A Broncho Biliary Fistula (BBF) is a rare complication of echinococcosis. This occurs from rupture of a hydatid cyst located at the upper surface of the liver into the bronchial tree. Fistulisation, results in biliopytsis, which is expectoration of bile-tinged greenish-yellow sputum, a pathognomonic feature of BBF. Bilopytsis may also occur in other conditions such as hepatectomies, liver abscesses or trauma. Surgical fistula closure is the definitive management of these patients, however downstream biliary obstruction should be ruled out first. Almost all cases can be approached through a right postero-lateral thoracotomy followed by phrenotomy. However, if there are multiple cysts in the liver, a thoraco-abdominal incision may be necessary.

Castelman’s disease (CD) is a rare lymphoproliferative disorder of unknown aetiology, with the unicentric form usually involving the chest. Posterior mediastinal involvement is uncommon, exceedingly so when associated with vascular malformation. We report the case of a young female patient who presented with 9 months of left-sided, dull chest and flank pain associated with weight loss and a subjective tingling sensation. Imaging reveled a well-circumscribed hyper-enhancing posterior mediastinal para-oesophageal mass. She underwent a right posterolateral thoracotomy, mass excision. Histopathologic examination confirmed Castleman’s disease (CD) with arteriovenous malformation. CD with vascular malformation is a very rare condition that can only be diagnosed histopathologically. Surgical resection is effective and has a good prognosis. Keywords: Castleman’s disease; AV malformation; posterior mediastinum