Eosinophilic granuloma (EG) is the unifocal osseous form of Langerhans cell histiocytosis (LCH), which usually affects the skull and long bones. Although it most commonly affects the pediatric age group, it can rarely be seen in adults. Skeletal involvement is common in adult patients, but isolated rib involvement is extremely rare. Differential diagnosis includes other osteolytic lesions such as Ewing’s sarcoma, tuberculosis, multiple myeloma, lymphoma, and primary bone malignancy. The diagnosis must be confirmed histopathologically. In addition to pathological Langerhans cells, inflammatory cells such as lymphocytes, eosinophils, and macrophages are observed in microscopy. Immunohistochemically, CD1a, S-100, and Langerin positivity are observed in biopsy and/or surgical excision material. Treatment options may vary depending on the localization and extent of the disease. In unifocal EG, close observation of the patient may be preferred, as well as surgical excision, radiotherapy, and intra-lesional steroid administration. The prognosis in patients with a single bone lesion is quite good compared to other groups. In this case report, we present a metachronous EG of rib developed in two different ribs by an interval of seven years, which were both surgically treated. In this mild variant of LCH, surgical resection with clean margins has a favorable outcome without the need for additional adjuvant therapy. Metachronous tumors may develop in isolated unifocal bone EGs, and long-term follow-up is mandatory.

The increasing number of studies published on coronavirus disease 2019 (COVID-19) pneumonia has improved our knowledge of the disease itself and its complications. Despite a considerable number of publications on COVID-19 pneumonia-associated pneumothorax, no article on spontaneous hemopneumothorax has been found in the English-language literature. According to published case reports, pneumothorax generally occurs in hospitalized patients during treatment, whereas cases that arise in the late period after discharge are exceptional. Herein, we present a case of spontaneous hemopneumothorax occurring as a late complication of COVID-19 pneumonia on day 17 after discharge.

Background: Primary pulmonary malignant mesenchymal tumors are rare, constituting only 0.4% of all lung cancers. Since sarcomas are chemo/radio-resistant, surgical resection is the optimal treatment choice for patients with suitable medical conditions and tumor stage. In the present study, we analyzed the surgical outcomes and survival of primary pulmonary malignant mesenchymal tumors treated surgically. Methods: We retrospectively examined the records of patients with primary pulmonary malignant mesenchymal tumors who underwent surgical resection at our department between January 2010 and December 2020. Patient data were analyzed according to age, sex, tumor grade and stage, resection completeness, surgical type, and tumor histopathology. Results: Twenty patients were included in the study. There were 13 men (65%) and 7 women (35%). The median survival rate was 36 months (range, 19-53 months), and the 5-year overall survival rate was 37%. Unfavorable prognostic factors for overall survival included parietal pleural invasion (p=0.02), high tumor grade (p=0.02), advanced tumor stage (p=0.02), and extensive parenchymal resection (pneumonectomy and bilobectomy, p=0.01). The median length of disease-free survival was 31 months (interquartile range, 21-41 months), and the 5-year disease-free survival rate was 32%. The most unfavorable prognostic factors for recurrence were parietal pleural invasion (p=0.02), high tumor grade (p=0.01), and tumors requiring lung resection with chest wall resection (p=0.02). Conclusion:Primary malignant mesenchymal lung tumors are aggressive and have a high mortality rate. However, acceptable overall and disease-free survival rates can be obtained with surgical therapy.

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The aim: Gamma-glutamyl transferase (GGT) is a membrane-dependent enzyme and is primarily involved in glutathione metabolism. While a correlation between high GGT levels and oxidative stress, cardiovascular diseases, and some cancers has been shown in the literature, its prognostic effect in patients with non-small-cell lung cancer remains unclear. The aim of this study was to investigate the correlation between the preoperative GGT levels and the prognosis of non-small-cell lung cancers treated surgically. Materials and methods: Following the approval of the loc al ethics committee, the medical records of patients surgically treated in our department for stage-I non-small-cell lung cancer between January 2010 and December 2019 were retrospectively reviewed. The patients were classified into a high group (high-GGT) and low group (low-GGT) according to the preoperative GGT cut-off levels, which were specific to our series and calculated by receiver operating characteristic (ROC) analysis. Survival differences between the groups were also investigated by Kaplan-Meier, log-rank, and Cox regression tests. Results: A total of 219 patients fulfilled the inclusion criteria and were included in the study. The median survival was 75 (range: 58.4–91.1) months in the high-GGT group and 91 (range: 85–96.8) months in the low-GGT group, and this difference was statistically significant (Hazard Ratio: 2.0, 95% CI 1.0-3.9, p = 0.03). Conclusions: Preoperative GGT may be an inexpensive and easily applicable prognostic indicator in early-stage non-small-cell lung cancers.