Biomedical subjects

Adnan Yilmaz

Publications and source records attributed to Adnan Yilmaz.

At least 19 recordsLinked to original sources

PubMed2006

Typical pulmonary carcinoid tumors: presentation and outcome of 24 cases.

BACKGROUND: The aim of the study was to determine the presenting clinical-radiological features and outcomes of typical pulmonary carcinoid tumors in our center. MATERIAL/METHODS: The medical records of 24 patients with typical pulmonary carcinoid tumor diagnosed between January 1995 and December 2003 were retrospectively reviewed. Follow-up information on patients was obtained from direct patient contact in February 2004. RESULTS: There were 17 female and 7 male patients with a mean age of 40.3 years (range: 17-69 years). Sixteen patients (66.7%) were nonsmokers. The most frequent presenting symptom was cough, followed by hemoptysis. Twenty-three patients had an abnormal chest X-ray, showing atelectasis in seven. Bronchoscopy revealed mass lesion in all cases. In 13 cases, tumor was located in the lobar bronchi. Diagnosis of carcinoid tumor was established with bronchoscopy in 19 patients and with thoracotomy in five cases. While surgery was the treatment modality in 23 patients, one patient refused treatment. Lobectomy was performed in 15 cases and six of them were sleeve lobectomy. One patient died two days after operation due to ischemic heart disease, two were lost to follow-up, and 21 patients were still alive. Survival for the 21 patients was between 5 and 96 months. Eight patients had survival of more than five years. CONCLUSIONS: Our data suggest that typical pulmonary carcinoids are different from major lung cancer types with respect to sex, age predilection, and smoking history. Surgery is the treatment of choice for pulmonary carcinoid tumors. These patients had excellent prognosis after surgical treatment.

Adolescent↗

PubMed2006

Does needle size affect diagnostic yield of transthoracic needle biopsy in malignant pulmonary lesions? Comparison of 18-, 22- and 25-gauge needles in surgical specimens.

OBJECTIVE: To evaluate the effect of needle size on the diagnostic yield of transthoracic needle aspiration biopsy in malignant pulmonary lesions. METHODS: The study assessed samples from 35 patients who underwent surgery for lung cancer. We used surgical specimens for needle aspiration biopsy. Aspirations were performed with 25-, 22- and 18-gauge, 9 cm in length aspirating needles. All pathology preparations were coded. At the end of the study period, all needle aspiration preparations were interpreted by the same pathologist. RESULTS: Lobectomy was performed in 19 patients, pneumonectomy in 15 and bilobectomy in one. Squamous cell carcinoma was the most frequent tumour type, followed by adenocarcinoma. The diagnostic yield of aspiration biopsy was 85.7% for 18-gauge needle and 82.9% for both 22-gauge and 25-gauge needles. There was no statistically significant difference for the three needles with respect to diagnostic yield (P > 0.05). Cell type concordance for 18-, 22- and 25-gauge needles was 70%, 65.6% and 65.6%, respectively. There was no statistically significant difference for the three needles with respect to cell type concordance (P > 0.05). CONCLUSION: Needle size did not affect diagnostic yield or accuracy for malignant lesions. Smaller needles such as 22-gauge needle would appear to be suitable for transthoracic needle aspiration biopsy in the diagnosis of malignant pulmonary lesions.

Adenocarcinoma↗

PubMed2006

A relapsing case of Wegener's granulomatosis presenting as an endobronchial mass.

Wegener's granulomatosis (WG) relapse is frequent. Although lung involvement occurs in 85% of patients, endobronchial presentation of the disease is uncommon. We reported a relapsing case of WG presenting as an endobronchial mass. A 56- year-old man present ed with recurrence of WG following 14 months of cyclophosphamide and prednisolone therapy and 36 months of complete remission. At his first presentation, he was diagnosed as having WG with involvement of kidney, lung, upper airways, skin, joints and eyes. His chest X-ray showed bilateral patchy consolidation. Cytoplasmic-anti-neutrophil cytoplasmic antibodies (c-ANCA) was also present in high titres. c-ANCA was negative after therapy. At the time of relapse, he presented with nasal symptoms and hemoptysis. His chest X-ray showed right paracardiac opacity. Fiberoptic bronchoscopy revealed a mass lesion subtotally obstructing the proximity of right lower lobe. He has been given prednisolone in tapering doses and cyclophosphamide for 10 months.

Bronchial Diseases↗

PubMed2006

[Thymic cysts: a report of six cases].

Thymic cysts are rarerly encountered lesions which are only 1 to 2% of all mediastinal masses. We present six patients with thymic cysts diagnosed between 2000 and 2004 in this report. There were three male and three female patients whose ages ranged from 34 to 64 years (mean age, 46 years). Four patients are nonsmoker. None of the patients had a previous history of an etiologic factor such as trauma, surgical procedure or evidence of significant inflammation. While one patient was asymptomatic, there were chest pain in three patients, cough in two patients, hemoptysis in two patients and dyspnea in one patient. Thymic cyst was located in anterior mediastinum in five patients and in upper mediastinum in one patient. Cysts were resected with thoracotomy in four cases and with sternotomy in two cases. Their size ranged from 5 to 9 cm in diameter. In pathologic examination, two cysts were multilocular. In conclusion, thymic cysts are rare masses. Differential diagnosis of mediastinal masses, especially anterior mediastinal masses should be included thymic cysts.

Adult↗

PubMed2006

[Primary pulmonary lymphoma].

Lymphoproliferative diseases affecting the lung occur over a broad clinical and pathologic spectrum. Primary Hodgkin and non-Hodgkin lymphoma of lung is a rare entity. Lymphomas generally affect lung secondarly. This lymphoma of lung occurs with non-specific clinical feature. The prognosis and treatment of this disease is very important due to fact that non-specific and different clinic are seen. In this paper, current approach in pulmonary primer lymphoma is presented.

Humans↗

PubMed2005

[Adenosquamous carcinoma of the lung (an analysis of 13 cases)].

Adenosquamous carcinoma of the lung is a rare disease. The biological behavior and clinicopathologic characteristics of this tumor have not been well described. In this study, we retrospectively evaluated 13 patients with adenosquamous carcinoma of the lung diagnosed at our center between January 2001 and May 2004. There were 12 males and 1 female whose ages ranged from 45 to 69 years, with a mean age of 55.9 years. Ten patients were smoker. The most frequent symptoms were chest pain and cough. Bronchoscopic examination detected that tumor was centrally located in four cases and was peripherally located in nine cases. Preoperative pathological diagnosis was squamous cell carcinoma in eight patients, non-small cell lung carcinoma in four patients and adenocarcinoma in one patient. One patient was in pathological stage IA, three patients in stage IB, one patient in stage IIA, two patients in stage IIB, five patients in stage IIIA, and one patient in stage IIIB. Twelve patients underwent resection (six, lobectomy; five, pneumonectomy; one, bilobectomy). Five of 12 patients received adjuvant therapy. Five patients died of disease within 3 and 21 months. Seven patients have had survival time between 9 and 31 months.

Aged↗

PubMed2004

Trace elements and some extracellular antioxidant proteins levels in serum of patients with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic progressive autoimmune disorder with a wide spectrum of clinical and immunological abnormalities. In this study, we aimed to investigate the levels of serum zinc (Zn), copper (Cu), magnesium (Mg), manganese (Mn), iron (Fe), ceruloplasmin (Cp), transferrin (Trf), and albumin (Alb) in SLE and whether it is related to the severity of the clinical condition of this chronic disease. Cp and Cu levels were higher, while Trf, Alb, Zn, Mg, Mn, and Fe levels were lower in serum of patients with SLE (n = 27) compared with healthy controls (n = 20). The mechanisms by which these alterations occur in certain inflammatory conditions need to be elucidated. It is also obscure whether these alterations are a cause or a consequence of the inflammation. As a conclusion, alterations in the levels of the parameters in SLE may not be a reason for, but in fact a consequence of the disease itself.

Adolescent↗

PubMed2004

Computed tomography-guided transthoracic fine-needle aspiration in diagnosis of lung cancer: a comparison of single-pass needle and multiple-pass coaxial needle systems and the value of immediate cytological assessment.

OBJECTIVES: The aim of the present study was to compare single-pass needle and multiple-pass coaxial needle systems and to evaluate the value of immediate cytological assessment during the procedure in the diagnosis of lung cancer with CT-guided transthoracic fine-needle aspiration. METHODOLOGY: One hundred and forty-three consecutive patients who underwent CT-guided transthoracic fine-needle aspiration were divided into three groups. In the first group (group A, 48 patients), a single-pass needle was used for aspiration, but immediate cytological examination was not performed. In the second group (group B, 48 patients), a single-pass needle was used for aspiration and a pathologist immediately assessed the adequacy of the sample obtained. In the third group (group C, 47 patients), a multiple-pass coaxial needle was used for aspiration and a pathologist immediately assessed the adequacy of the sample obtained. RESULTS: The mean number of fine-needle aspirations was 1.25 in group A, 1.39 in group B and 1.34 in group C (group A vs group B, P = 0.08). The diagnostic accuracy was 83.3, 97.9 and 100.0%, respectively (group A vs group B, P = 0.03; group B vs group C, P > 0.05). Although immediate cytological assessment resulted in adequate samples being obtained from all patients in groups B and C, adequate samples were obtained in 41 of 48 patients (85.4%) in group A (P = 0.004). There was no statistically significant difference among the groups with respect to the rate of pneumothorax. CONCLUSIONS: A single-pass needle technique in transthoracic fine-needle aspiration is preferred because there is no significant difference between single-pass needle and multiple-pass coaxial needle systems with respect to the diagnostic accuracy and the complication rate and, in addition, the single-pass needle has a lower cost. The results of the present study suggest that immediate cytological assessment during the procedure reduces an inadequate sampling rate, thus increasing the diagnostic accuracy of the procedure.

Adult↗

PubMed2004

Occult bronchial foreign body aspiration in adults: analysis of four cases.

Occult tracheobronchial foreign body aspirations are infrequently seen in adults because there is usually a high index of suspicion. Occult foreign bodies can remain undetected for months to years and often are misdiagnosed. The aim of this paper is to report the cases of four adult patients with occult bronchial foreign body aspiration. None of the patients had a previous history of aspiration. One patient had been misdiagnosed as having asthma. One was thought to have tuberculosis, while unresolved pneumonia was present in another. A CXR showed the presence of a foreign body in only one patient because it was metallic. The foreign bodies included a stone, a tooth fragment, a bone fragment, and a needle. The foreign bodies were removed using a rigid bronchoscope in two patients and via a surgical procedure in the other two. In conclusion, tracheobronchial foreign body aspiration should always be taken into consideration in the differential diagnosis of radiographic lesions or chronic respiratory symptoms that are poorly explained, even in the absence of a previous history of aspiration.

Adult↗

PubMed2004

Factors affecting delays in diagnosis and treatment of pulmonary tuberculosis in a tertiary care hospital in Istanbul, Turkey.

BACKGROUND: To investigate delays in the diagnosis and treatment of inpatients with smear-positive pulmonary tuberculosis and to identify factors affecting these delays. MATERIAL/METHODS: 204 hospitalized patients with smear-positive pulmonary tuberculosis were identified. The clinical files of the patients were analyzed and questionnaires were created. RESULTS: Mean application interval was 31.4 days, mean referral interval was 22.1 days, mean diagnosis interval was 3.3 days, and mean initiation of treatment interval was 1.4 days. Patient delay was present in 34.8 percent of the patients. The application interval was shorter for patients having an index case for tuberculosis (p=0.039) and for those with good economic status (p<0.005). 167 patients (81.9%) had institutional delay. The referral interval was longer for female patients than for male patients (p=0.015). The most common causes of institutional delays were a low index of suspicion for tuberculosis, health care system delays, and underutilized chest X-ray examinations. One hundred and three patients (50.5%) had delays in diagnosis and 51 patients (25.0%) had delays in treatment. The most frequent reason for diagnostic delay was health care system delays (35.9%). CONCLUSIONS: There were several delays in the diagnosis of tuberculosis patients. For an effective tuberculosis control, efforts should be made to reduce these delays. Physicians and the public should be educated about tuberculosis. Health care system and laboratory delays should be improved.

Adolescent↗

PubMed2004

[Tracheobronchopathia osteochondroplastica: a case report].

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder with unknown aetiology. In this paper, a case with TO was presented. A 77 year-old-man was admitted with cough for 2 years. Chest X-ray showed interstitial changes. Computed tomography of thorax demonstrated calcific density lesion in the trachea and in the left and right main bronchi. Fiberoptic bronchoscopy revealed numerous white, hard, irregular nodules on the anterior and lateral walls of trachea and on main bronchi. Pathologic diagnosis of bronchoscopic biopsy was TO.

Aged↗

PubMed2004

Primary endobronchial leiomyoma: a case report.

Pulmonary leiomyoma is a rare benign tumor. It has been usually described as a single case. The aim of this paper is to present a case of endobronchial leiomyoma. A 43 year-old nonsmoker female presented to our center with complaint of cough and sputum production for two years. Her chest roentgenogram showed consolidation on lower zone of right lung. Computed tomography of thorax demonstrated a mass lesion partially obstructing lateral segment bronchus of right middle lobe and consolidation on right lower lung field. Fiberoptic bronchoscopy detected mass obstructing lateral segment bronchus of right middle lobe. The biopsy specimen obtained by fiberbronchoscopy revealed the diagnosis of endobronchial leiomyoma. There was no pathologic finding in uterine examination. Bilobectomy inferior was performed. The patient was healthy six months later.

Adult↗

PubMed2004

Coexisting bronchial carcinoid tumor and pulmonary tuberculosis in the same lobe: a case report.

The synchronous occurrence of pulmonary tuberculosis and bronchial carcinoid tumor is unusual. Although pulmonary tuberculosis can coexist with all histological types of lung cancer, few coexisting cases of bronchial carcinoid tumor and pulmonary tuberculosis have been reported. We present coexistent bronchial carcinoid tumor and pulmonary tuberculosis in the same lobe. A 39-year-old woman was admitted to our clinic with chest pain for two months. Chest radiograph showed consolidation in the right lower field. Computed tomography of the thorax demonstrated multiple mediastinal lymphadenopathies, infiltration and atelectasis in the right lower lobe. Fiberoptic bronchoscopy showed a mass lesion totally obstructing the proximal right lower lobe bronchus. The pathological diagnosis was typical carcinoid tumor. Right lower lobectomy with mediastinal lymph node dissection was performed. The pathological examination of resected material revealed coexistent tuberculosis and carcinoid tumor in the same lobe and mediastinal tuberculous lymphadenitis.

Adult↗

PubMed2002

Extrathoracic staging of non-small cell bronchogenic carcinoma: relationship of the clinical evaluation to organ scans.

OBJECTIVE: The aim of this study was to investigate the value of systemic evaluation of extrathoracic extension of non-small cell lung cancer and to assess the value of the clinical evaluation in detecting extrathoracic metastases. METHODOLOGY: The study included 90 patients [87 men, three women; mean age 57.5 years (range 28-76)] with potentially resectable non-small cell carcinoma. Fifty-two were squamous cell carcinomas and 38 were adenocarcinomas. Organ-specific and non-organ-specific clinical findings suggesting metastases were analysed and computed tomographic scans of the brain and abdomen and whole-body bone scanning were performed in all patients. RESULTS: Extrathoracic metastases were detected in 23 (25.5%) of 90 patients. The metastases were located in the following areas: brain (n = 12, 13.3%); bone (n = 9, 10%); liver (n = 5, 5.6%); and adrenal gland (n = 5, 5.5%). Histological analysis revealed metastases in 21.1% (11/52) of the squamous cell carcinomas and 31.6% (12/38) of the adenocarcinomas (P > 0.05). Eleven (47.8%) of the 23 patients with extrathoracic metastases had no organ-specific clinical findings suggesting metastases. Eight patients with squamous cell carcinomas were intrathoracic T1N0 stage and in two (25%) of these patients extrathoracic metastases were detected. These patients had no organ-specific or non-organ-specific clinical factors suggesting metastases. CONCLUSIONS: Evaluation of extrathoracic extension should be routinely performed in all patients with newly diagnosed lung cancer. This approach will prevent many unnecessary thoracotomies.

Adrenal Gland Neoplasms↗

PubMed2002

Cavitary sarcoidosis: analysis of two cases.

The most commonly encountered radiological finding in sarcoidosis is bilateral hilar lymph node enlargement. Cavitation is extremely rare and the acute cavitary form is seen infrequently in young adults with acinar or nodular sarcoidosis. This unusual form of sarcoidosis may be misdiagnosed and treated as tuberculosis in countries where the prevalence of tuberculosis is high. Herein, we report on two patients with cavitary sarcoidosis who had been misdiagnosed and treated for tuberculosis.

Adult↗

PubMed2002

Pulmonary glomus tumour: a case initially diagnosed as carcinoid tumour.

Pulmonary glomus tumours are rare lesions, with few cases reported previously. Herein, we present the clinical and pathological features of a case of pulmonary glomus tumour. A 29-year-old female patient presented to our clinic complaining of cough, dyspnoea and left-sided chest pain. Computed tomography (CT) of the thorax revealed a nodular lesion causing obstruction of the left main bronchus. Fibreoptic bronchoscopy demonstrated a polypoid mass occluding the left main bronchus 10 mm distal to the main carina. Bronchoscopic biopsy was interpreted histologically as carcinoid tumour. Bronchotomy plus mass extirpation was performed with left thoracotomy. Microscopically, a tumoral structure composed of uniform cells with a round centrally located nucleolus and narrow eosinophilic cytoplasm was seen. Thin-walled vessels lined with endothelium were interspersed between tumoral structures. The cells were stained chromogranin and cytokeratin negative and strongly vimentin positive. The pathological diagnosis for the thoracotomy specimen was pulmonary glomus tumour. Follow-up chest CT was negative for recurrent tumour and the patient remains free of disease 17 months after surgery.

Adult↗

PubMed2002

The effect of adrenalectomy on leptin levels and some metabolic parameters in rats with diet-induced obesity.

Recently, there has been many investigations on the relationship between leptin and obesity, which is the main health problem in developed countries. In some reports, it has been claimed that the adrenalectomy has lead to weight loss and thus prevented obesity induced in rodents in various ways. It has also been accepted that diet-induced obesity in animals is very similar to obesity in humans beings. In this study, obesity has been developed with high-calorie diet given for 8 weeks in Sprague-Dawley rats. Then, it has been investigated how leptin and some metabolic parameters change in blood samples obtained from rats 15 d after adrenalectomy. Leptin levels was determined with Radio Immun Assay (RIA, Linco Research Co) method. Our study showed that, there were statistically significant increases in leptin (p<0.001), glucose (p<0.05), triglyceride (p<0.01) levels in diet-induced obese rats (n=19) when compared with the findings of control rats, lean ones (n=16), (Tables 3, 4). Adrenalectomy led to decreased serum leptin (p<0.001) and triglyceride (p<0.01) levels both in the obese and lean rats (Table 5). As a conclusion, it could be claimed that the decrease in leptin levels may be attributed to reduced adipose tissue due to adrenalectomy. On the other hand, the decreases in glucose and triglyceride levels might be the consequence of reduced lipogenesis and impaired gluconeogenesis with the effect of adrenalectomy. It was concluded that adrenalectomy might prevent obesity by affecting leptin and intermediate metabolism.

Adrenalectomy↗

PubMed2002

CT- guided transthoracic fine needle aspiration of pulmonary lesions: accuracy and complications in 294 patients.

BACKGROUND: The purpose of this study was to prospectively evaluate the effectiveness of CT-guided transthoracic fine needle aspiration in the diagnosis of pulmonary lesions and to determine the complication rate of this procedure. MATERIAL/METHODS: A prospective review was undertaken of 316 patients who underwent CT-guided transthoracic fine needle aspiration performed at our center between October 2000 and April 2001. Twenty-two patients were excluded because no final diagnosis was achieved. The present study included 294 patients. All fine needle aspirations were performed with a 22-gauge aspirating needle under CT guidance. RESULTS: An accurate diagnosis was made in 228 of 259 malignant lung lesions (88%). A specific diagnosis was obtained in 34.3% of the benign lesions. The sensitivity for malignancy and specificity for benign lesions were 88% and 100%, respectively. Positive and negative predictive values were 100% and 53%, respectively. There was no false-positive diagnosis for malignancy. Sensitivity was 87% for centrally located lesions and 89.3% for peripherally located lesions (p>0.05). Complications included pneumothorax, 24 of 294 cases (8.2%); chest tube, 3 cases (12.5%); minor hemoptysis, 5 cases (1.7%); and pulmonary hemorrhage, 4 cases (1.4%). CONCLUSIONS: Our results suggest that this procedure has high diagnostic accuracy and an acceptable rate of complications.

Biopsy, Needle↗