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.

Thymolipoma is a benign tumour composed of thymic elements and adipose tissue. It may be associated with myasthenia gravis or immune disorders. We aimed to evaluate the clinical and radiological features of thymolipoma. The clinical data from 10 cases of thymolipoma, diagnosed at our centre between 2002 and 2004, were analysed retrospectively. There were six female and four male patients, whose ages ranged from 16 to 67 years, with a mean age of 34.1 years. All but two patients had pulmonary or extrapulmonary symptoms. Five patients also had myasthenia gravis. All thymolipomas were localized in the anterior superior mediastinum. The surgical approach was sternotomy in nine cases and thoracotomy in one case. Thymectomy was performed on all patients. Thymolipomas are unusual tumours and may be associated with myasthenia gravis. Surgical resection is the most appropriate treatment modality.

We aimed to investigate the delays from the first symptom to thoracotomy and to examine whether the delays cause the stage advancement in lung cancer. This prospective study included 138 patients with non-small cell lung carcinoma who underwent thoracotomy. Clinical files of the patients were analyzed and a questionnaire was created to obtain information from the patients. The mean duration values were 81.3 days for the application interval, 61.3 days for the referral interval, 20.3 days for the diagnostic interval, and 21.9 days for the treatment interval. The application interval was longer than 30 days (patient delay) in 50 patients (37.9 %). The mean interval from the first visit to doctor to thoracotomy was 97.2 days. There was a doctor delay in 102 (73.9 %) patients; a referral delay in 83 patients (60.1 %), a diagnostic delay in 47 patients (36.4 %), and a treatment delay in 96 patients (69.6 %). The mean total duration was 176.2 days. Ninety-four patients (71.2 %) had a total delay. Mean total delay was 184.5 days in pathologic stage I, 187.3 days in stage II, 167.7 days in stage IIIA, 142.6 days in stage IIIB, and 150.3 days in stage IV (p>0.05). Delays during the course between the first symptom and thoracotomy in lung cancer patients were a common problem among our patients. Prolonged durations in the application and referral of patients are the most significant cause of delays. Presence of delay or length of delay did not correlate with pathologic tumour stage in this study.

Pulmonary hydatid disease is an important clinical problem where echinococcal infection is endemic. Bronchoscopy is unnecessary in patients with pulmonary hydatid disease who present with a typical clinical picture and radiological appearance. However, it may be performed when a tumour is suspected or when the radiological picture is atypical. This case report presents three patients with pulmonary hydatid disease diagnosed by bronchoscopy. All patients were male, aged between 24 and 30 years, presented with pulmonary symptoms and had an abnormal CXR. Bronchoscopy showed whitish membraneous material in all three patients and biopsy confirmed the diagnosis of hydatid disease. Cystectomy was performed in two patients and right pneumonectomy was performed in the third because of pulmonary artery involvement. Bronchoscopy may be valuable in the diagnosis of pulmonary hydatid cyst disease in patients with atypical clinical and radiological presentations.

Sağlık çalışanlarında tüberkülin cilt testi ile QuantiFERON-TB Gold-In Tube testinin karşılaştırılması Prospektif, kesitsel ve gözlemsel nitelikteki çalışmamızın amacı sağlık çalışanlarında latent tüberküloz infeksiyonu tanısında, tüberkülin cilt testi (TCT) ile QuantiFERON-TB Gold-In Tube (QTF-GIT) testini karşılaştırmaktır. Çalışma, aynı üçüncü basamak göğüs hastalıkları ve tüberküloz eğitim hastanesinde çalışan 78 gönüllü sağlık çalışanını içermektedir. Aktif tüberkülozu, immünyetmezliği ya da malnütrisyonu olanlar çalışmaya dahil edilmemiştir. TCT Mantoux metoduyla uygulandı. ESAT-6, CFP-10 ve TB7-7 antijenleri kanda interferon-gama (IFN-γ) araştırılması için kullanıldı (QTF-GIT). BCG skar sayısı ile TCT endürasyon çapı arasında istatistiksel olarak anlamlı ilişki saptandı (p< 0.01). QTF sonuçları ve önceki BCG aşılaması arasında anlamlı bir ilişki yoktu (p> 0.05). İki test arasında orta düzeyde uyum mevcuttu (κ: 0.346). QTF-GIT testinin duyarlılığı %56.14 (TCT ve QTF-GIT pozitif), özgüllüğü %90.48 (TCT ve QTF-GIT negatif), pozitif kestirim değeri %94.12, negatif kestirim değeri %43.18, doğruluk oranı da %65.38 olarak saptandı. QTF sonucuyla TCT endürasyon çapı arasında anlamlı düzeyde ilişki mevcuttu (p< 0.01). QTF-GIT testine göre çalışma popülasyonumuzdaki latent tüberküloz infeksiyon prevalansı %43, TCT'ye göre %73 idi ve BCG aşılanma oranı %87 idi. Sonuç olarak; TCT önceki BCG aşılanmasından etkilenmiş, buna karşın QTF-GIT etkilenmemiştir. Rutin BCG aşılama programı olan toplumlara latent tüberküloz infeksiyonu tanısında TCT'ye alternatif olarak QTF-GIT testini önerebiliriz.