B Br ro on nc ch ho og ge en ni ic c c cy ys st ts s: : c cl li in ni ic co op pa at th ho ol lo og gi ic ca al l p pr re es se en nt ta at ti io on n a an nd d t tr re ea at tm me en nt t S. Aktogu*, G. Yuncu**, H. Halilçolar*, S. Ermete + , T. Buduneli** Bronchogenic cysts: clinicopathological presentation and treatment. S. Aktogu, G. Yuncu, H. Halilçolar, S. Ermete, T. Buduneli. ©ERS Journals Ltd 1996. ABSTRACT: The aim of this study was to evaluate the preoperative and operative presentations of one paediatric and 30 adult patients with bronchogenic cyst of the mediastinum (n=11) and lung (n=20).At initial presentation, six patients were asymptomatic and 25 were symptomatic. The mean age of asymptomatic and symptomatic patients was 25 and 33 yrs, respectively. Six patients presented with complications, including superior vena cava syndrome, tracheal compression, pneumothorax, pleurisy and pneumonia. Two patients who were asymptomatic when initially observed eventually needed surgery because of the development of symptoms or enlargement of the cyst size. In one patient, the cyst was not seen on the chest radiograph but appeared as a lobulated nodule of 2 cm diameter in a chest computerized tomography (CT) scan. Operative difficulties were encountered in 13 patients, all of whom were symptomatic preoperatively.In conclusion, life-threatening complications occurred in these patients. Despite various diagnostic studies, definitive tissue diagnosis was established only by means of surgical excision. The frequency of operative difficulties in symptomatic cysts was higher than those of asymptomatic cysts. Surgery may be considered as the treatment of choice even when the cyst is asymptomatic, since complications are not uncommon.

The results suggest that determination of D-dimer plasma levels that is an inexpensive, easy and non invasive method may be useful in predicting clinical outcome, survival and treatment response of patients with lung cancer.

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UA excretion, as a marker of tissue hypoxia, may be useful in the management of OSA and COPD patients.

Objective: To report a case of Churg-Strauss syndrome who had asthma and allergic rhinitis treated with montelukast. Clinical Presentation and Intervention: A nonsmoking 59-year-old woman presented with fever, hemoptysis and dyspnea. Past medical history included allergic rhinitis and asthma which were diagnosed 18 years ago. The asthma was treated successfully with inhaled salmeterol and beclamethasone. She also received montelukast (10 mg/day) for 3 years. Although her chest X-ray was normal a week earlier, she had widespread bilateral pulmonary infiltrates on admission. She had leukocytosis (12.5 × 10⁹/l) with eosinophilia (15.6%). Her total IgE count was 550 U/ml. Testing for protoplasmic-staining antineutrophil cytoplasmic antibodies was positive. Bronchoalveolar lavage could not be performed due to bronchospasm and severe hypoxemia; however, mucosal biopsies were obtained, which revealed eosinophil leukocytes in the lumen and walls of small vessels. She was diagnosed to have Churg-Strauss syndrome and had remarkable clinical improvement on day 5 with high-dose of oral prednisolone (50 mg/day). Radiological improvement was detected at the end of the second week. Conclusion: This case shows the importance of being aware that leukotriene receptor antagonists could cause Churg-Strauss syndrome, in spite of the uncertainty about its mechanism.