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Introduction Chemical ablation with acetic acid or ethanol is effective against hepatocellular carcinoma and therefore its application in peripheral non-small-cell lung cancer (NSCLC) may be beneficial. Aim The aim of the study was to assess the efficacy and safety of percutaneous chemical ablation using acetic acid or ethanol in peripheral NSCLC cases. Patients and methods This was a prospective randomized control study conducted at the Chest and Clinical Oncology Departments, Mansoura, Egypt, from 2011 to 2014. Thirty-three patients were included with a mean age of 60 years, and were randomly divided into three groups: group A (acetic acid plus chemotherapy group) consisted of nine patients; group B (ethanol plus chemotherapy group) consisted of nine patients; and the control group C (chemotherapy alone group) consisted of 15 patients. Patients who were operable, who had tumors infiltrating the main stem bronchi or mediastinum, and those who refused to complete the study were excluded. Clinical and radiological data were evaluated before treatment and 3 and 6 months after treatment. Results There was a significant reduction in both cough score and chest pain in group A after 6 months of treatment, in the hemoptysis score in group A and group B after 6 months of treatment, and in dyspnea score in groups A and B after 3 and 6 months of treatment. There was a statistically significant difference in the tumor response results in both groups after 3 and 6 months of treatment when compared with the control group. There were one or more immediate complications but all were controllable with no mortality. Survival was better in groups A and B than in the control group. The cost of acetic acid and ethanol palliation for each patient was 10 $US. Conclusion Chemical ablation is an effective and inexpensive adjuvant palliative treatment for patients with inoperable peripheral NSCLC.

Airway obstruction presents with dyspnea, cough, hemoptysis, and atelectasis. Removing or decreasing the size of the obstructing lesions improves patient’s symptoms and life quality. Assessing the efficacy and safety of sequential use of cryoextraction and electrocautery in achievement of airway patency using fiberoptic bronchoscopy (FOB). This study was conducted at the Chest Medicine Department, Mansoura University, Egypt and included 22 patients with central airway obstruction (15 males and seven females) with a mean age of 50.5 ± 18.3 years. After etiologic diagnosis of airway obstruction, they were divided into two groups: group A (nonmalignant); eight patients and group B (malignant); 14 patients. All patients were subjected to sequential use of cryoextraction after electrocautery. Operable, unfit patients or patients with extraluminal obstruction were excluded. Clinical, radiological, functional, and bronchoscopic data were evaluated before and after FOB. The improvement in performance scale was highly significant in group B (P < 0.001) and significant in group A (P = 0.001). Spirometric parameters improved in both groups but were highly significant in group B (P < 0.001). Radiological improvement occurred in four out of eight of group A and in three out of 14 of group B. FOB score improved in group B (P = 0.003) and was more significant in group A. The procedure was complicated with atrial fibrillation and hemoptysis in one case and postbronchoscopy hypoxemia in two cases with no deaths. Cryoextraction after electrocautery using FOB are effective, safe, easy, and cheap in achieving airway patency. Egypt J Broncho 2015 9:269–275

Spontaneous regression (SR) of lymphoma is a rare phenomenon. While the precise mechanism of SR remains unknown, apoptosis may be associated with its process. Here, we present a case of a 52-year-old woman was admitted to our hospital with cough and orthopnea for 2 weeks. Multi-detector computed tomography of whole body showed anterior and middle mediastinal soft tissue mass with multiple adjacent malignant lymphadenopathy. The mediastinal mass invaded right atrium and pericardium. Another left subphrenic retro-pancreatic mass was detected. This mass surrounded upper pole of left kidney. Fine needle aspiration cytology was done and revealed lymphocytic smear with advised tru-cut biopsy. CT guided tru-cut was taken after 8 days. During CT guided technique; marked regression of left subphrenic mass was detected. Post-contrast MDCT scan was done and revealed partial response of the masses after 8 days. The partial regressive course of this disease suggests the effectiveness of fine needle aspiration cytology in initiating spontaneous regression. Tru-cut biopsy revealed non-Hodgkin lymphoma (diffuse large B-cell type). We report a case of NHL with abnormal location and spontaneous regression.

Hot saline thermoablation is effective and safe for hepatoma so its application to peripheral non small cell lung cancer NSCLC may be beneficial Aim Assess the efficacy and safety of palliative transthoracic hot isotonic saline injection of peripheral inoperable NSCLC Patients and methods Randomized clinical trial done at Chest, Clinical Oncology depatments and Oncology Center Mansoura, Egypt, 2013 to 2015. 23 patients with peripheral NSCLC randomly divided to 2 groups: group A, 11 patients subjected to transthoracic hot isotonic saline injection and group B, 12 patients subjected to transthoracic injection of isotonic saline at room temperature (immediately both groups were treated with chemotherapy).Primary endpoints were clinical, functional and radiological response and tumor tissue histopathology posttreatment. Secondary endpoint was survival Results Significant decrease in chest pain and dyspnea in group A versus group B, 3 and 6 ms posttreatment. Hot saline braked deterioration in quality of life. After 6 ms, there was statistically significant increase in FEV1 and FVC in group A versus before treatment. 8 patients in group A had partial response 72.7% and 3 patients had progression 27.3% and 7 patients in group B had stable course 58.3% and 5 patients had progression 41.7% after 6 months. 10 patients in group A had coagulative necrosis while 6 patients from group B had ischemic necrosis. There were few immediate controllable complications. Survival was better in group A than group B but statistically insignificant Conclusion Hot saline thermoablation is effective, safe palliative treatment for patients with inoperable peripheral NSCLC. PACTR2016001384408.