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PubMed | Ankara University, Celal Bayar University, Pamukkale University, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital and 13 more.
Type: Journal Article | Journal: Cancer epidemiology | Year: 2015

The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays.A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.510.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces.The patient delay was found to be 49.996.9 days, doctor delay was found to be 87.799.6 days, and total delay was found to be 131.3135.2 days. The referral delay was found to be 61.6127.2 days, diagnostic delay was found to be 20.444.5 days, and treatment delay was found to be 24.454.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (p<0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (p<0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (p<0.05).The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly.


PubMed | Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Hakkari state Hospital and Ordu University
Type: | Journal: The clinical respiratory journal | Year: 2016

Mounier-Kuhn syndrome (MKS) is a congenital disorder characterized by tracheobronchomegaly resulting from the absence of elastic fibers in the trachea and main bronchi or atrophy and thinning of the smooth muscle layer. In this syndrome, dead space associated with tracheobronchomegaly increases and discharge of secretions decreases because of ineffective coughing. The most common complications are recurrent lower respiratory tract infections and bronchiectasis. We examined the clinical characteristics, radiological features, and related complications of patients with MKS.The cases were obtained between September 2007 and November 2015. Computed tomography scans of the chest were used to diagnose tracheobronchomegaly.All cases (a total of 11) were males with a mean age of 6313 (range, 38-80) years. The mean diameter of the trachea was 31.532.99 mm; the mean transverse diameter was 31.693.10 mm and the mean sagittal diameter was 31.363.01 mm. Complaints at the time of presentation included chronic cough, purulent sputum, dyspnea, and hemoptysis. There were recurrent pulmonary infections in seven cases, bronchiectasis in six, and tracheal diverticulum in four at the time of diagnosis.In this article, 11 cases with various rarely seen complications are presented and evaluated in the light of current literature. We recommend that if chronic cough, recurrent pulmonary infections, and bronchiectasis seen in a patient, MKS should be kept in mind.


Demirag F.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Cakir E.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Bayiz H.,Atatiirk Chest Diseases and Chest Surgery Education and Research Hospital | Eren Yazici U.,Atatiirk Chest Diseases and Chest Surgery Education and Research Hospital
Acta Chirurgica Belgica | Year: 2013

Background: Adenosquamous carcinoma of the lung involves both adenocarcinoma and squamous cell carcinoma, each comprising at least 10% of the tumor. Atypical adenomatous hyperplasia (ADH), bronchiolar columnar cell dysplasia (BCCD), basal cell dysplasia (BCD), columnar cell dysplasia (CCD), bronchial epithelial dysplasia with transitional differentiation (BEDT) and squamous dysplasia (SD) are preinvasive lesions. The aim of this study is to define the preinvasive lesions and evaluate the role of MUC1, bcl-2, and the preinvasive and invasive components of adenosquamous carcinoma. Methods: A group of 31 patients with adenosquamous carcinoma of the lung were selected. The ratio of squamous to glandular differentiation, the associated preinvasive lesions, the features of peritumoral tissue, the stroma of the tumor, necrosis, perineural and vascular invasion were analyzed. For the immunohistochemical study, blocks containing squamous cell carcinoma, adenocarcinoma and preinvasive lesions were selected. MUC1 and bcl-2 analyses were performed by the immunoperoxidase method using the avidin-biotin complex. Results: Associated preinvasive lesions amd SD, BCCD, BEDT, AAH and CCD were observed in 24, 6, 3, 1 and 6 cases, respectively. Expression for MUC1 was positive in the squamous component of 30 cases, the adenocarcinoma component of 27 cases and in 34 preinvasive lesions. A strong correlation was found between MUC-1 expression in the squamous component and tumor localization (p = 0, 01). The positive expression of Bcl-2 in the adenocarcinomatous component was correlated with the presence of preinvasive lesions (p = 0, 01). Conclusions: Squamous dysplasia was the most frequent preinvasive lesion of adenosquamous carcinomas. MUC1 and bcl-2 expression levels were strongly associated with preinvasive lesions in adenosquamous carcinomas.


PubMed | Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Istanbul University, Bilkent University and Ankara University
Type: | Journal: BMC clinical pathology | Year: 2014

Anti-SOX2 antibody responses are observed in about 10 to 20% of small cell lung cancer (SCLC) patients. The aim of this study was to determine whether such responses reflect a particular pattern of SOX2 protein expression in the tumor and whether this pattern associates with clinical outcome.Paraffin embedded tumor tissues, obtained from SCLC patients who had no evidence of paraneoplastic autoimmune degeneration, were evaluated for SOX2 expression by immunohistochemistry for both intensity and extent of staining. Sera from the same patients were tested for autologous antibodies against recombinant SOX2 by enzyme-linked immunosorbent assay (ELISA). Correlates between overall survival and various clinical parameters including SOX2 staining and serology were determined.SOX2 protein expression was observed in tumor tissue in 89% of patients. Seventeen patients (29%) were seropositive for SOX2 antibodies and, in contrast to SOX2 staining, the presence of antibody correlated with limited disease stage (p=0.05). SOX2 seropositivity showed a significant association with the intensity of SOX2 staining in the tumor (p=0.02) but not with the frequency of SOX2 expressing cells.Anti-SOX2 antibodies associate with better prognosis (limited stage disease) while SOX2 protein expression does not; similar to reports from some earlier studies. Our data provides an explanation for this seemingly contrasting data for the first time as SOX2 antibodies can be observed in patients whose tumors contain relatively few but strongly staining cells, thus supporting the possible presence of active immune-surveillance and immune-editing targeting SOX2 protein in this tumor type.


PubMed | Ataturk Education and Research Hospital, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital and Hacettepe University
Type: Journal Article | Journal: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis | Year: 2016

Malignant pleural mesothelioma (MPM) increases the risk of thromboembolic events (TEEs). In this retrospective study, we aimed to determine the rate of TEEs in MPM and investigate its relationship with the presence of thrombocytosis, the disease stage, and the tumor histopathology.The study included 178 patients who were histopathologically diagnosed as MPM between the years January 2008 and June 2014.The mean age was 58.7 11.8 years, and the median follow-up time was 8 months. Seventy-one patients (39.9%) had thrombocytosis (>350 10(3)/mL). In total, 14 (7.9%) TEEs were identified: 6 (3.4%) pulmonary thromboembolism, 6 (3.4%) deep venous thrombosis, and 2 (1.1%) myocardial infarctions. Although 5 (2.8%) of the TEEs preceded the diagnosis of MPM, 1 (0.6%) occurred simultaneously with the diagnosis of MPM and 8 (4.5%) followed the diagnosis of MPM. Thromboembolic event rates were not statistically different based on the presence of thrombocytosis (P = .51), disease stage (P = .14), and histopathology (P = .38).The rate of TEEs was 7.9%. Presence of thrombocytosis, disease stage, and histopathology did not affect the incidence of TEEs.


PubMed | Gazi University and Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
Type: | Journal: European journal of cancer care | Year: 2016

Certain prognostic factors for small cell lung cancer (SCLC) have been validated, but the prognostic role of 18F-FDG PET/CT still remains unclear. The aim of this study was to evaluate the prognostic significance of 18F-FDG PET/CT in patients with SCLC. We reviewed 142 patients with pathologically proven SCLC who underwent pre-treatment 18F-FDG PET/CT. Standardised uptake value (SUV


PubMed | Cukurova University and Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
Type: Journal Article | Journal: Surgical pathology clinics | Year: 2016

Malignant mesothelioma (MM) is a rare primary malignant tumor of the surface serosal cells. The diagnosis of MM is challenging with a broad differential diagnosis. For many decades, studies have focused on distinguishing MM from other types of cancer; however, benign mesothelial cell hyperplasia, especially in small biopsies, has emerged as a major problem. The features of pleural lesions are somewhat different from peritoneal diseases, and this article primarily focuses on pleural diseases. Thorough interpretation and correlation of clinical, radiologic, and pathologic findings are essential for a correct diagnosis.


Cakir E.,Ankara Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Findik G.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Hosgun D.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Demirag F.,Ankara Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
Acta Chirurgica Belgica | Year: 2010

We report a case of primary mediastinal haemangiopericytoma in a 29-year-old female patient who presented with haemoptysis, cough and dyspnea. Computed tomography showed a 9 × 6 × 5 cm mass in the left posterior mediastinum. Bronchoscopic examination failed to obtain biopsy because of massive bleeding. The patient underwent left thoracotomy. Mediastinal mass and left lower lobe resection was performed despite the persistent bleeding. The lower lobe bronchus had been infiltrated by the tumour. Microscopic examination revealed a highly cellular tumour composed of round to fusiform cells, surrounded by thin walled endothelium lined vascular channels with a staghorn appearance. Immunohistochemical and molecular techniques rule out other soft tissue tumours which have a haemangiopericytomalike vascular pattern. The patient is alive and free from tumour recurrence 6 months post-operatively.


Koksal D.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Demirag F.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Bayiz H.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Ozmen O.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | And 4 more authors.
Journal of Cardiothoracic Surgery | Year: 2013

Background: We aimed to investigate the correlation of maximum standardized uptake value (SUVmax) with pathological characteristics of primary tumor and to determine a Tumor/ Lymph node (T/LN) SUVmax ratio predicting metastasis to lymph nodes in NSCLC patients.Methods: Eighty-one NSCLC patients who had PET/CT examination at initial staging and subsequently underwent surgical resection were retrospectively evaluated. There were 100 PET/CT positive mediastinal or hilar lymph node stations. Pathological characteristics of the tumor such as largest tumor diameter, tumor histology, differentiation, number of mitosis, degree of stromal inflammation, necrosis; etiology of PET/CT positive lymph node stations; SUVmax of primary tumor and positive lymph node stations were recorded. A T/LN SUVmax ratio was calculated for each lymph node station.Results: SUVmax of the primary tumor was positively correlated with the largest tumor diameter (p = 0.001, r = 0.374), number of mitosis (p < 0.001, r = 0.405), and postoperative pathological stage (p = 0.007, r = 0.298). Patients with squamous cell carcinoma had a statistically significant higher mean SUVmax, number of mitosis and advanced N stages compared to adenocarcinoma. The etiology of 100 PET/CT positive lymph node stations were metastasis in 14, anthracosis in 40, reactive in 39, granulomatous in 4, and silicosis in 3 patients. A T/LN SUVmax ratio of 5 or lower was suggestive for a malignant lymph node with a sensitivity of 92.8% and specificity of 47%.Conclusions: SUVmax of a primary tumor is related to certain pathological characteristics, such as largest diameter, histology, and number of mitosis. A T/LN SUVmax ratio lower than 5 predicts the metastasis to lymph nodes with a high sensitivity. © 2013 Koksal et al.; licensee BioMed Central Ltd.


PubMed | Ataturk Chest Diseases and Chest Surgery Education and Research Hospital
Type: | Journal: Respiratory medicine case reports | Year: 2015

Granulomatous reactions are seen in a wide variety of diseases.We present 3 cases referred to our clinic with presumptive diagnosis of tuberculosis (TB) were diagnosed as nontuberculous granulomatous diseases.Three cases were diagnosed as Tularemia, Cat-Scratch Disease (CSD) and idiopathic granulomatous mastitis (IGM) respectively.In countries with high incidence of TB, TB is considered firstly in differential diagnosis of granulomatous diseases. Detailed anamnesis and physical examinations should be done in differential diagnosis of granulomatous diseases, and TB must be excluded.

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