Patient: Male, 63Final Diagnosis: Sarcomatoid carcinoma of the lung with spine metastasisSymptoms: Back pain • coughMedication: —Clinical Procedure: Lung biopsy • laminectomySpecialty: PulmonologyObjective:Rare diseaseBackground:Sarcomatoid carcinoma is a rare, aggressive, malignant cancer composed of sarcoma and sarcoma-like components, and can occur in different organs such as the thyroid gland, bone, skin, breast, pancreas, liver, urinary tract, and lung. Pulmonary sarcomatoid carcinoma accounts for only a small percentage of lung cancers and has histological variants that include pleomorphic carcinoma, giant cell carcinoma, spindle cell carcinoma, carcinosarcoma, and pulmonary blastoma.Case Report:Here, we present a case of sarcomatoid carcinoma in a 63-year-old HIV-positive Hispanic male who presented with back pain, dry cough, and weight loss. A CT scan of his chest showed an ovoid mass in the lower lobe of the left lung, and an MRI of the spine showed a left lateral paraspinal soft tissue mass causing central canal stenosis and mild cord compression. The patient underwent laminectomy and resection of the spinal mass. A transthoracic needle biopsy of the lung and spinal masses had similar histopathology, and were indicative of sarcomatoid carcinoma.Conclusions:We report a rare case of sarcomatoid carcinoma involving both the lung and spinal cord in the same patient. Sarcomatoid carcinomas of the lung have poor prognosis and are aggressive cancers. Moreover, our case also had the co-occurrence of HIV and sarcomatoid carcinoma.

Patient: Female, 33Final Diagnosis: S1Q3T3 electrocardiographic abnormality in a pregnant asthmatic during acute bronchospasmSymptoms: Cough • shortness of breathMedication: —Clinical Procedure: EKGSpecialty: PulmonologyObjective:Rare co-existance of disease or pathologyBackground:Asthma is the most common chronic pulmonary disease during pregnancy. Several previous reports have documented reversible electrocardiographic changes during severe acute asthma attacks, including tachycardia, P pulmonale, right bundle branch block, right axis deviation, and ST segment and T wave abnormalities.Case Report:We present the case of a pregnant patient with asthma exacerbation in which acute bronchospasm caused S1Q3T3 abnormality on an electrocardiogram (ECG). The complete workup of ECG findings of S1Q3T3 was negative and correlated with bronchospasm. The S1Q3T3 electrocardiographic abnormality can be seen in acute bronchospasm in pregnant women. The other causes like pulmonary embolism, pneumothorax, acute lung disease, cor pulmonale, and left posterior fascicular block were excluded.Conclusions:Asthma exacerbations are of considerable concern during pregnancy due to their adverse effect on the fetus, and optimization of asthma treatment during pregnancy is vital for achieving good outcomes. Prompt recognition of electrocardiographic abnormality and early treatment can prevent adverse perinatal outcomes.

We report a case of invasive candidiasis presenting as multiple lung nodules and cavitary lesions with minimal pleural effusion. Candida infections of the lung are rare but can occur after hematologic dissemination of the yeast from other body sites, such as the skin and the gastrointestinal and genitourinary tracts. Here, we describe the case of a 56-year-old female with a history of end-stage renal disease (ESRD) who presented with fever, productive cough, and pulmonary nodules and cavitary lesions seen on a chest computed tomography (CT). The patient's blood cultures were positive for Candida zeylanoides.