Search

Severe asthmatics account 10% of the all asthmatic population. Those asthmatics whose disease is inadequately controlled account for up to half of the cost for asthma, because they have more emergency room visits, more hospital admission and greater absenteeism from work. New therapeutic options were tried in those patients whose asthma was uncontrolled with standart high dose inhaled corticosteroid and long acting beta-2 agonsit combination therapy. In this paper taking into account the conditions of our country, current literature was reviewed and treatment options was discussed and graded recommendations are made for daily clinical practice in patients with severe treatment-refractory asthma.

Sarcoidosis is an idiopathic granulomatous disease. It usually affects the lung. The diagnosis may be problematic since the known causes of granulomatous inflammation must be excluded. This multicenter study aimed to evaluate the clinical presentations and diagnostic approaches of sarcoidosis. The study protocol was sent via internet, and the participants were asked to send the information (clinical, radiological and diagnostic) on newly diagnosed sarcoidosis cases. 293 patients were enrolled within two years. Pulmonary symptoms were found in 73.3% of the patients, and cough was the most common one (53.2%), followed by dyspnea (40.3%). Constitutional symptoms were occured in half of the patients. The most common one was fatigue (38.6%). The most common physical sign was eritema nodosum (17.1%). The most common chest radiograhical sign was bilateral hilar lymphadenomegaly (78.8%). Staging according to chest X-ray has revealed that most of the patients were in Stage I and Stage II (51.9% and 31.7%, respectively). Sarcoidosis was confirmed histopathologically in 265 (90.4%) patients. Although one-third of the bronchoscopy was revealed normal, mucosal hyperemi (19.8%) and external compression of the bronchial wall (16.8%) were common abnormal findings. The 100% success rate was obtained in mediastinoscopy among the frequently used sampling methods. Transbronchial biopsy was the most frequently used method with 48.8% success rate. Considering sarcoidosis with its most common and also rare findings in the differential diagnosis, organizing the related procedures according to the possibly effected areas, and the expertise of the team would favour multimodality diagnosis.

Hermansky-Pudlak syndrome is a rare disease characterized by bleeding diathesis, oculocutaneous albinism and lysosomal ceroid lipofuscin pigment deposits. Pulmonary fibrosis may also accompany with the disease. A 48-year-old male patient with a diagnosis of Hermansky-Pudlak syndrome admitted with dyspnea. A thorax computed tomography revealed bilateral diffuse interlobular septal thickness which was more prominent in the basal segments of lower lobes. Although pirfenidone therapy was planned, clinical deteroriation developed and patient died because of respiratory failure. In conclusion; this report describes a patient with pulmonary fibrosis caused by lung involvement of Hermansky-Pudlak syndrome which is an extremely rare and mortal disease.

A 30 years old male patient was referred to our hospital with a diagnosis of pulmonary thromboembolism due to thorax-computerized tomography (CT) angiography, revealing a thrombus totally occluding left main pulmonary artery. The lesion was evaluated as tumoural mass. Positron emission tomography (PET)-CT revealed pathologic uptake at pulmonary artery mass. Due to localization of tumour, left pneumonectomy was performed. The pathological diagnosis revealed to be pulmonary artery sarcoma. The patient was presented because pulmonary artery sarcomas are very rare tumors and can mimick pulmonary thromboembolism. The true prevalence is underestimated as many pulmonary artery sarcomas are misdiagnosed as pulmonary thromboembolism. PET-CT may help to make a differential diagnosis.

Extramedullary plasmacytomas are rare tumors. In majority of cases tumors arise in the head and neck region and endobronchial localization is extremely rare. The treatment is usually resection alone or combination of surgery with radiotherapy. Herein we present a case of solitary endobronchial plasmacytoma which was resected with bronchoscopic electrocautery, because of extremely rare occurrence of solitary endobronchial plasmacytoma and also the successful outcome of bronchoscopic electrocautery therapy.

In order to prevent and control non-communicable diseases (NCDs), the 61st World Health Assembly has endorsed an NCD action plan (WHA resolution 61.14). A package for essential NCDs including chronic respiratory diseases (CRDs) has also been developed. The Global Alliance against Chronic Respiratory Diseases (GARD) is a new but rapidly developing voluntary alliance that is assisting World Health Organization (WHO) in the task of addressing NCDs at country level. The GARD approach was initiated in 2006. GARD Turkey is the first comprehensive programme developed by a government with all stakeholders of the country. This paper provides a summary of indicators of the prevalence and severity of chronic respiratory diseases in Turkey and the formation of GARD Turkey.

Elevated levels of matrix metalloproteinase have been implicated as playing important role in tumour progression in several types of cancers. Our aim was to determine whether these enzyme might be a useful tumour marker for lung cancer and also to evaluate the correlation of circulating levels of matrix metalloproteinase-9 (MMP-9) with tumour histology, staging, nodal status, metastasis and prognosis. Blood samples were collected from 35 nonsmall cell lung cancer patients who were diagnosed histologically, and 14 healthy controls. The MMP-9 levels were significantly higher in the cancer group (p< 0.001). However no significant correlation between several clinical features (such as histology of the tumour, staging, tumour status, or nodal status) and plasma MMP-9 levels have been observed. Though it does not show statistical significance, more patients with metastasis seemed to have higher MMP-9 levels. At the end of six month 11 patients were out of follow-up. Among the remaining 24 patients eight patients had lower MMP-9 levels, seven were survivors at the end of six months. Sixteen patients had MMP-9 levels above the threshold. Only 10 have survived to six months. In conclusion MMP-9 can serve as a marker for metastasis and can be valuable in the follow-up of lung cancer patients.

Endobronchial lipoma (EL) is a rare benign neoplasm that may cause irreversible pulmonary damage distally, and may be misdiagnosed clinically as a bronchial carcinoid or malignant tumor. They simulate malignant tumors, because of the age, sex and smoking history of the patients in whom they are found. Proper management is a "must" in order to avoid serious and unnecessary complications of the lung. We present a case of endobronchial lipoma, which is located in the right upper lobe bronchus, and diagnosed and treated by surgery.