Tracheal glomus tumor is an extremely rare disease. Literally, 16 cases has been until now published according to several authors. This case was the very first case of such tracheal tumor in our clinical practice. According to the new WHO classification of tumors the glomus tumor is divided into three groups according to their biological activity: glomus tumor, glomus tumor of uncertain activity and malignant glomus tumor. Benign tumors represent more than 95 %. We present a case of a 46 years old man with the tracheal glomus tumor.

Key words: glomus tumor, trachea, surgical treatment

Multiple pulmonary nodulations represent the most difficult diagnostic problems in pneumology. The differential diagnosis is very wide-range. The diagnosing of multiple pulmonary nodulations is very complicated and it involves many different testing. It can be caused by infectious diseases, various granulomatosis, vessels disorders, post-transplantation reactions, and primary or secondary lung tumors. We present a case of a young female patient with multiple tiny affections in lungs. Despite of detailed examination the definite diagnosis was made only by video-guided thoracoscopy with biopsy. Histological examination proved epithelioid hemangioendotelioma. By further testing other tumor lesions were found in liver, bones, soft tissues and the right breast; a combined chemotherapy was initiated.

Key words: epithelioid hemangioendotelioma, multiple pulmonary nodulations, video-guided thoracoscopy, immunohistochemistry, chemotherapy

Authors present a case of pulmonary fibrosis with dominant involvement of airways surroundings that was only recently defined and until now documented by few cases and one limited series. The authors discuss diagnostic conclusion and differential-diagnostic spectrum.

Key words: interstitial pulmonary fibrosis, airways

Common variable immunodeficiency (CVID) is the most common cause of primary inborn imunodeficience of unclear genetic error represented by an impaired antibodies IgG and IgA production; IgM level can be normal. On the contrary, the sarcoidosis is a granulomatous disease of unclear etiology with impairment of CD4+ T lymphocyte activity – i.e. cellular immunity impairment. We present a case of a patient diagnosed with CVID. After 6 years of standard treatment of immunoglobulins substitution the patient developed elevation of liver enzymes, splenomegaly and abdominal lymphadenopathy. The patient reported intermittent cough without expectoration, exertion dyspnoea, fever and increased fatigue. Liver biopsy was performed with histological finding of non-caseous granulomas confirming the diagnosis of sarcoidosis. Based on liver biopsy, elevated levels of sIL2R and SACE, thoracic HRCT, abdominal CT and ultrasound, functional pulmonary tests, and Mantoux II test the condition was diagnosed as generalized sarcoidosis with involvement of lungs, liver and lymphatic nodes along with CVID. The treatment with prednison was initiated with initial dose of 40 mg daily which resulted in the improvement of patient’s condition and the decrease of liver enzymes to normal levels. The patient was continuously treated with regular intravenous immunoglobulins without infectious complications.

Key words: primary immunodeficiency, common variable immunodeficiency, sarcoidosis, coincidence

The authors present a case of a 50 years old female patient with allergic vascullitis and granulomatosis known as Churg-Strauss syndrome (CSS). Clinical symptoms, upper airways affection, bronchial asthma, peripheral blood and bronchoalveolar fluid eosinophilia supported this diagnose. The diagnosis was verified by lung biopsy during the video guided thoracoscopy. The patient was successfully treated with corticosteroids.

Key words: allergic vascullitis and granulomatosis, Churg-Strauss syndrome

The case presents a 7 years old girl living in a village close to lignite mines. In the living place there is a high concentration of inhalational allergens and there are domestic animals and pigeons kept. Girl’s mother is treated for chronic pulmonary fibrosis. 
The examination of the little girl confirmed bilateral pulmonary fibrosis stage 1-2. The treatment with systemic oral and inhaled corticosteroids resulted in a stable disease and a possibility of gradual tapering off a steroid therapy. The patient is followed by allergy specialist, immunologist and pneumologist.

Key words: exogenous allergic alveollitis, chronic pulmonary fibrosis

The author presents a case of a 71 years old patient with endobronchial squamous cell carcinoma of the right main bronchus bulging to trachea. The patient had been repeatedly administered bleomycine solution intratumorally in a stage of the disease when all available standard treatment methods were used up and the dyspnoea worsened. Following this treatment the tumor significantly regressed locally and clinical symptoms withdrew. Thanks to this procedure patient lived another year of full QOL.

Key words: endobronchial carcinoma, bleomycine

The paper summarizes the facts of smoking history, epidemiology and its influence on human health. It discusses in details the possibilities of nicotine replacement therapy and mentions non-nicotine pharmacologic alternative treatment of tobacco addiction (bupropion, varenikline, and vaccination). The issue is supported by a case of a COPD patient who significantly improved his condition, reduced the number of exacerbations and hospitalizations caused by COPD after smoking cessation (with bupropion treatment).

Key words: smoking, smoking cessation, chronic obstructive pulmonary disease, nicotine replacement therapy

The case of a 12 years old girl with inborn anomaly of big vessels and compression of airways demonstrates the significance of the bronchoscopy in children with chronic cough and permanent airways obstruction in spirometry.

Key words: bronchoscopy, airways obstruction, inborn vessels anomaly