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Hzl Arama




RESPIRATORY CASE REPORTS - Respir Case Rep: 7 (1)
Cilt: 7  Say: 1 - ubat 2018

OLGU SUNUMU
1.
stiridye Mantarlarnn Neden Olduu Hipersensitivite Pnmonisi: Mantar isi Akcieri Olgusu
Hypersensitivity Pneumonitis Caused by Oyster Mushrooms: A Case of Mushroom Worker's Lung
Taha Tahir Beki, Mustafa alk, Burcu Yaln
doi: 10.5505/respircase.2018.25901  Sayfalar 1 - 4
Mantar ticari retimi yl boyu kapal iklimlendirilmi ortamlarda emek youn ekilde yaplmaktadr. Kapal ekim, iilerde ekstrensek allerjik alveolitis olarak bilinen hipersensitivite pnmonisi gibi alerjik semptomlara yol aar. Yirmi yandaki erkek hastann yaknmalar mantar retim iine baladktan sonra ortaya km. Hasta, me, titreme, ate, eklem arlar, cilt dkntleri ikyetiyle kliniimize bavurdu. Hastann anamnez, fizik muayene ve radyolojik incelenmesinde hipersensitivite pnmonisi dnlerek medikal tedavi baland. Hastann yaknmalar birka gn sonra geriledi. Birinci haftann sonunda taburcu edildi. Hastaln tansnda glklerle karlalsa da anamnez, fizik muayene ve radyolojik deerlendirmede aklda tutulmaldr.
The commercial production of mushrooms is often carried out in indoor areas and controlled environments with intense labor performed throughout the year. Indoor cultivation can lead to allergic symptoms, such as extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, in workers. A 23-year-old male patient's symptoms emerged after beginning to work in mushroom cultivation. The patient was admitted to the clinic with complaints of chills, fever, joint pain, and a skin rash. Based on his medical history and a physical and radiographical examination, the patient was diagnosed as hypersensitivity pneumonitis and medical therapy was initiated. The patient's symptoms dis-appeared within a few days and he was discharged at the end of the first week. Given the difficulties in the diagnosis of disease, the patients professional history should always be kept in mind as well as medical history, physical examination, and radiographic evaluation.

2.
Metotreksat ile likili Organize Pnmoni Tans Alan Psriasis Olgusu
Patient Diagnosed with Organizing Pneumonia after Using Methotrexate for Psoriasis
Fatih Uzer, Hlya Dirol, rem Hicran zbudak
doi: 10.5505/respircase.2018.22932  Sayfalar 5 - 8
Psriasis, genellikle benign karakterli, tekrarlayan ve kronik inflamatuar bir cilt hastaldr. Poplasyonun %2'sini etkiler. Genel poplasyondaki yksek insidansa karn pulmoner komplikasyon olduka nadirdir. Psriasis nedeniyle metotreksat kullanan bir hastada tan koyduumuz bir organize pnmoni olgusunu sunuyoruz.
Psoriasis is a recurrent chronic inflammatory skin disease. It affects some 2% of population. Despite the high incidence rate in the general population, pulmonary complications are rare. Presented here is a case of organizing pneumonia diagnosed in a patient using methotrexate for psoriasis.

3.
Malign Plevral Mezoltelyoma ve Santral Sinir Sistemi Metastaz: ki Olgu Sunumu
Malignant Pleural Mesothelioma and Central Nervous System Metastases: Report of Two Cases
Berna Aknc zyrek, Yurdanur Erdoan, Meri nver, Tue ahin zdemirel, Funda Demira, Sadi Kaya
doi: 10.5505/respircase.2018.82687  Sayfalar 9 - 12
Malign plevral mezotelyoma (MPM)de tan esnasnda uzak metastazlar nadiren grlr. Uzak metastaz hematojen yolla ya da komuluk yoluyla olur. Santral sinir sistemi metastaz nadir grlr. zellikle agresif tedaviler sonrasnda nispeten surveyi uzayan hastalarda metastazlara daha sk rastlanr. Metastazlar sklkla serebral korteks, serebellum, intrakranial meninksler ve spinal kordda grlr. MPM' nin btn histopatolojik tiplerinde grlebilir. Nadir grlmesi nedeniyle kranial metastaz saptanan malign mezotelyoma tans olan 2 olgumuzu sunmay amaladk.
At the time of diagnosis of malignant pleural mesothelioma (MPM), distant metastases are rare, but can occur through the hematogenous route or an adjacent route. Central nervous system (CNS) metastasis is rarely seen and the incidence is not known. Metastases occur more often in patients with relatively prolonged survival following aggressive treatment. Metastasis most often occurs in the cerebral cortex, cerebellum, intracranial meninges, or the spinal cord. CNS metastases can be seen in all histological types of MPM. Presently described are the cases of 2 patients diagnosed with malignant mesothelioma and in whom a rarely seen cranial metastasis was determined.

4.
Silika Maruziyetli Hastada PET/BT 'de Akcier Kanserinin Nodal Yaylmn Taklit Eden Sarkoid Benzeri Reaksiyon: Olgu Sunumu
Sarcoid-Like Reaction Mimicking Nodal Spread of Lung Cancer in a Silica-Exposed Patient on Positron Emission Tomography/Computed Tomography: A Case Report
Feyza en, Ahmet Sami Bayram, Mehmet Karada, Elif lker Akyldz
doi: 10.5505/respircase.2018.33600  Sayfalar 13 - 16
Malign pulmoner lezyonlarda mediastinal lenf nodu durumunun deerlendirilmesinde noninvaziv bir grntleme yntemi olan PET/BT nemli bir ilk adm saylmaktadr. Bununla birlikte yanl pozitifliklere bal hatal evre ykseltilmesi sz konusu olabilir. N evresinin belirlenmesi, tedavi planlama stratejisini etkileyebilecek son derece nemli bir durumdur. Silika maruziyeti olan bu olguyu akcierindeki kitle karakterizasyonu iin yaplan PET/BTsinde karlalan evreleme gl nedeniyle sunuyoruz. Youn FDG uptakei gsteren kitlenin lobektomi sonras histopatolojik olarak skuamz hcreli kanser olduu kantlanmasna ramen beraberindeki kalsifiye olmayan hipermetabolik lenf nodlarnn sarkoid benzeri reaksiyonu temsil eder ekilde nonkazez granlom ile uyumlu olduu deerlendirildi. Bu tarz reaksiyonlarn nemi, ilk evreleme PET/BTde ileri evreye ykseltilme ya da tedavi sonras hastalk progresyonu olduuna dair yanl bir izlenim oluturmasnda yatmaktadr. Mediastinal lenf nodlarnn benign nedenlerinden birisi olarak elikiye yol aan altta yatan meslek yks ayrca tartlmtr. PET/BTnin yanl pozitif olarak deerlendirilmemesi iin tmr ile ilikili sarkoid benzeri reaksiyonun farkndal gerekmektedir. Byle bir durumda doru evrelendirme iin lenf nodlarnn histolojik olarak konfirme edilmesi gereklilii vurgulanmtr.
As a noninvasive modality, Fluorine-18 Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is an important first step to assess mediastinal lymph node (LN) status in malignant pulmonary lesions. However, incorrect upstaging may occur due to false-positive results. Determining N stage is of utmost importance, and will affect the treatment planning strategy. Presently described is a staging challenge with PET/CT in a silica-exposed patient who was evaluated for characterization of a lung mass. The mass had an intense FDG uptake and proved to be squamous cell lung cancer (squamous cell carcinoma [SCC]) after a lobectomy. Histopathology revealed non-caseating granulomas representing sarcoidlike reaction (SLR) in non-calcified hypermetabolic mediastinal-hilar LNs. The significance of such reactions lies in how they can give a false impression of upstaging on the initial PET/CT or mimic disease progression after treatment. As an underlying clinical manifestation, occupational history is also discussed as a confounding factor for a benign cause of mediastinal lymphadenopathy. Awareness of tumor-related SLR is needed to avoid false positive PET/CT interpretation. To obtain histological confirmation of LNs for accurate staging in such a circumstance is also emphasized.

5.
Akcier Dokusunda Aspire Edilen Yabanc Cismin Ultrasonografi ile Grntlenmesi
Ultrasonographic Visualization of an Aspirated Foreign Body in Lung Tissue
Nalan Kozac, Mustafa Avc, Muharrem zkaya
doi: 10.5505/respircase.2018.65882  Sayfalar 17 - 20
Acil servislerde ultrasonografi tansal amal yaygn olarak kullanlmaktadr. Bu olgu sunumunda aspire edilen yabanc cisim ve etrafnda oluturduu inflamasyonun akcier ultrasonografi ile grntlenmesi anlatlmtr.
Ultrasonography is widely used for diagnostic purposes in emergency departments. The visualization of an aspirated foreign body and the surrounding inflammation using lung ultrasonography is described in this case report.

6.
Desendan Nekrotizan Mediastinit: ki Olgu Sunumu
Descending Necrotizing Mediastinitis: Report of Two Cases
Fatih Meterolu, Menduh Oru, Atalay ahin, Burak Gl, Gnl lmez Kavak
doi: 10.5505/respircase.2018.46503  Sayfalar 21 - 25
Desenden nekrotizan mediastinit (DNM) nadir grlen, fakat yksek oranda lmcl seyreden bir durumdur. DNM, mediastendeki hayati organlarn etrafnda nadir grlen enfeksiyz bir hastalktr. Zamannda tan konulmaz ve uygun olarak tedavi edilmezse sonu fatal olur. Tedavideki gecikme enfeksiyonun mediastene yaylmasna yol aar. Erken tan, uygun antibiyoterapi ve cerrahi giriimle ifa olasdr. Az tabannda kt kokulu bir svnn geldiini ifade eden 37 yandaki erkek hasta 5 gn sonra ve kemikli et yemesi sonras yutamama ikyetiyle acile bavuran 57 yandaki erkek hasta 7 gn sonra yatrld. Her iki olgu gerekli laboratuvar ve radyolojik tetkikler sonras acilden ameliyata alnd. Olgularn tanlarndaki gecikmelerden sonra mdahale edildi. Mdahale sonras takiplerde olgular ifa ile taburcu edildiler.
Descending necrotizing mediastinitis (DNM) is a rare but fatal progressive condition. DNM is infectious disease occurring in the tissues and structures of the mediastinum that spreads from the oral cavity and the neck. Unless it is diagnosed in a timely manner and properly treated, the outcome is fatal. Delay in treatment allows the infection to spread down to the mediastinum. Early diagnosis, appropriate antibiotherapy, and surgical intervention are necessary for a cure. Presently described are 2 cases: a 37-year-old man presenting with a fetid fluid discharge in his mouth ongoing for 5 days, and a 57-year-old man complaining of not being able to swallow after eating bony meat 7 days earlier. Both cases underwent surgery after the necessary laboratory and radiological procedures were performed in the emergency department. Though there was a delay in admission, both patients were discharged after an uneventful surgical intervention.

7.
Ektopik Paratiroid Adenomu: Nadir Bir Mediastinal Tmr
Ectopic Parathyroid Adenoma: A Rare Mediastinal Tumor
Orkide Kutlu, Mustafa alk, Cevdet Duran, Hdr Esme, Omer Karahan
doi: 10.5505/respircase.2018.80958  Sayfalar 26 - 29
Primer hiperparatiroidizm (PHPT) genellikle soliter paratiroid adenomuna baldr ve bu adenomlarn % 1'inde ektopik mediastinal yerleim olduu bildirilmitir. Ektopik paratiroid adenomu tansnda Tc99m-MIBI sintigrafisi, yaklak % 100 duyarll vardr; ancak tmrn preoperatif lokalizasyonu belirlenmesi iin MR ve / veya BT grntleri ile birlikte deerlendirilmelidir. Genelde tedavisi sternotomi gerektirebilen servikal yaklam, nadiren de antero-lateral torakotomidir. Son zamanlarda zellikle viseral tmrlerde, video yardml torakoskopik cerrahi (VATS) ile etkin ve rahat bir tedavi seeneidir. Bu yazda, genel cerrahi tarafndan yaplan total tiroidektomi ve paratiroidektomi ameliyatndan sonra devam eden klinik ve laboratuvar hiperparatiroidizmli hastann Tc-99m sintigrafisi ve SPECT ile belirlenen; lateral torakotomi ile baarl eksize edilen mediastinal paratiroid adenomunu bildirmeyi amaladk. Hasta L-tyroxine, kalsiyum ve D vitamini replasman tedavileri ile takip aamasndadr.
Primary hyperparathyroidism is generally due to a solitary parathyroid adenoma and among those adenomas, 1% have been reported to have an ectopic mediastinal location. In the diagnosis of ectopic parathyroid adenoma, technetium-99m methoxyisobutylisonitrile scintigraphy is an imaging method with a sensitivity of approximately 100%; however, in preoperative localization of the tumor, it should be evaluated together with magnetic resonance imaging and/or computed tomography images. In general, the treatment necessitates a cervical approach that may require a sternotomy, though rarely, an anterolateral thoracotomy is warranted. Recently, especially in visceral tumors, an effective and comfortable treatment option has been defined with video assisted thoracoscopic surgery. The aim of this article was to report the successful excision of a mediastinal parathyroid adenoma with a lateral thoracotomic approach that was localized with Tc-99m MIBI scintigraphy and single-photon emission computed tomography imaging in a patient with ongoing clinical and laboratory findings of HPT after the first operation, in which a general surgical team performed a total thyroidectomy and parathyroidectomy. The patient is still in follow-up with L-thyroxine, calcium, and vitamin D replacement treatment.

8.
Kostal Blgede Seyrek Rastlanlan Periosteal Kondrom
Periosteal Chondroma of the Rib: An Unusual Location
Cumhur Murat Tulay, Sadk Yaldz, Peyker Temiz
doi: 10.5505/respircase.2018.15046  Sayfalar 30 - 32
Periosteal kondrom, hiyalin kkrdan nadir karlalan iyi huylu tmrdr. Periosteal kondromlar, en sk uzun kemiklerin metafiz ksmnda, el ve ayaklarn ksa tbler kemiklerinde yer alr. Bu tmrn kosta yerleimine literatrde ok az rastlanmaktadr. Biz burada, 55 yanda, yldan uzun sredir gs ars ve ilii olan ve rezeksiyonun patolojik sonucu periosteal kondrom gelen olguyu sunuyoruz.
Periosteal chondroma is a rare, benign tumor of hyaline cartilage. Periosteal chondroma is commonly found in the metaphysis of long bones or the small, tubular bones of the hands and feet. Periosteal chondroma arising in the rib is an extremely rare event. Described is the case of a 55-year-old patient with periosteal chondroma of the rib found after more than 3 years of thoracic pain.

9.
Etyolojisi lgin bir ilotoraks Olgusu
A Case of Chylothorax with Interesting Etiology
Nalan Ogan, Evrim Eylem Akpnar, Tevfik Kaplan, Gke Trker, Meral Glhan
doi: 10.5505/respircase.2018.65807  Sayfalar 33 - 35
ilotoraks, duktus torasikusun zarar grmesine bal ilz svnn lenfatik sistemden plevral bolua gemesidir ve st rengi svda ilomikron formunda yksek konsantrasyonda trigliserid ierir. Tan iin balang testi plevra sv analizidir. Travmatik ve non-travmatik bir ok nedene bal olabilir. Bir ay nceki geirdii bronit neden ile ksrk ikayeti olan ve ilotoraks saptanan olguda, drt yl nce torakal vertebra kr nedeni ile ameliyat yks de mevcuttu. Toraks bilgisayarl tomografide, alt torakal vertebrada, operasyonda yerletirilen fiksasyon ivisinin anteriora doru kayd tespit edildi. yk, fizik muayene ve ileri tetkiklerle ilotoraksa neden olan dier etiyolojik neden bulunamad ve kme kr ameliyatnn ge komplikasyonu olduuna karar verildi. Daha nce literatrde bu ilgin etiyolojik neden ile bildirilen benzer bir olgu bulunmamas nedeni ile sunulmutur.
Chylothorax occurs when chylous fluid from the lymphatic system accumulates in the pleural space due to damage to the ductus thoracicus. The milky fluid contains a high concentration of triglycerides in the form of chylomicrons. The initial test for diagnosis is analysis of the pleural fluid. It may be associated with a number of traumatic and nontraumatic conditions. Chylothorax was diagnosed in a patient who underwent an operation for a thoracic vertebra fracture 4 years earlier who presented with bronchitis. Fixation pins in the lower thoracic vertebra inserted in the operation were observed on thorax computerized tomography. No other etiological cause for chylothorax was found based on the patient history, physical examination, or advanced examinations. It was decided that the collapse and fracture operation had a late complication. This case is presented as an interesting etiological cause of chylothorax as, to our knowledge, there is no similar case in the literature.

10.
Plevral Tutulumla Seyreden Sarkoidoz: Olgu Sunumu
Sarcoidosis Presenting with Pleural Involvement: A Case Report
Ali Kadri rak, Zeynep nde, Nur Ycel
doi: 10.5505/respircase.2018.90532  Sayfalar 36 - 40
Sarkoidoz, nedeni bilinmeyen, en sk akcierleri ve intratorasik lenf nodlarn tutan, multisistemik, non-kazeifiye granlomatz bir hastalktr. Literatrde plevra svs grlme skl %0-5 arasnda bildirilmektedir. Tan plevra biyopsisinde kazeifikasyon nekrozu iermeyen granlom gsterilmesi ve granlom yapan dier nedenlerin dlanmas ile konulur. Eforla nefes darl ve kuru ksrk ikayetleri olan 77 yandaki kadn hastamzn plevral biyopsi ve BT eliinde transtorasik tru-cut biyopsi rneklerinde nekroz iermeyen granlomatz enflamasyon saptadk. Giderek azaltlan dozlarda bir yllk metilprednisolon tedavisiyle tama yakn iyileme saladmz olguyu nadir grlmesi nedeniyle sunuyoruz.
Sarcoidosis is a multisystemic, granulomatous disease with particular involvement in the lungs and the intrathoracic lymph nodes. Pleural fluid has been reported to occur in 0% to 5% of the cases in the literature. Diagnosis depends on the presence of non-caseating granulomas in the biopsy sample and the exclusion of other possibilities. A 77-year-old woman with complaints of shortness of breath and a dry cough was found to have non-necrotizing granulomatous inflammation in pleural biopsy and computed tomography guided transthoracic Tru-Cut biopsy specimens. This was a rare case in which partial recovery was achieved through treatment with methylprednisolone for a year in reduced doses.

11.
Granlomatz Hastalklarda Ne, Nerede ve Nasl?
What, Where and How in Granulomatous Diseases?
Tue Glman Oyman, Glben Altan, Aye Baolu, Aye Fsun Kalpaklolu
doi: 10.5505/respircase.2018.54265  Sayfalar 41 - 46
Akcierin granlomatz hastalklar patolojik ve klinik adan ayrt edici tans zor olabilen durumlardr. Enfeksiyon d nedenlerden sarkoidoz, hipersensitivite pnmonisi ve enfeksiyz olarak ise tberkloz en sk grlenleridir. Burada granlomatz akcier hastal olup ayrt edici tanlarnda zorluk yaanan olgular uzun sreli takipleriyle sunuldu. Birinci olgu 64 yanda kadn hasta, klinik ve radyolojik olarak hipersensitivite pnmonisi ve ikinci olgu ise 67 yanda erkek hasta, patolojik olarak sarkoidoz n tanlar konularak kortikosteroid kullanmaktayd. Ancak, kortikosteroid altnda klinik ve radyolojik progresyon olmas zerine yeniden tansal aratrma yapld. Tekrarlanan bronkoskopik rneklemelerle ve farkl (PCR/BACTEC) tberkloz kltr yntemleri kullanlarak Mycobacterium tuberculosis remesi olmas ile akcier tberklozu tedavisi verildi. Sonu olarak, bu olgular granlomatz hastalklarn klinik, radyolojik ve patolojik adan benzerlik gsterebileceini ve ayrt edici tanda tberkloz mikrobiyolojik tetkik tekrarnn nemini gstermesi asndan ilgintir.
Granulomatous diseases of the lung may be difficult to diagnose in both pathological and clinical aspects. The most common reasons for granulomatous lung are tuberculosis as an infectious source, and sarcoidosis or hypersensitivity pneumonia (HP) as non-infectious causes. Here, 2 cases of granulomatous lung disease that had been incorrectly diagnosed are described. The first was a 64-year-old female patient diagnosed as HP clinically and radiologically, and the second was a 67-year-old male diagnosed as sarcoidosis pathologically. Both had progression clinically and radiologically under corticosteroid treatment. Repeat bronchoscopic evaluation revealed Mycobacterium tuberculosis in the bronchial lavage polymerase chain reaction/BACTEC (Becton Dickinson and Co., Franklin Lakes, NJ, USA) cultures, and lung tuberculosis treatment was initiated for both patients. These cases are interesting in that granulomatous diseases may have similarities in clinical, radiological, and pathological features, and repetition of tuberculosis microbiological examination is important in the differential diagnosis.

12.
Akut Solunum Yetmezliinin Nadir Bir Nedeni: Myastenik Kriz
A Rare Cause of Acute Respiratory Failure: Myasthenic Crisis
Mehmet Erdem akmak, Samet Er, Derya Ademolu, Hayriye Cankar Dal, Sema Sar, Bra Tezcan, Dilek Kazanc, Sema Turan
doi: 10.5505/respircase.2018.65902  Sayfalar 47 - 49
Miyastenia gravis, iskelet kaslarnda gszlk ve abuk yorulma ile karakterize bir kas hastaldr. Miyastenik hastalarda eitli nedenlerle miyastenik kriz geliebilir. Bu olgu sunumunda solunum sknts ile acil servise bavuran ve youn bakm yat gerektiren miyastenik krizli bir hasta ele alnmtr. zgemiinde, diabestes mellitus, hipertansiyon, koroner arter bypass grefti operasyonu ve miyastenia gravis nedeniyle timektomi yks vard. Hasta youn bakmda mekanik ventilatr desteinde izleme alnd. Hastada myastenik krize bal akut solunum yetmezlii dnld. Pridostigmin 120 mg 3x1 olarak ve 1 mg/kg/gn prednizolon baland. ntravenz immn globlin (IVIG) 2 gr/kg dozunda 5 gn sreyle verilmesi planland. Youn bakm yatnn 3. gnnde mekanik ventilatrden ayrld. Akut solunum yetmezliinin nadir bir nedeni olarak miyastenik krizli bu olguyu sunmay amaladk.
Myasthenia gravis is a muscle disorder characterized by weakness and rapid fatigue in the skeletal muscles. Myasthenic crisis can develop for various reasons. In this case report, a patient with respiratory distress and a myasthenic crisis who required urgent hospital admission and intensive care unit is described. He had a history of diabetes mellitus, hypertension, coronary artery bypass graft surgery, and a thymectomy due to myasthenia gravis. The patient required mechanical ventilator support in the intensive care unit as a result of acute respiratory failure due to myasthenic crisis. Pyridostigmine 120 mg 3x1 and 1 mg/kg/day prednisolone were administered. Intravenous immunoglobulin was given at a dose of 2 g/kg for 5 days. The patient was removed from the mechanical ventilator on the third day of the intensive care admission. This case is presented as myasthenic crisis as a rare cause of acute respiratory failure.

13.
Konjenital Lober Amfizem
Congenital Lobar Emphysema
Pnar Mutlu, Merve Ilcn Guven
doi: 10.5505/respircase.2018.55707  Sayfalar 50 - 53
Bir ya da birden fazla akcier lobunun dardan bir bas olmadan hiperinflasyonu konjenital lober amfizem olarak tanmlanr. 20.000 ila 30.000 doumda bir izlenen ok nadir bir durumdur. Olgularn %50sinde etyoloji bilinmemektedir. Etyolojide sulanan dier nedenler, broniyal anormallikler ya da alveolar defektlerdir. Yetersiz kkrdak desteinin sonucunda bronial kollapsn olduu ynnde teoriler de vardr. Sklkla sol st lob, ardndan orta ve sa st loblar etkilenir, alt loblar ise nadiren etkilenir. Olgularn %90 bebeklik dneminde ar solunumsal semptomlarla tan alr. Bu olgu sunumunda, erikin yata tan konan konjenital lober amfizem olgusundan bahsedilecektir.
Congenital lobar emphysema is defined by hyperinflation of 1 or more lung lobes in the absence of extrinsic bronchial obstruction. It is a very rare condition with an incidence of 1 in 20,000 to 30,000 births. The etiology is unknown in 50% of cases. Other factors suspected in the etiology are bronchial abnormalities or alveolar defects. Some theories also include bronchial collapse as a result of insufficient cartilage support. The left upper lobe is frequently affected, followed by the middle and right upper lobes, while the lower lobes are rarely affected. Some 90% of cases are diagnosed in infancy with severe respiratory symptoms. In this report, a case of congenital lobar emphysema diagnosed in adulthood is described.

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