e-ISSN 2147-2475

Hzl Arama




RESPIRATORY CASE REPORTS - Respir Case Rep: 5 (3)
Cilt: 5  Say: 3 - Ekim 2016

OLGU SUNUMU
1.
Dental kpr aspirasyonu ve tansal zorluklar
Aspiration of a dental bridge: a diagnostic challenge
Petar Jovan Avramovski, Maja Petar Avramovska, Kosta Sotiroski, Aleksandar Sikole
doi: 10.5505/respircase.2016.87609  Sayfalar 151 - 156
Metal-seramik di kprsnn kazara aspirasyonu ok seyrek olmamasna ramen, literatrde bildirilen olgu says snrldr. Hava yoluna kaan yabanc cisimler, larinks, trakea ve bronlara yerlemektedirler. Aspirasyon srasnda rastlanan en erken semptomlar, boucu ksrk ve hrlt iken, ge dnem komplikasyonlar ise apse ve pnmoni olmaktadr. Yetmi yanda Makedon bayan hasta, akut ve srekli bir ksrk, nefes darl ve hem inspiratuvar hem de ekspiratuvarda duyulan hrlt yaknmalar ile acil servisimize bavurdu. Oskltasyonda, akut asm atan taklit eden ekilde, sada solunum seslerinde azalma saptand. Radyolog, akcier grafisinde sa bron sisteminde metalik bir yabanc cisim olduunu belirledi. Tomografide, drtl yapda metalik bir cismin sa alt lob bronunda olduu grld. Hzl ve uygun zaman ierisinde yaplan bronkoskopik mdahale ile hasta ciddi bir cerrahi giriimden kurtarlm oldu.
Although accidental aspiration of metal ceramic bridge is not uncommon, the number of cases reported in the literature is limited. Airway foreign bodies can become lodged in the larynx, trachea, and bronchus. The earliest symptoms which commonly appear during aspiration include coughing, chocking, and wheezing including long-term complications, such as lung abscess and pneumonia. A 73-year-old Macedonian female due to acute onset of incessant cough, dyspnea and an inspiratory and expiratory wheeze was admitted to our emergency department. Auscultation findings showed right-sided weakened vesicular breathing, closely mimicking an acute asthma exacerbation. Based on chest X-ray findings, the radiologist described a metallic foreign body (MFB) in the right bronchus. Using a computed tomographic (CT) scan, we confirmed 4-unit crown MFB position in the right lower lobe bronchus. Rapidly and timely intervention by bronchoscopy saved the patients from extensive reconstructive surgery.

2.
Penil Sarkoidoz: Nadir ilk tutulum
Penile Sarcoidosis: A Rare Initial Manifestation
Sibel Doruk, Eyp Sabri Uan, Faruk Doan, Funda Tal, Hasan Umut Kantarc, Glistan Karadeniz, Kemal Can Tertemiz
doi: 10.5505/respircase.2016.53765  Sayfalar 157 - 160
Sarkoidozis genitoriner sistemin nadiren tutulduu sistemik bir hastalktr ve penis tutulumu ise genitoriner sarkoidoz olgular arasnda ok daha nadir grlr. Bu makalede penis sarkoidozu tans konulan ve takip edilen iki olgu literatr eiliinde sunulmutur. lk olgu roloji kliniine peniste kant ve ar yaknmas ile bavurmutu ve bu yaknmalar nonspesifik antibiyotik tedavi ile gerilememiti. Biyopside nonkazifiye granlomatz inflamasyon izlendi. Herhangi bir sistemik ve solunumsal yaknmas yoktu. Lokal kortikosteroid tedavi verildi. kinci olgu da roloji kliniine peniste nodl yaknmas ile bavurmutu ve nodl eksize edilmiti. Biyopsi rneinde dermisde multinukleer dev hcreler ve granlomlar izlendi. Nefes darl, hrlt ve terleme yaknmas olan hastaya sistemik prednizolon tedavisi baland. ki olgunun da yaknmalar uygulanan bu tedaviler ile dzeldi.
Sarcoidosis is a multi-systemic disease and genitourinary involvement is rarely seen. Penile involvement is even rarer among genitourinary sarcoidosis. In this article, we present two cases of penile sarcoidosis. The first case was admitted to our urology clinic with penile itching and pain and his symptoms did not improve with non-specific antibiotic therapy. In biopsy, non-caseified granulomatous inflammation was detected. He did not have any systemic and pulmonary compliant. The second case was admitted to our urology clinic with penile nodules and nodules were excised for diagnosis. In dermis biopsy, multiple multi-nuclear giant cells and granulomas were detected. He had shortness of breath, wheezing, and sweating. He was treated with systemic prednisolone. Both cases were successfully treated with pharmacological treatments.

3.
Yangn ve Yangn Sndrc Maruziyeti Sonrasnda Gelien Pulmoner Alveolar Proteinozis ve Trakeal Stenoz
Pulmonary Alveolar Proteinosis and Tracheal Stenosis After Exposure to Fire and Fire Extinghuisher
Mustafa rtk, Elif Tanrverdi O, Kenan Abbasl, Mehmet Akif zgl, Erdoan etinkaya
doi: 10.5505/respircase.2016.36854  Sayfalar 161 - 164
Pulmoner alveoler proteinozis (PAP) nadir bir hastalktr. PAP alveollere aseller srfaktan lipidlerin ve proteinlerin birkimi ile karakterizedir. diyopatik PAP btn PAP olgularnn %90n oluturur. Sekonder PAP ise insektisitlerle, silika gibi inorganik tozlara, hematolojik malignitelere, insan immn yetmezlik virs infeksiyonuna, leflunomide, toksik gaz inhalasyonuna, alminyum ve metal oksit ieren endstriyel tozlara sekonder geliebilir. Biz de yangn ve yangn sndrc maruziyeti sonras gelien pulmoner alveolar proteinozis ve trakeal stenoz olgusu sunduk.
Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the accumulation of acellular surfactant lipids and proteins within the alveoli. Idiopathic PAP accounts for about 90% of all patients. Secondary PAP factors include insecticides, inorganic dusts such as silica, hematological malignancies, Human Immunodeficiency Virus infection, leflunomide, toxic gas inhalation, various industrial exposures to aluminum- and metal oxide-containing dusts and clinical conditions. Herein, we present a case of pulmonary alveolar proteinosis and tracheal stenosis secondary to exposure to fire and fire extinguisher.

4.
Ar sokmas sonras yetikin solunum sknts sendromu
Adult respiratory distress syndrome after a wasp sting
Ahmet Arisoy, Hilmi Demirkiran, Huseyin Akdeniz, Selami Ekin
doi: 10.5505/respircase.2016.39200  Sayfalar 165 - 168
Bal ars veya yaban ars sokmas sonrasnda genellikle, kant, rtiker, anjiyodem ve anafilaktik reaksiyon gibi ar duyarllk reaksiyonlar grlr. Literatrde, ar sokmas sonras, myastenia gravis, periferik nrit, ensefalomiyelit, optik nrit, beyin kanamas, miyokard infarkts ve nefrotik sendrom gibi nadir olgular paylalmtr. Otuz yandaki bayan hasta tek ar sokmas sonrasnda nefes darl nedeniyle acil servisimize bavurdu. Nefes darl dnda hibir ikayetleri yoktu. Akcier grafisinde, bilateral yamal infiltrasyonlar vard. Oksijensiz alnan kan gaznda, pH 7,3, paO2 35 mmHg, paCO2 30 mmHg ve saturasyonu % 75 idi. Ekokardiyografi tamamen normaldi. Youn bakmda alnd ve non-invazif mekanik ventilasyon balanan hasta tedavi sonras tamamen dzeldi.
Hypersensitivity reactions such as itching, urticaria, angioedema, and anaphylactic reaction are usually seen after a bee or wasp sting. In the literature, rare cases such as myasthenia gravis, peripheral neuritis, encephalomyelitis, optic neuritis, cerebral hemorrhage, myocardial infarction, and nephrotic syndrome have been reported. A 33-year-old female patient was admitted to our emergency department due to the development of dyspnea after a single bee sting. She had no complaints other than dyspnea. On her X-ray, there were bilateral patchy infiltrations. In the blood gases without oxygen, the pH was 7.3, pO2 was 35 mmHg, pCO2 was 30 mmHg, and saturation was 75%. Echocardiography findings were normal. She was treated in the intensive care unit under non-invasive mechanical ventilation. She was discharged with full recovery.

5.
Metotreksata Bal Gelien Pulmoner Toksisite
Methotrexate-related Pulmonary Toxicity
Selim Erkan Akdemir, Pnar elik, Timur Prldar
doi: 10.5505/respircase.2016.66487  Sayfalar 169 - 173
Folat antagonisti olan metotreksat, inflamatuvar ve neoplastik hastalklarda kullanlr. Metotreksat kullanmna bal pulmoner toksisite nadirdir. Romatoid artrit nedeniyle 3 ay nce haftada bir 10 mg intramuskuler metotreksat ve 4 mg prednizolon balanan 67 yanda kadn hastada, nefes darl, ksrk, ate ve az iinde yara yaknmalar ortaya kmas, toraks bilgisayarl tomografide her iki akcierde st loblarda periferik yerleimli ve alt loblarda alveolar dk dansitede opasiteler ve konsolide alanlarn grlmesi zerine olas dispne nedenleri dlanm, klinik ve radyolojik olarak metotreksata bal pulmoner toksisite dnlm ve kortikosteroid tedavisi ile belirgin dzelme salanmtr. Tan ve tedavide gecikme lmcl sonulara yol aabilecei iin metotreksat kullanmna bal pulmoner toksisite geliebilecei akla getirilmelidir.
Methotrexate (folate-antagonist) is used in the treatment of several inflammatory and neoplastic diseases. However pulmonary toxicity due to methotrexate is uncommon. Herein, we present a 67-year-old woman with rheumatoid arthritis who was treated with methotrexate 10 mg intramuscular weekly and oral methylprednisolone 4mg daily. She was admitted with dyspnea, cough, fever, and oral ulcers. Thoracic computed tomography revealed bilateral alveolar low intensity areas and consolidation in peripheral region of upper and lower lobes. Other possible causes of dyspnea were excluded. Based on the clinical and radiographic findings, the patient was diagnosed with methotrexate-related pulmonary toxicity. Her overall status improved dramatically with corticosteroid therapy. The clinician should keep in mind the possibility of methotrexate-related pulmonary toxicity in cases, as in our case, since delay in diagnosis and treatment can be fatal.

6.
Akcier kanserini taklit eden byk kitle grnml Wegener Granlomatozu olgusu
A Wegener Granulomatosis case with a huge lung lesion mimicking lung cancer
Mevlt Karata, Songl zyurt, Aziz Gm, Halit narka, nal ahin, Recep Bedir
doi: 10.5505/respircase.2016.48343  Sayfalar 174 - 177
Wegener granlomatozu primer olarak, akcier, bbrek ve alt solunum yollarnda hastalk yapan, kk arterleri tutan bir vasklit tipidir. Olgularn %50-90nnda akcier tutulumu grlmektedir. Akcier tutulumu nodl ya da kitle lezyon olarak kendini gsterebilmektedir. Lezyonlar yaklak 30-70 mm byklnde olabilmektedir. Tan aamasnda zellikle kitle lezyonlar yanl deerlendirilip bata akcier kanseri olmak zere gerek hastalk gzden kaabilmektedir. Yirmi sekiz yanda n planda nefes darl, solda gs ars ikayeti olan bayan hastann sigara ve baka hastalk yks yoktu. Akcier tomografisinde solda 92x103 mm ebadnda, kenarlar ksmen spikler kitlesi olan ve n tanda akcier kanserini dndren bir wegener granlomatozu olgusunu ve tan koyma aamasnda karlatmz glkleri tarttk. Wegener granlomatozu akcier tutulumunda tan aamasnda dikkatli olunmas gerektiini vurgulamak istedik.
Wegener granulomatosis is a vasculitis of small arteries, primarily causing diseases of lung, kidneys and lower respiratory system. About 50 to 90 % of cases present with pulmonary involvement, sometimes with a nodule (single or multiple) or mass lesion. Lung lesions may range between 30 to 70 mm in size. These lesions can be evaluated false in the initial diagnosis and the main diseases such as lung cancer may be overlooked. A 28-year-old woman complaining of left-sided chest pain, shortness of breath with no history of smoking presented with a quite large and partly spiculated contours mass lesion of 92x103 mm in size on the left side of the lung on computed tomography, mimicking primarily lung cancer. In this case, we discuss the challenges we faced in the stage of diagnosis to emphasize that lung involvement of Wegener granulomatosis should be recognized in the diagnosis.

7.
EBUS Transbronial ne Aspirasyon Biyopsisi ile Tan Konulan Malign Plevral Mezotelyoma Olgusu
Malignant Pleural Mesothelioma Detected by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration
Aysegul Senturk, Ebru Sengul Parlak, Elif Babaoglu, Hayriye Tatli Dogan, Hatice Canan Hasanoglu
doi: 10.5505/respircase.2016.75046  Sayfalar 178 - 180
Posteroanterior akcier grafisinde sol hiler lenfadenopati saptanan 63 yanda erkek hasta kliniimize bavurdu. PET-CT'de solda lenf bezlerinde ve plevrada artm florodeoksiglukoz tutulumu saptand. Endobroniyal ultrason transbroniyal ine aspirasyonu (EBUS-TBA) ile elde histopatoljik incelemede malign mezotelyoma saptand. Bu olgu ile EBUS-TBNA'nn metastatik malign mezotelyoma olgularnda kullanmnn faydal olduu gsterildi.
A 63-year-old man was admitted to our clinic with left hilar lymphadenopathy on his chest radiography. Fluorodeoxyglucose positron-emission tomography showed multiple regions of high metabolic activity on the left pleura and left interlobar lymph nodes. Histopathological examination of the lymph node material obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) revealed malignant mesothelioma. This case report demonstrates the usefulness of EBUS-TBNA in the diagnosis of metastatic mesothelioma.

8.
Plevra Aspergillozis: Nadir Grlen Bir Mantar Enfeksiyonu
Pleural Aspergillosis: A Rare Presentation of Fungal Infection
Taha Tahir Beki, Mustafa alk, Suleyman Emre Akn, Saniye Goknil alk, Hdr Esme
doi: 10.5505/respircase.2016.38991  Sayfalar 181 - 183
Mantar enfeksiyonlar tm plevral efzyonlarn %1'den daha azndan sorumludur. Nadiren ampiyeme neden olurlar. Aspegillusa bal ampiyem ve pnmotoraks gelien immnsupresif bir olguyu sunmay amaladk. Altm yanda kadn hastada ilerleyici bir nefes darl ve sa gs ars ikayetleri mevcuttu. Radyolojik incelenmesinde sa orta lobda pnmoni tespit edildi. Ampirik antibiyotik tedavisi baland. Balgam kltrnde aspergillus redi. Kontrol incelemesinde sa hidropnmotoraks tespit edilen hastaya interkostal drenaj yapld. Hasta, uzam hava kaa, mltilokle ampiyem ve akcierin ekspansiyon kusuru nedeniyle ameliyata alnd. Komple sa dekortikasyon yapld. Ameliyat sonras dnem sorunsuz geti ve hastann genel durumu dzeldi. Yirmi be gn sonra taburcu edilen hastaya ay boyunca azdan vorikonazol tedavisi verildi. Fungal enfeksiyonlarn tedavisi zor olabilmektedir. Klinik phe, erken antifungal tedavi, plevral drenaj ve plevrektomi gibi cerrahi mdahalelerle iyi sonular alnabilir.
Fungal infections accounts for less than 1% of all pleural effusions and rare causes of empyema. Herein, we report an immunosuppressed case of aspergillus empyema thoracis with pneumothorax. A 63-year-old female presented with complaints of progressive shortness of breath and right-sided chest pain. Radiological examination revealed a pneumonic consolidation in the right middle lobe. Aspergillus was grown in the sputum culture. Repeated scans showed right hydropneumothorax which was treated with intercostal drainage. She underwent surgery due to persistent air leaks, multi-loculated empyema, and unexpanded lung. Total right pleurectomy (decortication) was performed. She was discharged after 25 days on oral voriconazole which was continued for three months. It can be challenging to treat fungal empyema. Clinical suspicion and early administration of anti-fungal agents with surgical interventions kind of pleural drainage or pleurectomy may be helpful in improving the outcome.

9.
Plevral svnn bir nedeni Ailevi Akdeniz Atei
A cause of pleural effusion is Familial Mediterranean Fever
Efsun Gonca Uur Chousen, Sinem Karaosman Iliaz, Hlya Abal, Sakine ztrk, Emel alar
doi: 10.5505/respircase.2016.26056  Sayfalar 184 - 187
Krk bir yanda kadn hasta tekrarlayan ate, sol yan ars, nefes darl yaknmalaryla bavurdu. Arka-n akcier grafisinde solda plevral efzyon ile uyumlu grnm saptand. Torasentez ile alnan plevral sv rnekleri eksuda zelliinde olup ntrofil hakimiyeti mevcutu.Hastaya plropnmoni tansyla antibiyoterapi uyguland ve klinik ve ksmi radyolojik iyilemeyle taburcu edildi. hafta sonra ayn ikayetlerle tekrar kliniimize mracaat etti. Hastaya Video Assisted Torakoskopi uyguland. Biyopsi sonucu kronik non-spesifik plrit olarak geldi. Anamnez derinletirildiinde iki ocuunda Ailevi Akdeniz Atei( AAA) olduu ve hastann M680I( G/C) heterojen taycs olduu renildi. Romatoloji blmyle konslte edilerek hastaya oral kolisin 0,5 mg 2x1 baland. Bu tedaviden sonra hastann klinii dzeldi, plevral svs geriledi. AAA tans olan hastalarnn %95 'inde ana yaknma abdominal ardr. Abdominal ar olmakszn plevral ar nadirdir. Plevral sv daha da nadirdir. Plevral efzyonlarn etiyolojisini aratrrken Akdeniz blgesinde yer alan lkemizde, AAAnin de plevral sv nedeni olabileceini aklmzda tutmamz gerekmektedir.
Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent abdominal pain and fever episodes. Pleural pain and effusion can also be seen, but rarely in the absence of abdominal pain. FMF is treated with colchicine to control symptoms and to prevent amyloidosis and renal failure. A 41-year-old woman was admitted to our hospital due to recurrent fever, chest pain, and dyspnea. She had an exudative pleural effusion and responded to antibiotic therapy with partial radiographic resolution. She had recurrence of her symptoms three weeks after the completion of therapy. Pleural biopsy by video-assisted thoracoscopy revealed chronic non-specific pleuritis. The patient disclosed that two of her offspring had FMF. Gene analysis showed she was heterozygous carrier of M680I (G/C) mutation. Treatment with colchicine led to resolution of her symptoms and of the pleural effusion. Turkey has a high prevalence of FMF. Pulmonologists should consider FMF in the differential diagnosis of patients with recurrent pleural effusions

10.
Karina Rekonstrksiyon Cerrahisi Sonras Gelien Stenoza Trakeal Y-stent Uygulamas
Tracheal Y-stent Implantation For Stenosis After Carina Reconstruction Surgery
Mehmet Akif zgl, Erdoan etinkaya, Mustafa rtk, Binnaz Zeynep Yldrm, Gler zgl, Fatma Esra Gnaydn, Thierry Sibomona, Cemal zelik, Alper Avc
doi: 10.5505/respircase.2016.71501  Sayfalar 188 - 191
Distal trakea ve trakeal karinann uzak metastaz olmakszn primer tmr ok nadirdir. Bu tr tmrlerin tedavisinde olgu serilerinde eitli komplikasyonlar bildirilmitir. Ancak cerrahi anastomoz hattnn stenozu ve bu nedenle yaplan stent implantasyonu bildirimi olduka nadirdir. Biz 41 yandaki erkek hastada karina rezeksiyon cerrahisi sonrasnda gelien stenoz nedeniyle baar ile trakeal Y-stent uyguladmz bir olguyu sunduk.
Primary tumors of distal trachea and tracheal carina without distant metastasis are extremely rare and surgical excision improves survival. Although various complications have been reported in case series, stenosis is rare on the anastomotic line and stent implantation. Herein, we present a 41-year-old male case who presented with successful tracheal Y-stent implantation for stenosis after carina reconstruction surgery.

11.
Akcier Kanseri ile likili Paraneoplastik Pemfigus: Olgu Sunumu
Paraneoplastic Pemphigus Associated With Lung Cancer: A Case Report
Hseyin Ula nar, Burin elik, Celalettin Kocatrk, Hale Kefeli elik
doi: 10.5505/respircase.2016.29484  Sayfalar 192 - 194
Akcier kanseri ile ilikili deri lezyonlar paraneoplastik sendrom olarak grlebilmektedir. Buna karn, akcier kanseri ile paraneoplastik pemfigus birliktelii olduka nadirdir. Az iinde yara ikayeti ile i hastalklar polikliniine bavuran hastann ekilen akcier grafisinde sa akcierde kitle grlmesi zerine toraks bilgisayarl tomografi ekildi. Bilgisayarl tomografidede sa akcier orta lobda yaklak 6x4 cm ebadnda, dzensiz, spikle konturlu malign grnml kitle lezyonu saptand. Transtorasik ine biyopsisi sonucu negatif gelmesi zerine eksploratris torakotomi uyguland. Kitleden alnan biyopsi sonucu kk hcreli d karsinom gelince hastaya sa pnmonektomi yapld. Az iinde, srtnda ve gs n blgesindeki yaygn deri lezyonlarndan alnan biyopsi sonucu pemfigusla uyumlu bulundu. Postoperatif dnemde dermatoloji tarafndan steroid ve immnoterapi uyguland. Hastann poliklinik kontrol postoperatif 6. aynda yapld. Bu olguyu nadir grlmesi ve deri lezyonlarnn akcier kanserinin bir gstergesi olabileceini vurgulamak amacyla sunduk.
Skin lesions related to the lung cancer can be encountered as a paraneoplastic syndrome. However, paraneoplastic pemphigus is a very rare comorbidity in lung cancer. The patient applied to the internal diseases department with complaint of mouth sore. His chest x-ray revealed a mass in the right lung, and, then, he underwent thoracic computed tomography. A 5x6 cm, irregular, spicule-contoured and seemingly malignant mass lesion was observed in computed tomography. Since the transthoracic needle biopsy result was negative, exploratris thoracotomy was performed. The biopsy result was squamous-cell carcinoma, and the patient underwent right pneumonectomy. The result of the biopsies taken from the skin lesions in the mouth, on the back, and on the front chest area was compatible with pemphigus. Postoperatively, dermatology clinic treated the patient with steroid and immunotherapy. At six months of treatment, he was alive. This rare case is being presented to emphasize that skin lesions can be the indicator of lung cancer.

12.
Nadir Bir Akcier Tmr olan Sklerozan Pnmositoma Olgusu
A Case of Sclerosing Pneumocytoma: A Rare Lung Tumor
Abdulkadir Yasir Bahar, Sercan imsek, Harun ralk
doi: 10.5505/respircase.2016.33254  Sayfalar 195 - 199
Sklerozan pnmositoma histolojik olarak solid, papiller, sklerotik, hemorajik paternlerde olabilen, papiller yzeyleri hiperplastik tip 2 pnmositlerle deli ounlukla orta ya erikin ve kadnlarda grlen benign, rekrrens yada hastala bal lm bildirilmeyen, nadir grlen bir neoplazidir. Biz 50 yandaki kadn hastada akut bronit ata srasnda insidental olarak saptanan sklerozan pnmositoma olgusunu sunduk
Sclerosing pneumocytoma is a rare, benign neoplasm which may be in solid, papillary, sclerosing or hemorrhagic patterns histologically, and its papillary surfaces are covered with hyperplastic type 2 pneumocytes. It is often seen in middle-aged adults and women with no recurrence and no reported disease-related deaths. Herein, we present a 50-year-old female case of sclerosing pneumocytoma case who was diagnosed incidentally during acute bronchitis episode.

13.
Safra Kesesi Kanserinin Kaviter Akcier Metastaz: Nadir Bir Olgu Sunumu
Cavitary Pulmonary Metastases of Gallbladder Cancer: A Rare Case Report
Mustafa alk, Saniye Gknil alk, Tahir Taha Beki, Yaar nl, Hdr Esme
doi: 10.5505/respircase.2016.85520  Sayfalar 200 - 203
Safra kesesi kanseri son derece lmcl malign bir tmrdr. Kaviter akcier metastazlar ok nadir ve olgularn sadece % 4'nde grlr. Burada, safra kesesi kanserinin neden olduu kaviter akcier metastaz olgusunu sunmay amaladk. Altm dokuz yanda bayan hasta olaan kontrolleri iin hastanemize bavurdu. yl nce, safra kesesi kanseri nedeniyle enblok safra kesesi ve parsiyel karacier rezeksiyonu ile blgesel lenf nodu diseksiyonu yaplm. Buna bal olarak 32 ay boyunca yaplan takipleri, son toraks bilgisayarl tomografisinde sa akcierde kaviter lezyon ortaya kana kadar negatifti. Metastazektomi ve mediastinal lenf nodu diseksiyonu yapld. Hasta komplikasyonsuz olarak ameliyat sonras 14. gnde taburcu edildi. Grece az sayda kaviter metastatik akcier kanseri bildirilmitir. Ayrc tan neoplastik hastalk yks olan hastalarda dikkatle yaplmaldr. Erken tan ve tedaviyle sa kalmn artacana inanyoruz.
A gallbladder carcinoma is extremely fatal malignant tumor. The occurrence of excavated lung metastases is rarely observed only in 4% of cases. Herein, we describe a case of cavitary pulmonary metastases of gallbladder cancer. A 69 year-old woman was admitted to our hospital for routine controls. Three years before, she underwent partial hepatectomy with enbloc resection of the gallbladder and dissection of regional lymph nodes. The patient was event-free during follow-up. At 32 months, thoracic CT revealed a cavitary lesion in the right lung. Metastasectomy and mediastinal lymph node dissection was performed. Patient was discharged on day 14 after surgery without any complications. To the best of our knowledge, a relatively small number of cases with metastatic lung tumors cavitation have been reported in the literature. The differential diagnosis should be made with caution in patients with a history of neoplastic disease. Early diagnosis and treatment increase survival.

14.
Erken dnem gs duvar metastaz oluturan akcierin byk hcreli nroendokrin karsinomu
Large cell neuroendocrine carcinoma of lung with early chest wall metastasis
Fazl Yank, Yekta Altemur Karamustafaolu, Adem Karata, Ebru Tatekin
doi: 10.5505/respircase.2016.43660  Sayfalar 204 - 208
Akcierin byk hcreli nroendokrin karsinomlar (BHNK) yksek gradeli tmrlerdir ve kk hcreli akcier kanserine(KHAK) benzer klinik ve biyolojik zellikler tarlar. Erken dnem gs duvar metastaz oluturan akcierin bir BHNKli olguyu tartmay amaladk. Altm iki yanda erkek hastann toraks bilgisayarl tomografisinde (BT) sol akcier st lob anterior segmentte 1,5 cm solid kitle izlendi. Pozitron emisyon tomografisinde kitle malign karakterdeydi. Peroperatuvar frozen sonucu; kk hcreli d akcier kanseri (KHDAK) gelmesi zerine sol st lobektomi uyguland. Sonu gastrointestinal sistem kaynakl p(T1aN0M0) nroendokrin karsinom olarak raporland. Primer kaynaa ynelik yaplan oktreotid sintigrafisi, gastroskopi, kolonoskopi, batn-toraks BTde bir patoloji saptanmad. Olgunun 3. ay kontrolnde; gs duvarnda kitle tespit edildi ve alnan biyopsi BHNK metastaz olarak raporland. Olguya kemo-radyoterapi planland. Olgu tandan bir yl sonra kaybedildi. BHNKler hzl metastaz yapabilen, agresif seyirli, nks edebilen tmrler olduklar iin dier KHDAKlerinden ayrlmas nemlidir, bu hastalarda yakndan takibe ihtiya vardr.
The large cell neuroendocrine carcinomas of the lung (LCNEC) are high-grade tumors and they have similar clinical and biological characteristics of non-small cell lung cancer (NSCLC). We discuss a patient with LCNEC of the lung which early metastasis to chest wall. Sixty-two-year-old male patient had a 1.5 cm solid mass in left upper lob on computered tomography (CT). The mass was reported by positron emission tomography as malignant. Left upper lobectomy was applied in the same period, when perioperatively frozen-section result was diagnosed NSLC. Histopathological examination was revealed a neuroendocrine carcinoma, which may originate from the gastrointestinal tract p(T1AN0M0). The octreotide scintigraphy, gastroscopy, colonoscopy, abdominal, and chest CT were performed for primary origin, but did not reveal any pathology. Chest wall mass was detected postoperative third months and biopsy result was reported as large cell neuroendocrine carcinoma. Then, chemoradiotherapy was planned. Patient died after one year from diagnosis. Accurate differentiation of LCNEC from other types of NSCLC is important, and there is a need for close follow-up in these patients for aggressive and metastatic nature and recurrent disease.

15.
Orta Lob Sendromu; Sa Akcier Lezyonlarnda Ayrc Tanlar Arasnda Olmal
Middle Lobe Syndrome: Differential Diagnosis Should be Made Between The Right Lung Lesions
Fatih Meterolu, Mahsuk Taylan, Melike Demir, Burak Gl, Ali Birak
doi: 10.5505/respircase.2016.66933  Sayfalar 209 - 212
Sa orta lob sendromu, sa orta lobda inat ya da tekrarlayan atelektaziler ile karakterize olan bir tablodur. Grntleme yntemlerindeki gelimelerin etkisiyle erken tan konulmas skl artmtr. Burada, sa orta lob tmr n tansyla tm invazif giriimlere ramen tans konulamayan 23 yandaki bayan hasta ile akcier- karacier hidatik kist nedeniyle operasyona alnan ve operasyon esnasnda orta lob sendromu tans konulan 15 yandaki olgularmz sunmay amaladk.
The right middle lobe syndrome is clinical condition of the right lung middle lobe, characterized by persistent or recurrent atelectasis. Thanks to recent advancements in imaging techniques, early diagnosis has become more widespread. Herein, we present a 23-year-old female case with a suspected middle lobe tumor that was left undiagnosed, despite all invasive procedures and a 15-year-old male case of lung and liver hydatid cysts that was diagnosed with middle lobe syndrome during surgery.

16.
Santral Sinir Sistemi Tutulumunun Elik Ettii Bir Miliyer Tberkloz Olgusu
A case of miliary tuberculosis accompanied by central nervous system involvement
Melike Demir, Mahsuk Taylan, Demet Arslan, Emel Aslan, Sreyya Ylmaz, Abdurrahman enyiit
doi: 10.5505/respircase.2016.56933  Sayfalar 213 - 216
Tberkuloz (TB), hala dnyada ve lkemizde nemli bir salk sorunudur. Yaygn TB'de nrolojik tutulum nadir de olsa grlebilmektedir. Nrotberklozda sklkla TB menenjit, daha az oranlarda intrakranyal tberklomlar da elik edebilir. Bu makalede, miliyer TB tans konduktan ksa bir sre sonra nrolojik semptomlar gelien hasta, menenjit ile birlikte daha nadir grlen intrakranyal tberklomlarn da elik etmesi nedeniyle sunuldu.
Tuberculosis (TB) is still an important health problem in Turkey as well as in the world. Although rare, neurological involvement may be encountered in disseminated TB. TB meningitis and to a lesser extent, intracranial tuberculomas may accompany neurotuberculosis. Herein, we present a case that developed neurological symptoms a short while after being diagnosed with miliary TB due to the fact that rarely seen intracranial tuberculomas accompanied meningitis.

17.
Akcier Kanser Metastazn Taklit Eden Akcier Tberklozu: Olgu sunumu
Pulmonary tuberculosis mimicking lung cancer metastases: a case report
Beyhan akar
doi: 10.5505/respircase.2016.84755  Sayfalar 217 - 219
Akcier tberklozu ve akcier kanseri klinik radyolojik zellikleri nedeniyle birbirlerini taklit ederler. Erken tehis ve tedavi bu hastalarn yaam sresini uzamasnda nemlidir. almamzda, 59 yanda akcier kanser metastaz dnlen akcier tberklozu tans alan hastay sunduk. Olgumuzda sol akcierde tberkloz, sa akcierde akcier kanseri (byk hcreli nroendokrin karsinom) ayn anda grld. Balgam yayma negatif akcier tberklozlu olgumuz tedavisini tamamladktan sonra ksrk ve balgam karma ikayetleri olan kznn balgam yaymasnda asit alkole rezistans basil (ARB) tespit edildi. Yayma negatif tberkloz olgularn temasl taramas nemlidir. Kanserli olgularda yerel immnite bozulduundan akcierde pnmonik infiltrasyon varlnda metastaz ve dier infeksiyon hastalklar dnda tberklozda aratrmaldr.
Pulmonary tuberculosis (PTB) and lung cancer may mimic each other in the aspect of the clinical and radiological features, particularly. Early diagnosis and treatment is of utmost importance for improved survival in these patients. Herein, we present a 59 yearold case diagnosed with PTB, while being considered lung cancer metastases. In our case, PTB in the left lung and lung cancer (large cell neuroendocrine carcinoma) in the right lung were found simultaneously. After our case with sputum smear negative completed tuberculosis therapy, his daughter who had symptoms of cough and sputum was diagnosed with smear positive pulmonary tuberculosis. In smear AFB negative pulmonary tuberculosis cases, contact screen is important for early TB diagnosis. The local immunity is deteriorated in cancer cases, if there is pneumonic infiltration in lung, excluding metastatic lesions and other infections; therefore, we must search tuberculosis too.

18.
Trakeomalazili iki olgu
Two cases with tracheomalacia
Ahmet Arsoy, Hanifi Yldz, Mehmet Hakan Bilgin, Selami Ekin
doi: 10.5505/respircase.2016.00922  Sayfalar 220 - 223
Trakeomalazi ynetimi zor olan ciddi bir hastalktr. Bu hastalarn muayene bulgular KOAH ve astm hastalarna benzerdir. Bu nedenle tanda yanlmaya sebep olabilir. Bu almada, inhaler tedavilerden fayda grmeyen iki trakeomalazi olgusunu sunmay amaladk. Hastalar bilgisayarl tomografi, bronkoskopi ve polisomnografi ile deerlendirildi. Birinci olgu 83 yanda erkek hasta idi. Elli paket-yl sigara anamnezi vard. Hasta ksrk ikayeti nedeni ile hastanelere bavurmu ve 10 yldr KOAH tansyla takip edilmiti. Polisomnografi ile uykuda obstrktif apneleri tespit edildi. Arttrlan pozitif basnca ramen apneleri dzelmedi. Bilgisayarl tomografi ile trakeada yasslama, trakeal halka ve kkrdaklarda bozulma tespit edildi. Trakeal stent taklan hastann birinci yln sonunda uyku apnesi yoktu. kinci olgu be yl boyunca kronik ksrk nedeniyle farkl inhaler tedaviler verilen 66 yanda bir erkek hastayd. Hastann ksr sert ve grltl idi ve uyku apnesi yoktu. Bronkoskopide expiryumda trakeann n ve arka duvarnn birbirine yapt grld. Trakeomalazisi hayat tehdit etmediinden takibe alnd.
Tracheomalacia is a difficult to manage condition. The symptoms are similar to those of COPD and asthma patients. This may cause misdiagnosis. Herein, we present two tracheomalacia cases who received no benefit from inhaled treatment. The patients were examined via computed tomography (CT), bronchoscopy, and polysomnography. The first case was a 83-year-old male having a 50 package-year smoking history. He applied to the hospital due to coughing and followed for COPD. Obstructive sleep apnea was detected via polysomnography. Despite increased positive pressure, the apneas did not heal. On CT, trachea flattening and tracheal ring and cartilages deterioration were detected. The patient had no sleep apnea one year after stenting. The second case was a 66-year-old male having inhaled treatment for five years for chronic coughing. In bronchoscopy, anterior and posterior parts of trachea were seen to cleave into each other in expiration. Since his tracheomalacia was not life-threatening, he has taken under follow-up.

19.
Trakeobronkopati Osteokondroplastika Olgusu
A Case of Tracheobronchopatia Osteocondroplastica
Derya Aydn, Nesrin Yaman, znur Tiryaki Aydoan, Erdoan Blbl, smail Engin Uzgren, Gkhan Aydn
doi: 10.5505/respircase.2016.50570  Sayfalar 224 - 226
Trakeobronkopatia osteokondroplastika, trakea ve major bronlar tutan ve nadir grlen benign bir bozukluktur. Bu yazda trakeobronkopatia osteokondroplastika tanl bir olgu sunulmutur. Atipik gs ve srt ars ile bavuran hastaya ekilen toraks bilgisayarl tomografide trakea ve her iki ana bronta mukozada dzensizlik ve polipoid lezyon izlendi. Yaplan fleksibl bronkoskopide, sert ve vasklaritesi artm polipoid lezyonlar youn ekilde izlendi. Alnan biyopsi sonucu trakeobronkopati osteokondroplastika olarak geldi.
Tracheobronchopatia osteocondroplastica is rare benign disorder at trachea and major bronchi. Herein, we present a case of tracheobronchopatia osteocondroplastica. Physical examination revealed atypical chest and back pain. Thoracic computed tomography of the trachea and both of main bronchi showed bronchial mucosal irregularity and polypoid lesions. Increased vascularity hard and polypoid lesions were observed intensively in fiberoptic bronchoscopy. Biopsy results were reported as tracheobronchopatia osteocondroplastica.

EDITRE MEKTUP
20.
Skuamz Hcreli Akcier Kanserli Hastada Intramedller Spinal Kord Metastaz
Intramedullary Spinal Cord Metastasis in a Patient With Squamous Cell Lung Cancer
Tahir Taha Beki, Ramazan Koylu, Mustafa alk, Sleyman Baktk, Saniye Gknil alk
doi: 10.5505/respircase.2016.33043  Sayfalar 227 - 228
Makale zeti | Tam Metin PDF

YAZAR NDEKSI
21.
2016 Yl Beinci Cilt Yazar ndeksi
Author Index

Sayfalar E1 - E2
Makale zeti | Tam Metin PDF

HAKEM NDEKSI
22.
Hakem ndeksi
Reviewer Index

Sayfa E3
Makale zeti | Tam Metin PDF

LookUs & Online Makale