Acute fibrinous organizing pneumonia: a rare lung pathology.

Acute fibrinous organizing pneumonia (AFOP) is a rare, non-infective lung pathology histologically characterized by patchy distribution of intra-alveolar fibrin "balls" and organizing pneumonia. It needs to be differentiated from other forms of acute pneumonia like community acquired pneumonia (CAP) because the treatment modalities are contrastingly different. Interesting case of a 45-year-old male initially suspected as a case of acute bacterial pneumonia but finally diagnosed as case of AFOP, is being reported. Initial empirical antimicrobial therapy was ineffective, and the main treatment to which the patient responded was corticosteroids.

A malignant wheeze!

Asthma is a common disorder presenting with nonspecific features, which may mimic other conditions such as tracheal tumors. Tracheal tumors are often misdiagnosed as asthma. We report a case of a 38-year female who was being worked up for persistent wheeze that was initially attributed to acute asthma, only to be later discovered as tracheal tumor. A high index of suspicion for alternative diagnoses must be kept in mind while evaluating a patient who presents with clinical features suggestive of asthma, but fails to respond to standard therapy. The present case report emphasizes the fact that not all wheezes are asthma.

Primary pleural synovial sarcoma: a rare cause of hemorrhagic pleural effusion.

Primary pleural synovial sarcoma (PPSS) is a rare malignant pleural tumor comprising < 1% of all primary lung malignancies. Primary pleural mesothelioma (PPM) has many similar features that may cause a diagnostic dilemma due to overlapping clinical and histopathological features. We present the case of a young male with recurrent hemorrhagic pleural effusion without any obvious lung mass who was diagnosed with PPSS. This rare entity must be considered with a high index of suspicion while evaluating pleural tumors.

Tuberculous vasculitic lung mass: Unique presentation of a common disease.

Tuberculosis is a common disease but it keeps on surprising with its unique presentations. It has been reported as lung mass but here we are reporting a case of Tuberculosis presented as vasculitic lung mass. A 61 years old female, known case of hypertension and secondary Sjogren syndrome, on treatment, presented with history of mild dyspnea and generalised weakness with incidental finding of Right hilar mass on chest X-ray undergoes a CECT thorax and CT guided biopsy. Histopathology contrary to expectations revealed granulomatous vasculitis with no microbiological evidence of TB, responded to antitubercular treatment and there was almost complete regression of the lesion after 6 weeks of ATT.