days vs. 138 days, p=0.053). Conclusion: MP-NGS provided superior diagnostic and clinical advantages over SMP in NSCLC, supporting its adoption as a standard diagnostic approach to enhance personalized therapy and improve patient outcomes.

Keywords: Non-Small Cell Lung Cancer, Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration, Sequential Molecular Profiling, Massively Parallel Next-Generation Sequencing, Actionable Mutations, Personalized Therap

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.

The authors report the case of a 28-year-old female patient with a giant cell tumor originating from the rib. The tumor, measuring 25 × 17 cm, occupied the entire hemithorax and caused atelectasis of the left lung. This tumor was a benign mesenchymal neoplasm, which rarely affects the ribs. A thoracotomy involving en bloc resection of the chest wall and tumor was performed. Despite the large dimensions of the tumor, complete resection was possible, and lung function was restored.

Keywords: Neoplasms; Giant cells; Mesoderm; Thoracotomy; Medical records.

The authors report a rare case of internal thoracic artery lesion caused by a chest tube in a patient under open drainage system treatment for empyema. The vessel rupture, leading the patient to hypovolemic shock and massive hemoptysis, was the indication for surgical intervention. They also emphasize the care with a thoracic drainage and the need for radiologic control.

Keywords: Thoracostomy. Internal thoracic artery. Chest tube.

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.

The authors report a typical case of pediatric sarcoidosis presenting a granulomatous pulmonary disease with systemic impairment, reviewing clinical, diagnostic, and particular aspects of the disease in this age group, with emphasis on the difficulty to differentiate its diagnosis from that of tuberculosis.

Keywords: Sarcoidosis. Pulmonary sarcoidosis. Lung diseases.

Trauma primarily affects young people and is the leading cause of death in the first three decades of life. Flail chest is observed in approximately 10% of all patients with severe chest trauma, and the mortality rate among such patients is 10-15%. We report herein the case of a car accident victim with chest trauma causing hemopneumothorax and multiple rib fractures, intense pain and deformity of the chest wall. Surgical stabilization was performed, with good results. Therapeutic options are also discussed.

Keywords: Thoracic injuries; Flail chest; Thoracoplasty.

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.