Sequential occurrence of combined pulmonary fibrosis and emphysema syndrome in a non‐smoker female patient

The combined pulmonary fibrosis and emphysema (CPFE) syndrome is a unique and an under‐recognized disorder characterized by emphysema in the upper lobes and interstitial fibrosis in the lower lobes of the lung. It occurs predominantly in males and almost exclusively in smokers. This rare combination of a restrictive and an obstructive mechanical defect carries a poorer prognosis than either of the two components. We present a case of CPFE syndrome in a non‐smoker female patient who developed lower lobe emphysema subsequent to development of interstitial fibrosis. The case was remarkable for the extreme rarity of several presenting features, namely, a lower lobe occurrence of emphysema subsequent to pre‐existent interstitial fibrosis, female gender and absence of a history of smoking.     

Massive haemoptysis from a central pulmonary arterial pseudoaneurysm secondary to advanced lung cancer: successful treatment by Guglielmi detachable coil embolization

Massive haemoptysis is a life‐threatening condition in patients with lung cancer. Endovascular embolization has been well‐established as an effective means of treating this condition. Haemoptysis of pulmonary arterial origin is rare, and a pulmonary artery pseudoaneurysm (PAP) is generally the main cause. PAP due to lung cancer is also very rare, and the site of bleeding always involves the peripheral lung. We report an unusual case of central PAP secondary to advanced central squamous‐cell carcinoma of the lung in a patient with acute massive haemoptysis. The sac of the pseudoaneurysm underwent successful embolization using various Guglielmi detachable coils (GDCs). The patient died of lung cancer without recurrence of haemoptysis 42 days post‐embolization. To the best of our knowledge, this case report is the first to describe massive haemoptysis caused by central PAP due to lung cancer and its successful treatment by GDC embolization.