Maligniteyi taklit eden pulmoner arteriyovenöz malformasyon: Olgu sunumu

Pulmonary arteriovenous malformations (AVM) are congenital lesions and are often arise in the lower lobes due to abnormal capillary development. Forty-two years old male patient presented with hemoptysis and he was referred to our clinic with the suspicion of malignancy. Postero-anterior chest roentgenogram revealed homogenous opacity on the right perihilar zone. Computed tomography revealed a mass which was located at the right upper lobe. For the dia gnosis and staging 18F-FDG PET- CT was obtained. The mass was 6.5x5x4.5 cm and showed increased FDG uptake, 2,97. The lesion was considered as a large PAVM because of the linear density showing luminal contrast enhancement which was located between the lesion and right upper pulmonary vein. Dynamic contrast enhaced tomography revealed a solid mass with a suspicion of PAVM with thrombotic occlusion. Pulmonary angiography was free of AVM and fistulae. The patient underwent right upper lobectomy. Pathologic studies were consistent with pulmonary AVM. This case is presented because of upper lobe involvement, normal pulmonary angiography and the need of surgical operation as the only diagnostic tool

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Granülamatosis Polianjitis tanılı beş olgunun Pozitron Emisyon Tomografisi ile değerlendirilmesi

Granülomatöz Polianjitis (GPA) eski adıyla Wegener Granülomatozu, öncelikle üst solunum yolları, akciğer ve böbrekleri tutan, granülomatöz nekrotizan vaskülit ile karakterizedir. Hastalığın 'sınırlı' ve 'yaygın' olmak üzere iki formu vardır. Radyolojik bulguları birkaç milimetreden santimetreye kadar değişen çok sayıda bilateral nodüller veya parankimal infiltrasyonlar, kavitasyonlar veya kavitasyonlarla karakterize nodüller olarak görülür. Bu nodüller bazen boyut ve görünüm açısından malignite ile karışabilir. Bu çalışmada, maligniteyi taklit eden GPA tanısı alan 5 olgunun ilk değerlendirmesinde pozitron emisyon tomografisi / bilgisayarlı tomografinin (PET / BT) rolünü tartışmayı amaçladıkGranulomatosis with polyangiitis (GPA) formerly Wegener’s Granulomatosis, is characterized by granulomatosis necrotizing vasculitis that primarily involves upper respiratory tracts, lung and kidney. There are two types of disease, ‘limited’ and ‘generalized’. Radiological findings are seen as multiple bilateral nodules that change from a few millimeters to centimeters in size or parenchymal infiltrations, cavitations or nodules presented with cavitations. These nodules sometimes can be confused with malignancy in terms of the size and appearance. In this study, we discussed the role of positron emission tomography/computerized tomography (PET/CT) in the initial evaluation of patients with the diagnosis of GPA mimicking malignanc

Starry Sky Sign: A Prevalent Sonographic Finding In Mediastinal Tuberculous Lymph Nodes

Background and Objectives: We report a prevalent finding in tuberculous lymphadenitis (TL): Starry sky sign, hyperechoic foci without acoustic shadows over a hypoechoic background. Materials and Methods: We retrospectively searched the database for a possible relationship of starry sky sign with a specific diagnosis and also the prevalence and accuracy of the finding. Results: Starry sky sign was found in 16 of 31 tuberculous lymph nodes, while none of other lymph nodes (1,015 lymph nodes) exhibited this finding; giving a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 51.6%, 100%, 100%, 98.5%, and 98.5%, respectively. Conclusion: Bacteriologic and histologic findings are gold standard in the diagnosis of tuberculosis, but this finding may guide the bronchoscopist in choosing the more pathologic node within a station and increase the diagnostic yield as it may relate to actively dividing mycobacteria.PubMedWo

Computed tomography findings of organizing pneumonia

Objective: In this study, we aimed to present computed tomography (CT) findings of 100 patients with histopathologically confirmed organizing pneumonia. Design: Retrospective study Setting: Ankara Atatürk Chest Diseases And Chest Surgery Training And Surgery Hospital, Ankara, Turkey Subjects: One hundred histopathologically confirmed organizing pneumonia patients between 2009 and 2013 admitted to our clinic. Intervention: A chest CT scan and the histopathological examination of the lung lesions of the patients were performed. Main outcome measure: The frequency and the types of CT findings of the patients with proven organizing pneumonia were examined. Results: Among 100 patients, 73 were male and 27 were female, and the mean age of the patients was 60±11 (range:19-90) years. Pulmonary consolidation was detected in 87 patients and ground-glass opacity was seen in 76 patients. Multiple nodules were seen in 20 patients while a solitary nodule was seen in 15 patients. Acinar nodular pattern was detected in 29 patients, micronodular pattern in 28 patients, bronchocentric pattern in 33 patients, perilobular pattern in 14 patients, progressive fibrotic pattern in 8 patients and reversed halo sign in 12 patients. Lymph node enlargement was seen in 80 patients. Conclusion: Computed tomography is very important for the diagnosis of organizing pneumonia which has various radiological findings. © 2022, Kuwait Medical Association. All rights reserved

Adhesion Formation and Intraperitoneal Catheters

OBJECTIVE: Aim of the present study was to determine effect of silicone and polyvinyl chloride in a rat model. STUDY DESIGN: A randomised blind study was performed using a rat model of laparotomy. Setting: Surgical Research laboratory in a university medical school. İntervention(s): Fifty four rats were divided into three groups:Group 1 (n:18),simple laparotomy; and group 2 (n:18) polyvinyl chloride were placed intraperitoneally;Group 3 (n:18),silicone was placed intraperitoneally. Main outcome measure(s): Three weeks after laparotomy,repeat laparotomy was performed and the adhesions were scored. RESULT General adhesion scores in groups 2 and 3 were higher than in group 1 (p<0.05). İn group 1, none of the rats presented adhesion.The results for groups 2 and 3 were similar. CONCLUSIONS: The overall adhesions score did not differed significantly between groups 2,3.Silicone and polyvinyl chloride causes adhesion development in rat model

Effect of Ovulation Induction on Ovarian Histologies in a Rat Model

OBJECTIVE: To examine the effect of human menopausal gonadotropin(HMG) and follitropinBeta (rFSH) on the ovarian histologies in a rat model. STUDY DESING:Thirty-nine female, one-year old rats were enrolled for the trial. They were divided into three groups. In the first group, 13 rats received, six cycles of ovulation induction with human menapausal gonadotropin.In the second group, 13 rats received six cycles of ovulation induction with folitropin beta the third study group consisted of 13 rats which received six cycles of saline intramuscularly. RESULT: The mean number of the cells that stained positive for Ki-67 was 42.3±20.6, 44.9±27.3and 42.5±24.8 in the folicles, respectively.The mean number of cells that stained positive for Ki-67 in epithelium was 0.15±0.42, 0.04±0.14,0.05±0.18, respectively. The mean dysplasiascore was 2.46±2.10, 1.69±13 and 1.62±1.89 in the ovarian epithelial cells respectively. CONCLUSION:Development of malignant lesion were not found in any of the rat ovaries after ovulation induction. As a result of this study, we found out that human menapausal gonodotropin and folitropin beta used in treatment of infertility, when administered for six cycles in accordence with the dosage determined, do not have the potential to develop neoplasia in rats

Effects of Spray Gel Compared with The Methods of Using Interceed Seprafilm and Ringer Lactate for The Prevention of The Postoperative Adhesions

OBJECTIVE: To compare the spray gel with the methods of using interceed, seprafilm or intraperitoneal lavage with ringer lactate, which are used to prevent the postoperative adhesions. STUDY DESIGN: The rats were randomly divided into 5 groups each including 10 rats. Laparatomy was performed via lower median incision. The first group (group 1) served as the control (nothing was given to prevent the adhesion). In group 2, 4 cc. Ringer lactate solution was instilled into the peritoneal cavity before abdominal closure. In group 3 Interceed (2 x 3 cm) was placed to the adhesion region. In the group 4 Seprafilm (2 x 3 cm) was used for to prevent adhesions. In the last group (group 5) spray gel was used 1 - 2 cc. to form 2 mm. thickness on the cauterized surface..Statistical evaluation was made using analysis of variance Kruskal - Wallis and Mann - Whitney U Tests and the results were accepted to be significant if the P<0.01. RESULTS: The postoperative average adhesion scores were found significantly decreased on the ringer lactate (p=0,00l), interceed (p=0,00l), seprafilm (p<0,001) and spray gel (p<0,001), groups compared to the control group.There were no statistical significant differences between the average adhesion scores of the groups which used spray gel: ringer lactate (p=0,473), interceed (P=0,888), and seprafilm (p= 1 ,000).(P>0,005). CONCLUSION: The effectiveness of the spray gel for the prevention of adhesion formation is found similar to the methods of ringer lactate, interceed and seprafilm

Türkiye’de akciğer kanserinde genetik mutasyonların bölgesel dağılımı (REDIGMA)

Introduction: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. Materials and Methods: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients’ biopsy materials. Results: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p< 0.000, p< 0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient’s age, area of residence, comorbidity and clinical stage and mutation frequency. Conclusion: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African–American and Caucasian patients, and was lower than in East Asia.Giriş: Akciğer kanserinde standart kemoterapinin sonuçları çok tatmin edici değildir, bu nedenle hedefe yönelik tedavileri sağlayan genetik mutasyonları belirlemek önemlidir. Son raporlar, ırksal farklılığın ve bölgesel değişikliğin akciğer kanserinde mutasyon sıklığı üzerindeki etkilerini göstermiştir. Çalışmamızda küçük hücreli dışı akciğer kanseri (KHDAK)'nde genetik mutasyonların Türkiye'deki sıklığını ve bölgesel dağılımını belirlemeyi amaçladık. Materyal ve Metod: Türkiye'de akciğer kanserinde genetik mutasyonların bölgesel dağılımı (REDIGMA) çalışması, akciğer kanseri hastalarının takip edildiği ve hastaların biyopsisinde genetik mutasyon analizi yapılabilecek çok sayıda merkezde prospektif, kesitsel ve gözlemsel bir çalışma olarak gerçekleştirildi. Bulgular: Çalışmaya 25 farklı merkezden KHDAK tanısı konan 703 hasta (%77.7 erkek, ortalama yaş 63.3 ± 12.5 yıl) alındı. Hastalardan alınan tümör örnekleri %87.1 adenokarsinom, %6.4 skuamöz hücreli karsinom ve %6.5 diğer olarak bildirildi. Mutasyon testleri bu hastaların %18.9'unda pozitif bulundu. Mutasyonlar %69.9 EGFR, %26.3 ALK, %1.6 ROS ve %2.2 PDL idi. Mutasyonlar kadınlarda ve sigara içmeyenlerde istatistiksel olarak daha yüksek tespit edildi (p< 0.000, p< 0.001). Yine, adenokarsinomdaki mutasyonların sıklığı metastatik hastalıkta daha yüksekti. Hastanın yaşı, ikamet alanı, komorbiditesi, klinik evresi ve mutasyon sıklığı arasında farklılık saptanmamıştır. Sonuç: Çalışmamızın sonucunda Türkiye geneli mutasyon pozitifliği literatür ile karşılaştırıldığında Türkiye’de KHDAK'lı hastalarda EGFR mutasyon oranının Doğu Avrupa, Afrikalı-Amerikalı ve Kafkasyalı hastalara benzer ve Doğu Asya'dan daha düşük olduğu ortaya koyulmuştu