Amaç: Bütün tedavi boyunca doðrudan gözetimli tedavi uygulanamayan ancak tedavisinin baþýndan sonuna kadar tek merkezden ve indirekt gözetim altýnda yönetilen, çok ilaca dirençli tüberküloz (ÇÝD-TB) vakalarýmýzýn tedavi sonuçlarýný deðerlendirmek.
Gereç ve yöntem: Þubat 2000-Mart 2005 tarihleri arasýnda, Süreyyapaþa Göðü̈s Hastalýklarý ve Göðü̈s Cerrahisi E.A. Hastanesi’nde tedavi gören ÇÝD-TB vakalarý çalýþmaya dahil edildi. Vakalarýn demografik, klinik, radyolojik, bakteriyolojik bulgularý ve tedavi sonuçlarý prospektif olarak deðerlendirildi.
Bulgular: Toplam 103 ÇÝD-TB vakasýnýn %78.6’sý erkek (n=81), %21.4’ü kadýn (n=22); yaþ ortalamasý 40.50±13.50 (14-72) idi. Hepsi HIV(-) vakalardý. ÇÝD-TB tedavisinde ortalama 5.0±0.4 (2-7) ilaç kullanýldý, 39 hastada (%37.9) tedavi sýrasýnda ilaç yan etkisi görüldü. Vakalarýn %86.4’ünde (n= 89) kür saðlandý; %3.9’u (n= 4) tedavi baþarýsýzlýðý ile sonuçlandý; %1.9’u (n=2) tedaviyi terk etti; %7.8’i (n= 8) tedavi sýrasýnda kaybedildi. Medikal tedaviye ek olarak, %19.4’üne (n=20) yardýmcý cerrahi tedavi uygulandý.
Sonuç: Tedavi yöntemi açýsýndan, ÇÝD-TB vakalarýnýn tek merkezden yönetilmesi ve indirekt gözetim altýnda tedavinin uygulanmasý, sýký takip olanaðý ve etkin yan etki kontrolü saðlamakta, tedavi uyumunu ve baþarýsýný artýrmaktadýr.

Aim: To investigate treatment results of multi-drug resistant tuberculosis (MDRTB) patients whose treatments were managed by a single center and with an indirect observation during whole treatment.
Material and method: We evaluated prospectively, 103 MDR-TB patients in our clinic between February 2000-March 2005 at Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital in Istanbul, Turkey.
Results: Among 103 MDR-TB patients, 78.6% (n=81) were male, 21.4% (n=22) were female; the mean age was 40.50±13.50 (14-72) and all were HIV(-). A mean number of 5.0±0.4 (2-7) second line drugs were administered, adverse effects of drugs were identified in 37.9% (n=39) of the patients. Of the patients, 89 (86.4%) were classified as cured, 2 patients (1.9%) were defaulters, failure was seen in 4 patients (3.9%) and 8 patients (7.8%) died during treatment. Surgical resection was applied in 20 (19.4%) patients. The patients who were classified as successful and poor outcome according to the treatment result, were compared with each other for the factors possibly effecting treatment result. Patients with unsuccessful outcomes were elder and had a higher incidence of secondary MDR-TB and extensive radiologic involvement. Extensive radiologic invovement and elder ages were found as
significant independent factors effecting unsuccessful treatment outcome.
Conclusion: Managing the treatment of MDR-TB patients in a single center and with an indirect observation during whole treatment, provideszopportunity for close follow-up and active control of adverse effects and therefore increases treatment compliance and success.

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Amaç: Küçük hücreli akciðer kanseri (KHAK) hýzla ilerleyen, kötü klinik seyirle giden,
kemoterapi ve radyoterapiye iyi yanýt veren bir hastalýktýr. Bazý klinik veriler
ve laboratuvar parametreleri saðkalýmý deðerlendirmede kullanýlabilir. Bu çalýþmaný
n amacý KHAK tanýsý alan hastalarda saðkalýmýn incelenmesi ve saðkalýma etki
eden prognostik faktörlerin belirlenmesidir.
Gereç ve Yöntem: KHAK tanýsý ile kemoterapi planlanan ardýþýk 46 hasta prospektif
olarak çalýþmaya alýndý. Hastalarýn bazal karakteristik özellikleri ve prognoza etki
edebilecek deðiþkenler kaydedildi. Hastalarýn yaþam süreleri belirlendi. Kaplan
Meier analizi ile yaþam süresi eðrileri çizildi.
Bulgular: Medyan saðkalým süresi 338 gün (%95 güven aralýðý: 243 - 432) olarak bulundu.
Bir aylýk saðkalým oraný %89, 6 aylýk saðkalým oraný %62, 1 yýllýk saðkalým
oraný ise %45 olarak hesaplandý. Tek deðiþkenli analizde p<0.05 olan deðiþkenlere,
çok deðiþkenli cox regresyon analizi uygulandý. Çok deðiþkenli analizde karaciðer
metastazý (Relatif Risk (RR): 4.99, %95 güven aralýðý: 1,21 - 20,53 ), kilo kayb› (RR:
11.3, %95 güven aralýðý: 1,11 - 115,5) ve 1. kür sonrasý total protein düzeyinin düþüklüðaaa
ü (RR: 0.198; %95 güven aralýðý: 0,06 - 0,63), saðkalým ile iliþkili baðýmsýz prognostik
faktörler olarak saptandý.
Sonuç: KHAK mortalite hýzý yüksek bir hastalýktýr. Saptadýðýmýz prognostik faktörlerin
ileri çalýþmalarla desteklenmesi gerektiðine inanýyoruz.

Aim: Small cell lung cancer (SCLC) is an aggressive tumour with a poor clinical course,
but responsive to both chemotherapy and radiotherapy. Some clinical and laboratory
parameters can predict survival in SCLC. The aim of this study was to analyze the
survival and identify the prognostic factors that influence survival in SCLC.
Material and Method: Forty six consecutive SCLC patients who were planned for
chemotherapy, enrolled in this study prospectively. We recorded basic
characteristic properties and factors affecting prognosis for each patient. We
determined their survival time and survival curves were calculated by the method
of Kaplan and Meier analysis.
Results: Median survival time was 338 days (95% confidence interval: 243-432).
Survival ratio for one month was 89%, for 6 months 62% and for one year 45%.
Significiant parameters (p<0.05) evaluated by univariate analysis followed by
multivariate analysis. In multivariate analysis liver metastas (Relative Risk (RR):
4.99, 95% confidence interval: 1,21 - 20,53), weight loss (RR: 11.3, 95% confidence
interval 1,11-115,5) and low level of total protein after first chemotherapy (RR:
0.198, 95% confidence interval 0,06-0,63) were found as independent factors
affecting survival.
Conclusion: SCLC is a disease with high mortality. Prognostic factors that we
found, can be supported by further investigations.

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Tütün kullanýmý, bütün dünya için önlenebilir ölüm nedenlerinden biridir.
Türkiye’de de sigara içimi, önemini koruyan bir saðlýk sorunudur ve eriþkinlerin
%43.5’inin sigara içtiði saptanmýþtýr. Solunumla ilgili herhangi bir hastalýðý olmayan
vakalarda, sigaranýn solunum fonksiyon testi, 6 dakika yürüme testi, dispne
indeksi ve yaþam kalitesi üzerindeki etkisinin araþtýrýlmasý amaçlandý. Yaþ ortalamasý
62 olan, %83.5’i erkek, toplam 139 vaka deðerlendirildi. Vakalarýn 36’sý
(%25.9) hiç sigara içmemiþ, 46’sý (%33.1) aktif içici ve 57’si (%41.0) içip býrakmýþtý.
Aktif içici olan vakalarýn spirometrik ölçümleri, hem içmeyen hem de býrakmýþ vakalardan
daha düþük bulundu. 6DYT mesafesi, dispne indeksi ve oksijen satürasyonu,
içmeyenler, aktif içiciler ve býrakmýþlar arasýnda farklý deðildi. SF36 yaþam
kalitesinin fiziksel komponent skoru sigara ile iliþkili bulunmadý. Sadece aktif içicilerin
mental komponent skoru, býrakmýþ vakalardan anlamlý derecede düþük bulundu.
Sigara maruziyeti <50 paket-yýl olan vakalarýn 6DYT mesafesi, dispne indeksi,
SpO2 ve yaþam kalitesi, sigara içmeyen vakalardan farklý deðildi. Sigara maruziyeti
≥50 paket-yýl olan vakalarýn 6DYT mesafesi, içmeyen vakalardan farklý de-
ðildi ancak dispne indeksi anlamlý derecede yüksek ve SpO2 anlamlý düzeyde düþük
bulundu. Sigara maruziyeti ≥50 paket-yýl olanlarýn 6DYT mesafesi, <50 paketyý
l sigara içen vakalardan farklý deðildi ama dispne indeksi anlamlý derecede yüksek
ve SpO2 anlamlý derecede düþük saptandý. SF36 yaþam kalitesi fiziksel ve mental
komponent skorlarýnýn sigara maruziyet düzeyi ile iliþkisi saptanmadý. Sigara
içen vakalarýn egzersiz kapasitesi, dispne algýlamasý ve yaþam kalitesinde de kayý
plar vardý ve bu fonksiyonel kayýplar sigara maruziyet düzeyi ile iliþkiliydi.

Worldwide, smoking is one of the preventable causes of death. It is a persistent
health problem in Turkey and 43.5% of adult population is smoking. The aim was
to study the effects of smoking on pulmonary function test, exercise capacity,
dyspnea index and life quality. 139 cases, 83.5% of whom were men with mean age
of 62 were evaluated; 36 cases (25.9%) were nonsmokers, 46 (33.1%) were smokers
and 57 (41.0%) were ex-smokers. Spirometric measurements of smokers were
found lower than that of both nonsmokers and ex-smokers. 6MWT distance,
dyspnea index and oxygen saturation did not differentiate among nonsmokers,
smokers and ex-smokers. Physical component score of SF36 life quality was not
associated with smoking. Only mental component score of smokers was found
lower than that of ex-smokers. 6MWT distance, dyspnea index, SpO2 and life
quality of cases whose exposure to smoking was <50 package-year were not
different than nonsmokers. 6MWT distance of cases whose exposure to smoking
was ≥50 package-year was not different than nonsmokers and cases with ≥50
package-year exposure to smoking; however, dyspnea index and SpO2 were found
significantly high and significantly low respectively. There were losses in exercise
capacity, dyspnea perception and life quality of smokers and these functional
losses were associated with the level of exposure to smoking.

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Amaç: Küçük hücreli dýþý akciðer kanserli (KHDAK) vakalarda mediastinoskopiyle
N2 saptanmayan lenf nodlarýnda, immünohistokimyasal boyama ile mikrometastaz
varlýðýný araþtýrdýk.
Gereç ve Yöntem: Ocak 2001- Aðustos 2005 tarihleri arasýnda Yedikule Göðüs Hastalý
klarý Hastanesi’nde tetkik edilen, sitolojik ve histolojik bulgularla küçük hücreli
dýþý akciðer kanseri (KHDAK) tanýsý alan 100 vaka çalýþmaya alýndý. Hastalar, fizik
muayene, konvansiyonel radyoloji, toraks BT ve bronkoskopi ile deðerlendirildikten
sonra, klinik evre IA-IIIB akciðer kanseri olarak evrelendirildi. Bütün hastalara evreleme
amaçlý mediastinoskopi yapýldý. Lenf nodu örneklerinde, immünohistokimyasal
boyama yöntemiyle sitokeratin 8/18 kullanýlarak mikrometastaz araþtýrýldý.
Bulgular: Vakalarýmýzýn 95’i erkek, 5’i kadýndý. Mediastinoskopiyle N2 saptanmayan
100 vakanýn 17’sinde (%17) lenf nodlarýnda sitokeratin 8/18 ile pozitif boyanma saptandý.
Literatürde mikrometastaz varlýðý kötü prognostik faktör olarak belirtilmektedir.
Sonuç: Bizim 2 yýllýk saðkalým takibimizde Kaplan Meier analizine göre istatitisksel
anlamlýlýk saptanmadý (p=0.6).

Aim: We investigated micrometastasis in lymph nodes with immunhistochemical
examination in cases that had no N2 in mediastinoscopy.
Material and Methods: We included in the study 100 non small cell lung cancer
cases who were diagnosed cytologically or histologically in Yedikule Chest
Diseases and Thoracic Surgery Hospital between January 2001 and August 2005 (95
of the cases were male and 5 female). We performed physical examination,
conventional radiography, thorax CT and bronchoscopy in all patients and staged
lung cancer as IA or IIIB. All patients underwent mediastinoscopy for staging and
we investigated micrometastasis in lymph nodes with immunhistochemical
examination, using cytokeratin 8/18.
Result: In 17 of 100 cases (17%) who had no N2 in mediastoscopy we established
positive reaction with cytokeratin 8/18. Micrometastasis is known as a poor
prognostic factor in literature.
Conclusion: During the two years of survival follow-up, our results were not
statistically significant according to Kaplan Meier analysis.

Abstract | Full Text PDF

Amaç: Çalýþmamýzýn amacý KOAH’lý hastalarda solunum fonksiyonlarý, yürüme ve
BODE indeksini deðerlendirerek bu verilerin hastalýk süresi ve þiddeti ile aralarýndaki
iliþkiyi araþtýrmaktý.
Gereç ve yöntem: Çalýþmaya gönüllü, 25 stabil KOAH’lý erkek hasta alýndý. Hastalara
solunum fonksiyon testi (SFT), 6 dakika yürüme testi (6DYT) yapýldý. Hastalarý
n dispneleri “Modifiye Medical Research Council” (MMRC), vizüel analog skala
(VAS) ve Borg skalasý ile belirlendi. BODE indeksi, miyokardial oksijen tüketimi
(MVO2) ve 6 dakika yürüme iþi (6DYÝ) hesaplandý.
Bulgular: Hastalarýn yaþ ortalamasý 66.8±9.2 yýldý. Beden kitle indeksleri (BKÝ)
28.2±2.7 kg/m2, SFT’nde FEV1 ortalamasý %56.8±22.7 (1.45±0.55 L), maksimal inspiratuar
basýnç (PImaks) ortalama 71.7±26.6 cm H2O, maksimal ekspiratuar basýnç (PEmaks)
ortalama 74.7±40,5 cm H2O idi. Altý dakika yürüme mesafesi (6DYM) ortalama
366±65 m idi. Altý DYT sonunda MVO2, dispne (VAS ve Borg) ve oksijen satürasyonu
(SaO2) anlamlý derecede deðiþti (p<0.001). Hastalýk þiddeti; %FEV1, %FVC,
FEV1/FVC, dispne (MMRC), BODE indeksi ile (sýrasýyla; rs=-0.955, p<0.001;
rs=0.793, p<0.001; rs=-0.556, p=0.04; rs=0.527, p=0.007; rs=0.775, p<0.001) ve 6DYT
sýrasýndaki dispne (VAS) ve MVO2 deðiþimleriyle (sýrasýyla; rs=0.609, p=0.001;
rs=0.453, p=0.02) anlamlý iliþki göstermekteydi. Bu iliþkilere yönelik çoklu lineer
regresyon modeli oluþturuldu: y=-0.03 FEV1 (%)+0.15 dispne (VAS)+0.08 BODE
(F=93.38, p<0.001; R=0.96, R2=0.93) olarak bulundu. Hastalýk süresi; BODE indeksi
(rs=0.525, p=0.007), dispne (MMRC) (rs=0.571, p=0.003), 6DYM (rs=-0.635, p=
0.001), 6DYT sýrasýndaki dispne deðiþimi (VAS) (rs=0.533, p=0.006) ile anlamlý olarak
iliþkiliydi. Bu iliþkilere yönelik çoklu regresyon modeli oluþturuldu. Hastalýk süresi=
0.38 dispne (MMRC) -0.30 (F=7.78, p=0.01, R=0.50, R2=0.25) olarak bulundu.
Sonuç: Hem hastalýk þiddeti hem de hastalýk süresinin dispne (MMRC ve VAS) ve
BODE indeksi ile iliþkili bulunmasý, fizyolojik ölçümlerin yaný sýra semptomlarýn da
nicel olarak deðerlendirilmesinin takipte yer almasý gerektiðini ortaya koymaktadýr.

Aim: The aim of our study was assessment of pulmonary functions, walking and
BODE index and evaluation of relationship with duration and severity of disease
in COPD.
Material and method: Twenty-five male patients with stable COPD participated in
the study. Patients performed pulmonary function tests (PFT) and six minute
walking test (6 MWT). Dyspnea of patients was estimated by “Modified Medical
Research Dyspnea Scale”, visual analog dyspnea scale (VAS) and Borg scale. BODE
index, myocardial oxygen consumption (MVO2) and six minute walking work
were calculated.
Results: Body mass index (BMI) were 28.2±2.7 kg/m2, predicted forced expiratory
volume in first second (FEV1) were %56.8±22.7 (1.45±0.55 lt), maximal inspiratory
pressures (PImax) were 71.7±26.6 cm H2O, maximal expiratory pressures were
74.7±40.5 cm H2O in PFT. Six minute walking distance was 366±65 m. MVO2,
dyspnea (VAS and Borg) and oxygen saturation were significantly changed after
the 6 MWT (p< 0.001). Severity of disease has shown significantly relationship with
%FEV1, %FVC, FEV2/FVC, dyspnea (MMRC), BODE index (rs=-0.955, p<0.001;
rs=0.793, p<0.001; rs=-0.556, p=0.04; rs=0.527, p=0.007; rs=0.775, respectively;
p<0.001 for all ), dyspnea (VAS) and MVO2 in 6 MWT (rs=0.609, p=0.001; rs=0.453
respectively; p=0.02 for all). Multiple lineer regression model was developed for
this relationship. y=-0.03 FEV1 (%)+0.15 dyspnea (VAS)+0.08 BODE (F=93.38,
p<0.001; R=0.96, R2=0.93) was found. Duration of disease was significantly related
with BODE index (rs=0.525, p=0.007), dyspnea (MMRC) (rs=0.571, p=0.003), 6
MWD (rs=- 0.635, p= 0.001), and dyspnea change (VAS) in 6 MWT (rs=0.533, p=
0.006). Duration of disease=0.38 dyspnea (MMRC) -0.30 (F=7.78, p=0.01, R=0.50,
R2=0.25) was found in multiple lineer regression analyses.
Conclusion: Both severity and duration of diseases have been found to be related
with dyspnea and BODE index and this reveals that physiological measurement as
well as symptoms quantified assessment are necessary to take part in the following
of patients.

Abstract | Full Text PDF

Astým hastalýðýnýn yönetimi, astýmý kontrol altýna almak için þarttýr. Yönetim, hasta-
hekim iþbirliðine dayanýr. Hasta eðitimi, yönetimin vazgeçilmez unsurudur.
Eðitim, iþbirliðini oluþturmaya ve hastanýn yönetimde aktif rol oynamasýna hizmet
eder. Hastanýn risk faktörlerini tanýmasýna, inhalasyon tekniklerini öðrenmesine ve
hastalýðý kontrol etme konusunda özgüven kazanmasýna yardýmcý olur. Kiþisel eylem
planý ile hastanýn kendi kendini takibi, yönetimin esasýný oluþturur.

Asthma management is essential in the control of the disease. Doctor/patient cooperation
as well as patient education constitute the base for asthma management.
Education plays a crucial role for the patient in establishing the cooperation and in
taking an active role in managment. Through the means of the education the
patient familiarizes himself/herself with the risk factors, learns inhalation techniques
and gains self-confidence in asthma management. Personal action plan, providing
self-monitoring/self-managment abilites to the patient, is the center of the
asthma management

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Wegener granülomatozu (WG) özellikle üst ve alt solunum yollarýný ve böbrekleri
tutan nekrotizan granülomatöz vaskülitik bir hastalýktýr. Nekrotizan bir doðasý
vardýr ve kaviter akciðer lezyonu yapar. Ýlk vaka sað akciðerinde, içinde 1x1.5 cm
kaviter lezyon içeren irregüler sýnýrlý nonhomojen kitle lezyonu olan 47 yaþýnda bayan
hastayken, diðeri kaviter kitle lezyonu olan 43 yaþýnda erkek hastaydý. Ýlk vaka
sýnýrlý form WG, diðeri ise yaygýn formdaydý. Her iki vakamýzda da ilk baþta c-
ANCA negatif iken ilk vakanýn takiplerinde pozitiþeþme gözlendi. Taný her iki vakada
da histopatolojik olarak kondu. Ýlk vaka kontrolümüzden çýktý ama ikinci vaka
günümüze kadar remisyonda takip edilmektedir.

Wegener granulomatosis (WG) is a necrotising granulomatous vasculitic disease
that especially involves upper and lower respiratory tract and kindey. It has a
necrotizing nature and causes cavitary lung lesions. First case was a 47 years old
female patient with a non-homogenous mass lesion with irregular countours and a
1x1.5 cm cavitary lesion in her right lung. The other one was a 43 years old male
patient with cavitary mass lesion. While the first case was a limited form the
second case was a disseminated form. In both of our cases c-ANCA is negative in
the begining but became positive in the follow up of the first case. The diagnosis
is made histopathologically in both of our cases. The first case was out of control
and the second case is in remission and being followed up to present day.

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Lenfoma en sýk görülen mediastinal tümörler arasýndadýr, ama non-Hodgkin
lenfomada (NHL) mediasten tutulumu nadirdir. NHL’nin bir varyantý olan primer
mediastinal büyük B-hücreli lenfoma (PMBHL) %6 oranýnda görülür ve özellikle
ön-orta mediastende yer alýr. PMBHL’nin arka mediastende görülmesi nadir bir
durumdur. Arka mediastende kitle saptanan 52 yaþýndaki bir erkek hastaya minitorakotomiyle
biyopsi yapýlmýþ ve lenfoma tanýsý konmuþtur. Lenfadenopati veya
hepatosplenomegalisi bulunmayan hastaya Galyum 67 sintigrafisi sonrasý PMBHL
kesin tanýsý konarak, tedavi amacýyla Medikal Onkoloji klini¤ine verilmiþtir. Nadir
görülmekle birlikte, arka mediastende lezyonlarýnýn ayýrýcý tanýsýnda PMBHL yer
almalýdýr.

Although lymphoma is one of the commonest mediastinal tumors, mediastinal
involvement of non-Hodgkin lymphoma (NHL) is rare. Primary mediastinal large
B-cell lymphoma (PMBCL) involves mostly anterior or middle mediastinum. Cases
of PMBCL involving posterior mediastinum are very rare. Lymphoma was
diagnosed after a biopsy via minithoracotomy of a 52-years-old male patient
having a posterior mediastinal mass lesion. He had neither lymphadenopathy nor
hepatosplenomegaly in physical examination, and radiological evaluation.
Gallium 67 scintigraphy showed accumulation only in the mediastinum, revealing
the diagnosis of PMBCL. Although very rare, PMBCL should be kept in mind in
the differential diagnosis of posterior mediastinal lesions.

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Plevra hastalýklarý, farklý akciðer hastalýklarýnýn yanýnda çok çeþitli sistemik hastalýklarýn tutulumunun sonucu olarak da ortaya çýkabilmektedir. Akciðer ya da akciðer dýþý hastalýklarýn plevrayý etkilemeleri ile ortaya çýkan en sýk görünüm, plevrada sývý birikimidir. Hematolojik maligniteler nadiren plevra sývýsýyla prezente olabilir. Multipl miyelomda plevra sývýsý nadir bulgudur, malign plazma hücreleri infiltrasyonuna baðlý plevra sývýsý ise çok daha nadirdir. Multipl miyelomda plevra sývýsý genellikle benign karakterdedir, hipoalbüminemi, enfeksiyon, amiloidoza baðlý kalp yetmezliði veya böbrek yetmezliði gibi nedenlere baðlý olarak geliþebileceði akýlda tutulmalýdýr. Biz, kliniðimize multipl miyeloma baðlý bilateral plevra sývýsý ile gelen 70 yaþýnda bir erkek hastayý rapor ettik.

Pleural diseases are most commonly seen with pulmonary disorders but can also be related to various systemic diseases. They often present as pleural effusion. Hematologic malignancies can rarely present with pleural effusion. Multiple myeloma presenting with pleural effusion have rarely been reported while malignant pleural cell infiltration is even more rarely seen. It should be remembered that pleural effusion in multiple myeloma are most commonly benign and develop secondary to other complications of the disease like
hypoalbuminemia, heart or kidney failure. We report a 70 year old male patient presented to our clinic with pleural effusion due to multiple myeloma.

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Pulmoner alveoler proteinozis (PAP), alveollerde Periodic Acid Schiff (PAS) ile pozitif boyanan proteinöz materyalin birikimi ile karakterize, nadir görülen bir hastalýktýr. Primer PAP 1958 yýlýnda Rosen tarafýndan tanýmlanmýþ, etiyolojisi bilinmeyen bir hastalýktýr. En sýk rastlanýlan semptomlar nefes darlýðý ve öksürüktür. Radyolojik olarak bilateral simetrik alveoler konsolidasyon veya buzlu cam görüntüsü saptanýr. Solunum fonksiyon testi (SFT) hafif restriktif özelliktedir. Taný transbronþiyal biyopsi veya daha sýklýkla açýk akciðer biyopsisi ile konulur. Vakamýz ise
yaklaþýk bir yýldýr prodüktif olmayan öksürük ve hafif efor dispnesi tariþeyen ve transbronþiyal biyopsi ile tanýya vardýðýmýz bir primer PAP hastasýdýr.

Pulmonary alveolar proteinosis (PAP) is a rare disease that is characterized by the accumulation of Periodic Acid Schiff-positive protinaceous material in the alveoli. Primary PAP is an unknown etiology which was first described by Rosen in 1958. The most common symptoms are dyspnea and dry cough. The radiographic finding is bilateral, symmetric alveolar consolidation or ground-glass
opacity. Pulmonary function test shows mild restriction. We decscribe the case of a primary PAP who had a nonproductive cough and mild dyspne on exertion for nearly one year and that the diagnosis was made by transbronsial biopsy.

Abstract | Full Text PDF