• Histology/cytology
• imaging/CT MRI etc
• rare lung diseases
• aspergillus lung disease
• interstitial fibrosis
• lung cancer
• mesothelioma
• sarcoidosis
• drug-induced lung disease
• emphysema
• systemic disease and lungs
• tobacco and the lung

A 41-year-old with idiopathic myelofibrosis was referred to the chest clinic with a 1-month history of progressive dyspnoea and intermittent wheeze. There was no history of haemoptysis and the patient was a lifelong non-smoker. On examination, the patient was afebrile, cachectic and had hepatosplenomegaly. Haemoglobin was 6.0 g/dl, white cell count 3.6×10⁹/l, platelet count 98×10⁹/l. Blood smear showed marked anisopoikilocytes, prominent tear drop cells and polychromasia. Bone marrow aspirate was hypercellular, showed reduction in the degree of maturation, and a marked decrease in the proportion of erythroid cells. There was no evidence of acute leukaemia or metastatic malignancy. Microbiologic analysis of the sputum and blood for pulmonary infection was negative. Lung function test showed a restrictive …