e-ISSN 2147-2475
Cilt : 11 Say : 3 Yl : 2023

Hzl Arama




RESPIRATORY CASE REPORTS - Respir Case Rep: 11 (3)
Cilt: 11  Say: 3 - Ekim 2022

OLGU SUNUMU
1.
ki Taraftan Bak: Trakeozafegeal Fistl
Viewing from both Sides: Tracheoesophageal Fistula
Ouz Karcolu, Serkan Uysal, Ula Kumbasar, Fuad Mustafayev, Ziya Toros Seluk
doi: 10.5505/respircase.2022.29863  Sayfalar 116 - 118
Erikinlerde malign olmayan trakeozofageal fistller genellikle entbasyon sonras komplikasyonlar nedeniyle ortaya kar. ay nce kafa ii kanama sonras uzam entbasyon nedeniyle trakeostomi ve beslenme sorunlar nedeniyle gastrostomi ykleri olan 80 yanda kadn hasta tekrarlayan ate ve youn kvaml sekresyon art nedeniyle bavurdu. Bilgisayarl toraks tomografisinde saptanan pheli trakeozofageal fistl (TF) bronkoskopi ve endoskopi ile doruland. Bronkoskopide hem fazla iirilmi cuff hem de zefagus kaslmalaryla alp kapanan TF izlendi. Ameliyata uygun bulunmayan hastaya stent yerletirilmesi hasta yaknlarn tarafndan kabul edilmedi. Hasta gastrostomi hattndan jejunostomi kateteri gnderilerek ve refly engellemek iin en az 45 derece dik konumda tutulmas nerileriyle taburcu edildi.
Non-malignant tracheoesophageal fistulas in adults often occur due to complications after intubation. We present an 80-year-old female patient who was consulted because of fever and increased thicky secretions that need frequent. An intracranial hemorrhage 3 months earlier led to her undergoing a tracheostomy and gastrostomy due to the resulting prolonged intubation and nutritional issues. Both bronchoscopy and endoscopy confirmed the presence of a tracheoesophageal fistula (TEF) detected on computed thorax tomography. In bronchoscopy, TEF, which was opened and closed by both over-inflated cuff and esophageal contractions, was observed. She was not a candidate for surgery, and her relatives declined an esophageal stent placement. We managed the case by sending a jejunostomy catheter through the gastrostomy tube and positioning at least 45 degrees to minimize the reflux.

2.
Nivolumab likili Trakeazefagial Fistl
Tracheoesophageal Fistula Associated with Nivolumab
Aye Bahadr, Sibel Yurt, Mehmet Akif zgl, Muhammet Atf Karagl, Levent Arafat
doi: 10.5505/respircase.2022.70846  Sayfalar 119 - 122
Trakea ve zafagus arasnda patolojik bir balant olmas trakea-zafagiyal fistl (TF) olarak adlandrlr, doutan veya bening ya da maling nedenlere bal sonradan oluabilmektedir. TF, akcier ve zefagus kanserlerinde kemoradyoterapi sonras veya mediastinal invazyon nedeni ile gelien, yksek morbidite ve mortaliteye neden olan bir komplikasyondur. Son yllarda Non-small cell akcier kanseri (NSCLC) tedavisinde immun kontrol inhibitr (ICI) ilalarn kullanmnn artna bal nadir grlen yan etkiler ortaya kmakta ve olgu baznda bildirilmektedir. Yetmi sekiz yanda bir yl nce NSCLC tans ile sol pnmonektomi olan olgumuzda mediastene invaze kitlenin zafagusa bassna bal disfaji nedeni ile iki ay nce zafagusa stent uygulama ve nivolumab kullanm yks vard. Yatnn ilk haftasnda hastada TF geliti. Trakeaya stent yerletirilmesi dnlen olgumuz, masif hemoptizi gelimesi nedeni ile eksitus oldu. Ayrc tan sonras ICI ilaa bal yan etki olarak TF gelitii dnld. Nadir bir yan etki olarak grlmesi nedeni ile olgumuzu literatr bilgileri ile sunmak istedik.
Tracheoesophageal fistula (TEF) is a pathological connection between the trachea and the esophagus that can be congenital or can develop in older ages as a result of benign or malignant causes. It develops as a result of mediastinal invasion or after chemoradiotherapy in lung and esophageal cancers, and is associated with high mortality and morbidity. TEF has been reported in the past to be a rare side effect of immune control inhibitor (ICI) drugs used for the treatment of non-small cell lung cancer, and several cases have been reported. A 78-year-old patient who underwent a left pneumonectomy after being diagnosed with NSCLC one year earlier had a history of esophageal stenting and Nivolumab use two months previously to relieve the pressure of a mediastinum mass invading the esophagus that was causing dysphagia in the patient. The patient developed TEF in the first week of hospitalization, which was thought to be a side effect of the ICI drugs. Our case, who was thought to place a stent in the trachea, died after developing massive hemoptysis. We present this case of the development of TEF to literature due to its rarity as a side effect of ICI drugs.

3.
Rotmund Thompson Sendromu: Aspirasyon Pnmonisi ile Prezente Olan Bir Olgu
Rothmund Thompson Syndrome: A Case Report Presenting with Aspiration Pneumonia
Halil brahim Yakar, Handan Inonu Koseoglu, Ahmet Cemal Pazarl, Gkhan Aykun, Mustafa Parti, Hacer Kln
doi: 10.5505/respircase.2022.68736  Sayfalar 123 - 126
Rothmund Thompson Sendromu (RTS) olduka nadir grlen bir sendromdur. ki klinik alt formu tanmlanmtr: poikiloderma, ektodermal displazi ve jvenil katarakt ile karakterize RTS-I formu ve konjenital kemik defektleri, ocuklukta artm osteosarkom ve cilt kanseri riski ile karakterize RTS-II formudur. Burada sunulan hasta, kemik deformiteleri, cilt kanseri yks ve gelime gerilii nedeniyle RTS-II formu idi. Hasta, iki gndr balayan nefes darl ve hrlt ikayeti ile hastanemize bavurdu. Posteroanterior akcier grafisinde ve toraks bilgisayarl tomografide sa akcierde total atelektazi, zefagusda ileri dzeyde dilatasyon ve zefagus distalinde obstrksiyon izlendi. Aspirasyon pnmonisi tansyla, antibiyoterapi, oksijen tedavisi ve destek tedavi baland. Tedavi altnda iken, kanama bozukluu nedeniyle alveolar hemoraji ve hematri geliti. Destek tedaviye ramen oklu organ yetmezlii (solunum yetmezlii, bbrek yetmezlii, pansitopeni) gelien hasta 8. gnde exitus oldu. Olgu RTS hastalarnda kanamaya eilim ve aspirasyon pnmonisi geliimine dikkat ekmek adna sunulmutur.
In the few studies of Rothmund Thompson Syndrome (RTS) to date in literature, two clinical subforms have been identified: the RTS-I form, characterized by poikiloderma, ectodermal dysplasia and juvenile cataract; and the RTS-II form, characterized by congenital bone defects, increased risk of childhood osteosarcoma and skin cancer. We present here a case with the RTS-II form with bone deformities, history of skin cancer and growth retardation. The patient was admitted to our hospital with complaints of dyspnea for two days. Total atelectasis in the right lung and severe dilatation and obstruction in the distal esophagus were observed on a posteroanterior chest X-ray and thorax computed tomography, and antibiotherapy, oxygen therapy and supportive treatments were initiated after a diagnosis of aspiration pneumonia was made. Alveolar hemorrhage and hematuria developed during follow up due to bleeding disorder. Despite supportive treatment, the patient developed multiple organ failure (respiratory failure, renal failure, pancytopenia), and died on the 8th day of hospitalization. We present this case study to draw attention to the risk of bleeding tendency and aspiration pneumonia in RTS patients.

4.
nsidental Bir Broniyal Atrezi Olgusu
A Case of Incidental Bronchial Atresia
Aye Baha, Ugurcan Balyemez
doi: 10.5505/respircase.2022.21298  Sayfalar 127 - 131
Broniyal atrezi nadir grlen bir durumdur. Radyolojik olarak genellikle perihiler kitle lezyonu ve periferal havalanma art eklinde karmza kar. Yirmi dokuz yanda asemptomatik erkek hastann i bavurusu srasnda yaplan salk taramasnda ekilen akcier grafisinde sa perihiler kitle saptanm. Kliniimize bavuru ncesinde hastaya kontrastsz toraks tomografisi (BT) ve PET-CT ekilmi. Fizik muayenesi normal olan hastaya kontrastl toraks BT ektik, sa santral kitle ve periferinde hava hapsi saptadk. Solunum fonksiyon testi normaldi. Bronkoskopide tm bronlar akt, sa st lob posterior segment giriinde kk kr sonlanan orifis grld. Bu olguyu, radyolojik olarak kanser le karabilmesi ve nadir grlmesi nedeniyle sunmak istedik. Kitle imaj ve periferik hava hapsi ile karakterize olan broniyal atreziye klinik ve radyolojik olarak tan koyulabilir ve gereksiz invazif giriimlerden kanlabilir.
Bronchial atresia (BA) is a rare condition that appears radiologically as a perihilar mass lesion and increased peripheral aeration. A 29-year-old asymptomatic male patient was identified with a right perihilar mass during a routine medical examination linked to a job application. Before applying to our clinic, the patient had had undergone non-contrast thoracic CT and PET-CT. Physical examination was normal, while contrast-enhanced thorax tomography revealed a right central mass and signs of air trapped in its periphery. A pulmonary function test was normal. All bronchi were open on bronchoscopy, however a small blunt orifice was observed at the right upper lobe posterior segment entrance. We present this case due to it being a rare condition and the potential for confusion with cancer radiologically. BA with mass image and increased peripheral aeration on thorax CT can be diagnosed based on clinical and radiological findings, allowing unnecessary invasive interventions to be avoided.

5.
Bbrek Nakil Alcs Olan Bir Hastada Rhodococcus equi likili Bakteriyemi ve Kaviter Akcier Lezyonu: Nadir Bir Olgu Sunumu
Rhodococcus equi Related Bacteremia and Cavitary Lung Lesion in a Patient Receiving Renal Transplant: A Rare Case Report
Furkan Kangl, Handan Kangl, Hadice Selimolu en, Sreyya Ylmaz, Nurullah Uzuner
doi: 10.5505/respircase.2022.54366  Sayfalar 132 - 137
Rhodococcus equi is HIV pozitif ve organ nakil alcs olan immunspresif hastalarda zellikle tberkloz ile sklkla karan kaviter akcier infeksiyonuna neden olan nadir bir etkendir. Altm dokuz yanda bbrek transplant alcs ve immnspresif tedavi alan erkek hasta 6 aydr devam eden kilo kayb, ksrk ve hemoptizi semptomlar olmas zerine d merkeze bavurmu. ekilen bilgisayarl tomografide sol akcier alt lob st segmentte kavite saptanm. Malignite dnlmesi zerine PET-CT ekilmi ve yksek SUV-max tutulumu tespit edilmi. Hasta hastanemize bavurduunda mevcut ikayetleri devam etmekteydi. Alnan Bronkoalveolar Lavaj kltrnde ve kan kltrlerinde R. equi remesi oldu. Hasta entbe edilerek mekanik ventilatr ile takip edildi. Kontrol ETA (endotrakeal aspirat) kltrnde A. baumannii remesi oldu. Bunun zerine tedaviye kolistin de eklendi. Hasta tedavisinin 23. gnnde kolistine bal nefrotoksisite nedeniyle exitus oldu. Bildiimiz kadaryla bu olgu lkemizde R. equi kaviter pnmonisinin R. equi bakteriyemisi ile birlikte grld ilk olgudur.
Rhodococcus equi is a rare cause of cavitary lung infection that is often mistaken for tuberculosis in immunosuppressed patients who are HIV positive and in organ transplant recipients. A 69-year-old male kidney transplant patient was admitted to an external healthcare center with complaints of weight loss, cough and hemoptysis that had started 6 months earlier. A computed tomography revealed a cavity in the upper segment of the left lung lower lobe, and a PET-CT revealed a high SUV-max uptake. Upon application to our hospital, the same symptoms were identified, along with R. equi growth observed in Bronchoalveolar Lavage and blood cultures. The patient was followed up with mechanical ventilator as intubated. Acinetobacter baumannii grew in the control ETA (endotracheal aspirate) culture on the 6th day of hospitalization, and he died subsequently on the 23rd day of hospitalization from colistin-induced nephrotoxicity. To the best of our knowledge this is the first case in which R. equi cavitary pneumonia has been seen together with R. equi bacteremia in our country.

6.
nc Trimester Gebede COVD-19 a Bal ARDS Geliimi ve Baarl Multidisipliner Olgu Ynetimi
Development of ARDS due to COVID-19 in a Pregnant Woman in the Third Trimester and Successful Multidisciplinary Case Management
lker Ylmam, Pervin Hanc
doi: 10.5505/respircase.2022.43179  Sayfalar 138 - 142
Gebe hastalarda COVID-19 hastal, gebeliin getirmi olduu fizyolojik deiiklikler nedeni ile daha ciddi seyredebilmektedir. ou COVD-19lu gebe hastamz, hastane yatna gerek duyulmadan ayaktan takip edilmekle birlikte, zellikle 3. trimesterde artan immnsupresyon, hastann asz olmas gibi risk faktrleri varlnda, olgumuzda olduu gibi COVD-19 enfeksiyonu hzl progresyon gsterip solunum yetmezliine neden olabilir. Gebeliinin 3. trimesterinde olan hastamzn yatnn 3. gnnde COVD-19 pnmonisine bal youn bakm ihtiyac gstermesi zerine multidisipliner bir yaklam ile nce acil doum operasyonu gerekletirildi ve hasta postop youn bakm nitesinde mekanik ventilasyonda takip edildi. Hastamz, gebeliinin 3. trimesterinde ciddi seyreden COVD-19 hastalna bir rnek tekil etmesi nedeni ile sunmak istedik.
The course of COVID-19 disease may be more severe in pregnant patients due to the physiologic changes induced by pregnancy. Although most pregnant patients with COVID-19 are followed up as outpatients, requiring no hospitalization, COVID-19 infection, especially in the presence of risk factors such as increased immunosuppression in the third trimester and lack of vaccination, can progress rapidly and lead to respiratory failure, as in our case. Our patient was in the third trimester of her pregnancy, and required intensive care due to COVID-19 pneumonia on the third day of hospitalization, and an emergency delivery was performed initially with a multidisciplinary approach. The patient was then followed up in the respiratory intensive care unit under mechanical ventilation. Our patient is a remarkable example of severe COVID-19 disease in the third trimester of pregnancy.

7.
COVID-19 Pandemisinde Buzlu Cam Ayrc Tans: Bir Olgu Sunumu
Ground Glass Opacities Differential Diagnosis in COVID-19 Pandemic: A Case Report
Ceren Degirmenci
doi: 10.5505/respircase.2022.44711  Sayfalar 143 - 146
Pandemi, doktorlarn tm viral pnmonileri birinci n tan olarak COVID-19 olarak deerlendirmeye yatkn hale getirmitir. COVID-19'un kesin tans, pozitif bir RT-PCR testi ile konur, ancak bazen RT-PCR test sonular negatif olan, fakat COVID-19'u gsteren toraks BT bulgular olan olgular da vardr. Bu nedenle, COVID-19 tedavilerinden fayda grmeyen hastalarda ayrc tanda immnsupresif sebeplerin ve dier viral pnmonilerin aratrlmas ok nemlidir. Buzlu cam opasiteleri ayrc tansnda HIV enfeksiyonu saptanan bir olgu sunulmutur.
The pandemic has predisposed all healthcare professionals to assess all viral pneumonia cases preliminarily as COVID-19, with a definitive diagnosis of COVID-19 made on the basis of a positive RT-PCR result. Occasionally, however, there are cases with negative RT-PCR test results both with thoracic CT findings indicative of COVID-19. It is thus very important to consider immunosuppressive conditions and other viral types of pneumonia in the differential diagnosis in patients who do not seem to respond to COVID-19 treatments. We present her a case of HIV infection identified in a differential diagnosis of ground glass opacities.

8.
COVD-19 Pnmonisi Sonras Progresyon ile Tan Alan diopatik Pulmoner Fibrozis Olgusu
A Case of Idiopathic Pulmonary Fibrosis Diagnosed with Progression Post-COVID-19 Pneumonia
Ayegl Pehlivanlar, Tevfik zl
doi: 10.5505/respircase.2022.24540  Sayfalar 147 - 151
Hastann COVD-19 geirdikten sonraki akcier tomografisinde bilateral fibrotik odaklar mevcuttu. ki ay sonraki bavurusu tomografisi ile karlatrldnda fibrotik odaklarn bal petei lezyonlarn ncl olduu ve COVD pnmonisi sonras olaan interstisyel pnmoni (UP) paterninin meydana geldii grld. COVD-19 ncesi dispnesi olan ancak interstisyel akcier hastal tans almayan hastada mevcut lezyonlarn UP nc lezyonlar olduu ve hastalk dneminde fibroblast aktivitesinin art ve fibrotik yolaklarn tetiklenmesi ile beraber progresyon gsterdii dnld. Hasta idiopatik pulmoner fibrozis (IPF) olgusu olarak deerlendirildi. Uzun dnem kontrollerde antiinflamatuvar tedaviler ile rahatlamayan ilerleyici fibrozis saptanan COVD-19 hastalarnda eer UIP grnm gelimi ise mutlaka PF olaslnn dnlmesini ve bu yn ile hastalarn COVD-19 ncesi klinik ve radyolojik bulgularnn erken IPF asndan aratrlmasn neriyoruz.
A chest tomography taken after COVID-19 revealed bilateral fibrotic foci areas, and two months later it was seen that they had been precursors to honeycomb lesions, and that the usual interstitial pneumonia (UIP) pattern associated with post-COVID pneumonia had occurred. It was noted that the fibrotic lesions in the left lung were already present before the disease. The lesions present in the patient, who had dyspnea pre-COVID-19 but had not been diagnosed with ILD, were considered to be UIP precursor lesions that progressed with the increase in fibroblast activity and the triggering of fibrotic pathways in the course of the disease. The patient was thus diagnosed with Idiopathic Pulmonary Fibrosis (IPF). We suggest that if a UIP appearance develops in COVID-19 patients with progressive fibrosis that is not relieved by anti-inflammatory treatments in long-term examinations, the possibility of IPF should be considered, and so the clinical and radiological findings of patients pre-COVID-19 should be investigated for the early identification of IPF.

9.
COVID- 19 Ayrc Tansnda Metanol ntoksikasyonu
Methanol Intoxication in the Differential Diagnosis of COVID-19
Emine Afin, Furkan Kk, Melike Elif Kalfaolu
doi: 10.5505/respircase.2022.71542  Sayfalar 152 - 155
Metanol intoksikasyonunda merkezi sinir sistemi bulgular n planda olsa da akcierler de etkilenmektedir. Literatrde otopsi olgularnda akcier bulgular tariflenmekte olup klinik olgulara rastlanmamtr. Olgumuz, radyolojik olarak akcier demi varl olmas ve COVID-19 ayrc tansnda yer almas nedeniyle sunulmaktadr.
Although central nervous system findings are prominent in methanol intoxication, the lungs are also affected. There have been several studies in literature describing autopsy-based lung findings, while there have been no clinical cases reported on to date. We present here a case identified radiologically as pulmonary edema that was included in the differential diagnosis of COVID-19.

10.
COVID-19a Bal Diffz Alveoler Hemoraji: Olgu Sunumu
COVID-19-Associated Diffuse Alveolar Hemorrhage: A Case Report
Glbahar Darlmaz Yce, Dorina Esendal, Koray Hekimolu, Merih Tepeolu, Merref ule Akay
doi: 10.5505/respircase.2022.66587  Sayfalar 156 - 159
Diffz alveoler hemoraji, ksrk, hemoptizi, yaygn pulmoner infiltratlar, anemi ve hipoksemik solunum sknts ile karakterize bir sendromdur. Etyolojisinde akcier enfeksiyonlar da rol oynamaktadr. Enfeksiyon riski nedeniyle COVID-19 hastalarnda bronkoskopi kullanmnn kstlanmas, diffz alveoler hemorajinin COVID-19da yeterince tannamamasna neden olmaktadr. Burada SARS-CoV-2 balamnda laboratuvar, radyolojik ve bronkoskopik olarak diffz alveoler hemoraji kant olan 35 yandaki hastada SARS-CoV-2 iin nasofarengeal srnt polymerase chain reaction (PCR) testi negatif saptanm, COVID-19 tans bron lavaj ile konulabilmitir. Yksek enfeksiyon riski nedeniyle pandemi dneminde bronkoskopi kullanmnn kstlanmas, SARS-CoV-2 PCR testi negatif immnsupresif hastalarda COVID-19 tansnn yanllkla dlanmasna veya SARS-CoV-2 PCR pozitif hastalarda diffz alveoler hemoraji ve sekonder enfeksiyon gibi durumlarn yeterince tannamamasna neden olmaktadr.
Diffuse alveolar hemorrhage is a syndrome characterized by cough, hemoptysis, diffuse pulmonary infiltrates, anemia, and hypoxemic respiratory distress, and lung infections also play a role in its etiology. The restricted use of bronchoscopy in COVID-19 patients due to the risk of infection has led to the poor recognition of diffuse alveolar hemorrhage in COVID-19. We present here the case of a 35-year-old patient with laboratory, radiological and bronchoscopic evidence of diffuse alveolar hemorrhage who was diagnosed with COVID-19 by bronchial lavage. The restrictions on the use of bronchoscopy during the pandemic due to the high risk of infection has led diagnoses of COVID-19 to be mistakenly excluded in immunosuppressive patients with a negative SARS-CoV-2 polymerase chain reaction test, and the under-recognition of conditions such as diffuse alveolar hemorrhage and secondary infection in patients with a positive SARS-CoV-2 PCR.

11.
COVID-19 ile likili Plevral Ampiyemin Ynetimi
Management of COVID-19-Associated Pleural Empyema
Sevinc Citak, Mustafa Vayvada, Murat Ersin ardak, Gonca Gemen, Erdal Tasci, Kaan Kirali
doi: 10.5505/respircase.2022.54522  Sayfalar 160 - 164
Son derece bulac ve hzla yaylan koronavirs 2 (SARS-CoV 2) hastal, potansiyel olarak lmcl bir hastalk olan iddetli akut solunum sendromuna neden oldu. Akut miyokard enfarkts nedeniyle koroner arter baypas ameliyat olan hastada ameliyat sonras erken dnemde koronavirs 2 (SARS-CoV-2) pnmonisine bal akut solunum yetmezlii geliti. Hastaya mekanik ventilatr (MV) ve V-V (veno-venz) ECMO (Ekstrakorporeal Membran Oksijenasyonu) destei verildi. Takipte pnmotoraks, uzam hava kaan takiben ampiyem ve plevral kalnlama gelimesi nedeniyle dekortikasyon uygulanan olguyu sunduk.
The highly contagious and rapidly spreading coronavirus 2 (SARS-CoV 2) has been associated with the development of severe acute respiratory syndrome, a potentially fatal disease. A patient who underwent coronary artery bypass surgery for an acute myocardial infarction developed acute respiratory failure due to coronavirus 2 (SARS-CoV-2) pneumonia in the early postoperative period. The patient was placed on mechanical ventilation (MV) and V-V (veno-venous) ECMO (Extracorporeal Membrane Oxygenation) support. Here we discuss the application of decortication in the patient due to the development of pneumothorax and prolonged air leak empyema in the follow-up, and the subsequent development of pleural thickening.

12.
Gs Cerrahisinin Nadir Bir Komplikasyonu Olan Akcier Hernisi: Olgu Serisi
Lung Hernia as a Rare Complication of Thoracic Surgery: A Case Series
Serkan Bayram, Mustafa Akyl, Deniz Grer, Pelin Erdizci, Aysun Kosif, Ayse Eece Yucel, aatay Saim Tezel, Volkan Baysungur
doi: 10.5505/respircase.2022.26032  Sayfalar 165 - 169
Sunulan bu olgular, cerrahi ilemler sonras gs duvarndaki bir defektten akcier hernisi olabileceini gstermeyi amalamtr. ubat 2009 ile Haziran 2017 arasnda, ameliyattan sonra ksrk ve gs duvarnda gzle grlr ilik gelien drt hasta incelendi. Akcier hernisi, gs cerrahisinden ziyade en sk travmaya bal grlen nadir bir durumdur. Olgularmzda iki torakotomi, bir VATS ve bir tp torakostomide herniasyon grld. Olgularn tamam interkostal yerleimliydi. Pnmotoraks riski tayan bir hasta dnda tm hastalar iki hafta baskl pansuman ile takip edildikten sonra ameliyat edildi. Metotreksat kullanan bir hasta dnda postoperatif komplikasyon grlmedi. Bu hasta miyoplasti sonras komplikasyonsuz olarak taburcu edildi. Akcier hernisi gs cerrahisinin nadir grlen bir komplikasyonudur ve daima aklda tutulmaldr. Semptomatik cerrahi sonular ar ve kozmetik nedenler asndan cesaret vericidir.
The four cases presented here reveal the possibility of herniation in the lung from defects in the chest wall following surgical procedures. A review was made of four cases who developed cough and a visible swelling of the chest wall after surgery between February 2009 and June 2017. Lung hernia is a rare condition that is most commonly associated with trauma rather than thoracic surgery. In the four presented cases, the herniation occurred following thoracotomies in two cases, VATS in one case and tube thoracostomy in one case. All cases had an intercostal localization. Aside from one patient who was at risk of pneumothorax, all patients were operated after being followed up with a pressure dressing for two weeks. No postoperative complications occurred other than in one patient who was using methotrexate, and this patient was discharged without complications after myoplasty. Lung herniation is a rare complication of thoracic surgery and should always be kept in mind. Symptomatic surgery results are encouraging from the perspectives of pain and aesthetics.

13.
Posterior Mediastenin Nadir Bir Tmr: yi Diferansiye Liposarkom
A Rare Tumor of the Posterior Mediastinum: Well-Differentiated Liposarcoma
Gzde Kalbaran Ksmet, Oguzhan Okutan, Seda Mazmanolu Atlman, Ismail Ylmaz
doi: 10.5505/respircase.2022.24650  Sayfalar 170 - 175
Liposarkom erikinlerde en sk grlen yumuak doku sarkomlarndan biridir; genellikle alt ekstremitelerde ve retroperitonda ortaya kar. Miksoid, iyi diferansiye, farkllamam (dediferansiye) ve pleomorfik olmak zere eitli histolojik alt tipleri vardr. Mediastenden kaynaklanan liposarkomlar son derece nadirdir. Bu tmrler genellikle yava byrler ve asemptomatik kalrlar ancak byk boyuta ulap komu yaplara bas yaptnda semptomatik olabilirler. Bilgisayarl tomografi ve manyetik rezonans grntleme tan iin faydal veriler salar. Kesin tan iin doku biyopsisi gereklidir ve tans tipik patolojik zelliklere dayanr. Kemoradyoterapiye duyarl olmadndan tam cerrahi rezeksiyon birinci basamak tedavi seeneidir. Nks oran yksek olduundan uzun sreli takip yaplmaldr. Bu yazda ksrk ikayeti ile bavuran primer mediastinal liposarkomlu 56 yanda kadn olgu nadir grlmesi sebebiyle sunuldu.
Liposarcoma is one of the most common forms of soft tissue sarcoma in adults, and usually occurs in the lower extremities and retroperitoneum. It has several histological subtypes, including myxoid, well-differentiated, dedifferentiated and pleomorphic. Liposarcomas originating from the mediastinum are extremely rare, and usually grow slowly and remain asymptomatic, but may become symptomatic when they become large enough to press on the adjacent structures. Computed tomography and magnetic resonance imaging provide useful data for diagnosis, while tissue biopsy based on typical pathological features is required for a definitive diagnosis. Complete surgical resection is the first-line treatment option as it is resistant to chemoradiotherapy. Due to the high risk of recurrence, long-term follow-up should be continued. We present here the rare case of a 56-year-old female patient with primary mediastinal liposarcoma who presented with a complaint of cough.

14.
Metastatik Kanseri Taklit Eden Ossez Sarkoidoz Olgusu
A Case of Osseous Sarcoidosis Mimicking Metastatic Cancer
Tuba Akkale, Glden Sar, Adem Koyuncu, Ceprail imek
doi: 10.5505/respircase.2022.14892  Sayfalar 176 - 179
Kronik granlomatoz multisistem bir hastalk olan sarkoidoz sklkla akcier, lenf nodlar, cilt ve gz tutulumlar ile seyreder. Nadir olarak kemik tutulumlar da grlr. Tm kemikler etkilenebilir ancak en sk el ve ayak parmaklar gibi ksa kemikleri tutar. Vertebra tutulumu ise daha nadirdir. Asemptomatik seyirli olmas nedeni ile kemik tutulumlar genellikle tesadfen tespit edilir. Yedi yl nce pulmoner sarkoidoz tans alan ve yeni gelien bel ars ikayeti nedeniyle kliniimizde tekrar deerlendirilen 62 yanda bir ossez sarkoidoz olgusu sunduk.
Sarcoidosis is a chronic granulomatous multisystem disease that often progresses with lung, lymph nodes, skin and eye involvement, while bone involvement may occur more rarely. All bones can be affected, however, although the short bones, such as fingers and toes, are the most commonly affected, while vertebral involvement is rare. Bone involvement is usually determined incidentally due to the asymptomatic course of the disease. We present here the case of a 62-year-old female osseous sarcoidosis case who was diagnosed with pulmonary sarcoidosis seven years earlier and re-evaluated in our clinic due to recently developed low back pain.

15.
Tekrarlayan Pnmoni ile Seyreden Endobroniyal Sarkoidoz Olgusu
A Case of Endobronchial Sarcoidosis with Recurrent Pneumonia
Betl Doan, Ceyda Anar, Sheyla Uygur, Muzaffer Turan, Bunyamin Sertogullarindan, Ebru Cakir
doi: 10.5505/respircase.2022.37108  Sayfalar 180 - 184
Sarkoidoz etiyolojisi bilinmeyen, kronik, multisistemik nonkazeifiye granlomatz bir hastalktr. Tans, klinik ve radyografik bulgularn birlikteliine, tipik granlomlarn gsterilmesine dayanr ve ou zaman dier granlomatz hastalklarn dlanmasyla konulabilir. Akcier tutulumu %90 oranndadr. Sarkoidozda akcier tutulumu sklkla parankimal hastalk eklindeyken, nadiren endobroniyal kitle eklinde tutulum grlebilir. Yaklak 3 yl nce sarkoidoz tans konan ve tedavisiz izlemde olan olgumuza son bir yl iinde ayn lokalizasyonda kez tekrarlayan pnmoni yks olmas nedeniyle bronkoskopi yapld. Bronkoskopide endobroniyal lezyon grlp alnan biyopsisinde granlomatz inflamasyon saptanan hastada klinik, radyolojik bulgularla progresif sarkoidoz dnld ve steroid tedavisi baland. Ayn lokalizasyonda tekrarlayan pnmoni ile gelen ve endobroniyal tutulum gzlenen sarkoidoz olgusunu, endobroniyal kitle lezyonlarn ayrc tansnda sarkoidozu vurgulamak iin sunduk.
Sarcoidosis is a chronic, multisystem and non-caseating granulomatous disease of unknown etiology. Its diagnosis is based on a combination of clinical and radiographic findings and the demonstration of typical granulomas, and can often be made based on the exclusion of other granulomatous diseases. There is lung involvement in 90% of cases, often in the form of parenchymal disease, while involvement in the form of an endobronchial mass is a rarer condition. Our patient underwent bronchoscopy after being diagnosed with sarcoidosis around 3 years earlier, and was followed up without treatment due to a history of pneumonia that had recurred three times in the same localization in the previous year. An endobronchial lesion was identified on bronchoscopy, while a biopsy revealed granulomatous inflammation. Progressive sarcoidosis was considered based on the clinical and radiological findings and the patient was started on steroid treatment. We present this study of a case of sarcoidosis with recurrent pneumonia in the same localization and endobronchial involvement to emphasize the need to consider sarcoidosis in the differential diagnosis of endobronchial mass lesions.

16.
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Author Index

Sayfalar 185 - 186
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17.
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Reviewer Index

Sayfa 187
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