Does Phantom Tumor Really Exist?!

Localized interlobar effusion in congestive heart failure (known as phantom tumor or vanishing tumor of the lung) is an uncommon entity. We report a case of a 61-year-old man who presented to the Emergency Departament with a two week history of dyspnoea, palpitations, dry cough and intermitent anterior chest pain. A posteroanterior chest radiography showed a nodular mass in the medium third of the right hemithorax suggestive of a pulmonary tumor. With this supposition of diagnosis, the patient was admitted to the Pneumology Departament for further investigations. Left ventricular systolic dysfunction was identified on the echocardiographic examination, in the presence of atrial flutter with 2 to 1 block. Lateral chest X-ray confirmed the presence of a pleural effusion with complete regression of "the lung tumor" after ten days of congestive heart failure treatment, avoiding other expensive and unnecessary investigations.

[Pulmonary fibrosis induced by amiodarone--a pitfall of antiarrhytmic treatment]. / Fibroza pulmonara indusa de amiodarona--o capcana a tratamentului antiaritmic.

Cardiac arrhythmia are one of the major causes of cardiovascular and general morbi-mortality. This is the reason for a very quick and well-guided approach. One of the most used drug for this purpose is amiodarone, due to its high therapeutic potency and despite its risk for adverse effects. The most wellknown adverse effect seems to be the thyroid toxicity but, in reality, the most common ones involve the gastrointestinal and respiratory tract, with lung toxicity as a leader (incidence 6-7%). The two clinical cases which make the central point of this work are clear examples for being interested about amiodarone presence when a pulmonary fibrosis is present.

[Treatment of pulmonary hypertension in COPD: is there hope for the better?]. / Tratamentul hipertensiunii pulmonare (HTP) din BPOC: exista sperante reale de mai bine?

The aim of this study is to prove for a well tolerated medication (clinical and financial) a supplementary effect in improvement prognosis of patients with pulmonary hypertension secondary to COPD, already treated with classical pneumology drugs. Three pts. groups were selected: the first received only classical pneumology treatment, the second with supplementary therapy by IECA and Ca-blockers, the third with supplementary therapy with IECA and nebivolol; the follow-up protocol included clinical and paraclinical status (blood gases, spirometry, ECG, echocardiography, 6 minute walk test) over 3 months. Clinical and paraclinical evolution of the pts. in group 2 and group 3 was significantly better that in pts from group 1. We conclude that addition of IECA + Ca-blocker/IECA + nebivolol therapy at classical pneumology therapy result in a better evolution in pts. with pulmonary hypertension secondary to COPD.

[Thromboembolic chronic pulmonary hypertension--a fake primary pulmonary hypertension--case report]. / Hipertensiunea pulmonara cronica tromboembolica--o falsa hipertensiune pulmonara primara--caz clinic.

Chronic pulmonary hypertension (CPHT) is on the third place of causes leading to cardiovascular morbidity and mortality in patients over fifty. Two of the rare causes of CPHT (< or = 7%) are: chronic thromboembolic hypertension and primary one; these two diseases resemble in many situations and, consequently, the diagnosis is frequently difficult (especially when risk factors for recurrent pulmonary thromboembolism are not present). Our case presentation is just such a situation; only pulmonary perfusion scintigraphy allowed us to make the right diagnosis--chronic thromboembolic pulmonary hypertension--in an "apparently clear" primary pulmonary hypertension.