Tüberküloz (TB) her yaþtan, cinsiyetten ve sosyoekonomik sýnýftan insaný etkileyen bir infeksiyon hastalýðýdýr. Ancak toplumun belli kesimlerinde daha sýk görülmekte ve bu durum TB kontrol programlarýnýn yapýlandýrýlmasýnda göz önüne alýnmaktadýr. Prevalansýn yüksek olduðu ülkelerde üretken yaþ gruplarýný etkilerken, prevalansýn düþük olduðu ülkelerde yaþlýlarda önemli bir sorundur. Yaþlýlarda klinik ve radyolojik bulgularýn atipik olmasý ve komorbiditeler nedeniyle tanýda ve uygun tedaviye baþlamada gecikmeler olabilmektedir. Hýzlý tanýnýn temeli ayýrýcý tanýda TB’nin düþünülmesidir. Yaþlýlarda aktif TB’nin tedavisi temelde gençlerden farklý deðildir. Standart tedavi kullanýlýr. Ancak yan etkiler gençlerden daha fazla görülmektedir. Yaþlý hastalarda tedavi baþarýsý daha düþük, TB’ye baðlý mortalite daha yüksektir. Risk grubundaki yaþlýlarda latent TB infeksiyonu taný ve tedavisi yapýlmalýdýr. Ancak hepatotoksisite riskini azaltmak için tedavi öncesi deðerlendirmeler yapýlmalý, yarar/zarar oraný doðru dengelenmelidir.

Tuberculosis (TB) is an infectious disease that can affect people of any age, gender, or socioeconomic class. It is more prevalent in some sections of the population and this situation is taken under consideration in implementing TB control programs. While TB affects mostly the productive age groups in high prevalence countries, it remains an important challenge in the elderly in low prevalence countries. The atypical clinical and radiological presentation of TB in the elderly and comorbidities can lead to delayed diagnosis and appropriate treatment. Considering TB in differential diagnosis is the cornerstone of a rapid diagnosis. Management of active TB in the elderly does not differ fundamentally from that in younger patients. Standart treatment is used. The incidence of adverse effects is higher in the elderly compared to the younger patients. Successful treatment outcomes are lower and TB-related mortality is higher in the elderly patients. The diagnosis and treatment of latent TB infection should be considered in risk groups. To minimize the risk of hepatotoxicity, careful pretreatment assessment is needed to balance the benefit against this potential risk.

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Aerosol ilaçlar, solunum yolu hastalýklarýnýn ve sistemik hastalýklarýn tedavisinde kullanýlan oral veya parenteral uygulanan ilaçlarýn yerini almaya baþlamaktadýr. Aerosol yolla ilaç uygulamasýnýn baþlýca avantajlarý, noninvazif olmasý, oral tedavi ile karþýlaþtýrýldýðýnda etkinin daha hýzlý baþlamasý, oral ve enjeksiyon tedavisine göre yan etkilerinin daha az olmasý ve enjeksiyona baðlý aðrýnýn oluþmamasýdýr. Aerosol yolla akciðerlere uygulanabilen terapötik ilaçlar arasýnda antibiyotikler, mukolitikler, kýsa ve uzun etkili bronkodilatörler, antikolinerjikler, steroid ve nonsteroid antiinflamatuar ilaçlar sayýlabilir. Günümüzde, aerolize ilaç uygulamasý amacýyla kullanýmda olan araçlar üç kategoride sýnýflandýrýlabilir: nebülizerler, ölçülü doz inhalerler (ÖDÝ) ve kuru toz inhalerler (KTÝ). Ülkemizde de çeþitli tipte inhaler ilaçlar bulunmaktadýr. Çocuklarda en etkili inhalasyon yönteminin seçimi, çocuðun yaþýna ve klinik durumuna baðlýdýr. Seçilen uygun yönteme göre çocuklarýn tedaviye uyumu artýrýlabilmekte ve hastalýk seyri olumlu yönde deðiþtirilebilmektedir.

Aerosol medications are replacing oral and injected drugs that are used in the treatment of respiratory and other diseases. There are many advantages of aerosolized drug delivery to the lung. This route of administration is non-invasive, provides a faster onset of action for some drugs compared to oral therapy, avoiding the side-effects associated with oral and injection therapy and the pain associated with injection therapy. Many therapeutic drugs are being administered to the lung by aerosols. They include antibiotics, mucolytics, short and long–acting bronchodilators, anticholinergics, steroidal antiinflamatory drugs, non-steroidal antiinflamatory drugs. Many new devices are now available for delivering aerosolized medications. The current methods to deliver therapeutic aerosols can be classified in three categories: nebulizers, pressurized metered dose inhalers (pMDI’s) and dry powder inhalers (DPT’s). Various types of inhalers have become available in our country. The most efficient method of delivering aerosol to children depends on the age and clinical condition of the child.

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Amaç: Hava kaçaðý, akciðer rezeksiyonlarý sonrasý en sýk görülen komplikasyondur. Bu yazýda, akciðer cerrahisi sonrasý aseptik boþluk ile ilgili deneyimimizi ve Heimlich valf kullanýmýmýzý tartýþmayý amaçladýk.
Gereç ve Yöntem: Çalýþmaya, Eskiþehir Osmangazi Üniversitesi Týp Fakültesi Göðüs Cerrahisi Anabilim Dalýnda Mart 2005 ile Mayýs 2010 yýllarý arasýnda ameliyat edilen, uzamýþ ve persistan hava kaçaðý olan hastalar alýndý. Yirmi hastaya Heimlich valf uygulandý, 27 hasta ise Heimlich valf olmaksýzýn aseptik boþluk ile taburcu edildi.
Sonuçlar: Heimlich valfe ortalama geçiþ zamaný 8,4 (4-15) gündür. Valf’in ortalama sonlandýrma zamaný 26,95 (7-120) gündür. Aseptik boþluk gurubunda göðüs tüpü ortalama 10,65 (9-12) günde sonlandýrýldý. Ýki gurupta da ampiyem oluþmadý.
Tartýþma: Uzamýþ veya persistan hava kaçaðý olan hastalarda postoperatif parankimal iyileþmenin deðerlendirilmesi, tedavinin zamanlamasý ve seçimi açýsýndan önemlidir. Parankim kaçaðý olmayan hastalarda aseptik boþluk uygulamasýnýn, parankim kaçaðý devam eden hastalarda ise Heimlich valf uygulamasýnýn faydalý olduðunu düþünüyoruz.

Aim: Air leak is the most common complication incurring after pulmonary resection. In this report, we have aimed to discuss our usage of the Heimlich valve and the application of aseptic space after lung operations.
Materials and Methods: Patients with prolonged or persistent air leakage, operated at the Thoracic Surgery Department of Eskiþehir Osmangazi University School of Medicine, between March 2005 and March 2010, were recruited for the study. While Heimlich valve was used on 20 patients because of persistent air leakage, 27 patients were discharged from the hospital with an aseptic space, without Heimlich valve attachment.
Results: The mean transient time of Heimlich valve application was 8.4 (4-15) days. The mean removal time of the valve was 26.95 (7-120) days. In the group with aseptic space, chest tubes were taken out in 9 to 12 days (mean 10.65). No empyema occurred in either group.
Conclusion: In patients with prolonged or persistent air leakage, evaluation of postoperative parenchymal recovery is of importance for the timing and the choice of treatment. We think that the use of aseptic space in patients without parenchymal leakage and placement of Heimlich valves in those with ongoing parenchymal leakages will be of benefit.

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Amaç: Pulmoner emboli (PE), hastanede yatan hastalarda sýk görülen, morbidite ve mortalitesi yüksek bir hastalýktýr. PE’lerin önemli bir kýsmý alt ekstremite derin venöz sisteminden kaynaklanýr ve bu derin ven trombozlarý (DVT) çoðunlukla asemptomatiktir. DVT ve PE proflaksisi tüm dünyada kabul gören, rutin kullanýma girmiþ yöntemler olmasýna karþýlýk risk grubundaki hastalara proflaksi uygulamalarý ihmal edilebilmektedir. Çalýþmamýzý, hastanemizde yatan ve risk faktörü taþýyan hastalarda DVT proflaksisinin hangi sýklýkta uygulandýðýný araþtýrmak için planladýk.
Gereç ve Yöntem: Hastanemizin cerrahi, ortopedi, yoðun bakým, dahiliye, onkoloji, plastik cerrahi, kadýn doðum, göðüs hastalýklarý, nöroloji, nöroþirürji ve üroloji kliniklerinde yatan hastalar, ayný gün içinde ziyaret edilerek, hem kendileri hem de dosyalarý görüldü. DVT ve PE için risk faktörleri saptandý. Proflaksi almasý gerekip gerekmediði, 2001 ACCP kriterlerine göre belirlendi. Proflaksi alýp almadýðý, proflaksiye kontrendike bir durumu olup olmadýðý kaydedildi.
Bulgular: Hastanemizde yatan 275 hasta ziyaret edildi ve dosyasý incelendi. Hastalarýn 134’ü (%48,7) kadýn, 141’i (%51,3) erkekti ve yaþ ortalamalarý 53,09±19 idi. Hastanede ortalama yatýþ sürelerinin 8,1±10,1 gün olduðu saptandý. En sýk saptanan risk faktörleri ileri yaþ (%52,0), immobilite (%38,9), operasyon öyküsü (%36,4), malignite (%28,7) ve obezite (%21,1) idi. Proflaksi almasý gereken 170 hasta vardý ve bunlarýn 56’sýna (%32,9) profilaksi uygulanýyordu. Klinikler ayrý ayrý incelendiðinde, risk gruplarýna profilaksi uygulanma oranýnýn en yüksek ortopedi (%84,6) ve nöroloji (%60,0) kliniklerinde bulunduðu, onlarý %37,5 ile yoðun bakým ünitesinin izlediði görüldü. Kadýn hastalýklarý ve doðum, onkoloji, plastik cerrahi ile üroloji kliniðinde profilaksi uygulanan hasta saptanmadý.
Sonuç: Hastanemizde venöz tromboemboli proflaksisine gereken önemin verilmediðini, risk grubundaki hastalara proflaksi uygulanmasý ile venöz tromboemboli insidansýnýn ve ona baðlý morbidite ile mortalitenin azalacaðýný düþünüyoruz. Bunu da eðitimle baþarabileceðimiz kanaatindeyiz.

Objective: Pulmonary embolism (PE) is frequent among hospitalized patients, with a high morbidity and mortality rate. Although prophylaxis for PE and deep venous thrombosis (DVT) is accepted worldwide and the procedures are routinely applied, prophylaxis may sometimes be ignored in risk groups. The aim of our study was to evaluate the rates of DVT prophylaxis in risk groups among patients hospitalized in our hospital.
Materials and Methods: This cross-sectional study was conducted in January 2008 at Dr. Lutfi Kýrdar Kartal Training and Research Hospital. Patients hospitalized in our surgery, orthopedics, intensive care, internal medicine, oncology, plastic surgery, obstetrics and gynecology, pulmonary diseases, neurology, neurosurgery and urology clinics were visited on the same day to evaluate the patients clinically and their medical records. Risk factors for DVT and PE were determined and patients receiving prophylaxis were documented.
Results: For the 275 patients, 134 (48.7%) females and 141(51.3%) males, included in the study, the average length of hospital stay was 8.1±10.1 days. The most frequent risk factors were advanced age (52.0%), immobility (38.9%), history of operation (36.4%), malignancy (28.7%) and obesity (21.1%). Among 170 patients who should receive prophylaxis, only 56 (32.9%) were found to receive prophylaxis. The highest rate of prophylaxis was given by the Orthopedics (84.6%) and the Neurology (60.0%) clinics, followed by the Intensive Care Unit (37.5%). During the study period, no patient was found to receive VT prophylaxis in the Gynecology, Oncology, Plastic Surgery and Urology Departments.
Conclusion: We have found out that in our hospital, the importance of DVT prophylaxis was not fully practiced. Prophylaxis of high risk patients for DVT would decrease the incidence of venous thromboembolism and the associated morbidity and mortality. We believe that the appropriate practice of prophylaxis could only be achieved through education.

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Amaç: Bu çalýþmada, bir üçüncü basamak saðlýk kuruluþunda çalýþan personelin organ nakli ve baðýþýyla ilgili görüþ ve tutumlarýnýn belirlenmesi amaçlandý.
Gereç ve Yöntem: Çalýþan 519 saðlýk personelinden ulaþýlabilen ve formu eksiksiz dolduran 256’sýna, görüþlerini ortaya çýkarma amacýyla, 5’i sosyodemografik özelliklere, 14’ü organ nakli ve baðýþýna iliþkin görüþlere, 6’sý hastanede açýlacak olan nakil merkezi konusundaki görüþlere yönelik, kapalý ve açýk uçlu sorulardan oluþan 27 soruluk anket formu uygulandý. Sonuçlarýn istatistiksel analizi için student-t test, ki-kare testi kullanýldý. Gruplar arasýndaki farklar Anova ve post hoc analiziyle belirlendi. Sonuçlar: Ankete yanýt veren 256 saðlýk personelinin %20,7’si (n=53) doktor, %34,8’i (n=89) hemþire, %3,1’i (n=8) idari personel, %10,5’i (n=27) personel, %13,7’si (n=35) tekniker, %17,2’si (n=44) týbbi sekreterdi. Organ/doku baðýþý ve nakli konusundaki tutumlar ile eðitim düzeyleri arasýndaki fark istatistiksel olarak anlamlýydý (p<0,05). Saðlýk personelinin organ baðýþlama durumlarý ile meslekler arasýndaki fark istatistiksel olarak anlamlýydý (p<0,001). “Bir yakýnýnýzýn beyin ölümü halinde organlarýnýn baðýþlanmasý konusunda giriþimde bulunur musunuz?’’ sorusuna verdikleri yanýtlar incelendiðinde, %50,8’inin (n=130) evet, %49,2’sinin (n=126) hayýr yanýtýný verdikleri görüldü. Yüzde 6,3’ünün (n=8), organ bekleyen yakýný olmasýna raðmen yakýnlarýnýn beyin ölümü halinde organlarýný baðýþlamayacaklarý saptandý.
Yorum: Nakledilecek organa gereksinimin arttýðý günümüzde, saðlýk çalýþanlarý baþta olmak üzere toplumun birçok kesiminin nakli gerçekleþtirilen organlar hakkýnda tam ve doðru bilgi birikimine sahip olmadýðý ve organ baðýþýnda bulunma oranlarýnýn yetersiz kaldýðý görülmektedir. Organ naklinde istenilen hedefe ulaþmanýn tek yolu organ baðýþ sayýsýný artýrmaktýr. Bu sorunun çözümü için tüm toplumun yeterli bilgi ve farkýndalýða sahip olmasý gerekmektedir ve hedef eðitim, bilinçlendirme ve bilgilendirme ile farkýndalýðýn artýrýlmasýdýr.

Objective: This study was planned to define opinions and attitudes of the staff working in a tertiary health institute for organ transplantation and donation.
Materials and Methods: A questionnaire form including a total of 27 closed and open-ended questions was distributed to 256 of the 519 health care personnel staff who were reached and asked to fill the form completely. Results: Of the 256 health personnel who answered the questionnaire, 20.7% (n=53) were physicians, 34.8% (n=89) nurses, 3.1% (n=8) administrative personnel, 10.5% (n=27) personnel, 13.7% (n=35) technicians and 17.2% (n=44) medical secretaries. The attitudes on organ donation and transplantation improved with rising educational level (p<0,001). The attitudes with respect to organ donation were clearly positive and the educational levels were higher among the physicians and the nurses and both statistically different than those of the other personnel (p< 0.05). The difference between the organ donation status of different professions was also significant (p< 0.001). When examined, the answers given to the question, “Would you make an attempt for organ donation in case of brain death of one of your relatives?" resulted in: 50.8% (n=130) as ‘yes’ and 49.2% (n=126) as ‘no’. Despite having relatives waiting for organs, %6.3 (n=8) of the participants were not willing to donate organs of their relatives in the case of brain death. Student-t and One-way Anova tests were used for the statistical analysis of the outcomes. The differences among the groups was determined by post hoc analysis.
Conclusion: Despite the increasing need for organs to be transplanted today, health care staff do not have a complete and accurate knowledge of organs transplantion, and their preparedness for organ donation is not satisfactory. The only way to reach the desired target in organ transplantation is to increase the number of organ donations. For the solution of this problem society must acquire sufficient knowledge and the awareness should be increased through the education.

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Amaç: Obstrüktif uyku apne sendromu (OUAS) sýk görülen bir durumdur. Sekelleri arasýnda sertleþme bozukluðu (SB) bulunur. Çalýþmamýzýn amacý OUAS ile SB arasýndaki iliþkiyi ortaya koymaktýr.
Gereç ve Yöntem: Çalýþma popülasyonu 34 OUAS hastasýndan oluþtu. Kontrol grubuna (basit horlama) 13 hasta alýndý. Demografik özellikler, beden kitle indeksi (BKÝ), polisomnografik parametreler, Epworth Uykululuk Skalasý (EUS) deðeri ve seksüel fonksiyon durumu kaydedildi. Tüm hastalarýn ürolojik muayeneleri yapýldý. Seksüel fonksiyonlarýný deðerlendirmek için erkeklere “The International Index of Erectile Function-5 (IIEF-5)”, kadýnlara “Female Sexual Function Index (FSFI)” uygulandý. AHÝ<5 olanlar kontrol grubu, AHÝ≥5 olanlar çalýþma grubu olarak kabul edildi. Veriyi analiz etmek için kullanýlan istatistiksel yöntemler Kruskal Wallis Varyans Analizi, Bonferroni Düzeltmeli Mann Whitney U Testi, Ýki Ortalalama Arasýndaki Farkýn Önemlilik Testi ve Mann Whitney U Testidir.
Bulgular: Semptomlarýna göre 34 hastanýn 24’ünde (%70,6) SB saptandý. SB’li hastalarýn çoðu ciddi OUAS’li idi. SB ile Beden Kitle Ýndeksi (BKÝ) arasýnda istatistiksel olarak anlamlý bir iliþki vardý (p= 0,007). IIEF-5’e göre de 24 hastada SB bulundu. SB’si olan ve olmayan OSAS’lilerde minimum O2 satürasyonu açýsýndan istatistiksel olarak önemli bir fark vardý (p=0,044). Respiratory disturbance index(RDI) ve ESS, ciddi SB’li hastalarda SB’si olmayan hastalarla karþýlaþtýrýldýðýnda daha yüksekti ama aradaki fark anlamlý deðildi (p>0,05).
Sonuç: OUAS'lý hastalarda seksüel fonksiyonlar etkilenmektedir. SB’si olan OUAS’li hastalarda SB’nin mekanizmasý ve SB’nin tedavisi için ek çalýþmalara ihtiyaç vardýr.

Aim: Obstructive sleep apnea syndrome (OSAS) is a common medical problem. Among its sequelae, erectile dysfunction (ED) has been reported. The aim of this study aim was to clarify the association between OSAS and ED.
Materials and Methods: The study population consisted of 34 OSAS patients and 13 control patients with simple snoring. Demographics, body mass index (BMI), polysomnography parameters, Epworth Sleepiness Scale (ESS) score, and sexual function situation were noted. All patients underwent urologic examination. The International Index of Erectile Function -5 (IIEF-5) was performed to males, and Female Sexual Function Index (FSFI) was performed to females in order to evaluated sexual functions. Patients were grouped as the control group whose apnea- hypopnea index was below 5, and as the study group with respiratory disturbance index RDI≥ 5. The data were statistically analyzed by using Kruskal Wallis Variance Analysis, Mann Whitney U Test with Bonferroni Correction, Independent Samples t Test and Mann Whitney U Test.
Results: ED was found in 24 (70.6%) of 34 patients on the basis of their symptoms. Most of the patients with ED (40%) had severe OSAS. There was a statistically significant relation between Body Mass Index (BMI) and ED (p=0.007). We found ED in 24 patients according to the IIEF-5 score. There was a statistically significant difference in the minimum O2 saturation f.indings between the OSAS patients with and without ED (p=0.044). Respiratory Disturbance Index (RDI) and ESS were higher in the patients with severe ED in comparison to the patients without ED, but the difference wasn’t statistically significant (p>0.05).
Conclusion: Sexual functions have been found to be affected in patients with OSAS. Additional studies are needed to ascertain the mechanism of ED in OSAS and the treatment of ED in this group of patients.

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Amaç: Ventilatörle iliþkili akciðer hasarý (ventilation induced lung injury, VILI), mekanik ventilasyondaki (MV) hastalarýn tedavisinde önemli bir sorun oluþturmaktadýr. Kafeik asit (KA) immünomodülatör, antiproliferatif, antiinflamatuar ve antioksidan özellikte olan bir moleküldür. Bu çalýþmada, MV’ye baðlý olarak geliþen VILI’nýn önlenmesinde KA’nýn etkisi araþtýrýldý.
Gereç ve Yöntemler: Çalýþmaya alýnan ratlar 4 gruba ayrýldý. Grup 1’e (kontrol grubu) fizyolojik volümlerde (9 mL/kg) MV, Grup 2’ye aþýrý doz (35 mL/kg) MV, Grup 3’e aþýrý doz MV ve 10 μmol/kg KA, Grup 4’e ise aþýrý doz MV ve 30 μmol/kg KA uygulandý. Tüm gruplarda akciðer hasarýnýn göstergesi olabilecek deðiþiklikler histopatolojik olarak deðerlendirildi.
Bulgular: Kontrol grubu ile karþýlaþtýrýldýðýnda, Grup 2 ratlarda akciðer hasarý göstergelerinde artýþ tespit edildi (p<0,01). Diðer yandan KA uygulanan Grup 3’te Grup 2 örneklerine göre akciðer hasarý bulgularýnýn çok daha düþük þiddette ortaya çýktýðý görüldü (p<0,01). KA uygulanan Grup 3 ile 4 ratlarda belirlenen akciðer hasarý histopatolojik bulgularýnýn þiddeti arasýnda ise anlamlý fark yoktu.
Sonuç: Yüksek tidal volümlerin VILI’ya sebep olduðunu ve KA’nýn bunu önlediðini histopatolojik olarak gösterdik.

Aim: entilation induced lung injury (VILI) constitutes a serious problem in the treatment of patients on mechanical ventilation (MV). Caffeic acid (CA) is a molecule with immunomodulating, antiproliferative, antiinflammatory and antioxidant properties. In this study the effect of CA in preventing VILI caused by MV has been investigated.
Materials and Methods: The rats included in the study were divided into four groups. Group 1, designated as the control group, was subjected to physiological volumes (9 ml/kg) of MV; Group 2 was subjected to overdose (35 ml/kg) of MV; Group 3 received an overdose of MV and 10 μmol/kg of CA; and Group 4 received an overdose of MV and 30 10 μmol/kg of Ca. In all four groups the changes indicating lung damage were estimated histopathologically.
Results: An increase in lung damage was observed in Group 2 rats as compared to the control Group 1 (p<0.01), whereas much less lung damage was noted in the Group 3 rats as compared to the Group 2 rats (p<0.01). There was no statistically significant difference in the severity of histopathologically estimated lung damage between the rats of Group 3 and Group 4.
Conclusion: We have shown through histopathological indices that high tidal volumes of ventilation cause VILI and that CA can prevent these.

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Pulmoner langerhans hücreli histiyositozis (PLHH), etyolojisi bilinmeyen ve sigara içenlerde görülen, nadir bir interstisyel akciðer hastalýðýdýr. Hastalýkta genellikle izole akciðer tutulumu vardýr ve santral sinir sistemi tutulumu nadirdir. Bu olgu sunumunda, birinde takip, diðerinde ise taný sýrasýnda santral diabetes insipidus (DÝ) saptanan iki olgu sunulmaktadýr. Olgular, yaþlarý sýrasýyla 24 ve 39 olan, sigara içme öyküsü olan erkek hastalardý. Ýki olgunun da yüksek rezolüsyonlu bilgisayarlý tomografilerinde (YRBT) yaygýn kistik lezyonlar izlenmiþ olup, video-yardýmlý torakoskopik cerrahiyle (VATS) alýnan biyopsilerinde PLHH saptandý. Takipte solunum fonksiyonlarýnýn bozulmuþ olduðu görülen birinci olguya 0,5 mg/kg metil prednisolon baþlandý. Bir ay sonra yapýlan kontrolde PLHH için kýsmi düzelme gözlenmesi üzerine tedavi 6 aya uzatýldý, tedavi bitiminde tam remisyon saptanarak steroid tedavisi kesildi. Ýki hastaya da DÝ için oral 0,1 mg/gün desmopressin baþlandý, bir ay sonra tam klinik düzelme gözlendi.

Pulmonary Langerhans’ cell histiocytosis (PLCH) is an uncommon interstitial lung disease with an unknown etiology in smokers. Disease is usually seen with isolated lung involvement and central nervous system involvement is rare.Two PLCH cases, with central diabetes insipidus (DI) determined at diagnosis in one of the cases and during follow-up in the other, is being presented in this report. The patients’ ages were 39 and 24, respectively and they were both male patients with a history of smoking. Widely cystic lesions were viewed at high-resolution computed tomography scans (HRCT) and PLCH was detected at the biopsies obtained by video-assisted thoracoscopic surgery (VATS), in both two cases. Therapy was started with 0.5 mg/kg methyl prednisolone for latter case, because of impairment in pulmonary function tests during follow up. On control, after one month therapy, partial improvement was seen for PLCH and the therapy was continued up to 6 months. At the end of the therapy complete remission was seen and corticotherapy was stopped. Desmopressin was started for both cases at 0.1 mg/day, orally. After one month of treatment clinical improvement was observed during control.

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Castleman hastalýðý, etiyolojisi tam olarak bilinmeyen ve nadir görülen benign bir hastalýktýr. Anjiyofoliküler lenf nodu hiperplazisi veya dev lenf nodu hiperplazisi olarak da adlandýrýlýr. Eriþkinlerde sýk olmasýna karþýlýk çocukluktan itibaren her yaþta görülebilmektedir.
Sýklýkla toraksa yerleþmekle beraber tüm vücutta bulunabilir. Genellikle orta ve ön mediastende lokalizedir. Mediastinal otoimmün ve neoplastik hastalýklardan ayýrt edilmesi gerekir. Burada, nadir bir yerleþim yeri olarak interlober bölgeden eksize ettiðimiz bir Castlamen hastalýðý olgusunu, literatür bilgileri eþliðinde sunmaktayýz.

Castleman’s disease is a rare benign disease with an unknown etiology. It is also called the angiofollicular lymph node hyperplasia or giant lymph node hyperplasia. Although it is more common in adults, it can be seen at any age starting from childhood.
It is more commonly observed in the thorax, but it can be found anywhere in the body. It is usually localized in the middle or anterior mediastinum. Castleman’s disease should be differentiated from other mediastinal autoimmune or neoplastic diseases. With the review of the literature, we hereby introduce a case of Castleman’s disease excised from the interlobar area, which is a rare location for this disease.

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Timoma ile timik karsinom birlikteliði nadir görülmektedir. Kuru öksürük nedeniyle kliniðimize baþvuran 59 yaþýndaki hastanýn posteroanterior akciðer grafisinde orta mediastende geniþleme izlendi. Toraks bilgisayarlý tomografisinde ve manyetik rezonans görüntülemesinde, anterior mediastende nodüler kitle lezyonu saptandý. Pozitron emisyon tomografisinde artmýþ metabolik aktivite tutulum saptandý ve cerrahi olarak eksize edilen kitlenin histolojik incelemesiyle kombine B3 timoma-timik skuamöz hücreli karsinom tanýsýna ulaþýldý. Tümörün kapsülünü aþarak çevre yumuþak dokularý infiltre ettiði saptandý. Masaoka evresi IIA olarak belirlendi. Kapsül invazyonu olmasý nedeniyle 25 fraksiyonda toplam 50 Gy üç boyutlu konformal radyoterapi uygulandý. Olgu, timoma-timik karsinom birlikteliðinin nadir olmasý nedeniyle sunulmaktadýr.

The coexistence of thymoma and thymic carcinoma is rare. A 59-year-old patient with the complaint of dry cough was admitted to our hospital. His chest x-ray showed expansion of the middle mediastinum. An anterior mediastinal mass was determined in the computed tomography and magnetic resonance imaging of thorax. Positron emission tomography showed increased metabolic activity and histological examination of the surgically excised mass was found to be thymic squamous carcinoma coexistent with type B thymoma. The tumor had infiltrated the surrounding soft tissues beyond its capsule. The Masaoka stage was IIA. Due to the capsule invasion three-dimensional conformal radiotherapy of 50 Gy in 25 fractions in total were applied. The case is presented here because of the rare coexistence of thymoma with thymic carcinoma.

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