AIM: Percutaneous transthoracic needle biopsy (PTNB), an alternative to bronchoscopic confirmation of lung lesions, is today being associated with a risk of pneumothorax and hemorrhage. Further, there are no data on the possible risk of malignant disease spreading to the pleura at the site of the PTNB. Previous studies have dealt with this risk in stage I non-small cell lung cancer only. The aim of this study was thus to assess the risk of pleural recurrence for all types of lung lesions. Secondary objectives included assessment of diagnostic yield and safety with respect to the incidence of pneumothorax and hemorrhage. METHODS: Clinical data of all patients from the University Hospital in Pilsen who had undergone PTNB of lung lesions between 1.1.2018 and 31.12.2022 were included in this retrospective study. RESULTS: Following PTNB, ipsilateral pleural effusion occurred in 4.8% of patients without prior pleural infiltration. The effusion was confirmed as malignant in one patient (0.7%). Diagnostic yield of the method was 86.6%. We recorded pneumothorax or hemorrhage in the lung parenchyma or pleural space requiring medical intervention in 3.4% and 1.1% of patients, respectively. CONCLUSION: In our study, percutaneous transthoracic needle biopsy of lung lesions showed high sensitivity and low degree of acute complications requiring an invasive solution. The risk of pleural recurrence after a biopsy was very low. Consequently, we continue to consider this method to be an alternative to bronchoscopy biopsies.

• Klíčová slova
• NSCLC, bleeding into the lung parenchyma, percutaneous transthoracic needle biopsy, pneumothorax, recurrence,
• MeSH
• dospělí MeSH
• jehlová biopsie škodlivé účinky   metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory plic * patologie   MeSH
• nemalobuněčný karcinom plic * patologie   MeSH
• pleurální výpotek etiologie   MeSH
• pneumotorax etiologie   epidemiologie   MeSH
• recidiva MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Circulating endometrial cells (CECs) have emerged as a new biomarker of advanced disease in women with endometriosis. The identification of several subtypes of CECs (e.g., stem cell-like, epithelial, glandular, stromal) has opened the way for characterization of endometriosis-associated CECs. This study focused on the isolation and characterization of CECs and disseminated endometrial cells (DECs) in patients with spontaneous pneumothorax (SP). The primary objective was to differentiate between cancer and non-cancer cells in patients with no previous cancer diagnosis. The MetaCell® size-based separation protocol was used to enrich CECs/DECs. Evaluation of the captured cells by 3D microscopy was performed using a NANOLIVE™ microscope using a holographic approach. Based on gene expression analysis (GEA), we can conclude that mitochondria are much more active in primary tumors compared to endometriosis tissue (e.g. MT-ND1, MT-ATP6 genes). The culture of DECs is made of stromal, stem and immune cells. In vitro culture of DECs is characterized by an increase in the epithelial marker KRT18. Similarly, NFE2L2, a proerythroid factor, is also elevated. Further, a significant decrease in the amount of stem and immune cells was observed in the cell culture of DECs. The data presented here show how morphologically plastic the changes in the mitochondrial network can be and how cells can reflect them at the level of gene expression. The markers identified could help in the accompanying diagnostic process of the spontaneous pneumothorax in women of reproductive age.

• MeSH
• dospělí MeSH
• endometrióza * patologie   diagnóza   genetika   MeSH
• endometrium patologie   metabolismus   MeSH
• lidé MeSH
• mitochondrie * metabolismus   patologie   MeSH
• pneumotorax * patologie   diagnóza   MeSH
• stanovení celkové genové exprese metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Pertussis, also known as whooping cough, is an acute respiratory illness primarily caused by Bordetella pertussis. Highly contagious, it poses significant morbidity and mortality risks, especially in infants. Despite widespread vaccination efforts, pertussis cases have recently resurged globally. This case report details possible complication in a 48-year-old woman, involving a cough-induced rib fracture and recurrent pneumothorax, highlighting the need for considering pertussis in patients with severe cough and back pain. CASE PRESENTATION: A 48-year-old female non-smoker with hypertension, treated with ACE inhibitor (perindopril), presented with a runny nose, productive cough, and back pain. Initial treatment for a common cold provided temporary relief. However, her symptoms worsened, and further examination revealed a fractured rib, pneumothorax, and subcutaneous emphysema. Laboratory tests confirmed elevated Bordetella pertussis toxin antibodies. She was treated with antibiotics, and despite recurrent symptoms, a conservative management approach was successful. Follow-up indicated resolution of symptoms, but significant anxiety related to her condition. CONCLUSION: This case emphasises the importance of considering pertussis in adults, as early symptoms resembling a common cold can lead to misdiagnosis. It also highlights the potential for significant musculoskeletal and pulmonary injuries due to intense coughing associated with pertussis. Prompt diagnosis and comprehensive management, including antibiotics and supportive care, are essential for favorable outcomes.

• Klíčová slova
• Back pain, Cough, Pertussis, Pneumothorax, Rib fracture,
• MeSH
• antibakteriální látky terapeutické užití   MeSH
• Bordetella pertussis izolace a purifikace   MeSH
• fraktury žeber * komplikace   MeSH
• kašel etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pertuse * komplikace   farmakoterapie   MeSH
• pneumotorax * etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• antibakteriální látky MeSH

INTRODUCTION: COVID-19 is considered a respiratory virosis in its classic form, although it may present with heterogeneous symptoms. Thoracic complications occur in a small percentage of patients. Our objective was to evaluate existing experience with this disease and its thoracic manifestations and to determine the real-world status of care of these patients. METHODS: This study is a retrospective, single-institution analysis of a group of patients hospitalized with acute and post-acute COVID-19 pneumonia at Thomayer Hospital in Prague in the period from December 2020 to March 2022 and indicated for a thoracic surgical procedure. RESULTS: During the peak of COVID-19 pandemic, a thoracic intervention was performed in 46 admitted patients. Thoracic drainage (due to pneumothorax in 18 cases, fluidothorax in 3 cases, CT-guided lung abscess drainage in 2 cases, and CT-guided pneumatocele drainage in 2 cases) were the most common thoracic surgical procedures. Pleurectomy/decortication surgery was done in 10 cases. Additionally, 12 lung parenchyma-sparing resections were performed, while lobectomy was required in 2 cases. Resection of postintubation tracheal stenosis due to a severe course of COVID-19 pneumonia was indicated in 2 patients. CONCLUSION: Even mild COVID-19 may cause a considerable morphological a functional alteration of the respiratory system. The most common complications of COVID-19 pneumonia that require a thoracic surgical intervention include pathologies associated with an air leak and accumulation of air (pneumothorax, pneumomediastinum and subcutaneous emphysema). The development of pulmonary necrosis, symptomatic bronchiectasis, pneumatocele, and bullous-fibrotic formations may result in pneumothorax, hemothorax or thoracic empyema in sporadic cases. An early thoracic surgical intervention to treat thoracic complications of COVID-19 pneumonia can improve the survival of COVID-19 patients.

• Klíčová slova
• COVID-19 pneumonia, complications, post-acute sequelae of COVID-19 (PASC), thoracic surgery,
• MeSH
• COVID-19 * komplikace   MeSH
• dospělí MeSH
• drenáž metody   MeSH
• hrudní chirurgické výkony * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pneumotorax chirurgie   etiologie   MeSH
• retrospektivní studie MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Amyloidosis is a rare metabolic disorder primarily brought on by misfolding of an autologous protein, which causes its local or systemic deposition in an aberrant fibrillar form. It is quite rare for pulmonary tissue to be impacted by amyloidosis; of the three forms it can take when involving pulmonary tissue, nodular pulmonary amyloidosis is the most uncommon. Nodular pulmonary amyloidosis rarely induces clinical symptoms, and most often, it is discovered accidentally during an autopsy or via imaging techniques. Only one case of nodular pulmonary amyloidosis, which manifested as a spontaneous pneumothorax, was found in the literature. In terms of more precise subtyping, nodular amyloidosis is typically AL or mixed AL/AH type. No publications on AH-dominant type of nodular amyloidosis were found in the literature. We present a case of an 81 years-old male with nodular pulmonary AH-dominant type amyloidosis who presented with spontaneous pneumothorax. For a deeper understanding of the subject, this study also provides a review of the literature on cases with nodular pulmonary amyloidosis in relation to precise amyloid fibril subtyping. Since it is often a difficult process, accurate amyloid type identification is rarely accomplished. However, this information is very helpful for identifying the underlying disease process (if any) and outlining the subsequent diagnostic and treatment steps. Even so, it is crucial to be aware of this unit and make sure it is taken into consideration when making a differential diagnosis of pulmonary lesions.

• Klíčová slova
• AH amyloidosis, amyloidoma, amyloidosis, nodular pulmonary amyloidosis, pneumothorax,
• MeSH
• amyloidóza * komplikace   diagnóza   patologie   MeSH
• familiární amyloidóza MeSH
• genetická onemocnění kůže MeSH
• lidé MeSH
• plíce diagnostické zobrazování   patologie   MeSH
• plicní nemoci * komplikace   diagnóza   patologie   MeSH
• pneumotorax * diagnóza   etiologie   MeSH
• senioři nad 80 let MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

INTRODUCTION: The paper presents unusual symptoms as a complication of therapeutic colonoscopy. CASE REPORT: A 70-year-old polymorbid female patient in chronic dialysis program underwent argon plasma coagulation treatment of leaking angioectasias in the cecum and ascending colon. Shortly after the procedure she presented with shortness of breath and subcutaneous emphysema of the neck which was initially misdiagnosed as swelling. Further tests revealed pneumoperitoneum, subcutaneous emphysema and pneumomediastinum. Considering the high risks for our patient (comorbidities, obesity), a laparoscopic approach was indicated. During laparoscopy neither peritonitis nor intestinal perforation were found. The patient recovered without complications after further complex treatment. CONCLUSION: Shortness of breath and subcutaneous emphysema are not typically among the first symptoms of colonoscopic perforation. Our case confirms that we should bear this complication in mind and when suspected, the diagnostic process should be started without delay.

• Klíčová slova
• argon plasma coagulation, iatrogenic colonoscopic perforation, pneumoperitoneum, subcutaneous emphysema,
• MeSH
• argonová plazmakoagulace škodlivé účinky   MeSH
• lidé MeSH
• mediastinální emfyzém * terapie   komplikace   MeSH
• pneumoperitoneum * etiologie   terapie   MeSH
• pneumotorax * diagnóza   MeSH
• senioři MeSH
• subkutánní emfyzém * etiologie   terapie   diagnóza   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Tension pneumopericardium is a life-threatening condition, manifesting most commonly as hemodynamic instability caused by cardiac tamponade. Reduced cardiac output and blood pressure can lead to difficulties in the detection of arterial bleeding from associated injuries while the increased venous pressure can increase the rate of bleeding. CASE REPORT: This is the case of a patient after a car accident, with bilateral serial fractures, bilateral pulmonary contusion, bilateral pneumothorax, emphysema of the neck and chest, pneumomediastinum and pneumopericardium, and other injuries. During treatment, the patient developed a gradually progressing hemodynamic instability, resulting in pulseless electrical activity. Further progression of the case is detailed in the paper. CONCLUSIONS: Tension pneumopericardium is a rare complication of a high-energy blunt thoracic trauma that manifests through hemodynamic instability. Its treatment requires early diagnosis and immediate decompression of the pericardial cavity, which should, where possible, be performed even before putting the patient on mechanical ventilation as ventilation bears a high risk of worsening the pneumopericardium due to the increased air pressure in the lungs. During diagnosis and treatment of associated injuries, we must bear in mind that the hemodynamic changes caused by pneumopericardium can mask typical signs of such injuries.

• Klíčová slova
• hemodynamic instability, mechanical ventilation, pneumopericardium, trauma,
• MeSH
• lidé MeSH
• pneumoperikard * diagnostické zobrazování   etiologie   MeSH
• pneumotorax * terapie   MeSH
• polytrauma * komplikace   MeSH
• poranění hrudníku * komplikace   MeSH
• umělé dýchání škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Chest pain is one of the most common symptoms encountered by doctors working in acute, internal, and pulmonary clinics. In the United States in 2006, 10 percent of all visits to the emergency room were caused by diseases of the respiratory system, and chest pain was the most common symptom. The most common situations that can cause chest pain with an emphasis on their diagnosis and early treatment are chest infections, pneumothorax, pneumomediastinum and tumors affecting the pleural cavity.

• Klíčová slova
• chest pain, pleural tumor, pleural tumors, pleuritis, pneumomediastinum, pneumothorax,
• MeSH
• bolesti na hrudi etiologie   komplikace   MeSH
• lidé MeSH
• mediastinální emfyzém * komplikace   diagnóza   MeSH
• plíce MeSH
• pneumotorax * diagnóza   etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Spontaneous pneumothorax is a serious and life-threatening complication of SARS-CoV-2 pneumonia. It most commonly occurs during the acute phase of the disease in patients with pre-existing lung disease (e.g. emphysema, bronchiectasis, cystic fibrosis, etc.) and in patients who require oxygen supplementation in any form (low-flow oxygen therapy, high-flow non-invasive or mechanical invasive or mechanical invasion). A rare case of a 52-year-old patient with a spontaneous pneumothorax who developed four weeks after PCR SARS-CoV-2 positivity was described. Interestingly, the patient did not have any factors that the literature considered risky for the development of this complication. During the acute phase of the disease, his condition did not require hospitalization. Imaging examinations could not clarify the cause of pneumothorax. With this case report, we want to point out the fact that spontaneous pneumothorax, as a rare and life-threatening complication of COVID-19 infection, may develop during recovery, and it is necessary to think about this complication in the differential diagnosis of dyspnoea.

• Klíčová slova
• COVID-19, Pneumonia, Pneumothorax, SARS-COV-2, Spontaneous,
• MeSH
• COVID-19 * komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• pneumotorax * diagnóza   etiologie   terapie   MeSH
• SARS-CoV-2 MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema are serious complications of COVID-19 infection caused by SARS-CoV-2, occurring in approximately 1% of hospitalized patients. The risk increases with the accumulation of risk factors, namely moderate or severe illness, high-flow oxygen therapy and noninvasive ventilation. The pathophysiology may be contributed to by patient self-inflicted lung injury. Hypoxia-induced respiratory effort in patients with pneumonia puts an enormous load on certain parts of their lungs, leading to subsequent progression of lung tissue damage. These complications start with destruction of the alveolar membrane, accompanied by emergence of a pulmonary bulla. Rupture of the bulla results in air leaking to the pleural space (pneumothorax). In the case of pneumomediastinum, the air spreads within the peribronchial interstitium along the airways to the mediastinum and subcutaneous tissues (Macklin effect). While pneumomediastinum and subcutaneous emphysema resolve spontaneously in most cases, pneumothorax treatment depends on its magnitude. While small pneumothorax may be managed conservatively, large pneumothorax usually requires active treatment with an acute chest drain; the latter is also associated with worse prognosis and a higher chance of death. We report air-leak complications in nine COVID-19 patients, of whom seven had spontaneous pneumothorax and four of them died. Three patients developed spontaneous pneumomediastinum together with subcutaneous emphysema, with two of them surviving. One patient with combination of pneumothorax, pneumomediastinum and subcutaneous emphysema died. These complications may accompany moderate or severe COVID-19-associated pneumonia, mostly the late phase of the disease. They should be considered when patients complain of sudden chest or back pain or worsening respiratory insufficiency.

• MeSH
• COVID-19 * komplikace   MeSH
• kyslík MeSH
• lidé MeSH
• mediastinální emfyzém * diagnóza   etiologie   terapie   MeSH
• pneumotorax * etiologie   terapie   MeSH
• puchýř komplikace   MeSH
• SARS-CoV-2 MeSH
• subkutánní emfyzém * komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kyslík MeSH