According to the literature, the metastatic affection of lungs can be proved by autopsy in up to 20–54 % of patients with a solid malignant tumorous disease. The report documents a case of a patient with the metastatic affection of lungs as generalization of cholangiogenic carcinoma. The course of the disease was atypical, the patient had no sings of a clinically obvious cholestasis, and most of his symptoms resulted from the pulmonary affection, which imitated an interstitial pulmonary disorder. The diagnosis was set only by the autopsy.
Even in the case of a correctly set diagnosis, the therapeutical options in a generalized disease are limited and the patient’s prognosis is life limiting in short term. The carcinomas usually grow slowly; nevertheless the advanced disease is characterized by a local invasion with perineural and perivascular spread and intergrowth into surrounding tissues with subsequent metastatic dissemination. The growth factors, cytokines, chemokines and their receptors produced by cancer cells are most likely responsible for the nature of the metastatic dissemination.

Key words: cholangiogenic carcinoma, lungs metastases, interstitial pulmonary disorder

The biologic treatment of asthma with anti-IgE antibody (omalizumab, Xolair) is the newest therapeutical strategy in the treatment of moderate and severe persistent allergic asthma. It is indicated in situations when nor symptoms neither frequency of exacerbations are controlled despite the administration of all available standard pharmacotherapeutical regimens. It represents a long-term additional treatment that is effective, well tolerated, but economically very expensive. Therefore, it is centralized only to the specialized centers that have special agreement and approval by insurance companies. The presented case report shows that if the treatment is correctly indicated and if patient responses, even so called “cost/benefit ratio“ may be favourable; the patient “catches a second wind” (literally “catches a second breath” in Czech) and often loses other symptoms of allergy as well.

Key words: eosinophilic inflammation, bronchial asthma, biologic treatment, monoclonal antibody, omalizumab

Authors in this article present the case of a patient with lymfangitis carcinomatosa in adenocarcinoma of the lung, while the finding was detected accidentally during examinations for shortness of breath. Authors point to the importance of careful anamnestic data collection, comprehensive assessment of the results of examinations and the benefit of taking samples for histological examinations at bronchoscopy. The present case report also gives evidence of the severity and poor prognosis of lymfangitis carcinomatosa.

Key words: lymfangitis carcinomatosa, adenocarcinoma, bronchoscopy

The authors present a complicated case of tuberculosis in an immunocompromised female patient after a liver transplantation with a permanent immunosuppressive therapy. The patient was admitted in serious condition to the Clinic of Respiratory Diseases and TBC due to tuberculosis of peritoneum and liver. During the hospitalization the tuberculosis of the intestine, the right eye, miliar pulmonary tuberculosis, and TBC pleuritis were diagnosed. On the treatment a quadrucombination of antituberculotics the originally serious health condition started to improve gradually, control samples were repeatedly negative for mycobacteria and the patient was discharged to the out-patient care.

Key words: tuberculosis, immunocompromised patient, non-pulmonary forms of tuberculosis

The spontaneous pneumomediastinum is defined as a presence of free air in the mediastinum without any previous injury and lung disorder. The incidence of the spontaneous pneumomediastinum is low, and therefore the disease is not very known among physicians. The authors present a case of a massive spontaneous pneumomediastinum in a young man. Leading signs and symptoms were chest pain, dyspnea, cough and subcutaneous emphysema in his neck area. A serious pathology, that could have caused the pneumomediastinum, was excluded. The restoration occurred following a conservative treatment at the intensive care unit, the patient was discharged to home care at day 7 of the hospitalization.

Key words: spontaneous pneumomediastinum, emphysema, intensive care

The authors describe in their article a comparatively new optical method determined for the examination of oscillating motion of vocal cords. The principal characteristic of the voice is described in the introduction, and a group of 85 patients with suspected tumor of vocal cords is presented there. The high-speed camera cannot substitute the final diagnosis given by histological examination but it can lead to its determination, it manages the follow-up of vocal rehabilitation. It is suitable for dispensatory of patients with precancerous lesions vocal cords.

Key words: high-speed camera, kymogram, oscillating motion of vocal cords

Key words: flexible bronchoscopy (FOB), bronchoscopic findings, middle lobe syndrome