Pulmonary sclerosing pneumocytoma (PSP) is a rare benign pulmonary tumor. Usually diagnosed incidentally by chest X-ray or chest CT scan. We presented a case of PSP in a 50-year-old woman who was diagnosed with a nodular lesion in the right lung. Thoracotomy was used for the excision of the mass. Pathologic examination revealed no malignant cells. Immunohistochemical studies were performed. TTF-1 was (+), Napsin-A was found to be weakly (+). After surgical resection, the patient was followed up.
Objective: Concomitant chemoradiotherapy (CRT) is the standard treatment for patients with stage III non-small cell lung cancer (NSCLC). Myelosuppression can be a significant problem in concomitant CRT. The aim of this study was to assess the parameters obtained before concomitant CRT to define the risk factors for myelosuppression in patients with locally advanced NSCLC. /w, on weeks 1-8) concurrently with thoracic radiotherapy to a total dose of 40-66.6 Gy. The risk factors were examined for their association with myelosupression (grade 3 or 4 leukopenia, neutropenia, thrombocytopenia, or anemia) by logistic regression analysis.
Results:Grade 3 or higher neutropenia, leukopenia, thrombocytopenia, or anemia occurred in 51.8%, 53%, 8.6%, and 7.4% of the patients, respectively. Multivariate analysis revealed that the risk factors for neutropenia were performance status (p=0.032), white blood cell count (p=0.023), and pretreatment creatinine level (p=0.018). On multivariate analysis, white blood cell count (OR, 3.311; p=0.027; 95% CI, 1.148-9.545) was found as significant risk factor for CRT-induced leukopenia Conclusion: Patients with a poor pretreatment performance status, low white blood cell count, and high creatinine level are at a risk of myelosupression. These characteristics of the patients should be considered while making treatment decisions.
The commercial production of mushrooms is often carried out in indoor areas and controlled environments with intense labor performed throughout the year. Indoor cultivation can lead to allergic symptoms, such as extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, in workers. A 23-yearold male patient's symptoms emerged after beginning to work in mushroom cultivation. The patient was admitted to the clinic with complaints of chills, fever, joint pain, and a skin rash. Based on his medical history and a physical and radiographical examination, the patient was diagnosed as hypersensitivity pneumonitis and medical therapy was initiated. The patient's symptoms disappeared within a few days and he was discharged at the end of the first week. Given the difficulties in the diagnosis of disease, the patient's professional history should always be kept in mind as well as medical history, physical examination, and radiographic evaluation.
<p><strong>Aim<br /></strong> Concurrent chemoradiotherapy (CRT) is the standard of care for locally advanced, unresectable non-small cell lung carcinoma (NSCLC). The aim of this study was to assess the prognostic value of maximum standardized uptake values (SUV max) in patients with unresectable stage III NSCLC treated with concurrent CRT. <br /><strong>Method<br /></strong> 18 F-FDG PET-CT scans were obtained before and after treatment in patients with unresectable stage III NSCLC treated with concurrent CRT. To determine the prognostic value of SU-V max of the primary tumor (PT), univariate and multivariate Cox regression model were carried out. <br /><strong>Results <br /></strong>Between January 2008 and December 2013, this study included 43 patients (median age 56 years, 95% male). Univariate analysis showed that having a high post-treatment PT-SU-V max was associated with a higher risk of death and having a high post-treatment PT-SUV max with a higher risk of disease recurrence. Multivariate analysis showed that having a low post-treatment PT-SUV max (cut off 3.9) was associated with longer overall and progression free survival (HR 8.55, 95% CI; 2.56-28.55, p=0.000 and HR 2.854, 95% CI; 1.43-5.67, p=0.003, respectively). <br /><strong>Conclusion <br /></strong>Post-treatment PT-SUV max may be an independent prognostic factor in patients with unresectable stage III NSCLC treated with concurrent chemoradiotherapy.</p>
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