Objective: Th oracentesis is the first investigation to be performed in a patient with lung cancer and pleural eff usion. Th e diagnostic yield of conventional smear studies varies in the first thoracentesis. In this study, we aimed to investigate if the cell block method increases the diagnostic yield in exudative pleural eff usions accompanying lung cancer. Material and Method:Forty patients with lung cancer and exudative pleural eff usions were included. Ten mililiters of fresh pleural fl uid was obtained by thoracentesis from all patients in the initial evaluation. Th e pleural fl uid sample was divided into two equal parts. One part was subjected to conventional smear and the other to the cell block method. Conventional smears were stained with May-Grünwald-Giemsa and Hematoxylin-Eosin. Cell block sections were stained with Hematoxylin-Eosin and mucicarmine. Conventional smear findings were grouped as "benign cytology" or "malignant cytology". Th e cell block sections were evaluated for the presence of single tumor cells, acinary or papillary pattern, solid islands and staining with mucicarmine.Results: Th ere were 20 patients each in the benign and malignant conventional smear group. In the benign group, adding the cell block method to conventional smear provided a diagnosis of malignancy in 4 more patients and the diagnosis of malignant eff usion was increased by a ratio of 10% (4/40). In the malignant group, adding the cell block technique provided the subtyping of lung cancer as adenocarcinoma in 7 patients (7/20, 35%). Conclusion:Our study confirms that the cell block method combined with conventional smear increases the diagnostic yield in exudative pleural eff usions accompanying lung cancer.Key Words: Lung carcinoma, Pleural eff usion, Cytology, Cytological Techniques ÖZ Amaç: Torasentez, plevra sıvısı olan akciğer kanserli bir hastada yapılması gereken ilk incelemedir. İlk torasentezde yapılan konvensiyonel sitolojik incelemelerin tanı başarısı değişkendir. Bu çalışmada, eksudatif plevra sıvısı olan akciğer kanserli hastalarda, hücre bloğu yönteminin tanıyı artırıp artırmağını araştırmayı amaçladık. Gereç ve Yöntem:Eksudatif plevral sıvısı olan 40 akciğer kanserli hasta çalışmaya alındı. Tanı aşamasında her hastadan torasentezle 10 ml plevra sıvısı alındı. Sıvı iki eşit parçaya ayrıldı. Bir kısım konvansiyonel sitoloji için kullanılırken diğer kısımdan hücre bloğu yapıldı. Konvansiyonel yaymalar May-Grünwald-Giemsa ve Hematoksilen-Eosin ile boyandı. Hücre bloğu kesitleri Hematoksilen-Eosin ve musikarmin ile boyandı. Konvansiyonel sitoloji bulguları "benign sitoloji" ve "malign sitoloji" olarak gruplandı. Sitoblok kesitleri tek tümör hücresi, asiner, papiller patern, solid ada varlığı, musikarmin ile boyanma açısından değerlendirildi. Bulgular:Benign ve malign konvansiyonel sitoloji grubunun her birinde 20'şer hasta vardı. Benign konvansiyonel sitoloji grubunda, konvensiyonel sitolojiye ek olarak sitoloblok yapılması 4 hastaya daha malignite tanısı konmasını sağlayarak, malign sıvı tanısını ...

Presence of leukocytosis, advanced disease stages, supportive therapy alone, and higher MAI were found to be negative prognostic factors in patients with MPM.

ÖZET Difüz plevral kalınlaşma ile prezente olan 11 yıl sonra nüks eden timoma olgusu

Objective: The coincidence of tuberculosis (TB) and lung cancer (LC) at the initial diagnosis or the development of TB during the course of LC is a challenge in the management of both diseases. Herein we reviewed 10 LC patients who coincidentally had TB and evaluated the challenges in the management of both diseases. Methods:The files of patients were retrieved from an archive, and available study forms were completed. Results:The study included 10 LC and TB patients during a 4 year-period. The sites of TB were the lung (seven patients), mediastinal lymph nodes (LN) (one patient), cervical LN (one patient), and subcutaneous nodules (one patient). LC and TB were simultaneously diagnosed in four patients. The diagnosis of pulmonary TB was confirmed by sputum culture two months after LC diagnosis in four patients. TB was diagnosed later in the follow-up period in two patients. Only one patient with early-stage LC who had undergone surgical resection tolerated anti-TB therapy well. In one patient, TB caused the over-staging of LC. In one patient, LC had progressed during the course of anti-TB therapy. Hepatotoxicity was the leading adverse reaction due to anti-TB therapy. Conclusion:These patients highlighted the importance of considering TB in the course of LC, especially in countries with a high TB prevalence. TB may cause the advanced staging of LC at the initial diagnosis; chemotherapy may worsen the TB course or cause reactivation TB. Reactivation TB may be considered as the progression of LC without tissue diagnosis or sputum analysis. The tolerability of anti-TB therapy is poor in these patients.