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A 27-year-old man, in good health but a moderate smoker, suddenly had two episodes of haemoptysis. Routine clinical examination was unremarkable. Erythrocyte sedimentation rate was increased to 34 mm/h. The chest radiography showed ill-defined, contrast-poor infiltrations bilaterally, as well as left hilar enlargement. Lung scintigraphy and pulmonary arteriogram suggested pulmonary embolism, possible from a "pelvic vein spur", i.e. an intimal proliferation due to crossing of the common iliac artery over the pelvic vein. He was placed on oral anticoagulants. Three months later he had another severe haemoptysis, providing the indication for an exploratory thoracotomy. This revealed the left pulmonary artery wall to have inflammatory changes with aneurysmal dilatation. The aneurysm was plicated. Histological examination demonstrated chronic vasculitis as seen in Behcet's syndrome, a diagnosis confirmed by the findings of ulcers of the oral mucosa and the presence of HLA B5 allo-antigens. Immunosuppressive treatment was given with prednisone (1 mg/kg), azathioprine (2.5 mg/kg) and ciclosporin (5 mg/kg). Over the next 12 months there has been only one further haemoptysis.

The accuracy of different histological and cytological methods were analysed in 240 patients with primary lung cancer. The diagnosis had been confirmed by either biopsy, surgery or autopsy. Using multiple diagnostic procedures a positive pre-operative diagnosis was obtained in 86.5%. Where the tumour was endoscopically visible and accessible to direct biopsy the correct diagnosis was made in 97.5%. In case of more peripheral tumour localisation positive results were obtained by cytological tests in 76.5%. The most accurate method of diagnosis was direct forceps biopsy of visible tumours (91% positive). Bronchial washing was positive in 64%, post-bronchoscopic sputum analysis in 60%, pre-bronchoscopic sputum in 55% and bronchial brushing in 30%.

A rare case of desquamating interstitial pneumonia, in a 15-year-old boy, is reported. Symptoms consisted of dry cough, progressive dyspnoea and chest pain. The chest X-ray revealed bilateral basal opacities. There were hypoxaemia and restrictive ventilatory changes. Bacteriological, virological and serological tests were all negative. An open lung biopsy established the diagnosis and corticosteroids were given as the drug of first choice. Other drugs, such as cytostatic ones, should only be given if steroids are ineffective. Arterial blood gases proved to be the most sensitive indicator of improvement, while the chest X-ray remained abnormal for several months.