E-cigarette or vaping product use-associated lung injury (EVALI) is an acute or subacute pulmonary condition that was recognized in 2019. Its incidence has risen in parallel with the rise in e-cigarette use among adolescents and young adults. EVALI remains a diagnosis of exclusion in patients with a history of vaping. No standardized treatment protocol exists, and most cases are managed with empirical antibiotics and systemic corticosteroids. Smoking cessation counseling is a crucial component of both treatment and long-term follow-up. Here, we present the case of a 63-year-old woman with a 4-year history of e-cigarette use who was admitted with symptoms of dyspnea, cough, and sputum production and was subsequently diagnosed with EVALI.

Bronchial Dieulafoy’s disease (BDD) is a rare vascular anomaly in which an enlarged, dysplastic submucosal bronchial artery can rupture through focally attenuated or even intact epithelium, causing life-threatening hemoptysis. A 65-year-old lifelong non-smoking female presented with massive hemoptysis. Bronchoscopy revealed a 5-mm pulsatile polyp in the basal segment of the left lower lobe; a bronchoscopic biopsy precipitated torrential bleeding that was temporarily controlled with vasoconstrictors. Selective arteriography demonstrated a tortuous bronchial artery with a 5-mm saccular ectasia and rapid arteriovenous shunting. Super-selective embolization achieved immediate homeostasis; however, a durable cure required subsequent lobectomy. BDD should be considered in cases presenting with cryptogenic massive hemoptysis. Endobronchial biopsy is contraindicated, and treatment requires either embolization or surgery.

Chemotherapy-induced lung disease (CILD) is a serious complication that can negatively impact quality of life. It usually presents with inflammation and interstitial fibrosis, accompanied by symptoms ranging from mild dyspnea and cough to severe respiratory failure. Diagnosis is challenging, as it is often confused with infections or other interstitial lung diseases, as bronchoalveolar lavage results are usually nonspecific. We retrospectively evaluated eight CILD cases that were treated in our clinic between 2023 and 2024. Most patients had pulmonary symptoms, and thoracic CT scans often showed bilateral ground-glass opacities. Most patients improved clinically and radiologically after chemotherapy was halted and methylprednisolone treatment initiated, although some did not survive, especially those with additional comorbidities. Timely diagnosis and management are crucial in reducing morbidity and mortality in affected patients. This case series aims to raise awareness about CILD and to emphasize the importance of a multidisciplinary approach to avoid misdiagnosis and unnecessary treatment.

Pulmonary embolism (PE) is a potentially fatal cardiovascular emergency for which catheter-directed thrombolysis has emerged as an alternative therapy in cases where systemic thrombolysis is contraindicated, particularly when assisted by ultrasound (US-CDT). We present here the clinical characteristics, management, and outcomes of six patients with intermediate–high or high-risk PE treated with US-CDT in a tertiary care center. All patients were diagnosed based on CT pulmonary angiography and echocardiography findings and underwent ultrasound-assisted thrombolysis with EKOS catheters. Demographic, clinical, and hemodynamic data were collected, and outcomes were assessed based on echocardiographic parameters and clinical recovery. All patients presented with hemodynamic compromise and right ventricular dysfunction. US-CDT resulted in improvements in pulmonary artery pressures, right ventricular size and function, and oxygenation indices. No major bleeding complications occurred. US-CDT can be considered a safe and effective option in acute PE patients in whom systemic thrombolysis is contraindicated. Further studies are needed to evaluate long-term outcomes and improve patient selection.

Pleural effusion is an abnormal accumulation of fluid in the pleural space that can result from a variety of etiological factors, ranging from benign to malignant. Despite investigations, the etiological cause remains undetermined in 20–25% of patients. In the case presented here, pleural fluid regressed with colchicine therapy in a patient with a history of recurrent pleural effusion, the etiology could not be determined, despite treatment with nonspecific antibiotic and nonsteroidal anti-inflammatory drugs. The therapeutic benefit of oral colchicine therapy for the treatment of pleural effusions that occur after lung resection or conditions with known etiologies, such as pericarditis and Familial Mediterranean Fever (FMF), has been well documented in the literature. Its potential for the treatment of pleural effusions with unknown etiology has also been documented.

Leptospirosis is a zoonotic infection caused by Leptospira spirochetes. We present here the case of a 31-year-old male with alveolar hemorrhage, renal, and hepatic dysfunction who reported abdominal pain and weakness after cleaning out a warehouse containing rats 2 weeks earlier. Physical examination revealed abdominal tenderness but no other significant findings. As his clinical condition worsened, he developed cough and shortness of breath. Chest radiography revealed bilateral consolidation, and computed tomography (CT) of the chest revealed ground-glass opacities. Bronchoalveolar lavage pathology identified hemosiderin-laden macrophages. Leptospirosis testing confirmed antibodies against L. icterohaemorrhagiae with a titer of 1/800. The patient was placed on antibiotic therapy, corticosteroids, and plasmapheresis. Following treatment, his symptoms and laboratory results improved, and he was discharged.

Microscopic polyangiitis, a necrotizing small-vessel vasculitis, typically presents with renal involvement and pulmonary-renal syndrome, while diffuse alveolar hemorrhage (DAH) as the sole initial presentation without concurrent glomerulonephritis is exceedingly rare and diagnostically challenging. We present here the case of a 68-year-old female with massive hemoptysis, hypoxemia, and radiologic evi-dence of bilateral ground-glass opacities, in whom bronchoalveolar lavage confirmed DAH. Coagulation parameters were within normal limits and infectious and cardiogenic causes were excluded. Despite initially preser-ved renal function, the presence of MPO-ANCA positivity established the diagnosis of microscopic polyangiitis. The patient exhibited rapid clinical improvement following high-dose corticosteroids and cyclophosphamide, although renal dysfunction developed during follow-up. This case underscores the need to consider ANCA-associated vasculitis in pati-ents with isolated pulmonary hemorrhage. Early immunologic evaluation and bronchos-copic confirmation are critical for timely di-agnosis and therapeutic intervention, even in the absence of extrapulmonary findings.

Acute eosinophilic pneumonia (AEP) is a rare but life-threatening pulmonary disease characterized by the acute onset of respiratory symptoms, hypoxemia, and diffuse pulmonary infiltrates. Its clinical presentation is often mistaken for pneumonia or acute respiratory distress syndrome, leading to diagnostic delay. We report the case of a 59-year-old female who presented with a 3-week history of dyspnea and cough and was initially treated with antibiotics for presumed pneumonia. During follow-up, progressive peripheral eosinophilia, eosinophils in bronchoalveolar lavage, histopathological findings, and radiological progression supported the diagnosis of AEP. Spirometry performed before discharge demonstrated an obstructive pattern with significant bronchodilator reversibility; however, clinical and physical findings did not support asthma. Subsequently, the reversible obstruction was attributed to transient airway inflammation associated with AEP. Methylprednisolone (1 mg/kg) was initiated, resulting in rapid and dramatic clinical improvement. This case highlights the importance of considering AEP in the differential diagnosis of antibiotic-refractory pneumonia, the diagnostic value of spirometry findings, and the effectiveness of corticosteroid therapy.

A 63-year-old postmenopausal Asian woman with a history of breast cancer, hypertension, diabetes, and hypothyroidism presented with persistent respiratory symptoms, including chronic dry cough and exertional dyspnea. Despite multiple courses of antibiotics for presumed pneumonia, imaging revealed a non-resolving consolidation in the left lower lobe with central necrosis and air bronchogram. Given her oncological background and family history of lung cancer, malignancy was suspected. High-resolution CT and PET/CT scans revealed progressive consolidation with increased metabolic activity, raising concerns for a neoplastic process. Bronchoscopy with transbronchial cryobiopsy was performed, and subsequent histopathological examination demonstrated glandular architecture with abundant intracytoplasmic mucin and basally located nuclei, consistent with invasive mucinous adenocarcinoma of the lung. This case highlights the importance of considering underlying malignancy in patients with non-resolving pneumonia, especially in patients with a prior cancer history. Early histological confirmation is crucial for accurate diagnosis and timely oncologic management.

Mediastinal lipomas are rare lesions that are often missed on chest radiographs. A healthy 45-year-old male (ASA I) developed acute chest pain with palpitations in the post-anesthesia care unit after uncomplicated renal surgery. Examination, chest radiograph, and biomarkers were normal and ECG showed sinus tachycardia. The symptoms resolved with low-flow oxygen. CT/MRI the following day revealed a subcarinal fat-density mass (~6 × 5 × 8 cm) causing mild left-atrial compression. Bronchoscopy was normal; needle aspiration confirmed mature adipose tissue, consistent with lipoma. Surgery was advised but declined. This case underscores a structural cause of postoperative chest pain and the value of early cross-sectional imaging when initial evaluation is nondiagnostic.