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Introduction: New diagnostic tools are being investigated for rapid and accurate TB detection. We aimed to find out the diagnostic yield and accuracy of chemokine CXCL12 (SDF-1a) levels in diagnosing active TB (aTB) and making a differential diagnosis from other several infectious/non-infectious pulmonary conditions. Methodology: We collected demographic, clinic features and studied plasma CXCL12 levels using ELISA kit of the participants, classified into five categories: aTB (n = 30); cured TB (cTB, n = 15); close contacts of aTB (CC, n = 15); chronic obstructive pulmonary disease (COPD) with active nonspecific pulmonary infection (infCOPD, n = 15); and healthy controls (HC, n = 15). Results: CXCL12 levels were highest in aTB, but no significant difference was seen between other groups. When a cut-off level for CXCL12 was determined as 2835 pg/mL, the increased CXCL12 rate was significantly more in aTB than CC and HC (p = 0.02, p = 0.05). Also, participants with an active infection (aTB and infCOPD) had significantly higher increased CXCL12 rates (p = 0.01). The sensitivity and specificity of CXCL12 for diagnosing aTB were found to be 0.56 and 0.63, respectively. We found that bacterial load, the radiological severity and the extent of chest x-ray involvement were independent factors for increased CXCL12 levels. Conclusions: Our study demonstrates that CXCL12 may be a representative of active pulmonary infection regardless of the cause but correlated with the severity of the disease; enabling this test to be used as a prognostic factor rather than a diagnostic test for aTB.

INTRODUCTION: There is one of the new methods in the differential diagnosis QuantiFERON-TB Gold in tube QFTGIT , in which the most common cause of sarcoidosis and tuberculosis lymphadenitis of benign mediastinal lymphadenopathy, we aimed to investigate the value of the test for TB lymphadenitis. METHODS: Chest CT transverse diameter of 10 mm and directed to our clinic to investigate the etiology of mediastinal lymph nodes above sarcoidosis was diagnosed in 36 patients with TB lymphadenitis was diagnosed in 37 patients, including 73 patients age, sex, comorbid disease, the tuberculosis contact history, symptoms, number of BCG scar, TST and QFTGIT results were recorded test results. RESULTS: The mean age of patients with sarcoidosis 42.2± 17.2 were female 52.8% , 17 were male 47.2% . Average follow-up time was 14.6 ± 12.3 months. 3-36 months . With sarcoidosis, which is still being used in the differential diagnosis of TB lymphadenitis, TCT's sensitivity in diagnosis of TB lymphadenitis was 62%, specificity 75%; QFT-GIT sensitivity of the test was 92%, specificity of 83% was calculated. Sarcoidosis QFT-GIT and TST test results of there were no significant correlation between [p = 0.618]; Significant correlation was found for TB lymphadenitis [p = 0.028]. DISCUSSION AND CONCLUSION: As our country and communities of routine BCG vaccination should be vaccinated again applied according to TST results, BCG also affected in the differential diagnosis of tuberculosis infection, QFT-GIT be recommended for use with the TST test. Also planned patients receiving systemic steroid therapy for starting INH prophylaxis be taken into account rather than the TST positive QFT-GIT test may be appropriate., GİRİŞ ve AMAÇ: Mediastinal benign lenfadenopatinin en sık nedenleri sarkoidoz ve tüberküloz lenfadenit hastalıklarıdır. Çalışmamızda, TB lenfadenitin ayırıcı tanısında yeni yöntemlerden birisi olan QuantiFERON–TB Gold in tube QFTGIT testinin değerini araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Toraks BT’de transvers çapı 10 mm ve üzerinde olan mediastinal lenf nodlarının etiyolojisinin araştırılması amacıyla kliniklerimize yönlendirilerek 36’sı sarkoidoz ve 37’si TB lenfadenit tanısı konulan toplam 73 hastanın prospektif olarak yaş, cinsiyet, eşlik eden ek hastalık, tüberküloz temas öyküsü, semptomları, BCG skar sayısı, TCT sonuçları ve QFT-GIT testi sonuçları kaydedildi. BULGULAR: Sarkoidoz hastalarının yaş ortalamaları 42,2±17,2 idi. Olguların 19’u kadın %52.8 , 17’si erkekti % 47,2 . Ortalama takip süreleri 14,6±12,3 ay idi 3 – 36 ay . Sarkoidoz ile TB lenfadenit ayırıcı tanısında halen kullanılmakta olan TCT nin, TB lenfadenit tanısında duyarlılığı %62, özgüllüğü %75; QFT-GIT testinin duyarlılığı %92, özgüllüğü %83 olarak hesaplandı. Sarkoidozda QFT-GIT testi ve TCT sonuçları arasında anlamlı korelasyon bulunmazken [p=0,618]; TB lenfadenit için anlamlı korelasyon saptandı [p=0,028]. TARTIŞMA ve SONUÇ: Ülkemizde olduğu gibi rutin BCG aşılamasının ve TCT sonucuna göre yeniden aşılanmaların uygulandığı topluluklarda, tüberküloz enfeksiyonun ayırıcı tanısında BCG den etkilenmeyen QFT-GIT testinin TCT ile birlikte kullanılması önerilebilir. Ayrıca sistemik steroid tedavisi alması planlanan hastalarda INH proflaksisi başlanması için tek başına TCT’den ziyade QFT-GIT testi pozitifliğinin gözönüne alınması uygun olabilir.

We present the case of an extremely rare tumor of the diaphragm. The patient was a middle-aged woman with a 1-month history of dyspnea, fatigue, and cough. Chest roentgenogram and computed tomography scan of the thorax revealed a mass located at the dome of the right diaphragm. Pathologic examination of the biopsy specimen revealed pleomorphic rhabdomyosarcoma.

The most common site for gastrointestinal involvement in tuberculosis is the ileocecal region. Tuberculosis of stomach is quite uncommon. It is usually associated with pulmonary tuberculosis or with immunodeficiency. In this case non specific gastrointestinal complaints yielded a diagnosis of primary gastric tuberculosis, which is very rare. Absence of pulmonary focus and endoscopic findings of pangastritis are different features of this case which makes it presentable.

Amaç: Bu çalışmanın amacı pür bronkioloalveolar akciğer karsinomlu (BAK) hastalarda patolojik ve radyolojik bulgular arasındaki ilişkiyi değerlendirmektir. Yöntem ve Gereç: Pür BAK’lı hastaların patolojik ve radyolojik bulguları retrospektif olarak incelendi. Bulgular:Üç yılda pür BAK tanısı alan 26 hastanın dosyası, patolojik örnekleri ve bilgisayarlı filmleri incelendi. Musinöz patoloji ile diffüz radyolojik patern, non-musinöz patoloji ile soliter nodül/kitle/kavitasyon arasında istatistiksel olarak anlamlı ilişki vardı (X2 = 15,143, P = 0,004). Radyolojk lezyonla tümörün lenfositik infiltrasyonu arasında istatistiksel olarak anlamlı ilişki bulunmadı (X2 = 10,057, P = 0,122). Radyolojik bulgularla ile patolojik olarak skleroz varlığı arasında istatistiksel olarak anlamlı ilişki vardı (X2 = 6,229, P = 0,044). Skleroz varlığında radyolojik olarak soliter nodül/kitle/ kavitasyon daha sık izlendi. Sonuç: Çalışmamızda bronkioloalveolar karsinomun müsinöz subtipi radyolojik olarak diffüz paternle korele iken, non-müsinöz subtipi ve sklerozis varlığı soliter nodül/kitle/kavitasyonla ilişkili bulundu. Ancak aralarında yüzde yüz ilişki yoktur. Bu nedenle hastalığın biyolojik davranışını daha iyi anlamak için moleküler ve genetik çalışmalar gerekmektedir. Aim: To assess the correlation between pathological and radiological findings in patients with pure bronchioloalveolar carcinoma (BAC). Materials and Methods:We retrospectively evaluated the pathological and radiological findings in patients with pure BAC. Results: We reviewed the case records, pathological specimens, and computer files of 26 patients with a pathologic diagnosis of pure BAC during a 3-year period. There was a statistically significant relationship between pathological and radiological findings (X2 = 15.143, P = 0.004). There was a correlation between mucinous pathology and diffuse pattern, as well as between non-mucinous pathology and solitary nodule/mass/cavitation. A statistically significant relationship between lymphocytic infiltration of the tumor and radiological findings was not observed (X2 = 10.057, P = 0.122). A statistically significant relationship between the presence of sclerosis and radiological findings was observed (X2 = 6.229, P = 0.044). In the presence of sclerosis, solitary nodule/ mass/cavitation radiological findings were seen more frequently. Conclusions: A diffuse radiological pattern was correlated with BAC mucinous subtype, while solitary nodule/mass/cavitation was correlated with non-mucinous pathology and the presence of sclerosis; however, we could not define a 100% relationship between them. In order to understand the biological nature of the disease, additional molecular and genetic studies are required.