An old woman with weight loss and chest pain

Pulmonary sarcomas constitute only 0.1-0.5% of all primary lung malignancies. These tumors may derive from the lung parenchyma, bronchial tree or pulmonary arteries. The most important entity in the differential diagnosis is metastatic synovial sarcoma. A 76-years-old woman was admitted for investigation of a fever, productive cough, dyspnea, weight loss and left-sided chest pain which had been present for one month. A chest computerised tomography showed enlarged mediastinal lymph nodes were observed, as well as a left-sided pleural effusion. Thoracentesis revealed hemorrhagic pleural effusion which was exudate and lymphocyte predominant, closed pleural biopsy showed chronic inflammation. Left sided thoracoscopy was performed under local anesthesia, total collapse of left lung and multiple pleural nodules were observed on the visceral pleura multiple biopsies were obtained from those nodules. Pathologic examinations revealed "synovial sarcoma". As skeleton single photon emission tomography was unremarkable, primary pleuropulmonary synovial sarcoma was decided as diagnosis and chemotheraphy was planned for the patient. Primary pleuropulmonary synovial sarcoma is a rare neoplasm of lung and pleura but it is rare entity

Secretory meningiomas: Report of clinical, immunohistochemical findings in 12 cases and review of literature

Secretory meningiomas are a rare meningioma subtype. Among meningiomas, the frequency of secretory meningiomas is 1.6%. Unlike other meningioma types, most of the patients were female (ratio 3:1). No recurrence was reported during the 24-180 months follow-up period of our secretory meningiomas in which, a low level of 0.3% Ki-67 proliferative index was reported. In this meningioma subtype, the percentage of cases with positive progesterone receptor is 33%. With carcinoembryonic antigen, cytokeratin and epithelial membrane antigen, in all the cases positivity was observed in both, the inclusions and the cells surrounding them. With human milk fat globulin 2, a high ratio (92%) of positivity was observed. Majority of the cases were negative with CA125, only three of the cases had suspicious positivity. Distribution of inclusions was irregular and their positive reactions showed varying staining features. Positivity with alpha-1-antitripsin was seen not only in the inclusions but also in some meningothelial cells as well. Ubiquitin was positive in inclusions of the 83% of cases. Staining features of the inclusions pointed out the possibility of them being in a varying age and/or content. Secretory meningiomas are a different type compared to other meningiomas, not only with their histological features but also with their clinical features as well

The renal effects of ten hour sevoflurane anaesthesia in rats: The role of soda lime

The aim of this study was to evaluate the effects of sevoflurane anaesthesia on renal functions by conducting with or without soda lime comparatively. Eighteen male Wistar rats were divided into three equal groups randomly. Sevoflurane in 1.5 % concentration were administered directly to first group in 4 L/min fresh gas flow (50 % O2 + 50 % N2O), while the second group were applied the same gas mixture through soda lime, that is exposed to 150 mL/min carbon dioxide. Third group were control group, breathing room air. Glucose in blood specimens at the begining and end of application and glucose, gamma glutamyl transferase and protein levels were measured in urine samples collected during application period. Renal tissue specimens were evaluated histopathologically. Groups were similar with respect to blood glucose levels. Although urine glucose levels were higher in both of two study groups compared to control (p<0.00001), there was no significant difference between them. Mean urinary GGT level was reasonably high in sevoflurane group, that was not used soda lime, with respect to other two groups (p<0.0004). Mean urine protein levels were similar in all groups. Inflammatory cell collections were observed in the renal tissue specimens of study groups. It was concluded that long term sevoflurane anaesthesia can have toxic effects on renal tissue of rats; and in vivo metabolites may have greater role than in vitro ones, that result from reaction with soda lime

Central nervous system infections and diagnostic brain biopsy: Two case reports

Cerebral biopsy is an invasive technique with limited, specific indications in view of the potential risk of complications. Brain biopsy, aside from the direct sampling of a suspected neoplasm, is often diagnostic in cases of granulomatous angiitis, some forms of encephalitis, subacute spongioform encephalopathy, and a number of other rare diseases. Two cases who had a central nervous system infection and had undergone diagnostic brain biopsy in our clinic will be discussed by reviewing the literature. Copyright © 2005 by Türkiye Klinikleri