Tansiyon pnömotoraksı taklit eden dev bül

Göğüs grafisinde, tansiyon pnömotoraksı, bir hemitoraksta geniş radyolüsenite ve mediastinal yapıları karşı tarafa itmiş olarak izleriz. Dev bül de geniş radyolüsen görünümü ve mediastinal şift oluşturarak tansiyon pnömotoraksı taklit edebilir. Sunduğumuz olgu dev akciğer bülü olan 35 yaşında bir kadındır. Dev bül acil serviste tansiyon pnömotoraks olarak teşhis edilerek göğüs tüpü takılmıştır. Tansiyon pnömotoraks ile dev bülü ayırt etmek çok zordur. Bu iki çok benzer antitenin tedavileri tamamen farklıdır. Bundan dolayı anamnez, fizik muayene ve radyolojik incelemede, doğru tanı için çok dikkatli olmalıyız.In the chest X-ray, we observe tension pneumothorax (TPX) as wide radiolucent view in a hemithorax and pushing the mediastinal structures contralateral. Giant bulla may mimic TPX with wide radiolucent view and mediastinal shift. The present report includes giant pulmonary bulla in 35-year-old woman. The giant bulla was diagnosed as a TPX in emergency, and chest tube was performed. The differentiation between TPX and a giant bulla may be very difficult. The therapies of these two similar entities are completely different. So that, we must be careful about anamnesis, physical examination and radiology for true diagnosis

Hemitoraksta dev liposarkom

Obezitesi olan 57 yaşındaki kadın hasta, şiddetli dispne ve göğüs ağrısı yakınması ile acil servise başvurdu. Hastanın akciğer grafisinde sol hemitoraksı tamamen kapatan opasite ve sağ mediastinal şift saptandı. Bilgisayarlı toraks tomografisinde sol hemitoraksı tamamen dolduran ve mediastinal kaymaya neden olan heterojenik yoğunlukta dev kitle izlendi. Liposarkomun komplet cerrahi rezeksiyonu yapıldı. Cerrahi sonrası yapılan patolojik inceleme sonucu plevral liposarkom olarak bildirildi. Bu yazıda plevral liposarkom tedavisi literatür eşliğinde tartışıldı.A 57-year-old female with obesity was admitted to the emergency service with the complaint of severe dyspnea and chest pain. Chest X-ray showed opacity occupying left hemithorax completely and the right mediastinal shift. Thoracic computed tomography indicated a heterogeneous density of a giant mass in the left hemithorax and right mediastinal shift. Complete surgical resection of the liposarcoma was performed. The pathological examination following surgery suggested pleural liposarcoma. In this article, treatment of pleural liposarcoma was discussed in the light of literature review

Our cases of sarcoidosis diagnosed by mediastinoscopy; Western black sea experience [Mediastinoskopi ile tanı konulan sarkodioz olgularımız; Batı karadeniz deneyimi]

Aim: Sarcoidosis is a multisystemic disease, characterized by noncaseating granuloms, the aetilogy remains unknown. We have stated that sarcoidosis diagnosis used by mediastinoscopy and our patients evaluated by stage and clinical features. Material and Method: 38 cases with a diagnosis of sarcoidosis by mediastinoscopy in our, clinics (University Hospitals of Western Black Sea) were retrospectively analyzed. Cases was staging according to posteroanterior chest x-rays. Admission complaints,Pulmonary Function Tests, diagnostic methods, disease stages, co-morbid diseases, clinical and laboratory features of the patients were assessed. Results: 26 of the patients were female, 12 were male. Mean age was 49 and age range was between 24-71 years. Most common complaint at appeal was cough, and the most common radiological stage was 2. The most common biopsy taken from the lymph nodes was right paratracheal (2R, 4R), the least common was the left paratracheal lymph nodes. There was no mortality. Complications developed 3 patients. Discussion: Sarcoidosis diagnoses usually settled was in stage 2 with hilar lymphadenomegalia and lung parenchymal infiltration. Mediastinoscopy in the diagnosis of sarcoidosis with mediastinal lymph node biopsy is an effective procedure with quick results, low morbidity and mortality rates. © 2012, Derman Medical Publishing. All rights reserved

Mediastinoskopi ile tanı konulan sarkodioz olgularımız; Batı Karadeniz deneyimi

Amaç: Sarkoidoz etyolojisi bilinmeyen, sistemik tutulum gösteren ve nonka-zeifiye granülomlarla seyreden bir hastalıktır. Sarkoidoz tanısını mediasti-noskopi ile koyduğumuz hastalarımızı evreleri ve klinik özellikleri bakımından değerlendirdik. Gereç ve Yöntem: Kliniklerimizde (Batı Karadeniz Üniversite Hastanelerinde) mediastinoskopi ile sarkoidoz tanısı alan 38 olgu geriye dö-nük olarak incelendi. Olgular posteroanterior akciğer grafilerine göre evre-lendirildi. Hastaların başvuru şikayetleri, solunum fonksiyon testleri, tanı yön-temleri, evreleri, eşlik eden hastalık varlığı, klinik ve laboratuar özellikleri de-ğerlendirildi. Bulgular: Hastaların 26’sı kadın 12’si erkeklerden oluşmaktaydı. Ortalama yaş 49 yıl iken yaş aralığı ise 24-71 yıl idi. En sık başvuru şikayeti öksürük olarak tespit edildi, en sık radyolojik evre ise evre II idi. En sık sağ pa-ratrakeal lenf nodlarından biopsi (2R,4R) alınırken en az sol paratrakeal lenf nodlarından biopsi alındı. Mortalite izlenmedi. 3 hastada komplikasyon geliş-ti. Sonuç: Sarkoidoz tanısının genelde hiler lenfadenomegali ve akciğer pa-rankiminde infiltrasyonun bulunduğu evre II’de konulduğu görüldü. Sarkoidoz tanısında mediastinoskopi ile mediastinal lenf nodu biopsisi hızlı sonuç veren ve düşük morbidite ve mortalite ile etkili bir yöntemdir.Aim: Sarcoidosis is a multisystemic disease, characterized by noncaseating granuloms, the aetilogy remains unknown. We have stated that sarcoidosis diagnosis used by mediastinoscopy and our patients evaluated by stage and clinical features. Material and Method: 38 cases with a diagnosis of sarcoidosis by mediastinoscopy in our clinics (University Hospitals of Western Black Sea) were retrospectively analyzed. Cases was staging according to posteroanterior chest x-rays. Admission complaints,Pulmonary Function Tests, diagnostic methods, disease stages, co-morbid diseases, clinical and laboratory features of the patients were assessed. Results: 26 of the patients were female, 12 were male. Mean age was 49 and age range was between 24-71 years. Most common complaint at appeal was cough, and the most common radiological stage was 2. The most common biopsy taken from the lymph nodes was right paratracheal (2R, 4R) , the least common was the left paratracheal lymph nodes. There was no mortality. Complications developed 3 patients. Discussion: Sarcoidosis diagnoses usually settled was in stage 2 with hilar lymphadenomegalia and lung parenchymal infiltration. Mediastinoscopy in the diagnosis of sarcoidosis with mediastinal lymph node biopsy is an effective procedure with quick results, low morbidity and mortality rates

Mediastinal kitleler; Batı Karadeniz bölgesindeki 28 olgunun analizi

Amaç: Mediastinal kitleler hayati organlara yakın olması ve çeşitli histopatolojik tipler içermesinden dolayı çok önemlidir. Bu çalışmanın amacı, cerrahi olarak tanı konulan ve rezeksiyon yapılan mediastinal kitleli olguları retrospektif olarak analiz etmektir. Gereç ve Yöntem: Mayıs 2008-Aralık 2011 tarihleri arasında, Batı Karadeniz bölgesinde ki üniversite hastaneleri göğüs cerrahisi kliniklerimizde mediastinal kitle nedeniyle operasyon uygulanan 28 hasta retrospektif olarak incelendi. Olgular yaş, cinsiyet, şikâyet, klinik ve radyolojik bulgular, cerrahi yaklaşım, histopatolojik tanı, postoperatif komplikasyon ve mortalite açısından incelendi. Olguların yaş aralığı 31-76 arasında (ortalama: 52,07) ve 19’u kadın, 9’u erkek toplam 28 hastadan oluşuyordu. Başvuru şikâyetleri öksürük, göğüs ağrısı, kas güçsüzlüğü ve dispne idi. Bir olguda vena kava süperior sendromu vardı. Olguların %21,4’ü asemptomatikti. Olguların %85,72’sine komplet rezeksiyon yapılırken, %14,28’ine ise yalnızca biyopsi yapılabildi. Postoperatif komplikasyon bir olguda görüldü ve mortalite izlenmedi. Sonuç: Cerrahi tedavi, mediastinal kitlelerin kesin tanı ve tedavisinde düşük mortalite ve morbidite oranı ile güvenilir bir yöntemdir.Aim: Mediastinal masses are important because they are adjacent to vital structures and have various histopathologic types. In this study, the cases with mediastinal masses which were diagnosed by surgical approach and resected were analyzed retrospectively. Material and Method: 28 patients with mediastinal masses, who were operated in thoracic surgery clinics of Western Black Sea region universities between May 2008 and December 2011, were analyzed retrospectively. The cases were examined in terms of age, sex, complaint, clinical and radiologic findings, surgical approach, histopathological diagnose, postoperative complications and mortality. The cases are consisted of 19 woman and 9 men whose ages vary between 31 and 76 (median: 52,07). They were attended with cough, chest pain, muscle weakness and dyspnea. One patient had vena cava superior syndrome. 21,4% of patients were asymptomatic. Complete resection was made in 85,72% while only biopsy was performed in 14,28% of the cases. Postoperative complication was one patient and there was no mortality. Discussion: Operative therapy, a definitive diagnose and treatment of mediastinal masses is a reliable method with low mortality and morbidity rate

Mediastinal masses; the analysis of 28 cases in the Western Black Sea Region [Mediastinal kitleler; batı karadeniz bölgesindeki 28 olgunun analizi]

Mediastinal masses are important because they are adjacent to vital structures and have various histopathologic types. In this study, the cases with mediastinal masses which were diagnosed by surgical approach and resected were analyzed retrospectively. Material and Method: 28 patients with mediastinal masses, who were operated in thoracic surgery clinics of Western Black Sea region universities between May 2008 and December 2011, were analyzed retrospectively. The cases were examined in terms of age, sex, complaint, clinical and radiologic findings, surgical approach, histopathological diagnose, postoperative complications and mortality. The cases are consisted of 19 woman and 9 men whose ages vary between 31 and 76 (median: 52,07). They were attended with cough, chest pain, muscle weakness and dyspnea. One patient had vena cava superior syndrome. 21,4% of patients were asymptomatic. Complete resection was made in 85,72% while only biopsy was performed in 14,28% of the cases. Postoperative complication was one patient and there was no mortality. Discussion: Operative therapy, a definitive diagnose and treatment of mediastinal masses is a reliable method with low mortality and morbidity rate

Chylothorax due to leukemic infiltration in a patient with chronic lymphocytic leukemia

Chylothorax is characterized by accumalation of milky fluid called chyle into the plural space. Most common causes of cyhlothorax are trauma or surgery of thoracic duct and malignancies. Among the malignancies lymphoma is responsible approximately 70% of cyhlothorax but other lymphocytic tumors including chronic lymphocytic leukemia (CLL) is rarely reported. A 71 years old man with known CLL, presented with dispnea and pleural effusion and diagnosed cyhlothorax due to leukemic infiltration that confirmed by immuno flow cytometric analyse

SOLITARY PULMONARY NODULE DUE TO COMPLICATED COAL WORKER'S PNEUMOCONIOSIS WITHOUT MINOR OPACITY

Komplike kömür işçisi pnömokonyozu (KİP) akciğer dokusunda 1 cm veya daha büyük pnömokonyoza bağlı nodüllerin varlığı olarak tanımlanır ve basit pnömokonyoz zemininde gelişir. Minör opasite olmaksızın komplike KİP ortaya çıkması beklenen bir durum değildir. Biz de minör opasite olmaksızın tek nodülle ortaya çıkan ve nodülün karakteristik özellikleri açısından öncelikle pnömokonyoz dışı nedenlere bağlı pulmoner nodülü akla getiren ilginç bir komplike KİP olgusunu sunmayı amaçladık. Altmış beş yaşında erkek hastanın 25 yıl kömür madeninde çalıştığı ve daha sonra emekli olduğu öğrenildi. Akciğer grafisinde belirgin bir patoloji tespit edilmedi. Hastanın toraks tomografis'nde sol akciğer alt lob laterobazal segmentte 16 mm çaplı subplevral nodül görüldü. Bronkoskopide bronş mukozasında bir kaç adet antrakotik pigmentasyon görüldü. Hastaya tanı ve tedavi açısından videotorakoskopi yardımlı akciğer cerrahisi ile birlikte wedge rezeksiyon yapıldı. Akciğer wedge rezeksiyon materyalinin patololojik incelemesinde ardışık bant tarzında dizilim gösteren karbon pigment birikimlerinin yer aldığı iyi sınırlı nekrobiyotik nodül tespit edildi ve hastaya KİP tanısı koyuldu. Takip altına alınan hastanın en son çekilen tomografisinde (cerrahiden 1 buçuk yıl sonra) yeni bir lezyon veya progresyon tespit edilmedi. Sonuç olarak komplike KİP'in beklenmedik yerlerde ve beklenmedik radyolojik görünümlerde ortaya çıkabileceği unutulmamalı, soliter pulmoner nodülleri olan hastalarda mutlaka meslek öyküsü sorgulanmalı ve invazif girişimlere karar vermeden önce hasta bu açıdan da değerlendirilmelidir.Complicated coal worker's pneumoconiosis (CWP) was defined the nodules that equal or greater than 1cm Complicated CWP was developed on the basis of simple pneumoconiosis. Complicated CWP without minor opacity was seen very rarely. We aimed to introduce an interesting case of complicated CWP without minor opacity that suggest the nonpneumoconiosis diseases. Sixty five age years old patient was retired from coal mine. There was no pathological view on chest x-ray. In computed thorax tomography there was 16mm diameter of pulmonary nodule in laterobasal segment of lower lobe of left lung. A few anthracotic pigmentation on bronchus mucosa were determined in bronchoscopy. Videoassociated thoracoscopic surgery was performed. Carbon pigmentation was seen in the surgical material of pulmonary nodule. The patient was followed up for 1.5 years. At the end of the follow up period there were no pathological view in control computed thorax tomography. In conclusion complicated CWP may have seen in varied radiological view and different areas of the lung. In the patients with solitare pulmonary nodule occupational history should be questioned attentively and before the invazive interventions the patients should be evaluted in this respect