Endobronchial inflammatory pseudotumor of the lung.

Inflammatory pseudotumor (also called plasma cell granuloma, histiocytoma and x-anthofibroma) is a benign, slow growing lesion which may present with cough, dyspnea, hemoptysis and unresolving pneumonia or can be discovered radiographically as a localised lesion. It has been reported in individuals up to 70 years old, but approximately two-thirds have developed in individuals under 30 years of age. The sex incidence is approximately equal. Inflammatory pseudotumors of the lung are usually peripheral lesions but may occasionally be endobronchial. We report the case of an endobronchial inflammatory pseudotumor in a 17-year-old girl who presented with unresolving right-sided pneumonia. Appropriate radiological, bronchoscopic and histopathological investigations lead to accurate pre-operative diagnosis and early complete surgical resection through a limited right main bronchus incision (bronchotomy). The patient made good postoperative recovery and an excellent prognosis is anticipated.

Pattern and surgery for oesophageal carcinoma in Saudi Arabia.

Forty-three patients with carcinoma of the oesophagus are presented, 30 of whom were male and 13 female, with ages ranging from 42 to 88 years. Mean duration of symptoms was 4.6 months. Of patients, 65.2% were in stage III and 30.2% in stage IIA. Stages I and IV were encountered in one patient each. Twenty-five were Saudis and 14 non-Saudis. Of the Saudi patients, 64.3% were from the Qaseem region. 48.8% had subtotal oesophagectomy with neck anastomosis and 51.2% had limited oesophagectomy with intrathoracic anastomosis. The mortality rate was 11.6% The 5-year survival rate was 33.3%. We found sex, histology, stage of disease and extent of oesophageal resection influence long-term survival.

Maximal thymectomy for myasthenia gravis.

Maximal thymectomy was carried out in 48 patients with myasthenia gravis (MG). There were 18 males and 30 females. Thymic hyperplasia was found in 38, and atrophic thymus in 8, patients. Two patients had thymoma. In the non-thymomatous myasthenia gravis complete remission was achieved in 16 patients (34.8%) and pharmacological remission in 20 patients (43.5%) thus giving a total remission in 36 (78.3%) patients. Six patients (13%) improved. There was no improvement in four patients. Thus, the overall benefit from thymectomy was 91.4% in this series. We found that sex, age at onset of disease and steroid therapy influenced the outcome of thymectomy. On the other hand, duration of disease, anti-acetylcholine receptor (AntiAchR) antibodies and thymic histology did not have any bearing on the complete remission rate.

Massive haemoptysis caused by congenital absence of a segment of inferior vena cava.

A patient with congenital absence of a part of the inferior vena cava is described. This resulted in spontaneous rupture of a bronchial vein leading to massive haemoptysis.