e-ISSN 2147-2475
Cilt : 8 Say : 3 Yl : 2022

Hzl Arama




RESPIRATORY CASE REPORTS - Respir Case Rep: 8 (3)
Cilt: 8  Say: 3 - Ekim 2019

OLGU SUNUMU
1.
mmnkompetent Bir Hastada Masif Yaygn Tberkloz: Endemik Bir lke Endonezya'dan Erken Tan ve Ampirik Tedavi Yaklam (Olgu Sunumu ve Literatr Deerlendirmesi)
Massive Disseminated Tuberculosis in an Immunocompetent Patient: Early Diagnostic and Empiric Treatment Approach from an Endemic Country: Indonesia (A Case Report and Literature Review)
Allen Widysanto, Audrey Suryani Soetjipto, Nata Pratama Lugito
doi: 10.5505/respircase.2019.09825  Sayfalar 86 - 93
Tberkloz (TB), yzyllardr bu hastal yenmek iin verilen abalara ramen hala yaygndr. Endonezya, salk hizmetlerine; zellikle de yksek derecede duyarl ve spesifik molekler aratrmaya eriime eit olmayan bir dalmyla, dnyadaki toplam TB yknn en yksek olduu nc lkedir. Enfeksiyonun kontrol altna alnmas iin hzl ve doru TB tans ok nemlidir. ARB smear testi (balgam yayma), kolayca eriilebilir ve uygun maliyetli bir testtir. Ancak, baz eksiklikleri vardr. Akcier, perikardiyal, peritoneal, utero-over, genitoriner ve dalak tutulumu ile ikinci basamak bir salk tesisine bavuran, ncesinde salkl 23 yandaki Endonezyal bir kadnda, ARB yayma negatif dissemine tberkloz (TB) saptadmz olguyu sunuyoruz. Klinisyen, hastann klinii ve hastaln endemik epidemiyolojisini gz nne alarak, pozitif mikrobiyoloji ve tansal biyopsi sonucu olmadan anti-tberkloz tedavisine balamay tercih etti. Anti-tberkloz tedavinin balanmasndan 2 ay sonra ortaya kan pozitif mikobakteriyel kltr ile tan doruland. Ayrca, dier lkelerden bildirilen 20 adet immnokompetan dissemine tberklozular da inceledik.
Tuberculosis is still rampant, despite the centuries of efforts to conquer it. Indonesia is host to the third highest TB burden in the world, with an uneven distribution of health care access, and especially to highly sensitive and specific molecular investigations. Rapid and accurate TB diagnosis is crucial for the control of the infection. An AFB smear test is easily accessed and is cost-effective, although there are a number of shortcomings with the approach. We report here on a case of negative acid-fast bacilli (AFB) smear disseminated tuberculosis (TB) in a previously healthy 23-year-old Indonesian female who presented to a secondary care facility with pulmonary, pericardial, peritoneal, utero-ovarian, genitourinary and splenic involvement. The clinician chose to start anti-tuberculosis therapy without a positive microbiology and biopsy for bacterial load containment purposes, considering also the patients clinical and endemic epidemiology. The diagnosis was confirmed with a positive mycobacterial culture after the initiation of anti-tuberculosis therapy. In the present study, we also review the diagnosis of 20 other cases of disseminated tuberculosis reported in other countries.

2.
Tedaviye Dramatik Yant Veren Akut dyopatik Nonspesifik Pnmoni Olgusu
A Case of Acute Idiopathic Non-specific Pneumonia with Dramatic Response to Treatment
Gulsah Gunluoglu, Fatma Esra Gnaydn, Halide Nur Urer, Nurdan Kalkan, Nurdan imek Veske, Sedat Altn
doi: 10.5505/respircase.2019.52296  Sayfalar 94 - 98
Nonspesifik interstisyel pnmoni (NSP), idiopatik interstisiyel pnmonilerin bir formudur. Spesifik histolojik paternini, deiken derecelerde alveolar duvar inflamasyonu veya fibrozis elik eden temporal uniform lezyonlar oluturur. Organize komponent deiik derecelerde bulunabilir ve histolojik olarak organize komponentin varl NSP tansn dlatmaz. Akut solunum yetmezlii NSP'te nadir grlr. Radyolojik olarak yaygn konsolidasyon bulgular ve akut solunum yetmezlii tablosunda kliniimize bavuran kadn hastaya, cerrahi akcier biyopsisi yaplm ve organize pnmoni komponentli NSP tans konmutur. Steroid tedavisine hzl cevap gzlenmi ve klinik bulgular dramatik olarak dzelmitir. Organize pnmoni komponentili idiopatik NSP olgularnn solunum yetmezlii ile bavurabileceklerini ve hzl tan ve tedavinin bu hastalardaki nemini vurgulamak amacyla olgumuzu sunuyoruz.
Non-specific interstitial pneumonia (NSIP) is a form of idiopathic interstitial pneumonia with a specific histological pattern involving varying degrees of alveolar wall inflammation or fibrosis, and with a temporal uniformity of lesions. The organized component can be found at different degrees, and the presence of a histologically organized component does not exclude a diagnosis of NSIP. Acute respiratory failure is rare in NSIP. A female patient who presented to our clinic with radiological findings of widespread consolidation and acute respiratory failure was diagnosed with NSIP with organized pneumonia through a surgical lung biopsy. The patient responded rapidly to steroid therapy, and the clinical findings improved dramatically. We present our case in order to emphasize the importance of treatment in the event of respiratory failure in idiopathic NSIP with organized pneumonia, and recommend rapid diagnosis and treatment.

3.
Kronik Konstipasyonun Nadir bir Komplikasyonu: Lipoid Pnmoni
A Rare Complication of Chronic Constipation: Lipoid Pneumonia
Berna Duman, Ali Vefa ztrk, Ipek Coban, Tugba Cosgun, Alper Toker, Levent Dalar
doi: 10.5505/respircase.2019.40326  Sayfalar 99 - 102
Lipoid pnmoni nadir grlr. zellikle yallarda kronik konstipasyon amac ile kullanlan mineral yalarda aspirasyon riski vardr. Burada zeytinya aspirasyonu sonucu gelien lipoid pnmoni olgusu anlatlmaktadr.Yetmi yanda erkek hasta iki aydr devam eden ksrk, balgam ikayetleri ile bavurdu.Toraks BTde sa akcier alt lob posterior segmentte ve sa orta lobda yaygn buzlu cam dansiteleri saptand.Nonspesifik antibiyoterapiden bir ay sonra ekilen Toraks BTde orta lobda bulgularn sebat ettii grld. Sa orta lobdan bronkoalveolar lavaj yapld. ARB, nonspesifik kltr, mantar ve sitoloji incelemeleri tanya ulatrmad. Yeni toraks BTde sa orta lobda volm kaybnn gelitii grld. Tan ve tedavi amal sa orta lobektomi yapld. Patolojik incelemesi lipoid pnmoni ile uyumlu bulundu. Tekrar sorgulandnda kronik konstipasyonu iin hergn sekiz yemek ka zeytinya itii renildi. Buzlu cam infiltrasyonu olan olgularda lipoid pnmoni aklda bulundurulmaldr. zellikle ocuklarda, yallarda, refl, yutma gl veya nrolojik hastal olan kiilerde laksatif amal mineral ya kullanm braktrlmaldr.
Lipoid pneumonia is a rare lung disease. Consuming mineral oils for the specific treatment of chronic constipation can lead to aspiration. Herein, a case of lipoid pneumonia is presented resulting from the consumption of olive oil to treat constipation. A 70-year-old male referred with a cough and sputum expectoration. A patchy ground glass opacity was noted in right lower lobe posterobasal segment and the middle lobe in a thoracic computerized tomography (CT). The findings persisted in the middle lobe after broad spectrum antibiotherapy. An examination of the bronchoalveolar lavage fluid was inconclusive. A loss of volume was noted in the middle lobe in a new CT. A middle lobectomy was carried out, and the pathological examination revealed lipoid pneumonia. Under deep questioning, the patient disclosed that he consumed olive oil every morning for chronic constipation. Lipoid pneumonia can be an alternative diagnosis for ground glass opacities. Consuming mineral oil should be avoided, especially in the elderly and children, and in patients with impaired swallowing, reflux or neurological disorders.

4.
Pnmotoraks Aspergilloma Nedeni Olabilir mi?
Can Pneumothorax be the Cause of Aspergilloma?
Onur Derdiyok, Levent Alpay, Volkan Baysungur
doi: 10.5505/respircase.2019.34713  Sayfalar 103 - 106
Spontan pnmotoraksn cerrahi tedavisinde blektomi ve plrodezis genellikle kullanlmaktadr. Bullektomi ve plredez nks nlemek iin birlikte uygulanr. Bununla birlikte, plredez gs duvar ve bllz akcier neovasklarizasyonuna neden olduunda, zellikle apikal blgede uygulanr. Ancak, ortaya kan steril alan, Aspergillus gibi birok karmak klinik problemle sonulanabilir. Bu almada, 7 yl nce yaplan tp torakostomi sonras, sa hemitoraksn steril alanndan kaynaklanan aspergillomaya bal hemoptizi komplikasyonlar nedeniyle sa st lobektomi yaplan olgumuzu sunuyoruz.
Bullectomy and pleurodesis are frequently used for the surgical treatment of spontaneous pneumothorax. Bullectomy and pleurodesis are combined to prevent recurrence, but when pleurodesis causes chest wall and bullous lung neovascularization, it is applied particularly to the apical region. The resulting sterile area, however, may lead to many complex clinical problems, such as aspergillus. In the present study we present a case who underwent a right upper lobectomy due to hemoptysis complications related to aspergilloma, arising from the sterile space in the right hemithorax after a tube thoracostomy performed 7 years previously.

5.
Pulmoner Hcreli Sarkomatoid Karsinom: Olgu Sunumu
Pulmonary Spindle Cell Sarcomatoid Carcinoma: A Case Report
Nesrine Fahem, Ahmed Ben Saad, Rania Kaddoussi, Manel Njima, Asma Migaou, Saoussen Cheikh Mhamed, Samah Joobeur, Naceur Rouatbi
doi: 10.5505/respircase.2019.26539  Sayfalar 107 - 110
Primer akcier sarkomatoid karsinomu (SC) bir nadir grlen maling tmrlerden olup i hcreli SC, bu histolojik kategorinin bir alt trn temsil eder. Literatrde sadece birka olgu bildirilmitir. Tedavi ve prognoz, pulmoner SC iin net olarak belirlenmemitir. Burada, bilgisayarl toraks tomografide (BT) sol apikal kitle saptanan ve gs ars aratrmas yaplan 40 yandaki bir hastay sunuyoruz. BT eliinde yaplan akcier biyopsisi ve immnhistokimya inceleme sonunda hastaya i hcreli SC tans kondu. Radyo-kemoterapi uyguland. Balangta ksmi bir cevap alnmakla beraber sonra bir tmr progresyon gsterdi.
Primary lung sarcomatoid carcinoma (SC) is a rare malignant tumor, with spindle-cell SC representing one subtype of this histological category, only few cases of which have been reported in literature. The treatment and prognosis of pulmonary SC have yet to be clearly determined. Herein we report on the case of a 40-year-old patient with a complaint of chest pain who was found to have a left apical mass in a chest computed tomography (CT). CT-guided lung biopsy and immunohistochemistry confirmed the diagnosis of spindle-cell SC. After radio-chemotherapy, the patient showed an initial partial response and then tumor progression.

6.
Primer Pulmoner Leiyomyosarkom: Olgu sunumu
Primary Pulmonary Leiomyosarcoma: A Case report
Ilgin Timarci, Glistan Karadeniz, Gulru Polat, Fatma Demirci sular, Grkem Vaysolu ahin, Enver Yalnz, Nur Ycel
doi: 10.5505/respircase.2019.79847  Sayfalar 111 - 114
Leiyomyosarkom dz kaslardan kken alan malign mezenkimal tmrdr. Sklkla uterus, retroperitonium ve intraabdominal blgeden kaynaklanrken primer pulmoner kkenli olarak da grlmektedir. Krk yanda, nefes darl yaknmas ile bavuran primer pulmoner leiyomysarkom tans konan kadn hasta nadir grlmesi nedeniyle sunulmutur.
Leiomyosarcoma is a malignant mesenchymal tumor originating from smooth muscle, and frequently from the uterus, retroperitoneum and intraabdominal region, and is of primary pulmonary origin. We present the rare case of a 43-year-old female patient with primary pulmonary leiomyosarcoma who was admitted with shortness of breath.

7.
Yetikinde Mediastinal Kistik Higroma: Olgu Sunumu
Adult Mediastinal Cystic Hygroma: A Case Report
Hulya Dirol, Fatma Deniz, Aykut Cilli, Levent Dertsiz
doi: 10.5505/respircase.2019.00921  Sayfalar 115 - 118
Kistik higroma, lenfatik sistemin nadir grlen konjenital bir malformasyonudur ve genilemi ve sv dolu lenfatik damarlardan oluur. Oluum srasnda lenfatik sistemde meydana gelen tkanma nedeniyle gelitii varsaylmaktadr. ou boyunda bulunur, ancak aksilla ve mediastende de bulunabilirler. Erikinlerde izole mediastinal kistik higroma ok nadir grlen bir patolojidir. Tam cerrahi eksizyon, tercih edilen tedavi yntemidir. Yksek nks oranlar nedeniyle inkomplet eksizyon yerine lezyon ve evresindeki dokunun tamamen rezeke edildii komplet eksizyon tercih edilir. Eksizyonun imkansz olduu durumlarda radyoterapi, aspirasyon, sklerozan enjeksiyonu, sistemik kemoterapi ve interferon-α gibi dier tedavi yntemleri uygulanabilir. Burada, tesadfen saptanan bir mediastinal kistik higroma olgusunu ve tam rezeksiyondan sonra 4 yllk takip sonularn sunuyoruz.
Cystic hygroma is an uncommon congenital malformation of the lymphatic system that is composed of dilated and fluid-filled lymphatic vessels. It is thought to occur due to a blockage in the lymphatic system during the developmental stage. Most are located in the neck, although they can also present in the axilla and mediastinum. Isolated mediastinal cystic hygroma is a very rare pathology in adults, with complete surgical excision being the treatment of choice. The lesion and the surrounding tissue must be fully resected due to the high recurrence rates associated with incomplete resections. In cases where a total excision is impossible, radiotherapy, aspiration, sclerosing injections, systemic chemotherapy and interferon-α are the other treatment options. Here, we report on a case with an incidentally detected mediastinal cystic hygroma, presenting the results of a four-year follow up after a complete resection.

8.
Bronkopulmoner 'Psdo' Sekestrasyon
Bronchopulmonary 'Pseudo' Sequestration
Nur Erik, eyma Ballar, Sedef Kaya, Beng aylan
doi: 10.5505/respircase.2019.33603  Sayfalar 119 - 122
Bronkopulmoner sekestrasyon terimi geni bir bronkopulmoner vaskler malformasyon spektrumunu ierir. lyak arterin dalndan kanlanan, normal sa akcier alt lobu olan asemptomatik bir olguyu sunuyoruz. Yirmi yanda asemptomatik, sigara imeyen, erkek askeri personel rutin salk kontrol iin bavurdu. Kontrastl toraks bilgisayarl tomografisinde (BT) sa akcier alt lobun kanlanmasn lyak arterden ald tespit edildi. Konjenital bronkopulmoner psdosekestrasyon olarak deerlendirildi ve solunum semptomu olursa bavurmas nerildi. Bronkopulmoner sekestrasyon tanm Pryce tarafndan yaplm ve grupta toplanmtr. Tip I: Normal bir akcier lob/segmentinin anormal sistemik kanlanmasnn olmas, Tip II: Akcierden bamsz olan akcier dokusu ve komu normal akcierin anormal sistemik kanlanmasnn olmas, Tip III: Normal trakeobroniyal sistemden bamsz olan ilevsiz akcier dokusunun anormal sistemik kanlanmasnn olmasdr. Daha sonra Pryce Tip I sekestrasyon 'psdosekestrasyon' olarak adlandrlmtr. Konjenital psdosekestrasyon en sk alt loblarda grlr ve kanlanma desendan torasik aorta, lyak arter veya abdominal aortann bir dalndan kaynaklanr. Tanda BT en iyi yntemdir.
The term pulmonary sequestration refers to a wide spectrum of bronchopulmonary vascular malformations. In this case report, we present an asymptomatic case with a normal right lower lobe supplied by a branch of the celiac artery. A 23-year-old male member of the military applied for a periodical physical examination. A thorax computerized tomography (CT) scan revealed a normal right lung volume, although the right lower lobe received its blood supply from the celiac artery. A diagnosis of a congenital pseudosequestration was made, and the patient was advised to seek treatment should pulmonary symptoms develop. Bronchopulmonary sequestration was first described by Pryce, who distinguished between three types of developmental abnormality: Type I: A normal lung with anomalous systemic arterial supply, Type II: An anomalous artery supplying a disconnected lung and an adjacent normal lung, and Type III: A nonfunctional and abnormal lung with systemic arterial blood supply. Later, the Pryce Type I sequestration was renamed pseudosequestration. Congenital pseudosequestration is usually seen the in the lower lobes, and anomalous systemic blood supply arises from the descending thoracic aorta, celiac trunk or abdominal aorta. CT is the best diagnostic method.

9.
Trakeal Bron: Nadir Bir Anomali
Tracheal Bronchus: A Rare Anomaly
Mesut zgke, Fatma Durmaz, Ensar Trko, Muhammed Bilal Aknc
doi: 10.5505/respircase.2019.08760  Sayfalar 123 - 125
Trakea ya da ana bronlardan kken alan dallanma anomalileri nadirdir. Trakeal bron da bu anomalilerden biridir. Genellikle semptomsuzdur. Tan genellikle baka nedenle ekilen bilgisayarl tomografi veya bronkoskopi ile konur. Bronial anatominin radyolog tarafndan tannp ortaya konmas olas giriimsel ilemlere rehberlik yapmas asndan nemlidir. Biz de trakeal bron tans alan olgumuzu nadir grlmesi nedeniyle, bigisayarl tomografi bulgular ile beraber, literatr eliinde sunmay amaladk.
Abnormal bronchi originating from the trachea or main bronchi are rare anomalies, with one of the most significant of these abnormalities being tracheal bronchus. It is usually asymptomatic, and is usually diagnosed from a computed tomography or bronchoscopy made for another reasons. The bronchial anatomy is recognized by the radiologist in order to guide possible interventions. In this case report we present a particularly rare case of tracheal bronchus, with the computed tomography findings and accompanying literature.

YAZAR NDEKSI
10.
Yazar ndeksi
Author Index

Sayfalar 126 - 127
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HAKEM NDEKSI
11.
Hakem ndeksi
Reviewer Index

Sayfa 128
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