Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways. However, bronchoscopy is commonly used to confirm and obtain a specific diagnosis to guide specific therapy. In recent years, interventional pulmonology (IP) is becoming widely available and offer a minimally invasive approach for the management of central airway diseases such as cancers, benign strictures, and other conditions. Various bronchoscopic modalities are used to treat central airway obstruction (CAO), such as mechanical debulking, endobronchial laser therapy, electrocautery, argon plasma coagulation, cryotherapy, and airway stenting. In patients with CAOI, the role of therapeutic bronchoscopy is not clearly defined, but many isolated reports in the literature described bronchoscopic intervention in combination with medical therapy as the initial management approach. In this paper, we present cases of CAOI that underwent bronchoscopic intervention as part of their management. We described the infectious etiology, locations, bronchoscopic findings and bronchoscopic modalities for airway management.

Since the endobronchial ultrasound bronchoscope was introduced to clinical practice, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become the procedure of choice to sample hilar and mediastinal adenopathy. Multiple studies have been conducted in the last two decades to look at the different technical aspects of the procedure and their effects on the final cytopathological yield. In addition, newer modes of ultrasound scanning and newer tools with the potential to optimize the selection and sampling of the target lymph node have been introduced. These have the potential to reduce the number of passes, reduce the procedure time, and increase the diagnostic yield, especially in rare tumors and benign diseases. Herein, we review the latest updates related to the technical aspects of EBUS-TBNA and their effects on the final cytopathological yield in malignant and benign diseases.

We are pleased to announce this focused issue of the Journal of Thoracic Disease on “interventional pulmonology”. Thoracic procedures are better tolerated when they are minimally invasive, leading to shorter hospital stays, fewer complications, and possibly lower costs.

In the last two decades, there have been remarkable advances in the diagnosis and treatment of lung cancer, resulting in improved quality of life and increased survival. Despite that, lung cancer remains the leading cause of cancer death worldwide. The diagnosis, staging and management of lung cancer are dictated by guidelines that constitute a clear path for patients. However, the emotional and psychological challenges faced by patients with lung cancer may be overlooked and can affect the well-being of these patients. This can also negatively impact the patient adherence to therapy and the ultimate patient outcomes. In this article, we address the emotional and psychological manifestations in patients who are diagnosed with lung cancer. We highlight the importance of recognizing these symptoms early to ensure they are managed alongside the stressful and challenging lung cancer therapy, with the goal of improving the patients’ quality of life and general outcome.