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Amniotic fluid embolism (AFE) is a rare pathological syndrome, sometimes fatal that arises as an obstetric complication during vaginal delivery, caesarean, immediate postpartum or during pregnancy. It remains as an important cause of fetal and maternal morbidity and mortality. The authors present a clinical report of a young woman who developed an acute respiratory failure during labour demanding invasive mechanical ventilation and an urgent caesarean. In spite of early medical intensive therapy, hypoxemia was refractory and had a progressive worsening leading to multi-organ failure and ultimately to death. Diagnosis was confirmed through the identification of fetal material in the lumen of maternal pulmonary microcirculation.

Pleural effusions can be a manifestation of several nosological entities. Etiologic diagnosis involves a good clinical history, followed by thoracocentesis with pleural biopsy and eventually bronchoscopy or thoracoscopy. The differentiation between transudates and exudates, by the biochemical characteristics of the pleural effusions, can orientate the underlying disorder. It is known that there are more than 35 different etiological entities of exudative pleural effusions. However, pneumonia, malignancies, pulmonary embolism, abdominal disease and tuberculosis are the major causes (around 90%). Transudative effusions are more frequently due to congestive heart failure, renal or hepatic failure. The AA present a clinical situation of pleural effusion, the etiology of which was initially attributed to congestive heart failure, with a good response, clinical and radiological response to the treatment established. However the laboratory alteration persisted (anaemia, renal failure, acute inflammation). The subsequent study showed the existence of a rare syndrome, a Myeloma Ig M lambda that can lead to differential diagnosis with Waldenström's Macroglobulinemia, about which the authors make some theoretical considerations showing the difficulty in etiologic diagnosis of some pleural effusions.

Concerning a clinical situation of intralobar pulmonary sequestration, in a seventeen year old young man, the authors review this nosological entity. They emphasize the importance of the complementary examens of diagnosis, namely of thoracic scan and aortography, for the establishment of the said diagnosis.

The case of a 52 year old man, whose initial clinical manifestations were dyspnea, bloodstained sputum and malaise is reported. After the initial cancer hypothesis, a diagnosis of diffuse primary tracheo-bronchial amyloidosis was made. The amyloid substance present was not of A A type and the plasma cells next to the deposits were polyclonal. The piece-meal removal of the masses by bronchoscopy led to profuse bleeding. The patient died with sepsis. The clinical, pathological and therapeutical aspects of lower respiratory tract amyloidosis are reviewed.