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Introduction: In patients with fibrotic interstitial lung disease, hypoxaemia on exertion is frequent, and contributes to exercise intolerance, exertional dyspnoea and reduce quality of life. The recent AmbOx trial shown that ambulatory oxygen is associated with improved quality of life in ILD patients with isolated exertional hypoxia. However, few data are available on the predictors of desaturation in ILD and no physiological parameter thresholds have been identified. Methods: We analysed predictors of oxygen desaturation (SpO2≤88%) on a 6MWT in patients with ILD without severe resting hypoxia (SpO2 at rest≥92%), in a derivation cohort (N=146) and a validation cohort (n=154) presenting at a single institution. Univariable logistic regression analyses was used to identify variables predictive of oxygen desaturation (SpO2≤88%) on a 6MWT. Any factors potentially associated on univariable analysis (p < 0.10) were added to the multivariable model. Finally, a backward stepwise selection (p-in < 0.05, p-out > 0.10) was used to determine the factors independently associated with SpO2≤88%. Receiver operator curve (ROC) analyses were performed on significant variables derived from the final logistic regression models, and optimal cut-off points for each variable were identified by using the Youden's index. Results: A total of 300 ILD patients were included in the analysis. Patients from the validation cohort had less severe disease (mean CPI: 44.4 (SD 13) vs 52.9 (SD 10.6), p=0.0001) and were less likely to desaturate on 6MWT (26% vs 63%, p-value

We report a case of a 68-year-old woman with an occasional image of a wide paratracheal oval air cyst of not easy definition. Patient had never received a chest X-ray and she had never suffered from symptoms that needed to investigate the trachea or the neck. The diagnostic hypothesis was a wide tracheal diverticulum or a bronchogenic cyst. (www.actabiomedica.it)