Pinch-off syndrome is a rare but potentially serious complication of subclavian venous port systems, resulting from mechanical compression between the clavicle and first rib and leading to catheter fracture and embolization. A 63-year-old man with lung cancer presented with a fractured port catheter that had migrated into the left main and lower lobe pulmonary arteries. Endovascular retrieval was attempted but was unsuccessful due to firm endothelial adhesion. Preoperative coronary angiography revealed concomitant significant coronary artery disease. The patient subsequently underwent successful surgical catheter extraction combined with coronary artery bypass grafting. This case illustrates a Grade 3 pinch-off syndrome and highlights the limitations of percutaneous techniques in chronically embedded catheters. It also demonstrates that a combined surgical approach can be a safe and effective strategy in selected patients.

Objective: In this study, we aimed to evaluate high-resolution computed tomography (HRCT) features of granulomatous-lymphocytic interstitial lung disease (GLILD) in patients with Common Variable Immunodeficiency (CVID), and to describe a novel imaging feature-termed the "Kebab sign"-as a potential radiologic marker of GLILD. Materials and Methods: We retrospectively reviewed HRCT scans of 15 patients with GLILD diagnosed between 2005 and 2025 at a single institution (seven biopsy-confirmed, eight probable diagnoses based on multidisciplinary consensus). CT patterns were assessed for predominant morphology (nodular, reticular, alveolar, fibrotic), distribution (axial and cranio-caudal), and presence of extra-parenchymal findings. Nodules were characterized by size, density, morphology, and the presence of air bronchograms. The "Kebab sign" was defined as nodules aligned along bronchial structures with associated peribronchial thickening. Results: All patients demonstrated a diffuse nodular pattern, with non-calcified macronodules in 100% and micronodules in 60% of cases. Air bronchograms were present in 87% of macronodules. A peri-bronchovascular distribution with lower lung predominance was observed in the majority of cases. The "Kebab sign" was identified in 87% of patients. Splenomegaly and hilar/mediastinal lymphadenopathy were observed in 75%. In 20% of patients, fibrosing features were also present, particularly in older individuals. Conclusions: HRCT findings of GLILD typically include peri-bronchovascular nodules with lower lobe predominance, typically associated with splenomegaly and mediastinal lymphadenopathy. The newly described "Kebab sign," reflecting nodular alignment along thickened bronchial structures, may represent a useful imaging clue to support the diagnosis of GLILD.

Esophagopulmonary fistula (EPF) with lung abscess is a rare but serious complication during neoadjuvant chemoradiotherapy (nCRT) for esophageal squamous cell carcinoma and is often associated with poor prognosis. We report a 52-year-old man with cT3N3M0 esophageal squamous cell carcinoma who developed fever and hemoptysis during the third week of nCRT. Computed tomography showed a newly developed right lower lobe lung abscess adjacent to the primary tumor, suspicious for esophageal perforation with fistulous communication. Because the lesion and infection appeared localized, staged aggressive surgery was undertaken. The patient underwent en bloc esophagectomy and right lower lobectomy with cervical esophagostomy, followed by delayed reconstruction using a laparoscopically created gastric conduit. Final pathology showed marked treatment response with ypT1bN0 disease, and the resected lung showed no malignant involvement. R0 resection was achieved, and the patient remains disease-free at 28 months. This case illustrates a possible management pathway in a highly selected patient with localized EPF and lung abscess during nCRT, suggesting that early staged source control may preserve reconstructive options when systemic deterioration has not yet occurred.

Legionnaires' disease is a severe form of pneumonia most commonly caused by Legionella pneumophila serogroup 1. While primarily affecting the lungs, extrapulmonary manifestations such as hyponatremia, renal dysfunction, and hepatic involvement are well described. In contrast, cutaneous manifestations are rare and remain poorly characterized. We report the case of a 62-year-old immunocompetent man with a history of chronic alcohol use and active smoking who presented with fever, dyspnea, and productive cough. On admission, he was febrile (38.5°C), tachycardic, and had crackles over the right lower lung field. Laboratory evaluation revealed hyponatremia (132 mmol/L) and markedly elevated inflammatory markers (CRP 480 mg/L, procalcitonin 41 ng/mL). Chest imaging demonstrated right lower lobe pneumonia. Initial empiric therapy with amoxicillin-clavulanate was started. Within 48 hours, the patient developed acute respiratory failure requiring intubation and ICU admission. Urinary antigen testing confirmed Legionella pneumophila infection, and antibiotic therapy was switched to levofloxacin and spiramycin. The course was complicated by severe ARDS (PaO2/FiO2 ratio 100) requiring prone positioning, and septic shock requiring vasopressors. On day 9 of hospitalization (seven days after targeted therapy initiation), the patient developed a diffuse, non-pruritic erythematous maculopapular rash with targetoid lesions, involving the trunk and limbs, with palmar involvement and petechiae at the ankles, without mucosal involvement. A drug eruption was initially suspected; however, skin biopsy showed mild interkeratinocytic edema with superficial lymphocytic infiltrate and rare keratinocyte necrosis, without eosinophilia or features of toxidermia. Direct immunofluorescence and PCR testing for herpes simplex virus and Mycoplasma pneumoniae were negative. These findings supported a diagnosis of erythema multiforme (EM) secondary to Legionella infection. The rash resolved spontaneously without specific treatment. The patient improved clinically, was extubated on day 12, weaned off vasopressors by day 10, and discharged on day 20 after completing antibiotic therapy. This case illustrates a rare presentation of Legionnaires' disease complicated by EM. Recognition of this association is important, as cutaneous findings may mimic drug reactions and lead to inappropriate modification of effective antimicrobial therapy. This report contributes to the limited literature describing dermatologic manifestations of Legionella infection and underscores the need for clinical awareness of this uncommon presentation.

Primary pulmonary undifferentiated pleomorphic sarcoma (PPUPS) is a highly malignant tumor with extremely rare occurrence and is known for its distinct cellular pleomorphism. This tumor lacks specific differentiation markers. Consequently, PPUPS diagnosis requires thorough exclusion of other tumors through a comprehensive assessment of clinical, histopathological, and radiological outcomes.

Pulmonary adenoleiomyomatous hamartomas represent a rare and intriguing entity in pulmonary pathology. This study presents a unique case of adenoleiomyomatous hamartoma along with a comprehensive analysis of 14 cases identified through a systematic review of the literature. A 69-year-old Caucasian female presented for evaluation of an incidentally discovered, PET nonavid and slow-growing pleural-based nodule in the medial aspect of the lower lobe of her right lung. The biopsy showed pulmonary parenchyma with chronic inflammation, fibrosis, and smooth muscle hyperplasia. Subsequently, a diagnosis of pulmonary adenoleiomyomatous hamartoma was made on wedge resection after the exclusion of differential diagnoses. The literature review suggests a mean age of 54.5 ± 3.5 years at diagnosis and male predominance with a male-to-female ratio of 6:1. Follow-up data on our patient and literature suggest a uniformly benign course. The key takeaways include the indolent radiologic growth pattern. From a pathologic standpoint, excluding mimics such as solitary fibrous tumor, inflammatory myofibroblastic tumor, PEComa, Langerhans cell histiocytosis, mesothelial proliferations, and IgG4-related diseases is crucial.

Pancreatic cancer has an extremely poor prognosis due to recurrence in the early postoperative period. We report here a case of long-term survival after radical pancreatic cancer resection for lung metastasis. A 63-year-old man was found to have a pancreatic head mass during abdominal ultrasound examination due to an elevated CA19-9 level. He was referred to our department with a diagnosis of pancreatic head cancer (cStage ⅡB), and pancreatoduodenectomy was performed. The pathology results showed a diagnosis of pancreatic head cancer (pStage ⅡB), and GEM (1,000 mg/m2) was administered for 6 months (6 courses) as postoperative adjuvant therapy. Two and a half years after surgery, a nodule appeared in the lower lobe of the right lung (S10) on CT. Although the nodule had been gradually increasing, it was unclear whether it was a primary lung cancer or a lung metastasis of pancreatic cancer. A wedge resection of the lower lobe of the right lung was performed 3 years and 3 months after the initial surgery to confirm the diagnosis. The pathology results were consistent with lung metastasis of pancreatic cancer, and the patient was diagnosed as a case of recurrent pancreatic cancer. TS-1 (100 mg/day) was administered for 6 months (4 courses) as postoperative adjuvant therapy. The patient is currently under outpatient follow-up with no recurrence, 6 years and 1 month after the initial surgery and 3 years and 11 months after the recurrence surgery.

Lung cancer during pregnancy is rare, and placental metastases are exceptionally uncommon. Neuroendocrine lung tumours with RET point mutations have scarcely been reported in this setting.An early 40s G6P1031 woman at 33 weeks' gestation presented with dyspnea and flank pain. Imaging revealed a right lower lobe lung mass with hepatic metastases. Liver biopsy confirmed lung adenocarcinoma with neuroendocrine features and next-generation sequencing identified a RET p.M918T mutation. Following multidisciplinary discussion, labor was induced at 35 weeks with uncomplicated delivery of a healthy infant. Placental pathology demonstrated metastatic carcinoma consistent with pulmonary origin. The patient was treated with selpercatinib, resulting in radiographic response and clearance of circulating RET-mutant DNA. She remains progression-free 10 months into therapy and the infant continues normal development. This is the first reported case of RET p.M918T-mutated neuroendocrine lung cancer with placental metastases diagnosed during pregnancy, highlighting the importance of molecular profiling and multidisciplinary care.