Background. There is a paucity of data from India on changing trends in lung cancer. Objective. In this study, we analysed the spectrum of lung cancer patients in cigarette and bidi smokers and nonsmokers presenting to a tertiary care centre. Methods. A retrospective analysis of lung cancer cases diagnosed at the Vallabhbhai Patel Chest Institute between 2001 and 2013 was done. Results. Out of a total of 106 patients with lung cancer, 35 (33%) were non-smokers. Their mean age was 51.7±14.9 years [non-smokers (39.4±14.3), bidi smokers (57.5±10.9) and cigarette smokers (58.1±11.2)] (p<0.0001). Cigarette smoking was common among patients (34.9%). Smoking was predominantly seen in males (n=80, 77.5%) (p<0.05). History of biomass fuel exposure was observed in 9 (25.7%) non-smokers. Cough was the commonest symptom (n=90; 84.9%) followed by dyspnoea (n=80; 75.5%) and haemoptysis (n=48; 45.3%). On chest radiograph, right lung (n=52; 49%) was the most common site. Mass was the commonest radiological presentation. The bronschoscopy showed no visible abnormality in 51.4% of non-smokers. Endobronchial mass seen in 32.3%, 54%, 25.7% of bidi smokers, cigarette smokers and non-smokers, respectively. Non-small cell lung carcinoma was seen in 82.1%, squamous cell carcinoma in 59.8% and adenocarcinoma in 40.2% patients. Squamous cell carcinoma was the predominant subtype amongst smokers, while adenocarcinoma was the commonest histological subtype in non-smokers (p<0.05%). Conclusions. The study concludes that bidi smoking poses a similar risk for lung cancer as with cigarette smoking. The focus of tobacco control programmes should be extended to all types of tobacco users to reduce the increasing incidence of lung cancer in India.

Background. Interstitial lung diseases (ILDs) are a group of progressive diseases with few effective treatments. Pulmonary rehabilitation is a non-pharmacological intervention with a proven role in COPD. However, there is limited evidence on its usefulness in patients with ILDs. Objectives. This study was planned to assess the effect of pulmonary rehabilitation on exercise capacity and healthrelated quality-of-life (HRQoL) in patients with ILD. Methods. Forty patients with stable ILDs were randomised to receive either conventional treatment (control group) or standard treatment plus pulmonary rehabilitation programme for 8 weeks (study group). Exercise capacity was assessed by six-minute walk test (6MWT) and QoL was measured by St George's Respiratory Questionnaire (SGRQ) at baseline and at the end of 8 weeks. Results. At the end of 8 weeks, there was a statistically significant improvement in 6MWT distance (mean increase of 23.8 meters; p=0.037) and a significant decline in the SGRQ score (by 8.8 units; p=0.003) in the study group as compared to the control group. Conclusion. Pulmonary rehabilitation improves exercise capacity and HRQoL in patients with stable ILDs.

Extra-pleural solitary fibrous tumours (SFTs) are relatively rare tumours, usually located in the subcutaneous tissue, deep soft tissue of extremeties, retroperitoneum and abdomino-pelvic cavity, and may be difficult to recognise when encountered at unusual locations. Mediastinal SFTs are extremely rare tumours and the occurrence of cystic changes in these tumours is even more rare. We report the case of a 35-year-old male with a posterior-superior mediastinal mass with extensive cystic change causing a diagnostic dilemma. Histopathological examination revealed a tumour with extensive cystic change, with the cystic spaces containing blood. The solid areas showed plump, round to oval cells arranged in a pattern-less pattern, with a prominent Staghorn pattern of vasculature. Tumour cells were immunopositive for CD99, B-cell lymphoma-2 (bcl2), and CD34 (focally), leading to a diagnosis of SFT, which was confirmed by nuclear immunopositivity for signal transducer and activator of transcription 6 (STAT6). In view of the atypical clinical and radiological features and the many morphological mimics, an appropriate immunohistochemical panel is extremely useful in arriving at the right diagnosis, particularly STAT6 immunohistochemistry which identifies the molecular signature characteristic of SFT/haemangiopericytoma group of tumours. Also, mediastinal SFTs are associated with unusually aggressive behaviour, unlike at other sites; thus, patients with mediastinal SFT should be followed-up for a prolonged period.

We report a case of a 48-year-old housewife diagnosed to have sarcoidosis based upon the characteristic clinical features and presence of non-caseating granulomas on endobronchial ultrasound guided fine needle aspiration biopsy. After an year, she developed severe chest pain due to acute pleuritis and dramatically responded to corticosteroids. To the best of our knowledge; acute pleuritis is a very rare presentation of sarcoidosis and has not been reported in the literature in recent times.

Teratomas are tumours originating from totipotent cells at various sites. Intrapulmonary teratoma is a rare occurrence and presents with non-specific signs and symptoms. We report a case of a 14-year-old boy who came to us with progressive breathlessness and chest pain with cough and intermittent haemoptysis.