Pneumocytoma is a rare benign tumor of the lung that usually presents as a solitary pulmonary nodule. It is believed to arise from the primitive undifferentiated respiratory epithelium. We report a case of pulmonary pneumocytoma that was suspected on needle aspiration smears and confirmed histologically. This case describes the cytological features of pneumocytoma that are rarely described in textbooks.

Introduction and purpose Pulmonary aspergilloma is the formation of saprophytic colonies of fungus in pre-existing pulmonary cavities. They may cause life-threatening haemoptysis. As medical treatment often fails, surgery is the mainstay of treatment in symptomatic patients. Earlier studies had reported high levels of mortality and morbidity with surgery while more recent studies have shown better results. Hence, being in a large tertiary care centre in India, we decided to analyse the details of our own experience in the surgical management of pulmonary aspergilloma. Methods Details of all adult patients treated surgically for pulmonary aspergilloma, between the years 2009 and 2020, maintained in a live database in our institute, were retrieved and analysed. Results There were 102 patients in the study. The average age was 40 years. There was a male (M: F, 3:1) and right side preponderance. Pulmonary tuberculosis (TB) was the commonest cause for cavities in which aspergilloma developed as identified in 84 (82%) patients and diabetes mellitus, the commonest comorbidity present in 28 (27.5%) patients. Parenchymapreserving lung resections (PPLRs) were feasible in 8 (44%) of the non-tubercular patients, but only in 14 (17%) of the TB patients. Post-operative complications (11.7%) were higher among the patients with TB. There were 2 (1.9%) post-operative mortalities. Conclusion Though surgery is technically complex in the presence of pulmonary aspergilloma, it is yielding better results with improvements in treatment strategies. Surgery for aspergilloma in patients with prior or current pulmonary TB has more morbidity and mortality when compared to the non-TB patients.

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Introduction and purposeThough hydatidosis is a ubiquitous zoonosis endemic to India, there is a dearth of literature regarding the management of thoracic hydatid disease (THD) in India. There are no surgical guidelines available. The aim of this study is to analyse the details of THD operated upon in a tertiary care hospital in India and propose a protocol for its management. Methods The case files of all adult patients operated upon for THD in our institution between 2009 and 2019 were retrieved and a retrospective study done. Results A total of 186 patients, 103 (55.4%) males and 83 (44.6%) females, with a mean age of 34.2 years were studied. The commonest symptom was cough as in 83 (44.6%) patients. Complications were seen in 22 (11.8%) patients. Computerized tomogram (CT) was confirmatory in most patients. Isolated pulmonary disease was seen in 135 (72.6%) patients with 153 (82.3%) uni-lobar involvement. Right lower lobe was most frequently involved as in 56 (30.1%). Extra-pulmonary, intrathoracic involvement was seen in 6 (3.2%) and synchronous extra-thoracic disease in 45 (24.2%) patients. All patients were initiated on anthelmintics. Postero-lateral thoracotomy was the commonest surgical approach. Twenty (10.7%) patients required lung resections. The mean hospital stay was 5.9 days. Air leak, seen in 10 (5.4%) patients, was the commonest post-operative complication. There was single in-hospital mortality. Age, diabetes mellitus, secondary bacterial infection of the cyst and cyst characteristics were found to significantly affect the surgical outcomes. Conclusion Surgery, the treatment of choice for THD, can be done with negligible morbidity and mortality and should be expedited to prevent complications. Risk factors should be identified pre-operatively for better decision-making. Adequate concurrent medical therapy may prevent recurrences. Prolonged follow-up is mandatory to detect late recurrences.

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