Mucus plugs on CT warn of COPD trouble, and a sharper way to biopsy the lung edge

The edition in brief

Today's pulmonology edition leads with a Chinese cohort of nearly 2,000 people showing that airway mucus plugs on CT predict respiratory trouble even in those with preserved spirometry: three or more plugged segments carried higher exacerbation risk and a higher chance of developing spirometry-defined COPD (18.2% vs 7.6%). A phase 2 trial found consolidation toripalimab after chemoradiotherapy in limited-stage small-cell lung cancer improved progression-free (hazard ratio 0.55) and overall survival (hazard ratio 0.39), promising but small and stopped early. A clinic pearl reinforces an oxygen saturation target of 88-92% in COPD and others at risk of hypercapnic failure. The edition closes on a 2,485-patient randomised trial in which contrast-enhanced ultrasound-guided biopsy of subpleural lung lesions beat both standard ultrasound and CT guidance for diagnostic yield (88.8%) while causing the fewest complications (4.6%).