Bu olgu ile aðýzdan göðüs duvarýna yeþil çiçek aspirasyonunun alýþýlmamýþ bir yolunun tanýmlanmasý amaçlandý. Ýki haftalýk pisi pisi otu (Hordeum murinum ÝTALÝK YAZ) aspirasyonu þikayeti olan 14 yaþýnda bir erkek çocuk göðüs duvarý apsesi nedeniyle kliniðimize sevk edildi. Rutin tanýsal yaklaþýmlar sonrasýnda apse drenajý, video yardýmlý toraks cerrahi kullanarak etkilenmiþ akciðer lobunun kama rezeksiyonu ve yabancý cismin çýkarýlmasý gerçekleþtirildi. Hasta herhangi bir komplikasyon olmaksýzýn postoperatif 16. günde taburcu edildi.

An unusual route of grass inflorescence aspiration from the mouth to the chest wall is described in this case. A 14-year-old boy, with a history of grass inflorescence (Hordeum murinum ÝTALÝK) aspiration some 2 weeks prior, was referred to the clinic due to a chest wall abscess. After routine diagnostic approaches, abscess drainage, wedge resection of the affected lung lobe, and removal of the foreign body were performed using video-assisted thoracic surgery. On postoperative day 16, the patient was discharged without any complication.

Primer hiperparatiroidinin en sýk nedeni paratiroid adenomlarýdýr. Adenomlar genellikle tiroid bezlerin alt pollerinde görülmekle birlikte mediastinal, intratiroidal, retroözofageal, intratimik gibi ektopik bölgelerde yerleþtiði bildirilmektedir. Ektopik paratiroid dokusunun tanýmlanmasýnda en etkili görüntüleme yöntemi 99mTc ile iþaretli sestamibi sintigrafisidir ve adenomlarýn cerrahi eksizyonu tedavi için yeterlidir. Bu çalýþmada mediastinal yerleþimli ektopik paratiroid adenomlu dört hastayý sunduk.

Parathyroid adenoma is the cause of the majority of cases of primary hyperparathyroidism. Most of these adenomas are located near the lower poles of the thyroid gland; however, mediastinal, intrathyroidal, retroesophageal, and intrathymic localizations have also been reported. The most effective imaging method to localize ectopic parathyroid adenoma is 99mTc-sestamibi scintigraphy, and a surgical approach is applied to excise the adenoma. In this study, 4 cases of mediastinal ectopic parathyroid adenoma are described.

Trakea cerrahisi çoðunlukla genel anestezi altýnda endotrakeal tüp entübasyonu ile yapýlmaktadýr. Trakeal stenozlu olgularýn endotrakeal tüp ile entübasyonu darlýðýn derecesine göre zor olabilmektedir. Bu nedenle ya ince entübasyon tüpü kullanýlmakta ya da entübasyon öncesi rijid bronkoskopik dilatasyon yapýlarak hastanýn entübasyonu saðlanmaktadýr. Bu yazýda, akut koroner sendrom sonrasý yoðun bakýmda entübe kalan ve sonrasýnda trakeal stenozu geliþen hastada, endotrakeal entübasyon uygulamadan laringeal maske ile yaptýðýmýz trakea cerrahisini sunmak istedik.

Tracheal surgery is usually performed under general anesthesia with endotracheal intubation. In a patient with tracheal stenosis, depending on the degree of stenosis, intubation with an endotracheal tube can be difficult. Therefore, narrow intubation tubes may be used, or intubation may be provided with rigid bronchoscopic dilatation before intubation. Tracheal surgery with a laryngeal mask and without endotracheal intubation in a patient with tracheal stenosis who was intubated in the intensive care unit due to acute coronary syndrome is described in this report.

Fibromatozis, primer göðüs duvarý tümörleri arasýnda sýnýflandýrýlan ve nadir görülen bir tümördür. Etyolojisinde, travma, geçirilmiþ operasyonlar, genetik ve hormonal nedenler yer almaktadýr. Yüzeyel ve derin tip olmak üzere iki ana grupta incelenirler. Özellikle derin fibromatozisler benign karakterde olmasýna karþýn, lokal agresif özellik gösterdikleri için lokal geniþ rezeksiyonlar ile tedavi edilmelidirler. Bu çalýþmada, göðüs duvarý yerleþimli bir posttravmatik fibromatozis olgusu literatür bilgileri eþliðinde sunulmuþtur.

Fibromatosis is a rare tumor that is classified among the primary chest wall tumors. The etiology can include trauma, previous operation, hormonal, and genetic causes. Fibromatosis can be broadly divided into superficial and deep categories. Deep fibromatosis, in particular, should be treated with wide, local resections because of its aggressive local behavior despite its benign character. In this report, a case of posttraumatic fibromatosis located on the chest wall is presented.

Tansiyon pnömotoraks mediastinal yapýlarýn yer deðiþtirmesine baðlý kardiyopulmoner fonksiyonun kötüleþmesi ile sonuçlanan, erken taný ve tedavi edilmediðinde ölümcül olan bir durumdur. Biz bu yazýda miyofasiyal aðrý tedavisinde kullanýlan kuru iðneleme metoduna baðlý iyatrojenik bilateral pnömotoraks geliþen ve sonra tansiyon pnömotoraksa ilerleyen olguyu sunmayý amaçladýk

Tension pneumothorax, resulting in deterioration of cardiopulmonary function due to displacement of the mediastinal structures, is a fatal condition without early diagnosis and treatment. This article is a description of the case of a patient who developed iatrogenic bilateral pneumothorax and subsequent tension pneumothorax due to dry needling used in the treatment of myofascial pain.

Elli beþ yaþýnda, koroner arter hastalýðý nedeni ile prasugrel ve asetilsalisilik asit kullanmakta olan kadýn hasta, senkop ve hipotansiyon ile acile servise getirildi. Ekokardiyografide paradoks septum ve sað ventrikülde geniþleme saptanan, kontrastlý bilgisayarlý toraks tomografisinde bilateral ana pulmoner arterlerde ve dallarýnda yaygýn trombüs görülen hastaya rt-PA uygulandý. Trombolitik bitiminde heparinize edilen hastanýn tedavisine yirmi dördüncü saatte warfarin eklendi. Kanama komplikasyonu geliþmeyen hasta yedinci günde warfarin, klopidogrel, asetilsalisilikasit tedavileri altýnda taburcu edildi. Bu olgu, yeni kuþak antitrombotik olan presugrelin kanama riskinin yüksek olmasý, bu ilaç ile birlikte daha önce trombolitik kullanýmýnýn bildirilmemiþ olmasý, sonuçta kanama komplikasyonu geliþmeden hastanýn takip edilmesi açýsýndan önemlidir.

A 55-year-old female patient was admitted to emergency service for hypotension and syncope. The patient was under dual antiplatelet therapy, aspirin, and prasugrel for coronary artery disease. Echocardiography revealed dilated right heart chambers as well as paradoxical septal motion, suggesting a diagnosis of pulmonary embolism. Thorax computerized tomography with contrast enhancement was performed and revealed thrombi in both main pulmonary arteries and their branches. Thrombolytic treatment was provided. There were no bleeding complications, and patient was discharged from the hospital on the seventh day, taking warfarin, clopidogrel, and aspirin. The present case is important because thrombolytic treatment for a patient who is on prasugrel has not been reported in the literature previously, and it illustrates that such therapy can be administered safely, though prasugrel has been associated with an increased rate of bleeding complications.

Septik akciðer embolisi, vücuttaki herhangi bir enfeksiyon kaynaðýndan köken alan mikroorganizma içeren trombüsün pulmoner arterlerde oluþturduðu enfakt sonucu akciðerin enfektif hastalýðýdýr. Ateþ yüksekliði, öksürük ve göðüs aðrýsý gibi nonspesifik semptomlar ve akciðerlerde bilateral infiltrasyonlar ile karakterizedir. Morbidite ve mortalitesi yüksek olup prognozda en önemli nokta, düþünmek ve erken dönemde geniþ spektrumlu antibiyotik tedavisi baþlamaktýr. Birincil enfeksiyon odaðý ve ateþ yüksekliði ile birlikte akciðerlerde bilateral periferik multipl nodüler, kaviter infiltrasyonlar görüldüðünde septik akciðer embolisi akla getirilmelidir. Hematojen metastazlar baþta olmak üzere maligniteler, bakteri-mantar-paraziter enfeksiyonlar, vaskülitler ve romatizmal hastalýklar ayýrýcý tanýda düþünülmesi gerekir. Bu makalede kalýcý kateteri olan rektum kanserli bir septik akciðer emboli olgusu nadir görülmesi nedeniyle literatür eþliðinde sunulmuþtur.

Septic pulmonary embolism is an infectious disease of the lung that occurs when a thrombus containing microorganisms from any source of infection in the body is mobilized and causes infarction of the pulmonary arteries. It is characterized by nonspecific symptoms, such as fever, cough, chest pain, and bilateral infiltrates in the lungs. Morbidity and mortality are high, and the most important point in the prognosis is to start wide spectrum antibiotic treatment in the early period. When there is a primary infectious focus, fever with bilateral peripheral multiple nodules, and cavitary infiltrates in the lungs, septic pulmonary embolism should be considered. Malignancies, especially hematogenous metastases, bacterial-fungal parasitic infections, vasculitis, and rheumatic diseases should be considered in the differential diagnosis. In this article, a rare case of septic pulmonary embolism in a patient who had rectal cancer and a persistent catheter is presented in the context of the literature.

Hipereozinofilik sendrom (HES) nadir görülen, çok sistemi tutabilen, heterojen bir sendrom olup, eozinofillerin aþýrý üretilmesinin yol açtýðý eozinofilik infiltrasyonun birden fazla organa zarar vermesine neden olabilir. Kardiyak tutulum sýklýkla görülür ve yüksek oranda morbidite ve mortalite taþýr. Bu yazýda, tetkikleri esnasýnda miyokard enfarktüsü geçiren ve HES tanýsý alan periferik eozinofilisi olan bir olgu literatür bilgileri eþliðinde sunulmaktadýr.

Hypereosinophilic syndrome (HES) is a rare, multisystem, heterogeneous syndrome, characterized by a sustained overproduction of eosinophils, and in which eosinophilic infiltration can cause damage to multiple organs. Cardiac involvement is frequent and carries with it a high rate of morbidity and mortality. Presently described is a patient with peripheral eosinophilia who had myocardial infarction at admission and was diagnosed with HES, a literature review, and discussion.

Küçük hücre dýþý akciðer karsinomunda subtiplendirmenin yapýlmasý önemlidir. Epidermal growth factor reseptör (EGFR) Egzon 19 delesyonuna sahip adenokarsinomlu olgularda, gefitinib ve erlotinib olarak bilinen EGFR-Tirozin kinaz inhibitörü tedaviler ile ileri evre hastalarda saðkalýmda fayda elde edilebilmektedir. Ancak birçok moleküler ve biyolojik mekanizmalar ile bu ilaçlara karþý direnç geliþebilmektedir. Bu yazýda, erlotinib tedavisinin 13. ayýnda, direnç mekanizmalarýndan biri olan küçük hücreli akciðer kanseri dönüþümünü, bir olgu eþliðinde sunmayý amaçladýk.

It is important to determine the histological tumor type in non-small cell lung cancer (NSCLC). In patients with adenocarcinoma harboring the epidermal growth factor receptor (EGFR) exon 19 deletion mutation, targeted therapy can yield survival benefit. The epidermal growth factor receptor tyrosine kinase inhibitors gefitinib and erlotinib can provide survival benefit for advanced stage NSCLC patients. However, increasing evidence of acquired resistance to these drugs has been reported, and numerous molecular and biological mechanisms of acquired resistance have been detected. The present report is description of 1, such resistance mechanisms: transformation to small cell lung cancer in a patient who was in the 13th month of erlotinib therapy.

Bronþa ait mukoza iliþkili lenfoid dokudan kaynaklanan primer pulmoner ekstranodal marjinal zon lenfoma nadir görülmektedir. Yavaþ progrese olan lokalize kitle ya da konsolidasyon olarak ortaya çýkar. Kronik öksürük, dispne gibi non-spesifik pulmoner semptomlar olabilir ama sýklýkla tesadüfen taný alýr. Hastamýza ait toraks tomografisinde dev kistik bir lezyon ve eþlik eden konsolidasyon ve nodüller vardý. Transtorasik akciðer biopsisi ve immünhistokimayasal inceleme ile marjinal zon lenfoma tanýsý elde edildi. Dev kistik lezyon ile radyolojik bulgu veren ilk olgu olarak sunmayý amaçladýk.

Primary pulmonary extranodal marginal zone lymphoma (PPEMZL) arising from the mucosa-associated lymphoid tissue of the bronchus is a very rare disorder. It appears in the form of a slowly progressing localized mass or consolidation. Clinical presentation may include non-specific pulmonary symptoms, such as chronic cough, or dyspnea, but it is more often diagnosed incidentally. Computed tomography (CT) the thorax revealed that the present patient had a giant cystic lesion, parenchymal nodules, and consolidation area. The patient was symptomatic and diagnosed as marginal zone lymphoma by immunohistochemical study of the transthoracic biopsy specimen. This patient is thought to be the first diagnosed as PPEMZL from a cystic lesion.

Otoimmün hastalýklar grubunda deðerlendirilen, kronik, erozif ve inflamatuvar bir poliartrit olan romatoid artrit en sýk görülen poliartrittir. Akciðer tutulumunun da eþlik ettiði bu inflamatuvar hastalýk akciðer parankiminde metastazý taklit eden nodüllere yol açmakta ve tanýda zorluða neden olmaktadýr. Bu yazýda, bilinen romatoid artrit tanýlý ve 15 yýldýr tedavi gören 63 yaþýnda kadýn olgu, akciðerindeki metastazý taklit eden romatoid nodülleri nedeniyle sunuldu. Taný zorluðu olan bu olgularda tanýsal amaçlý yapýlan akciðer rezeksiyonu deðerlendirildi.

Rheumatoid arthritis, classified in the autoimmune disease group, is a chronic, erosive, inflammatory, and the most frequently seen form of polyarthritis. This inflammatory disease, which is often accompanied by pulmonary involvement, can cause nodules to form in the pulmonary parenchyma that mimic metastasis, leading to difficulty in diagnosis. In this article, the case of a 63-year-old female patient with rheumatoid arthritis for 15 years and pulmonary rheumatoid nodules mimicking pulmonary metastasis is described. Diagnostic pulmonary resection is criticized for those patients who are difficult to diagnose.

Poland sendromu pektoralis majör kasýnýn yokluðu ile karakterize konjenital bir sendromdur.Bu sendrom ile beraber, ayný tarafta pektoralis minör kasýnýn yokluðu, göðüs ve üst ekstremite deformiteleri, meme dokusunun geliþmemesi, aksillada alopesi, 2. ila 5. arasýndaki kaburgalarýn olmamasý, latissimus dorsi, serratus anterior ve eksternal oblik kaslarýnýn geliþmemiþ olmasý gibi ilave bulgular görülebilir. Ayný taraflý toraks çöküklüðü, toraksta paradoksal hareket ve akciðer herniasyonu da bulunabilir. Poland sendromunun genel olarak 1/30000 sýklýkta görüldüðü tahmin edilmektedir. Eriþkin yaþta taný konulmasý nedeniyle bu iki nadir olguyu sunuyoruz.

Poland syndrome is a congenital syndrome characterized by the absence of the pectoralis major muscle. Additional findings may include a lack of the pectoralis minor muscle, breast and upper extremity deformities, nondevelopment of breast tissue, axillary alopecia, and the absence of ribs 2 to 5, the latissimus dorsi, serratus anterior, and the external oblique muscles. Same side thoracic depression, paradoxical movement of the thorax and pulmonary hernia may occur. It is estimated that Poland syndrome is generally seen at a frequency of 1/30000. Presently described are these 2 cases that are rare due to diagnosis at adult age.