Pulmonary hypertension is an umbrella term including many different disorders causing an increase of the mean pulmonary arterial pressure (mPAP) ≥ 25 mmHg. Recent data revealed a strong association between obesity and pulmonary hypertension. Adiponectin is a protein synthetized by the adipose tissue with pleiotropic effects on inflammation and cell proliferation, with a potential protective role on the pulmonary vasculature. Both in vivo and in vitro studies documented that adiponectin is an endogenous modulator of NO production and interferes with AMP-activated protein kinase (AMPK) activation, mammalian target of rapamycin (mTOR), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κβ) signaling preventing endothelial dysfunction and proliferation. Furthermore, adiponectin ameliorates insulin resistance by mediating the biological effects of peroxisome proliferator-activated receptor-gamma (PPARγ). Therefore, adiponectin modulation emerged as a theoretical target for the treatment of pulmonary hypertension, currently under investigation. Recently, consistent data showed that hypoglycemic agents targeting PPARγ as well as renin–angiotensin system inhibitors and mineralocorticoid receptor blockers may influence pulmonary hemodynamics in different models of pulmonary hypertension.

Ischemic heart disease is currently a major cause of mortality and morbidity worldwide. Nevertheless, the actual therapeutic scenario does not target myocardial cell regeneration and consequently, the progression toward the late stage of chronic heart failure is common. Endothelial progenitor cells (EPCs) are bone marrow-derived stem cells that contribute to the homeostasis of the endothelial wall in acute and chronic ischemic disease. Calcium modulation and other molecular pathways (NOTCH, VEGFR, and CXCR4) contribute to EPC proliferation and differentiation. The present review provides a summary of EPC biology with a particular focus on the regulatory pathways of EPCs and describes promising applications for cardiovascular cell therapy.

Lung cancer is the leading cause of cancer-related death worldwide and majority of patients are diagnosed in advanced/metastatic disease stage. Sites of distant metastases mainly include contralateral lung, lymph nodes, brain, bones, adrenal glands and liver; skeletal muscles metastases (SMMs) are less common. Psoas muscle and diaphragm metastases are mainly found during autopsy, as their involvement commonly is asymptomatic. We report a case of a 60-year-old female, suffering from non-small cell lung cancer (NSCLC), with refractory lower back pain, as expression of malignant psoas syndrome (MPS). MPS is a rare and difficult-to-treat cancer-pain syndrome, unresponsive to majority of analgesic therapy, related to psoas muscle metastasis; it is usually caused by different tumors such as uterus, ovary, bladder, prostate, colon-rectum, lymphoma, melanoma and sarcoma and represents an uncommon finding in NSCLC patients.

Trans-bronchial needle aspiration allows lymph node sampling in several thoracic conditions; the ability of Rapid On-Site Evaluation (ROSE) to predict the final diagnosis in this setting has not been well characterized. We performed a retrospective study to establish the utility of ROSE in the diagnosis of thoracic diseases with mediastinal lymph node involvement. We retrospectively reviewed 297 patients with hilar-mediastinal lymph node enlargement detected at CT scan from January 2013 to April 2016. 201 patients underwent conventional TBNA; in 96 patients, TBNA procedure was performed by on-site presence of a team of pathologists and research morphologists. Lung neoplasms, sarcoidosis, infections and lymphoma were the most common diseases diagnosed with TBNA samples. TBNA simultaneously performed in combination with ROSE produced an increase in percentage of appropriate samples compared to single cTBNA (adequate samples cTBNA vs ROSE-TBNA: 73% vs 81%; p<0.05). Our observations indicate an increase in adequacy of fine needle aspirations and increased diagnostic yield in the ROSE group. In conclusions, ROSE may serve to reduce procedure time and enhance sample triaging therefore limiting the need for further invasive diagnostic testing.

Background/Objectives: Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal dominant disorder caused by germline pathogenic variants in the FLCN gene. Although it carries a substantial lifetime risk of renal cell carcinoma, its earliest manifestations are typically pulmonary cysts and spontaneous pneumothorax, which are frequently misclassified as primary spontaneous pneumothorax, resulting in diagnostic delay and inadequate oncological surveillance. We aimed to characterise the real-world phenotypic spectrum of BHD encountered in a respiratory referral setting. Methods: We retrospectively describe seven consecutive patients with genetically confirmed BHD syndrome diagnosed at our tertiary referral centre between 2022 and 2024. Demographic data, smoking history, FLCN variants, pneumothorax episodes, HRCT findings, pulmonary function tests and extrapulmonary neoplasms were collected. Reporting followed the PROCESS 2020 guideline. Results: Mean age at genetic diagnosis was 53.1 years (range 41–64). All seven patients had multiple thin-walled pulmonary cysts on HRCT, with the typical basal, subpleural and paramediastinal distribution; three had a pneumothorax history. Despite largely preserved spirometry (mean FEV1 82.4% predicted), DLCO was reduced in five patients (mean 67.4% predicted) and was the most frequently affected functional parameter, although the overall functional picture was heterogeneous. Five patients had solid neoplasms (one renal, one colorectal, one thyroid/parathyroid, one ovarian, one lung adenocarcinoma). Conclusions: In this referral-based case series, pulmonary cysts were a constant finding and DLCO was the most frequently reduced functional parameter, although the functional picture varied across patients. These descriptive observations are hypothesis-generating and require prospective, controlled validation—including comparison with other diffuse cystic lung diseases—before any diagnostic algorithm can be proposed.