A twelve year Mongolian girl fell ill shortly after her arrival in the Czech Republic with the right side exudative pleuritis. The thoracic puncture cultivation proved Mycobacterium tuberculosis resistant to all antituberculotic drugs except for pyrazinamid. We have not succeeded in proving the source of the disease, she was probably infected in Moscow where she had lived for several years prior to her arrival in the Czech Republic. Despite nine month of treatment with antituberculotic drugs an extensive pachypleuritis developed and we had to perform surgical decortication. Seventeen months after the treatment was completed, the relapse of the disease was detected in the form of extensive throat lymphadenitis. Cultivation of extirpated nodes confirmed again the multi-resistant Mycobacterium tuberculosis. The girl (of her own will) interrupted the repeated treatment with antituberculotic drugs several months later and she left for Mongolia. The prognosis of the disease remains uncertain. It is the first case of child tuberculosis in the Czech Republic caused by multi-resistant Mycobacterium tuberculosis.

Key words: multi-resistant tuberculosis, MDR TB, child tuberculosis, antituberculotic drugs, Mycobacterium tuberculosis

The paper summarizes principal effects of asbestos, its influence on health conditions of exposed persons, and occupational diseases listed in the Czech Republic in the List of Occupational Diseases in relationship with this exposure.
Two asymptomatic professional disease are described – hyalinosis of the pleura and lung cancer, found in a preventive medical examination.

Key words: asbestos, occupational diseases due to asbestos dust, hyalinosis of the pleura, lung cancer

The authors describe a case of a 59 years old patient with a cystic formation in her left lung that was first detected when she was 13 years old and examined for contact with tuberculosis. In the course of her life she had suffered from repeated pneumonia, particularly in the last five years. She was hospitalised at our clinic in November 2004 and in December 2004 we performed upper lobectomy because of repeated infection of the cyst. The finding was histologically described as a cystic well differentiated pneumoblastoma classified as a rare congenital tumor that occurs in children and young people but that is rare in adults. We have not found records of this diagnosis in a patient 59 years old.

Key words: cystic well differentiated pneumoblastoma

In this work we present interesting case of the patient with coin lesion. The importance of transparietal pulmonary biopsy under CT guidance is discussed with attention to such cases in which bronchology examination is often negative.

Key words: peripheral pulmonary node, nodular parenchyma form of amyloidosis, transparietal pulmonary biopsy

A case of diagnostic search concerning slowly progressing unclear X-ray finding in a middle aged woman that lasted several years. In the course of six years since 1993 the patient was subjected besides others to six bronchological examinations, a number of CT examinations, broncho-alveolar lavage (three times) and three surgical thoracic interventions but the exact diagnosis was made only after pneumonectomy in 1999. Despite the progressive lympho-prolipherative malign finding the woman is still alive thanks to the haemato-oncological treatment and she does not show any signs of the relaps of her disease.

Key words: lympho-prolipherative disease, lymphoma, broncho-alveolar lavage, lymphocytes, pulmonary neoplasm

The cause of the edema can be both, primary and secondary, adjacent with a lot of diseases. Differential diagnosis is often difficult and multisteps. We demonstrate the case of a woman, whose edema, though were almost typical for hypothyreosis, resulted in the false diagnosis of allergy and hereafter to inefficient treatment. The primary misleading diagnosis was caused both by a slow and inconspicuous development of her primary illness and the coincidence of several disorders including atopy in which the edema is a common symptom.

Key words: hypothyreosis, allergy