Adnan Tolga Öz

A rare tumor of the lung: Pulmonary sclerosing hemangioma (pneumocytoma)

A 67-year-old woman was referred to our department for further evaluation of her abnormal, chest radiogram. Thorax computed tomography revealed a well-circumscribed, round mass in the middle lobe of the right lung. A thoracotomy was performed and pulmonary sclerosing hemangioma was diagnosed. We herein present a rare tumor of the lung.

Vancomycın resıstant enterococcus bacteremıa ın a patıent wıth Pneumocystis jiroveci pneumonıa , granulocystıc sarcoma and acute respıratory dıstress syndrome

In this case report we aimed to present a patient with granulocytic sarcomaa, neutropenic fever, ARDS and Pneumocystis jirovecii pneumoniae that was hospitalized in our intensive care unit. The patient recovered and then developed vancomycin resistant enterococci (VRE) bacteremia due to port catheter during follow up. The patient had risk factors for VRE bacteremia and he was administered linezolide without removing the catheter. He was discharged with recovery.

Role of Toll-Like Receptors in Tuberculosis Infection

Background One-third of the world’s population is infected with Mycobacterium tuberculosis. Investigation of Toll-like receptors (TLRs) has revealed new information regarding the immunopathogenesis of this disease. Toll-like receptors can recognize various ligands with a lipoprotein structure in the bacilli. Toll-like receptor 2 and TLR-4 have been identified in association with tuberculosis infection. Objectives The aim of our study was to investigate the relationship between TLR polymorphism and infection progress. Methods Twenty-nine patients with a radiologically, microbiologically, and clinically proven active tuberculosis diagnosis were included in this 25-month study. Toll-like receptor 2 and TLR-4 polymorphisms and allele distributions were compared between these 29 patients and 100 healthy control subjects. Peripheral blood samples were taken from all patients. Genotyping of TLR-2, TLR-4, and macrophage migration inhibitory factor was performed. The extraction step was completed with a Qiagen mini blood purification system kit (Qiagen, Ontario, Canada) using a peripheral blood sample. The genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism. Results In total, 19 of the 29 patients with tuberculosis infection had a TLR-2 polymorphism, and 20 of the 100 healthy subjects had a TLR-2 polymorphism (P < 0.001). The TLR-4 polymorphism and interferon-γ allele distributions were not statistically correlated. Conclusions Toll-like receptor 2 polymorphism is a risk factor for tuberculosis infection. The limiting factor in this study was the lack of investigation of the interferon-γ and tumor necrosis factor-α levels, which are important in the development of infection. Detection of lower levels of these cytokines in bronchoalveolar lavage specimens, especially among patients with TLR-2 defects, will provide new data that may support the results of this study.

Diagnostic Yield of Bronchoscopy with C-Arm Scopy in Cases without Endobronchial Lesion

1 Jülide Çeldir Emre1, Ayşegül Baysak2, Adnan Tolga Öz2, Gürsel Çok3, Tuncay Göksel3 1Turgutlu State Hospital, Manisa, 2Izmir University School of Medicine, Department of Chest Diseases Izmir, 3Ege University School of Medicine Department of Chest Diseases Izmir, Turkey Diagnostic Yield of Bronchoscopy with C-Arm Scopy Diagnostic Yield of Bronchoscopy with C-Arm Scopy in Cases without Endobronchial Lesion

The Evaluation of Preoperative Diagnostic Approach to Solitary Pulmonary Nodule with Solid Structure

DOI: 10.4328/JCAM.3560 Received: 11.05.2015 Accepted: 23.05.2015 Publihed Online: 24.05.2015 Corresponding Author: Tumay Ozgur, Pathology Department, Mustafa Kemal University, School of Medicine, 31100, Serinyol, Hatay, Turkey. T.: +90 3262291000-3329 F.: +90 3262455654 E-Mail: ozgurtumay@yahoo.com Ozet Prostat kanseri erkeklerde en sik gozlenen prostat malignensilerindendir ve duktal adenokarsinom klinik ve histolojik ozellikleri ile belirgin patolojik bir subtipidir. Yetmis alti yasinda Kronik lenfositik losemi/Kucuk hucreli lenfositik lenfomali (KLL/SLL) erkek hasta alt uriner sistem semptomlari ile hastanemize basvurdu. Son prostat spesifik antijen seviyesi (PSA) 26 ng/ml ile bir cok transrektal ultrasound rehberligindeki biopsiler uygulandi ve patoloji raporlari benign prostat hiperplazisi ve non-spesifik prostatit olarak sonuclandi. Semptomlarin devam etmesi uzerine prostata transuretral rezeksiyon uygulandi. Materyalin patolojik degerlendirilmesinde benign hiperplazik prostat dokulari arasinda stromasi olmayan adenokarsinom odaklari gozlendi. Tumor 4+4 Gleason patern skoru ile duktal adenokarsinom olarak tani aldi. Metastaza bagli lomber vertebrada kemik sintigrafisinde aktivite tutulumu vardi. Bilgisayarli tomografide onceki KLL/SLL ‘ye bagli inguinal ve sag iliak lenfadenopati izlendi. Total androjen kisitlama tedavisi ve bilateral orsiektomi uygulandi. 3 ay sonra biokimyasal ve radyolojik goruntuleme sonuclarina gore radyoterapi tedavisi planlandi. Duktal adenokarsinoma konvansiyonel adenokarsinomdan farkli klinik davranisi olan prostatin nadir bir subtipidir. Diger yandan KLL/SLL takibi yapilan bir hastada sekonder bir malignensi olarak ortaya cikmasi olguyu degerli kilmaktadir.

Case Report: Pulmonary Nocardiosis in a Patient with Chronic Obstructive Pulmonary Disease and Receiving Corticosteroid Treatment due to Nephrotic Syndrome.

Introduction : Nocardia spp. belong to Actinomycetes family and usually found in soil. They show variation in acid fast stain. Microscobic examination reveals Gram positive filamentous bacilli. Nocardiosis, is a rare clinical situation caused by Nocardia species and takes place especially in immunosuppressed individuals. In our case report we aimed to present pulmonary nocardiosis in a patient receiving corticosteroid treatment due to nephrotic syndrome and also accompanying chronic obstructive pulmonary disease. Case Presentation : 53 year old male patient was admitted to the Chest Diseases outpatient clinic with fever, sputum and cough complaints. The patient had a previous story of nephrotic syndrome and chronic obstructive pulmonary disease and receiving corticosteroid treatment. Thorax CT image showed a 13 cm cavitary lesion at the lower lobe of the right lung, and 21 mm lesion neighboring to the other lesion. Fibrotic structure was detected on both hilus of the lung. This was evaluated as a sequela of infection. The patient underwent flexible bronchoscopy and respiratory tract specimens (bronchoalveolar lavage, bronchial lavage and sputum) were sent to the Microbiology Laboratory. The Gram stain showed filamentous Gram positive bacilli and on the fourth day of incubation Nocardia spp was reported. The patient was administered trimethoprim sulfamethoxazole treatment and recovered. Discussion : Pulmonary nocardiosis is a rare disease. The importance of this infectious pathogen has increased due to recent increase immunosuppressive treatment modalities, HIV infection, and organ transplantation. The clinical and radiological symptoms are nonspecific and because of this microbiological methods are important in diagnosis of nocardiosis. Consecutive examination of clinical material showing the typical microscopic appearance in these patients should draw the attention of the clinician to this pathogen and treatment is needed to be done accordingly.

A rare cause of pleurisy in pregnancy: Tuberculosis

Tuberculosis is a granulomatous infectious disease of lungs due to Mycobacterium tuberculosis. Tuberculosis is a chronic disease and tuberculosis pleurisy takes place with acute disease symptoms. We aimed to present a rare case of young pregnant woman with pleural effusion due to tuberculosis in light of literature.