RESPIRATORY CASE REPORTS - Respir Case Rep: 5 (3)

Cilt : 5 Say� : 3 Y�l : 2022

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RESPIRATORY CASE REPORTS - Respir Case Rep: 5 (3)

Cilt: 5 Say�: 3 - Ekim 2016

�zetleri Gizle


OLGU SUNUMU
1.	Dental k�pr� aspirasyonu ve tan�sal 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� k�pr�s�n�n kazara aspirasyonu �ok seyrek olmamas�na ra�men, literat�rde bildirilen olgu say�s� s�n�rl�d�r. Hava yoluna ka�an yabanc� cisimler, larinks, trakea ve bron�lara yerle�mektedirler. Aspirasyon s�ras�nda rastlanan en erken semptomlar, bo�ucu �ks�r�k ve h�r�lt� iken, ge� d�nem komplikasyonlar� ise apse ve pn�moni olmaktad�r. Yetmi� �� ya��nda Makedon bayan hasta, akut ve s�rekli bir �ks�r�k, nefes darl�� ve hem inspiratuvar hem de ekspiratuvarda duyulan h�r�lt� yak�nmalar� ile acil servisimize ba�vurdu. Osk�ltasyonda, akut as�m ata��n� taklit eden �ekilde, sa�da solunum seslerinde azalma saptand�. Radyolog, akci�er grafisinde sa� bron� sisteminde metalik bir yabanc� cisim oldu�unu belirledi. Tomografide, d�rtl� yap�da metalik bir cismin sa� alt lob bron�unda oldu�u g�r�ld�. H�zl� ve uygun zaman i�erisinde yap�lan bronkoskopik m�dahale ile hasta ciddi bir cerrahi giri�imden kurtar�lm�� 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. Makale �zeti \| Tam Metin PDF

2.	Penil Sarkoidoz: Nadir ilk tutulum Penile Sarcoidosis: A Rare Initial Manifestation Sibel Doruk, Ey�p Sabri U�an, Faruk Do�an, Funda Ta�l�, Hasan Umut Kantarc�, G�listan Karadeniz, Kemal Can Tertemiz doi: 10.5505/respircase.2016.53765 Sayfalar 157 - 160 Sarkoidozis genito�riner sistemin nadiren tutuldu�u sistemik bir hastal�kt�r ve penis tutulumu ise genito�riner sarkoidoz olgular� aras�nda �ok daha nadir g�r�l�r. Bu makalede penis sarkoidozu tan�s� konulan ve takip edilen iki olgu literat�r e�ili�inde sunulmu�tur. �lk olgu �roloji klini�ine peniste ka��nt� ve a�r� yak�nmas� ile ba�vurmu�tu ve bu yak�nmalar� nonspesifik antibiyotik tedavi ile gerilememi�ti. Biyopside nonkazifiye gran�lomat�z inflamasyon izlendi. Herhangi bir sistemik ve solunumsal yak�nmas� yoktu. Lokal kortikosteroid tedavi verildi. �kinci olgu da �roloji klini�ine peniste nod�l yak�nmas� ile ba�vurmu�tu ve nod�l eksize edilmi�ti. Biyopsi �rne�inde dermisde multinukleer dev h�creler ve gran�lomlar izlendi. Nefes darl��, h�r�lt� ve terleme yak�nmas� olan hastaya sistemik prednizolon tedavisi ba�land�. �ki olgunun da yak�nmalar� uygulanan bu tedaviler ile d�zeldi. 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. Makale �zeti \| Tam Metin PDF

3.	Yang�n ve Yang�n S�nd�r�c� Maruziyeti Sonras�nda Geli�en Pulmoner Alveolar Proteinozis ve Trakeal Stenoz Pulmonary Alveolar Proteinosis and Tracheal Stenosis After Exposure to Fire and Fire Extinghuisher Mustafa ��rt�k, Elif Tanr�verdi O, Kenan Abbasl�, Mehmet Akif �zg�l, Erdo�an �etinkaya doi: 10.5505/respircase.2016.36854 Sayfalar 161 - 164 Pulmoner alveoler proteinozis (PAP) nadir bir hastal�kt�r. PAP alveollere asel�ler s�rfaktan lipidlerin ve proteinlerin birkimi ile karakterizedir. �diyopatik PAP b�t�n PAP olgular�n�n %90��n� olu�turur. Sekonder PAP ise insektisitlerle, silika gibi inorganik tozlara, hematolojik malignitelere, insan imm�n yetmezlik vir�s infeksiyonuna, leflunomide, toksik gaz inhalasyonuna, al�minyum ve metal oksit i�eren end�striyel tozlara sekonder geli�ebilir. Biz de yang�n ve yang�n s�nd�r�c� maruziyeti sonras� geli�en 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. Makale �zeti \| Tam Metin PDF

4.	Ar� sokmas� sonras� yeti�kin solunum s�k�nt�s� 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 ar�s� veya yaban ar�s� sokmas� sonras�nda genellikle, ka��nt�, �rtiker, anjiyo�dem ve anafilaktik reaksiyon gibi a��r� duyarl�l�k reaksiyonlar� g�r�l�r. Literat�rde, ar� sokmas� sonras�, myastenia gravis, periferik n�rit, ensefalomiyelit, optik n�rit, beyin kanamas�, miyokard infarkt�s� ve nefrotik sendrom gibi nadir olgular payla��lm��t�r. Otuz �� ya��ndaki bayan hasta tek ar� sokmas� sonras�nda nefes darl�� nedeniyle acil servisimize ba�vurdu. Nefes darl�� d��nda hi�bir �ikayetleri yoktu. Akci�er grafisinde, bilateral yamal� infiltrasyonlar� vard�. Oksijensiz al�nan kan gaz�nda, pH 7,3, paO2 35 mmHg, paCO2 30 mmHg ve saturasyonu % 75 idi. Ekokardiyografi tamamen normaldi. Yo�un bak�mda al�nd� ve non-invazif mekanik ventilasyon ba�lanan hasta tedavi sonras� tamamen d�zeldi. 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. Makale �zeti \| Tam Metin PDF

5.	Metotreksata Ba�l� Geli�en Pulmoner Toksisite Methotrexate-related Pulmonary Toxicity Selim Erkan Akdemir, P�nar �elik, Timur P�r�ldar doi: 10.5505/respircase.2016.66487 Sayfalar 169 - 173 Folat antagonisti olan metotreksat, inflamatuvar ve neoplastik hastal�klarda kullan�l�r. Metotreksat kullan�m�na ba�l� pulmoner toksisite nadirdir. Romatoid artrit nedeniyle 3 ay �nce haftada bir 10 mg intramuskuler metotreksat ve 4 mg prednizolon ba�lanan 67 ya��nda kad�n hastada, nefes darl��, �ks�r�k, ate� ve a��z i�inde yara yak�nmalar� ortaya ��kmas�, toraks bilgisayarl� tomografide her iki akci�erde �st loblarda periferik yerle�imli ve alt loblarda alveolar d��k dansitede opasiteler ve konsolide alanlar�n g�r�lmesi �zerine olas� dispne nedenleri d��lanm��, klinik ve radyolojik olarak metotreksata ba�l� pulmoner toksisite d��n�lm�� ve kortikosteroid tedavisi ile belirgin d�zelme sa�lanm��t�r. Tan� ve tedavide gecikme �l�mc�l sonu�lara yol a�abilece�i i�in metotreksat kullan�m�na ba�l� pulmoner toksisite geli�ebilece�i 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. Makale �zeti \| Tam Metin PDF \| DICOM

6.	Akci�er kanserini taklit eden b�y�k kitle g�r�n�ml� Wegener Gran�lomatozu olgusu A Wegener Granulomatosis case with a huge lung lesion mimicking lung cancer Mevl�t Karata�, Song�l �zyurt, Aziz G�m��, Halit ��narka, �nal �ahin, Recep Bedir doi: 10.5505/respircase.2016.48343 Sayfalar 174 - 177 Wegener gran�lomatozu primer olarak, akci�er, b�brek ve alt solunum yollar�nda hastal�k yapan, k��k arterleri tutan bir vask�lit tipidir. Olgular�n %50-90�n�nda akci�er tutulumu g�r�lmektedir. Akci�er tutulumu nod�l ya da kitle lezyon olarak kendini g�sterebilmektedir. Lezyonlar yakla��k 30-70 mm b�y�kl��nde olabilmektedir. Tan� a�amas�nda �zellikle kitle lezyonlar yanl�� de�erlendirilip ba�ta akci�er kanseri olmak �zere ger�ek hastal�k g�zden ka�abilmektedir. Yirmi sekiz ya��nda �n planda nefes darl��, solda g��s a�r�s� �ikayeti olan bayan hastan�n sigara ve ba�ka hastal�k �yk�s� yoktu. Akci�er tomografisinde solda 92x103 mm ebad�nda, kenarlar� k�smen spik�ler kitlesi olan ve �n tan�da akci�er kanserini d��nd�ren bir wegener gran�lomatozu olgusunu ve tan� koyma a�amas�nda kar��la�t��m�z g��l�kleri tart��t�k. Wegener gran�lomatozu akci�er tutulumunda tan� a�amas�nda dikkatli olunmas� gerekti�ini 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. Makale �zeti \| Tam Metin PDF

7.	EBUS Transbron�ial ��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 akci�er grafisinde sol hiler lenfadenopati saptanan 63 ya��nda erkek hasta klini�imize ba�vurdu. PET-CT'de solda lenf bezlerinde ve plevrada artm�� florodeoksiglukoz tutulumu saptand�. Endobron�iyal ultrason transbron�iyal i�ne aspirasyonu (EBUS-TB�A) ile elde histopatoljik incelemede malign mezotelyoma saptand�. Bu olgu ile EBUS-TBNA'n�n metastatik malign mezotelyoma olgular�nda kullan�m�n�n faydal� oldu�u g�sterildi. 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. Makale �zeti \| Tam Metin PDF \| DICOM

8.	Plevra Aspergillozis: Nadir G�r�len Bir Mantar Enfeksiyonu Pleural Aspergillosis: A Rare Presentation of Fungal Infection Taha Tahir Bek�i, Mustafa �al�k, Suleyman Emre Ak�n, Saniye Goknil �al�k, H�d�r Esme doi: 10.5505/respircase.2016.38991 Sayfalar 181 - 183 Mantar enfeksiyonlar� t�m plevral ef�zyonlar�n %1'den daha az�ndan sorumludur. Nadiren ampiyeme neden olurlar. Aspegillus�a ba�l� ampiyem ve pn�motoraks geli�en imm�nsupresif bir olguyu sunmay� ama�lad�k. Altm�� ya��nda kad�n hastada ilerleyici bir nefes darl�� ve sa� g��s a�r�s� �ikayetleri mevcuttu. Radyolojik incelenmesinde sa� orta lobda pn�moni tespit edildi. Ampirik antibiyotik tedavisi ba�land�. Balgam k�lt�r�nde aspergillus �redi. Kontrol incelemesinde sa� hidropn�motoraks tespit edilen hastaya interkostal drenaj yap�ld�. Hasta, uzam�� hava ka�a��, m�ltilok�le ampiyem ve akci�erin ekspansiyon kusuru nedeniyle ameliyata al�nd�. Komple sa� dekortikasyon yap�ld�. Ameliyat sonras� d�nem sorunsuz ge�ti ve hastan�n genel durumu d�zeldi. Yirmi be� g�n sonra taburcu edilen hastaya �� ay boyunca a��zdan vorikonazol tedavisi verildi. Fungal enfeksiyonlar�n tedavisi zor olabilmektedir. Klinik ��phe, erken antifungal tedavi, plevral drenaj ve plevrektomi gibi cerrahi m�dahalelerle iyi sonu�lar al�nabilir. 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. Makale �zeti \| Tam Metin PDF

9.	Plevral s�v�n�n bir nedeni Ailevi Akdeniz Ate�i A cause of pleural effusion is Familial Mediterranean Fever Efsun Gonca U�ur Chouse�n, Sinem Karaosman Iliaz, H�lya Abal�, Sakine �zt�rk, Emel �a�lar doi: 10.5505/respircase.2016.26056 Sayfalar 184 - 187 K�rk bir ya��nda kad�n hasta tekrarlayan ate�, sol yan a�r�s�, nefes darl�� yak�nmalar�yla ba�vurdu. Arka-�n akci�er grafisinde solda plevral ef�zyon ile uyumlu g�r�n�m saptand�. Torasentez ile al�nan plevral s�v� �rnekleri eksuda �zelli�inde olup n�trofil hakimiyeti mevcutu.Hastaya pl�ropn�moni tan�s�yla antibiyoterapi uyguland� ve klinik ve k�smi radyolojik iyile�meyle taburcu edildi. �� hafta sonra ayn� �ikayetlerle tekrar klini�imize m�racaat etti. Hastaya Video Assisted Torakoskopi uyguland�. Biyopsi sonucu kronik non-spesifik pl�rit olarak geldi. Anamnez derinle�tirildi�inde iki �ocu�unda Ailevi Akdeniz Ate�i( AAA) oldu�u ve hastan�n M680I( G/C) heterojen ta��y�c�s� oldu�u ��renildi. Romatoloji b�l�m�yle kons�lte edilerek hastaya oral kol�isin 0,5 mg 2x1 ba�land�. Bu tedaviden sonra hastan�n klini�i d�zeldi, plevral s�v�s� geriledi. AAA tan�s� olan hastalar�n�n %95 'inde ana yak�nma abdominal a�r�d�r. Abdominal a�r� olmaks�z�n plevral a�r� nadirdir. Plevral s�v� daha da nadirdir. Plevral ef�zyonlar�n etiyolojisini ara�t�r�rken Akdeniz b�lgesinde yer alan �lkemizde, AAA�nin de plevral s�v� nedeni olabilece�ini akl�m�zda tutmam�z 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 Makale �zeti \| Tam Metin PDF

10.	Karina Rekonstr�ksiyon Cerrahisi Sonras� Geli�en Stenoza Trakeal Y-stent Uygulamas� Tracheal Y-stent Implantation For Stenosis After Carina Reconstruction Surgery Mehmet Akif �zg�l, Erdo�an �etinkaya, Mustafa ��rt�k, Binnaz Zeynep Y�ld�r�m, G�ler �zg�l, Fatma Esra G�nayd�n, Thierry Sibomona, Cemal �z�elik, Alper Avc� doi: 10.5505/respircase.2016.71501 Sayfalar 188 - 191 Distal trakea ve trakeal karinan�n uzak metastaz olmaks�z�n primer t�m�r� �ok nadirdir. Bu t�r t�m�rlerin tedavisinde olgu serilerinde �e�itli komplikasyonlar bildirilmi�tir. Ancak cerrahi anastomoz hatt�n�n stenozu ve bu nedenle yap�lan stent implantasyonu bildirimi olduk�a nadirdir. Biz 41 ya��ndaki erkek hastada karina rezeksiyon cerrahisi sonras�nda geli�en stenoz nedeniyle ba�ar� ile trakeal Y-stent uygulad��m�z 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. Makale �zeti \| Tam Metin PDF

11.	Akci�er Kanseri ile �li�kili Paraneoplastik Pemfigus: Olgu Sunumu Paraneoplastic Pemphigus Associated With Lung Cancer: A Case Report H�seyin Ula� ��nar, Bur�in �elik, Celalettin Kocat�rk, Hale Kefeli �elik doi: 10.5505/respircase.2016.29484 Sayfalar 192 - 194 Akci�er kanseri ile ili�kili deri lezyonlar� paraneoplastik sendrom olarak g�r�lebilmektedir. Buna kar��n, akci�er kanseri ile paraneoplastik pemfigus birlikteli�i olduk�a nadirdir. A��z i�inde yara �ikayeti ile i� hastal�klar� poliklini�ine ba�vuran hastan�n �ekilen akci�er grafisinde sa� akci�erde kitle g�r�lmesi �zerine toraks bilgisayarl� tomografi �ekildi. Bilgisayarl� tomografidede sa� akci�er orta lobda yakla��k 6x4 cm ebad�nda, d�zensiz, spik�le konturlu malign g�r�n�ml� kitle lezyonu saptand�. Transtorasik i�ne biyopsisi sonucu negatif gelmesi �zerine eksploratris torakotomi uyguland�. Kitleden al�nan biyopsi sonucu k��k h�creli d�� karsinom gelince hastaya sa� pn�monektomi yap�ld�. A��z i�inde, s�rt�nda ve g��s �n b�lgesindeki yayg�n deri lezyonlar�ndan al�nan biyopsi sonucu pemfigusla uyumlu bulundu. Postoperatif d�nemde dermatoloji taraf�ndan steroid ve imm�noterapi uyguland�. Hastan�n poliklinik kontrol� postoperatif 6. ay�nda yap�ld�. Bu olguyu nadir g�r�lmesi ve deri lezyonlar�n�n akci�er kanserinin bir g�stergesi olabilece�ini vurgulamak amac�yla 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. Makale �zeti \| Tam Metin PDF \| DICOM

12.	Nadir Bir Akci�er T�m�r� olan Sklerozan Pn�mositoma Olgusu A Case of Sclerosing Pneumocytoma: A Rare Lung Tumor Abdulkadir Yasir Bahar, Sercan �imsek, Harun ��ral�k doi: 10.5505/respircase.2016.33254 Sayfalar 195 - 199 Sklerozan pn�mositoma histolojik olarak solid, papiller, sklerotik, hemorajik paternlerde olabilen, papiller y�zeyleri hiperplastik tip 2 pn�mositlerle d��eli �o�unlukla orta ya� eri�kin ve kad�nlarda g�r�len benign, rek�rrens yada hastal��a ba�l� �l�m bildirilmeyen, nadir g�r�len bir neoplazidir. Biz 50 ya��ndaki kad�n hastada akut bron�it ata�� s�ras�nda insidental olarak saptanan sklerozan pn�mositoma 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. Makale �zeti \| Tam Metin PDF \| DICOM

13.	Safra Kesesi Kanserinin Kaviter Akci�er Metastaz�: Nadir Bir Olgu Sunumu Cavitary Pulmonary Metastases of Gallbladder Cancer: A Rare Case Report Mustafa �al�k, Saniye G�knil �al�k, Tahir Taha Bek�i, Ya�ar �nl�, H�d�r Esme doi: 10.5505/respircase.2016.85520 Sayfalar 200 - 203 Safra kesesi kanseri son derece �l�mc�l malign bir t�m�rd�r. Kaviter akci�er metastazlar� �ok nadir ve olgular�n sadece % 4'�nde g�r�l�r. Burada, safra kesesi kanserinin neden oldu�u kaviter akci�er metastaz� olgusunu sunmay� ama�lad�k. Altm�� dokuz ya��nda bayan hasta ola�an kontrolleri i�in hastanemize ba�vurdu. �� y�l �nce, safra kesesi kanseri nedeniyle enblok safra kesesi ve parsiyel karaci�er rezeksiyonu ile b�lgesel lenf nodu diseksiyonu yap�lm��. Buna ba�l� olarak 32 ay boyunca yap�lan takipleri, son toraks bilgisayarl� tomografisinde sa� akci�erde kaviter lezyon ortaya ��kana kadar negatifti. Metastazektomi ve mediastinal lenf nodu diseksiyonu yap�ld�. Hasta komplikasyonsuz olarak ameliyat sonras� 14. g�nde taburcu edildi. G�rece az say�da kaviter metastatik akci�er kanseri bildirilmi�tir. Ay�r�c� tan� neoplastik hastal�k �yk�s� olan hastalarda dikkatle yap�lmal�d�r. Erken tan� ve tedaviyle sa� kal�m�n artaca��na inan�yoruz. 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. Makale �zeti \| Tam Metin PDF \| DICOM

14.	Erken d�nem g��s duvar� metastaz� olu�turan akci�erin b�y�k h�creli n�roendokrin karsinomu Large cell neuroendocrine carcinoma of lung with early chest wall metastasis Fazl� Yan�k, Yekta Altemur Karamustafao�lu, Adem Karata�, Ebru Ta�tekin doi: 10.5505/respircase.2016.43660 Sayfalar 204 - 208 Akci�erin b�y�k h�creli n�roendokrin karsinomlar� (BHNK) y�ksek gradeli t�m�rlerdir ve k��k h�creli akci�er kanserine(KHAK) benzer klinik ve biyolojik �zellikler ta��rlar. Erken d�nem g��s duvar� metastaz� olu�turan akci�erin bir BHNK�li olguyu tart��may� ama�lad�k. Altm�� iki ya��nda erkek hastan�n toraks bilgisayarl� tomografisinde (BT) sol akci�er �st lob anterior segmentte 1,5 cm solid kitle izlendi. Pozitron emisyon tomografisinde kitle malign karakterdeydi. Peroperatuvar frozen sonucu; k��k h�creli d�� akci�er kanseri (KHDAK) gelmesi �zerine sol �st lobektomi uyguland�. Sonu� gastrointestinal sistem kaynakl� p(T1aN0M0) n�roendokrin karsinom olarak raporland�. Primer kayna�a y�nelik yap�lan oktreotid sintigrafisi, gastroskopi, kolonoskopi, bat�n-toraks BT�de bir patoloji saptanmad�. Olgunun 3. ay kontrol�nde; g��s duvar�nda kitle tespit edildi ve al�nan biyopsi BHNK metastaz� olarak raporland�. Olguya kemo-radyoterapi planland�. Olgu tan�dan bir y�l sonra kaybedildi. BHNK�ler h�zl� metastaz yapabilen, agresif seyirli, n�ks edebilen t�m�rler olduklar� i�in di�er KHDAK�lerinden ayr�lmas� �nemlidir, bu hastalarda yak�ndan takibe ihtiya� vard�r. 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. Makale �zeti \| Tam Metin PDF \| DICOM

15.	Orta Lob Sendromu; Sa� Akci�er Lezyonlar�nda Ay�r�c� Tan�lar Aras�nda Olmal� Middle Lobe Syndrome: Differential Diagnosis Should be Made Between The Right Lung Lesions Fatih Metero�lu, Mahsuk Taylan, Melike Demir, Burak G�l, 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. G�r�nt�leme y�ntemlerindeki geli�melerin etkisiyle erken tan� konulmas� s�kl�� artm��t�r. Burada, sa� orta lob t�m�r� �n tan�s�yla t�m invazif giri�imlere ra�men tan�s� konulamayan 23 ya��ndaki bayan hasta ile akci�er- karaci�er hidatik kist nedeniyle operasyona al�nan ve operasyon esnas�nda orta lob sendromu tan�s� konulan 15 ya��ndaki olgular�m�z� sunmay� ama�lad�k. 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. Makale �zeti \| Tam Metin PDF \| DICOM

16.	Santral Sinir Sistemi Tutulumunun E�lik Etti�i Bir Miliyer T�berk�loz Olgusu A case of miliary tuberculosis accompanied by central nervous system involvement Melike Demir, Mahsuk Taylan, Demet Arslan, Emel Aslan, S�reyya Y�lmaz, Abdurrahman �enyi�it doi: 10.5505/respircase.2016.56933 Sayfalar 213 - 216 T�berkuloz (TB), hala d�nyada ve �lkemizde �nemli bir sa�l�k sorunudur. Yayg�n TB'de n�rolojik tutulum nadir de olsa g�r�lebilmektedir. N�rot�berk�lozda s�kl�kla TB menenjit, daha az oranlarda intrakranyal t�berk�lomlar da e�lik edebilir. Bu makalede, miliyer TB tan�s� konduktan k�sa bir s�re sonra n�rolojik semptomlar� geli�en hasta, menenjit ile birlikte daha nadir g�r�len intrakranyal t�berk�lomlar�n da e�lik 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. Makale �zeti \| Tam Metin PDF \| DICOM

17.	Akci�er Kanser Metastaz�n� Taklit Eden Akci�er T�berk�lozu: Olgu sunumu Pulmonary tuberculosis mimicking lung cancer metastases: a case report Beyhan �akar doi: 10.5505/respircase.2016.84755 Sayfalar 217 - 219 Akci�er t�berk�lozu ve akci�er kanseri klinik radyolojik �zellikleri nedeniyle birbirlerini taklit ederler. Erken te�his ve tedavi bu hastalar�n ya�am s�resini uzamas�nda �nemlidir. �al��mam�zda, 59 ya��nda akci�er kanser metastaz� d��n�len akci�er t�berk�lozu tan�s� alan hastay� sunduk. Olgumuzda sol akci�erde t�berk�loz, sa� akci�erde akci�er kanseri (b�y�k h�creli n�roendokrin karsinom) ayn� anda g�r�ld�. Balgam yayma negatif akci�er t�berk�lozlu olgumuz tedavisini tamamlad�ktan sonra �ks�r�k ve balgam ��karma �ikayetleri olan k�z�n�n balgam yaymas�nda asit alkole rezistans basil (ARB) tespit edildi. Yayma negatif t�berk�loz olgular�n temasl� taramas� �nemlidir. Kanserli olgularda yerel imm�nite bozuldu�undan akci�erde pn�monik infiltrasyon varl��nda metastaz ve di�er infeksiyon hastal�klar� d��nda t�berk�lozda ara�t�rmal�d�r. 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 year�old 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. Makale �zeti \| Tam Metin PDF

18.	Trakeomalazili iki olgu Two cases with tracheomalacia Ahmet Ar�soy, Hanifi Y�ld�z, Mehmet Hakan Bilgin, Selami Ekin doi: 10.5505/respircase.2016.00922 Sayfalar 220 - 223 Trakeomalazi y�netimi zor olan ciddi bir hastal�kt�r. Bu hastalar�n muayene bulgular� KOAH ve ast�m hastalar�na benzerdir. Bu nedenle tan�da yan�lmaya sebep olabilir. Bu �al��mada, inhaler tedavilerden fayda g�rmeyen iki trakeomalazi olgusunu sunmay� ama�lad�k. Hastalar bilgisayarl� tomografi, bronkoskopi ve polisomnografi ile de�erlendirildi. Birinci olgu 83 ya��nda erkek hasta idi. Elli paket-y�l sigara anamnezi vard�. Hasta �ks�r�k �ikayeti nedeni ile hastanelere ba�vurmu� ve 10 y�ld�r KOAH tan�s�yla takip edilmi�ti. Polisomnografi ile uykuda obstr�ktif apneleri tespit edildi. Artt�r�lan pozitif bas�nca ra�men apneleri d�zelmedi. Bilgisayarl� tomografi ile trakeada yass�la�ma, trakeal halka ve k�k�rdaklarda bozulma tespit edildi. Trakeal stent tak�lan hastan�n birinci y�l�n sonunda uyku apnesi yoktu. �kinci olgu be� y�l boyunca kronik �ks�r�k nedeniyle farkl� inhaler tedaviler verilen 66 ya��nda bir erkek hastayd�. Hastan�n �ks�r�� sert ve g�r�lt�l� idi ve uyku apnesi yoktu. Bronkoskopide expiryumda trakean�n �n ve arka duvar�n�n birbirine yap��t�� g�r�ld�. Trakeomalazisi hayat� tehdit etmedi�inden takibe al�nd�. 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. Makale �zeti \| Tam Metin PDF

19.	Trakeobronkopati Osteokondroplastika Olgusu A Case of Tracheobronchopatia Osteocondroplastica Derya Ayd�n, Nesrin Yaman, �znur Tiryaki Aydo�an, Erdo�an B�lb�l, �smail Engin Uzg�ren, G�khan Ayd�n doi: 10.5505/respircase.2016.50570 Sayfalar 224 - 226 Trakeobronkopatia osteokondroplastika, trakea ve major bron�lar� tutan ve nadir g�r�len benign bir bozukluktur. Bu yaz�da trakeobronkopatia osteokondroplastika tan�l� bir olgu sunulmu�tur. Atipik g��s ve s�rt a�r�s� ile ba�vuran hastaya �ekilen toraks bilgisayarl� tomografide trakea ve her iki ana bron�ta mukozada d�zensizlik ve polipoid lezyon izlendi. Yap�lan fleksibl bronkoskopide, sert ve vask�laritesi artm�� polipoid lezyonlar yo�un �ekilde izlendi. Al�nan 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. Makale �zeti \| Tam Metin PDF

EDIT�RE MEKTUP
20.	Skuam�z H�creli Akci�er Kanserli Hastada Intramed�ller Spinal Kord Metastaz� Intramedullary Spinal Cord Metastasis in a Patient With Squamous Cell Lung Cancer Tahir Taha Bek�i, Ramazan Koylu, Mustafa �al�k, S�leyman Bakt�k, Saniye G�knil �al�k doi: 10.5505/respircase.2016.33043 Sayfalar 227 - 228 Makale �zeti \| Tam Metin PDF

YAZAR �NDEKSI
21.	2016 Y�l� Be�inci 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