Deepak K. Pandey

Traumatic pulmonary pseudocyst: a case report.

Traumatic pulmonary pseudocyst is a rare clinical event that may occur following chest trauma. This complication usually occurs as a result of blunt trauma and rarely, due to a penetrating injury. We report an unusual case of a 10-year-old boy who developed a left-sided pneumothorax along with a traumatic pulmonary pseudocyst when he was hit by a cricket ball while playing.

Unusual presentation of tuberculosis

Mediastinal mass is not an unusual entity. It occurs mostly due to lymphoma, thymoma, germ cell tumours, granulomatous diseases, and so on. Tuberculosis is an uncommon cause of mediastinal mass. It is rarely suspected when it is presented in such an unusual way. We report here a case of a 35-year-old male who presented with mediastinal mass, which was later confirmed as a case of tuberculosis on histopathological examination. He was successfully treated with anti-tubercular drugs.

The vanishing lung.

A 35-year-old man presented to the emergency department (ED) with a 3-month history of increasing shortness of breath associated with reduced exercise tolerance. The patient was a smoker with more than 20 pack-years of tobacco use. He had no history of fever, night sweats, cough, hemoptysis or chest pain, and his medical history was unremarkable. Physical examination revealed a well-looking man who was alert, stable and in no respiratory distress. Vital signs were blood pressure 122/74 mm Hg, pulse 92 beats/min, respiratory rate 22 breaths/min, temperature 35.8°C and oxygen saturation 97% on room air. The patient had no pallor, cyanosis, diaphoresis, clubbing or peripheral edema. His jugular veins were not distended; however, his trachea was shifted to the right and breath sounds were diminished over the left hemithorax without dullness to percussion. The patient’s heart sounds were maximally audible over the right hemithorax. An electrocardiogram revealed normal sinus rhythm and right axis deviation without evidence of ischemia. Pulmonary function tests were consistent with an obstructive pattern (forced expiratory volume in 1 second [FEV1] = 1.71 L; 45% predicted). A posterior–anterior chest x-ray is shown in Figure 1. Question

Herniation of pulmonary bulla--a case report.

Herniation of lung is an abnormal protrusion of the lung beyond the confines of the thoracic cage. Thoracic lung hernias are classified as cervical, intercostal, diaphragmatic or mediastinal. Each of these types can be either congenital or acquired. Acquired hernias can be spontaneous, posttraumatic or pathologic as a result of neoplastic or inflammatory process. Bullae are thin walled structures with a diameter more than 1 cm. They are most commonly seen in the upper portion of the lung. The underlying disease process is characterized by abnormal enlargement of the air spaces distal to the terminal bronchioles accompanied by destruction of their walls. These anatomic changes result in decreased elastic recoil, increased airway resistance and decreased maximal expiratory flow rate. The lung became hyperinflated and may demonstrate focal areas of bulla formation.. This causes overinflation and even burst of bulla into pleural cavity resulting in pneumothorax. We report a case where overinflated bulla herniated across the anterior mediastinum into the opposite hemithorax. This case is the first of its kind.