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Ýzole nodüler pulmoner amiloidozis nadir bir hastalýktýr. Tedavi verilmeden dört yýlllýk bir sürede takip edilen 68 yaþýndaki Ýspanyol bir kadýnýn kliniði ve çarpýcý radyolojik progresyonunun görünümünü sunuyoruz. Ýzole nodüler pulmoner amiloidoz, genellikle selim seyirli olup belirli bir tedavisi yoktur ve hastalýk takibi radyolojik ve fonksiyonel parametreler ile yapýlýr.

Isolated nodular pulmonary amyloidosis is an uncommon disease. We describe the presentation and diagnosis of a 68 year old Hispanic female as well as her clinical and striking radiographic progression over a four year period in the absence of treatment. Isolated nodular pulmonary amyloidosis lacks a definitive treatment and disease monitoring is performed with radiographic and functional parameters over time.

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Ekzojen lipoid pnömoni; petrol ürünleri, hayvansal ya da bitkisel yaðlarýn kazara aspirasyonu sonucu geliþen, nadir görülen bir klinik durumdur. Olgu, yirmi iki yaþýnda erkek hasta, öksürük, nefes darlýðý ve ateþ þikayetleri ile yatýrýldý. Öyküsünde bir taþýtýn yakýt deposundan hortumla mazot çekmeye çalýþýrken kazara aspire ettiði öðrenildi. Baþvurduðunda taþikardi, taþipne, ateþ ve oskültasyonla solda daha belirgin olmak üzere her iki hemitoraksta ince raller duyuldu. Hastada oksijen desteði gerektiren hipoksemi ve hipokapni mevcuttu ve genel durumu kötüydü. Akciðer grafisinde sol hemitoraksta daha fazla olarak infiltrasyon mevcuttu. Aspirasyondan sonraki 19. günde sol akciðerdeki konsolidasyon alanýnda hava sývý seviyesi gösteren nekrotik abse formasyonu geliþti. Sonraki günlerde klinik ve radyolojik olarak düzelme gözlendi. Hastaneye yatýþtan 6 ay sonra çekilen toraks BT’de bronþiektazi, pnömatosel ve sekel görünümlü parankimal dansiteler görüldü. Sonuç olarak bu durum ciddi plöropulmoner tablolara ve sekel geliþimine neden olabilir.

Exogeneous lipoid pneumonia is a rare clinical condition occuring after accidentally aspiration of petroleum products, vegetable or animal oils. A twenty-two years old male patient complaining from fever, cough and shortness of breath admitted. He had a history of accidently aspiration of diesel fuel from a car's fuel depot by inserting a hose. He had tachycardia, tachypnea, fever and fine crackles at both hemithorax on auscultation. The patient had worsening general condition due to hypoxemia and hypocapnia that required oxygen support. Prevalent infiltration dominating on left hemithorax was observed at chest radiography. Consolidation area on the left lung transformed to a necrotizing abcess with a sign of air-fluid level in the 19th day after the aspiration. Clinical and radiological improvement was observed in the following days. Bronchiectasis, pneumatocel and sequelae parenchymal dansities were observed at Chest CT after 6 months of hospital admission. In conclusion, this condition can cause severe pleuropulmonary complications.

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Hastalýðýn yaygýn lokalizasyonlarý bildirilmiþ olmakla birlikte hidatik hastalýk mediastende oldukça nadirdir. Kliniðimize refere edilen mediastinal kisti olan 53 yaþýnda bayan hastayý sunuyoruz. Hastanýn nefes darlýðý ve öksürüðü mevcuttu. Fiberoptik bronkoskopide sað ana bronþa kompresyon izlendi. Kist torakotomi yoluyla çýkartýldý. Kistotomi uygulandý. Mediastinal kist hidatik mediastinal kistlerin ayýrýcý tanýsýnda yer almalýdýr.

ABSTRACT
Hydatid disease is rarely present in the mediastinum although many common locations of the disease have been reported. We present a 53 year old woman with a mediastinal cyst referred to our clinic. The patient had dyspnea and cough. Fiberoptic bronchoscopy revealed a compression on the right main bronchus. The cyst was removed via thoracotomy. Cystotomy was performed. Mediastinal hydatid cyst should be in the differential diagnosis of mediastinal cysts.

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Schwannomalar sinir kýlýfýndan veya schwann hücrelerinden köken alan sýklýkla soliter, kapsüle, asemptomatik lezyonlardýr. 68 yaþýnda bayan hastadan kontrol amaçlý istenen akciðer radyogramýnda arka mediastinal kompartmanda 5 cm çaplý yuvarlak kitle lezyonu tespit edilmiþti. Çekilen toraks bilgisayarlý tomografi incelemesi sonucunda, akciðer kist hidatiði radyolojik ön tanýsý ile kliniðimize yatýrýldý. Sol postero lateral torakotomi ile çýkarýlan paraspinal kitlenin histopatolojik incelemesi sonucu schwannoma olarak raporlandý. Posterior mediasten yerleþimli bir kitle tespit edildiðinde, schwannoma ayýrýcý tanýda düþünülmelidir.

Schwannomas are usually solitary, capsulated, and asymptomatic lesions originating from nerve sheath or schwann cells. A round mass lesion measuring 5 cm in diameter was detected in posterior mediastinal compartment on chest radiography obtained for control in a 68-year-old female patient. The patient was hospitalized in our clinic with radiological prediagnosis of pulmonary hydatid cyst after the imaging study of thorax computed tomography. Histopathological examination of the paraspinal mass removed with left posterolateral thoracotomy was reported as schwannoma. Schwannoma should be considered in differential diagnosis when a mass is detected in the posterior mediastinum.

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Burada nadir görülen endobronþial tutulumlu bir Hodgkin lenfoma olgusu sunulmuþtur. Yirmi üç yaþýnda erkek hasta öksürük, hemoptizi, sað yan aðrýsý ve efor dispnesi yakýnmalarý sebebi ile hastaneye yatýrýldý. Oskültasyonda sað hemitoraksta skapula üstünde solunum sesleri azalmýþ olarak duyuldu. Akciðer grafisinde sað üst zonda paratrakeal çizgiyi silen düzgün sýnýrlý homojen dansite izlendi. Bilgisayarlý toraks tomografide mediastende milimetrik boyutta multiple lenfadenopatiler ile sað akciðer üst lob ve orta lob medial segmentte 8x10x6 cm boyutlarýnda içerisinde hava bronkogramý izlenen konsolidasyon alaný rapor edildi. Fiberoptik bronkoskopide sað üst lob giriþini tamamen týkayan ve intermedial bronþa uzaným gösteren kitle lezyonu görüldü. Mukoza biyopsisinin histopatolojik incelemesi sonucu klasik tip Hodgkin Lenfoma tanýsý kondu.

A rarely observed case of Hodgkin's disease with endobronchial involvement is presented here. Twentythree years old male patient with the complaints of cough, hemopthysis, right sided chest pain and efort dispnea was hospitalized. Lung sounds were diminished over the scapular area at right hemithorax on oscultation. A well defined homogenous dansity in the right upper zone obliterating paratracheal line was observed at chest x-ray. Multiple milimetric lymphadenopathies in the mediastinum and a consolidation area of 8x10x6 cm in size showing air bronchograms in right lung upper and middle lobes medial segment was reported at computed chest tomography. A mass lesion obliterating the entire right upper lobe entrance which is spreading to the intermediate bronchus was observed with fiberoptic bronchoscopy. Classical type Hodgkin's disease was diagnosed by the histopathologic examination of the mucosal biopsy specimen.

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