Air pollution is a serious problem in Romania, with the country ranking 13th among the most polluted countries in Europe in the 2021 World Air Quality Report. Despite the recognized impact of pollutants on health, there has been a lack of large-scale studies conducted in Romania. This study investigated the impact of air pollutants on patients with chronic respiratory, cardiovascular, cerebrovascular, or metabolic diseases in Bucharest and its metropolitan area from 20 August 2018 to 1 June 2022. The daily limit values for particulate matter PM10 and PM2.5 were exceeded every month, especially during the cold season, with a decrease during the COVID-19 pandemic restrictions. A significant statistical correlation was found between the monthly average values of PM2.5 and PM10 and hospitalizations for respiratory and cardiovascular diseases. A 10 µg/m³ increase in monthly average values resulted in a 40–60% increase in admissions for each type of pathology, translating to more than 2000 admissions for each pathology for the study period. This study highlights the urgent need for national and local measures to ensure a cleaner environment and enhance public health in Romania according to international regulations.

Pulmonary disease caused by nontuberculous mycobacteria represents an important diagnostic challenge, particularly in immunocompromised patients, in whom clinical and radiologic findings may mimic malignancy. We report the case of a 70-year-old woman with myelofibrosis treated with ruxolitinib who developed a tumor-like lesion in the left upper lobe on computed tomography, highly suggestive of lung cancer. Despite broad-spectrum antibiotic therapy, the lesion persisted; bronchoscopy did not yield diagnostic findings, and CT-guided transthoracic biopsy demonstrated necrotizing granulomatous inflammation without evidence of malignancy. Microbiological analysis subsequently identified Mycobacterium avium, and targeted antimycobacterial therapy led to clinical and radiologic improvement. This case highlights that pulmonary nontuberculous mycobacterial infection may present as a pseudotumoral lesion and should be considered in the differential diagnosis of mass-like pulmonary opacities, particularly in patients receiving Janus kinase inhibitor therapy.

Introduction: Tuberculosis-HIV co-infection remains a challenge to the clinician largely as a result of the potentiation mutual, which will result in deterioration of the immunological status and increased risk of mortality. Case presentation: 37-year-old patient, smoker 5 pack-year (5PA), without pathological history, who is hospitalized in 2021 in an ear, nose and throat otolaryngology (ENT) service in the context of the appearance of laterocervical and axillary polyadenopathy, during the examination histopathologically resulting to be of tuberculous etiology. The transfer was made to the pneumophthisiology clinic where human immunodeficiency virus (HIV) testing was performed it was positive. It was decided to initiate antituberculosis and systemic corticoid treatment with initially favorable evolution, with the association following antiretroviral therapy. The patient develops motor deficits, and the brain magnetic resonance imaging (MRI) examination revealed the presence of two left hemispheric intracranial processes biopsied by neuronavigation, the result of which revealed histopathological changes highly suggestive of granulomatosis. In dynamics, the clinical examination carried out in an infectious disease service highlights the appearance of a pseudotumoral formation, with consistent right sterno-costal fluctuation, which is why it was decided to redirect the case to the thoracic surgery department, where drainage of the formation was practiced with the microbiological detection of Mycobacterium tuberculosis. Discussions: The peculiarity of the case resides in the presence of multiple foci of extrapulmonary tuberculosis in a case of tuberculosis-human immunodeficiency virus ( TB-HIV) co-infection, without lung damage, in a patient with apparent compliance to treatment. Conclusions: Tuberculosis remains a challenge for the clinician, especially in the case of HIV co-infection, association with mortality and increased morbidity.

Background and Clinical Significance: Solitary fibrous tumors (SFTs) of the pleura are rare mesenchymal neoplasms accounting for less than 5% of pleuro-pulmonary tumors. Recurrence after complete resection of benign SFT is exceptional, with an estimated rate of approximately 3%. Case Presentation: We describe a 78-year-old woman who developed a late recurrence 10 years after resection of a giant benign pleural SFT. The new pleura-based mass was confirmed as SFT by CT-guided biopsy demonstrating spindle-cell morphology, patternless architecture, staghorn vasculature, and STAT6/CD34 positivity, consistent with intermediate-risk disease by Demicco scoring. Surgical tumorectomy was successfully performed. Conclusions: This case illustrates the unpredictable long-term behavior of pleural SFTs and reinforces the importance of extended imaging surveillance even in initially benign lesions. An updated review of contemporary classification systems, molecular mechanisms, and management strategies is included.