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Background: Malignant pleural effusions indicate advanced stage of cancer and making the treatment decisions difficult for the treating physicians. There are multiple treatment options for the treatment of malignant pleural effusion including pleurodesis, thoracocentesis, indwelling pleural catheters (IPCs), and pleural decortication surgeries. However, there is a considerable number of patients who are not candidates for either pleurodesis or have repeated thoracocentesis, these patients can be carefully selected for management with IPCs. Aims and Objectives: To establish the use of indwelling pleural catheter in malignant pleural effusions. Materials and Methods: Patients who are not candidates for either pleurodesis or have repeated thoracocentesis, these patients can be carefully selected for management with IPCs. This is a prospective study of 23 patients with underlying trapped lung or recurrent pleural effusions who have been treated with IPCs from January 2021 to December 2022. We have used Rocket pleural catheter in this study. Results: The common primary malignancy was from lungs with the most common histologic type being adenocarcinoma type. We had good improvement in symptoms and have observed minor complications in about 21% of the individuals. Conclusion: IPC can be considered a good treatment option for patients with malignant pleural effusion with trapped lungs and patients with recurrent pleural effusions.

Mucormycosis refers to the infection caused by a growing number of members of the Mucorales. Mucormycosis has emerged as an important opportunistic infection in severely immunocompromised patients with hematological malignancies and recipients of stem cell or organ transplantation and in poorly controlled diabetics. The diagnosis of mucormycosis relies upon histopathology and culture. Blood tests are of limited diagnostic value. Here, we present two cases of mucormycosis in diabetic patients diagnosed with tissue biopsy.

Introduction: This study is the easiest and fastest; patient and observer comfort level increase with the convenience of evaluation of pleural effusion (PE) qualification, and assessment of quality and guidance for management is taken into consideration. Four plus one formula are taken for the existing literature, and the patient imaging evaluation and all the four plus one measurement are taken and calculated and kept for comparison. Later, the patient has aspirated patient PE catheter drainage done and calculated with the above four plus one measurement, and statistical analysis correlation is done. Aim: The aim of this study was to find the quantity, quality, and nature of PE in planning the management. Objectives: Primary objective - study to assess the nature of PE by clinical, sonography laboratory results. Secondary objective - To decide the mode of management and follow-up by diagnostic, therapeutic, closed pleural biopsy, pleuroscopy, video-assisted thoracoscopic surgery, and surgical decortication. Need of the Study: Because of the shape of pleural space and its anatomy, the PE volume variability in the estimation of actual quantity is complex subjectively even for an experienced clinician estimation or by computed tomography scan and sonography. Hence, instead of many available complicated clinical estimation and imaging formulae, the sonography formulae showed a wide spectrum of values in measuring the actual PE amount. This observational study was performed utilizing and comparing the available references and formulae. Sonography is modified to give the best comfort to patients and the most accessible and fastest sonographic t estimation and comparison with other groups of studies and to arrive at a consensus value for the purpose of our institutional uniformity. Study Site: Department of Radiology and Imaging Sciences and Department of Pulmonary Medicine, Apollo Hospitals, Chennai-06. Study Design: This was an observational, cross-sectional study. Study Duration: The duration of the study was March 2020–September 2021. Inclusion Criteria: patients with clinical suspicion of PE are taken up for study. Exclusion Criteria: patients with noncooperation and restless severe hydropneumothorax. The total number of patients is 181, both male and female, Equipment: High-end EPIQ-7G, PHILIPS ULTRASOUND machine with advanced feature and with broadband convex C5-1 transducer used, and all parameters are recorded systematically. If the fluid is beyond the image frame, we utilized a panoramic software view for any length of fluid, heightens the advantage in the study. Results: Balick et al. and our single measurement study were correlated, and we found in this study stresses on any axis, longest single measurement and position of the patient made easier for the estimation utilizing, highest hand equipment, having panoramic view software. Conclusion: Single-free longest axis measurement in this study is useful with the standard deviation of the single-fixed axis of measurements of other studies.

The most common organ affected in smokers is lungs. The usual presentations are obstructive airway disease, interstitial lung disease, and malignancy. Rarely, some individuals with specific genomic characteristics may develop pulmonary Langerhans' cell histiocytosis, which commonly presents as bilateral upper lobe predominant cystic lung disease. The main array of treatment is cessation of smoking.

The importance of knowledge about pulmonary aspergillosis has increased immensely in the era of COVID-19 as a significant number of post-COVID patients develop lung infection with aspergillosis, an entity called COVID-associated pulmonary aspergillosis producing increasing morbidity and mortality. In this case report, we describe an immunocompetent elderly man presenting with a peripheral lung mass, suspected to have lung malignancy which turned out later to be pleuropulmonary aspergillosis.

The mediastinum is the site of infection, benign and malignant, primary and metastatic, many of which present as mediastinal masses and remains an interesting diagnostic challenge. Mediastinal masses affect patients of all ages and can be asymptomatic. Although clinical data, location in the mediastinum and radiological findings all aid in narrowing the differential diagnosis, tissue diagnosis is the gold standard for arriving the final diagnosis. The diagnosis of the mediastinal tumours requires a combination of clinical, radiological and pathological information. The purpose of this review study is to describe demographic, clinical features, radiology and pathological information of mediastinal masses which helps in organised diagnostic approach of mediastinal mass.

Fascioliasis, which is a zoonotic infestation caused by the trematode Fasciolia hepatica (liver fluke), is primarily a disease of herbivorous animals such as sheep and cattle. Humans become accidental hosts through ingesting uncooked aquatic plants such as watercress. It presents a wide spectrum of clinical pictures ranging from fever, eosinophilia and vague gastrointestinal symptoms in the acute phase to cholangitis, cholecystitis, biliary obstruction, extrahepatic infestation, or asymptomatic eosinophilia in the chronic phase. Because of its infrequent and protean presentation and the lack of clinical data, the management of acute infection is challenging. Lung manifestations of fasciolia are very rarely reported in the literature. This article reviews the pleuropulmonary complications of fasciolia hepatica infection in humans.

Fibrous Dysplasia is a non inherited skeletal developmental abnormality, where normal bone is replaced by fibrous tissue and poorly formed area of immature bone. Monostotic lesions are 80% of the cases; and Polyostotic lesions are characteristic component of specific syndromes. It is usually detected in 1st and 2nd decade of life as an incidental finding and can cause occasionally dull aching pain2. The clinical course is variable and depends upon the extent and location of the lesion. Fibrous Dysplasia is the most common benign rib lesion3,4. In this case report, we describe a patient with large progressively increasing in size symptomatic rib tumour diagnosed as benign lesion with biopsy and underwent successful resection surgery.

Mediastinal cysts account for 20% of all mediastinal masses. A 22-year-old pregnant female was admitted for delivery. She developed dyspnea on the 3rd day of delivery. Chest X-ray revealed a large right hydropneumothorax and tube thoracostomy was done. She was referred to us for further management. We decided to operate. At surgery, a ruptured cystic lesion was seen in the posterior mediastinum separate from all three lobes. It was communicating with the bronchus. The cyst was excised completely and bronchial communication was sutured. The lung expanded completely. Post operative period was uneventful. Histopathology revealed it to be a bronchogenic cyst.

Mediastinal cysts account for 20% of all mediastinal masses. A 22-year-old pregnant female was admitted for delivery. She developed dyspnea on the 3rd day of delivery. Chest X-ray revealed a large right hydropneumothorax and tube thoracostomy was done. She was referred to us for further management. We decided to operate. At surgery, a ruptured cystic lesion was seen in the posterior mediastinum separate from all three lobes. It was communicating with the bronchus. The cyst was excised completely and bronchial communication was sutured. The lung expanded completely. Post operative period was uneventful. Histopathology revealed it to be a bronchogenic cyst.

A 14-year-old boy came to our outpatient department with pleuritic chest pain and dyspnea. He was found to have a loculated empyema on the right side. He was taken up for surgery and decortication was done. He developed air leak in the postoperative period. When the air leak did not settle until the 10th day, we decided to attach the atrium Pneumostat™, a modified version of the Heimlich valve to his Intercostal drainage tube and sent him home. On further follow-up, his lung expanded, and ICD could be removed. The patient remains well until the current follow-up. We present this case in an attempt to change the perceptions about various options available to drain the chest. The Heimlich valve appears to be a more compliant option than the conventional underwater seal drainage in terms of early mobility, reduced length of stay, and patient compliance.

Lymphomas, malignancies of the lung, breast, and ovaries, most frequently give rise to malignant pleural effusions (MPE). The prognosis is often bad when an MPE is present. Malignant cells found in the pleural fluid or tissue can be used to confirm the diagnosis of MPE. Palliative care should emphasize on symptom relief, quality-of-life enhancement, and acceptance of an initial intervention to drain an MPE or prevent recurrence and affordability. Our preferred initial treatment for the majority of patients with recurrent MPE is the placement of an IPC (also known as a tunneled pleural catheter), with intermittent outpatient drainage performed by the patient or attender. Patients with expandable lung are candidates for both IPC drainage and pleurodesis, but those with nonexpandable lung are often only eligible for IPC drainage. IPC requires interventional expertise and may not be available in some institutions. IPC can produce spontaneous pleurodesis and gives good symptom alleviation, according to many randomized trials and one meta-analysis. Effective pleurodesis occurs in up to 70% of patients.