Tracheobronchial endoluminal hamartochondroma (HC) is a rare benign tumor, most frequently diagnosed in individuals between the sixth and seventh decades of life. The clinical presentation is usually very noisy. Here, we report two interesting cases. The first patient is a 58-year-old man who was wrongly treated for chronic obstructive pulmonary disease. HC was in the lower third of the trachea. The second patient is a 43-year-old man with a history of bronchiectasis and right lower lobectomy. HC was in the middle lobe bronchus. The resection via rigid bronchoscopy with diode laser was successful without any complications. Only one patient keeps a small stable tumor residue. The rigid bronchoscopy with laser-application in tracheobronchial endoluminal HC is safe and effective. Flexible bronchoscopy is important during the follow-up.

Hodgkin's disease with an initial tracheobronchial involvement is not common. The symptoms might be misleading, resulting in a diagnosis delay. We report the case of a 38-year-old woman with a one-month history of wheezing associated with a dry cough. The physical examination revealed a good general state of health, bilateral wheezing and supra-clavicular lymphadenopathy. The adenopathy biopsy's histopathology revealed Hodgkin lymphoma. The whole body FDG-PET scan was an important tool to assess the diagnosis as well as for the staging. The patient was treated with chemotherapy. Another unusual aspect is the tracheobronchial metastasis confirmed by a bronchial biopsy. Thus, our patient was put on a second-line chemotherapy. She died one year after the initial diagnosis. To conclude, it is an atypical clinical presentation of an Hodgkin lymphoma with a tracheobronchial relapse. It should be considered in the differential diagnosis of asthma or a tracheal tumor.

Introduction: The relation between smoking and the severity of COVID-19 infection has been evoked in the literature. The results are controversial and no conclusions have been drawn regarding this association. The aim is to study the relation between smoking and the severity of COVID-19 infection Methods: This is a retrospective, comparative and analytical study, including 100 patients hospitalized in our pulmonology department for COVID-19 from October 2020 to January 2021. Patients (P) were divided into two groups: Group 1 (G1): 35 P who are active or weaning off tobacco for less than 6 months, and Group 2 (G2): 65 P who had not smoked or weaned off for more than 6 months Results: There was no significant difference in the average age(62.1:G1 vs. 62.83:G2,p=0.39). A male predominance was noted in G1 (94.3% vs. 44.6%, p<0.001). Comorbidities were associated in 72%, presented mainly by high blood pressure(37%) diabetes(32%) and obesity(19%) with no statistical difference between the two groups. Severe clinical presentations were more frequent in G1(OR=3.963, 95%CI: 0.752-9.561, p=0.042). More frequent use of high-flow oxygen therapy and non-invasive ventilation was noted in G1(14.3% vs. 1.5%, p=0.01). Transfer to intensive care unit was more common in G1 (OR=6.921, 95%CI: 2.139-11.308, p=0.027). CT presentation was more severe in smokers(OR=5.014, 95%CI: 3.380-9.102, p=0.012) The multivariate analysis with clinical severity as a dependent variable, finds smoking, male sex and comorbidities as independent factors No significant differences in the duration of hospitalization or mortality were identified between the two groups (p=0.6 vs p=0.716) Conclusion: Our study highlighted the role of smoking in development of a severe form of COVID-19 disease.

Introduction: The relationship between smoking and COVID-19 remains controversial, between a protective factor and a death-risk-increaser during the pandemic. However, its respiratory impact after the infection is poorly described. We aimed to study the role of tobacco in the persistence of respiratory post COVID-19 syndrome. Methods : A retrospective study including 348 patients hospitalized in the pneumology department 2 of A.Mami Hospital for moderate to severe COVID-19 infection between October 2020 and August 2021. Patients were divided into two groups according to their smoking status:G1 smokers(n=89) and G2 non-smokers(n=259). Results: Our population consisted of 187 men (53,7%) and 161 women (46,3%), with a mean age of 57,78±13,48 years. The mean smoking rate was 34,41±28,26 pack-year. At three months post COVID-19, the dyspnea was more frequent in G1(24,5% Vs 23,5%, p=0,959), cough and chest pain less frequent in G1 with respectively 3,4% Vs 6,4%, p=0,407 and 2,2% Vs 2,9%, p=1. Parenchymal distortion on the three-month follow-up CT scan was noticed within 54,7% of smokers and 29,2% of non-smokers and was significantly correlated with smoking(p=0,001). At six months after discharge, smokers had more dyspnea (20,22% Vs 16%, p=0,46), and less cough and chest pain with respectively 3,4% Vs 4% ,p=1 and 1,1% Vs 2,5%,p=0,67. The six-month follow-up CT scan showed parenchymal distortion in 40,9% of G1 and 46,7% of G2(p=0,795). In terms of respiratory function, the mean percentage of diffusing capacity of the lungs for carbon monoxide(DLCO) was similar in the 2 groups with 73,85±20,08 in G1 and 73,33±15,99 in G2 (p=0,860). Conclusion: Our study showed that smoking is a significant predictor pf parenchymal sequelae at three months post COVID-19.

Introduction: Pulmonary embolism (PE) is a relatively common complication in COVID-19 and is associated with increased mortality risk. However, its respiratory impact after SARS COV2 infection has been poorly investigated. We aimed to investigate the role of PE in the persistence of the Post COVID-19 syndrome. Methods: A retrospective study including 348 patients hospitalized in the pneumology department 2 of A.Mami Hospital for moderate to severe COVID-19 infection between October 2020 and August 2021. Patients were divided into two groups according to the result of the thoracic angioscanner: G1 those who had COVID-19 pneumonia complicated with PE (n=10) and G2 those who had no PE (n=338). Results: Our population consisted of 187 men (53.7%) and 161 women (46.3%), with a mean age of 57.78 ± 13.48 years. The mean D-dimer level at acute infection was 3607,11 ± 2807.504 in G1 and 2039,19 ± 4269.65 in G2 (p=0,291). Follow-up at three months post COVID-19 showed that patients with PE had more dyspnea (20% Vs 8,28%, p=0,853) and cough ( 10% Vs 9,2%, p=1) and less asthenia ( 10% Vs 22,4%,p=0,681). No G1 patient had chest pain (p=1). Parenchymal distortion on chest CT scan at three months was similar in both groups (44,4% in G1 Vs 41,7% in G2,p=0,877). At six months post COVID-19, dyspnea and cough were more frequent within G1 with repectively 20% Vs 4,43%, p=0,521 and 10% Vs 6,8%,p=0,549. No patient of G1 had asthenia (p=0.591) nor chest pain (p=1). The presence of parenchymal distortion on chest CT scan at six months was not associated to EP (p=0.937). Conclusion: Our study showed no correlation between PE and the persistence of respiratory signs and CT abnormalities at Post COVID-19 follow-up.

Background: Concomitant coagulation disorder can occur in patients (pts) with severe COVID-19 symptoms, but in- depth studies are limited. We compared the differences in the indexes of coagulation function between severe and non-severe COVID-19 to investigate the risk factors of developing severe disease, based on the fibrinogen, D-dimer and Platelet count (plt) Methods: Retrospective study including pts with COVID-19 who were hospitalised in our department between October 2020 and December 2020. Biological data were collected from medical records: the rate of fibrinogen, D-dimers and plt count. Two groups were compared G1 [32pts (32%)]: pts having severe and critically severe symptoms apart from any occurrence of thrombo-embolic events, G2 [G2 68pts (68%)]: pts with non-severe, mild or moderate symptoms. We define severe as having a respiratory distress (tachypnea; oxygen saturation ≤92% with an oxygen flow equal to or higher than 5 l/mn), critical as: respiratory failure and requiring mechanical ventilation; admission to ICU with other organ function failure Results: One hundred pts were included in this study, the mean age was 62 years. Sixty-four of them were males (64%). It was shown that fibrinogen, and D-dimer were significantly higher in G1 (4.13 g/L versus 3.17 g/ L; p=0.002) and (0.42 mg/L versus 0.24 mg/L, p=,0.046) respectively. However PLT were lower in G1: 142*109/L versus 210*109/L; p=0.034. Conclusion: A higher rate of fibrinogen associated with higher D-dimer count and low PLT count could predict the development of severe illness.

In thoracocentesis, the clinician usually relies on his clinical examination and chest x-ray to choose the appropriate site. This can be easy and safe for abundant pleural effusion . For pleural effusions of low to medium abundance ultrasound tracking is necessary. Aims: To Compare the accuracy of the diagnostic pleural puncture site between the clinical location and the ultrasound location in the patient9s bed. Methods: We carried out a prospective comparative study including 29 patients hospitalised for exploration of a pleural effusion based on the chest radiography. First, each patient had a double-blind clinical detection (based on the clinical examination and the chest X-ray) by an experienced doctor and a an intern. In a second step, and without changing the patient9s position, this site was checked by a doctor trained in thoracic ultrasound. our study included 29 patients (58 ± 18 y). A pleuritic syndrome was found in 95% of the cases. The abundance of effusion based on the radiography was estimated to be low to medium in 68% cases.Ultrasound did not confirm the presence of effusion in 4 patients (13%) rather revealing atelectasis (n=2) and pachypleuritis (n=2). The clinical identification proposed by the expert verified on ultrasound was precise and adequate in 69% of cases, versus 31% of an inadequate and dangerous site (liver, diaphragm or lung), especially in low abundance pleurisy.For interns, a pleural puncture site error was detected in 51% of the cases (liver, spleen, diaphragm or lung). Ultrasound tracking corrected the site chosen by clinical tracking in more than 50% of cases in both groups.