Introduction: Tuberculous aneurysm of the thoracic aorta (TBAA) is an extremely rare but potentially fatal manifestation of tuberculosis (TB). Clinical presentation may include hemoptysis in the absence of parenchymal lung abnormalities. Case report: We presented a 62-year-old male with cough, chest pain, and minimal hemoptysis. Diagnostic evaluation confirmed an aneurysm of the descending thoracic aorta at a site previously treated with endovascular repair, with no imaging findings suggestive of pulmonary TB. Bronchoscopy revealed blood in the main bronchi without an identifiable endobronchial source. The diagnosis of TB was established by polymerase chain reaction (PCR) testing of bronchial aspirate obtained during bronchoscopy. Emergency surgical intervention was recommended because of an impending aortic rupture, but the patient declined surgery. Standard antituberculous therapy was initiated, and the patient subsequently developed drug-induced liver injury, prompting temporary cessation of treatment. The clinical course was later complicated by the development of an aortoesophageal fistula (AEF), with significant implications for prognosis. Conclusions: Early recognition of TBAA, along with a multidisciplinary approach that integrates advanced diagnostic modalities, timely vascular intervention, and carefully managed antituberculous therapy, is essential to reduce mortality and optimize treatment outcomes.

Introduction. Pulmonary actinomycosis is a chronic inflammatory infectious disease caused by anaerobic and/or microaerophilic bacteria of the genus Actinomyces spp. It causes non-specific symptoms in the patient and gives an atypical clinical and radiographic presentation. It is extremely rare and is characterized by the formation of abscesses and fistulas in the lungs or local fibrosis. In the differential diagnosis, diseases and pathological conditions from tuberculosis to neoplastic processes in the lungs must be considered. Case report. We present a 39-year-old patient with an infiltrative lesion in the apex of the right lung and non-specific symptoms. In this patient, actinomycosis was pathohistologically proven after surgical intervention. Within a period of just over a month, a multi-detector computed tomography of the chest and bronchoscopy with transbronchial biopsy and bronchial swab were performed twice. Initially, pulmonary actinomycosis was not suspected. After an atypical resection of the tumor mass in the apex of the right lung and histopathologically proven infection, the patient was treated with antibiotic therapy for 6 months. Further examination was carried out to prove a potential primary or secondary immunodeficiency. Conclusion. Patients with non-specific changes in the lung parenchyma should also be suspected of having actinomycosis, and after diagnosis, it is necessary to supplement the examination to confirm or exclude immunodeficiency.

Introduction. Tuberculosis (TB) continues to be a global health problem, with various manifestations affecting different organs and organ systems. Tuberculous lymphadenitis (TBL), also known as scrofula or lymph node (LN) TB, is a manifestation of Mycobacterium tuberculosis infection primarily affecting the LNs. Our region has a low annual incidence rate of TB, which is why the expected prevalence of TBL is also low. Case report. We present two cases of TBL diagnosed three months apart. Both presented patients had the disease localized in the LNs of the neck. These were young people without chronic diseases and previously in good health condition. The diagnosis was confirmed by surgical biopsy of the LNs in the first patient and fine needle aspiration biopsy in the second patient. Both patients were treated with standard protocols for TBL, with favorable outcomes and without significant complications and side effects. Conclusion. Presented cases highlight the importance of considering TBL in the differential diagnosis of neck masses, even in regions with a low prevalence of TB. Timely diagnosis and treatment are essential for preventing complications and ensuring a successful outcome.

Introduction. Crack cocaine (CC), a potent form of cocaine, is well-known for its rapid and intense effects on the central nervous system. Its detrimental impact on the respiratory system is often disregarded. This type of cocaine originates from cocaine hydrochloride, a compound extracted from the leaves of the coca plant (Erythroxylum coca). Through various pathophysiological mechanisms, its pharmacokinetics and interaction with the respiratory system contribute to acute and chronic lung damage. Case report. We present a 35-year-old male with progressive dyspnea and chronic lung damage caused by long-term abuse of CC. Morphological changes in the lungs along with abnormalities in pulmonary function tests were also observed. The patient was treated with a combination of medication therapy and enrolled in a detoxification support program. The applied therapeutic measures led to a gradual reduction in symptoms and significant improvement in pulmonary function tests. Conclusion. CC-induced lung damage represents a clinical challenge with profound implications for patient health and well-being. Substance abuse counseling, relapse prevention strategies, and social support services are key components of comprehensive treatment to support patient recovery and prevent relapse.

Introduction. Bardet-Biedl syndrome (BBS) is a rare autosomal recessive ciliopathy caused by structural and functional abnormalities of primary cilia, leading to disruption of key signaling pathways. It is clinically characterized by progressive retinal degeneration, polydactyly, early-onset obesity, cognitive impairment, hypogonadism, and renal abnormalities. Malignant mesothelioma (MM) is a malignant tumor of mesothelial cells that most commonly affects the pleura and is strongly associated with asbestos exposure and poor prognosis. In addition to environmental factors, genetic predisposition may contribute to its pathogenesis. Case report. We present a 27-year-old male with BBS who was evaluated for chest pain and progressive dyspnea. Pleural fluid analysis and video-assisted thoracoscopic pleural biopsy confirmed epithelioid pleural MM. The patient received systemic chemotherapy with pemetrexed and cisplatin, together with palliative treatment for recurrent pleural effusions. Therapeutic options were further limited by the underlying genetic disorder. Despite advanced disease and limited treatment options, the patient achieved unexpectedly prolonged overall survival of 7 years from the time of MM diagnosis. Conclusion. This case illustrates the diagnostic and therapeutic complexity of managing malignancies in patients with rare genetic syndromes and emphasizes the importance of an individualized multidisciplinary approach. It also raises the possibility that ciliary dysfunction may contribute to mesothelioma pathogenesis, warranting further molecular and clinical investigation.