INTRODUCTION:The differential diagnosis of sarcoidosis creates a challange due to tuberculosis also having lung and lymph node involvement. Because both diseases show granulomatous inflammation, it may not be possible to distinguish tuberculosis and sarcoidosis in pathological specimens. As a result of the complexity in the differential diagnosis of sarcoidosis and tuberculosis, new markers for differentiation are being investigated.OBJECTIVE:The aim of our study is to investigate the value of neutrophil/lymphocyte ratio (NLR) as a possible marker in differentiating sarcoidosis and tuberculosis.MATERIALS AND METHODS:In our study, 51 acid-fast bacilli (AFB) positive and/or culture-positive patients with pulmonary tuberculosis, ​​40 patients with biopsy-proven sarcoidosis and a control group consisting of 43 patients were included. In our study, information was collected retrospectively based on hospital records.RESULTS:Leukocyte and neutrophil counts, NLR, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) were significantly higher, and albumin was significantly lower in the tuberculosis group compared with sarcoidosis (for all parameters P < 0.001). The most appropriate cut-off value of NLR to distinguish tuberculosis from sarcoidosis was determined as 2.55. For this cut-off value of NLR there was 79% sensitivity, 69% specificity, 73% positive predictive value (PPV), 75% negative predictive value (NPV), and area under the curve (AUC) was 0.788. For differentiation of sarcoidosis from tuberculosis, accuracy of the NLR test according to this cut-off value was found as 76%.CONCLUSION:NLR as a little known marker in respiratory medicine was found to be supportive in differentiation of tuberculosis and sarcoidosis. More studies on this issue is needed.

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy.

Çağlayan performed the patient recruitment and clinical follow-up. All collaborators contributed to the clinical management of the COVID-19 patients. Y. Peker, Y. Celik and A. Baygül performed the statistical analysis. Y. Peker prepared the manuscript, and drafted the article. All authors interpreted the data. Y. Peker takes full responsibility for the work as a whole, including the study design, access to data, and the decision to submit and publish the manuscript. All authors approved this manuscript in its final form. Data Sharing: Data collected for the study, including de-identified individual participant data will be made available to others within 6 months after the publication of this article, as will additional related documents (study protocol, statistical analysis plan, and informed consent form), for academic purposes (e.g., meta-analyses), upon request to the corresponding author

Bu çalışmada endobronşiyal ultrasonografi elastografinin maligniteyi öngörmedeki rolü araştırıldı. Ça lış ma pla nı: Ocak 2016 -Aralık 2016 tarihleri arasında, endobronşiyal ultrasonografi eşliğinde transbronşiyal iğne aspirasyon biyopsisi ile 119 ardışık hastadan (69 erkek, 50 kadın; ort. yaş 63.2±12.4 yıl; dağılım 16-86 yıl) toplam 221 lenf nodu çalışmaya alındı. Lenf nodları işlem öncesinde elastografi ile renklerine göre dört kategoride skorlandı. Gerginlik oranı, üç ölçüm sonrasında ilgili bölgeye göre hesaplandı. Bul gu lar: Hastaların 93'üne endobronşiyal ultrasonografi eşliğinde transbronşiyal iğne aspirasyon biyopsisi ile malignite tanısı konuldu. Benign ve malign lenf nodlarının ortalama skoru sırası ile 2.2±1.0 ve 3.2±1 idi (p<0.001). Lenf nodunun skoru ve lenf nodunun çapı, gerginlik oranı ve florodeoksiglukoz alım değeri arasında pozitif bir ilişki vardı (p<0.01). Lenf nodu skorunun ≥3'lük eşik değeri ile malignite için duyarlılık %79 ve özgüllük %60 idi. Malign ve benign lenf nodlarının ortalama gerginlik oranı sırası ile 22.2±30.1 ve 5.2±1.7 idi (p<0.001). Gerginlik oranının ≥2.47'lik eşik değeri ile malignite duyarlılığı %75 ve özgüllüğü %65 idi. Pozitron emisyon tomografisi ve lenf nodu skoru veya gerginlik oranı birlikte kullanıldığında, malignite duyarlılığı sırası ile %80.4 ve %61.2 ve özgüllüğü %80 ve %70.3 idi. So nuç: Endobronşiyal ultrasonografi elastografi, lenf nodu malignitelerini öngörmede yararlıdır. Pozitron emisyon tomografisi ile birlikte kullanıldığında, malignite özgüllüğü ve pozitif öngördürücü değeri artar.

BackgroundMalignant mesothelioma (MM) is an aggressive asbestos-related pleural tumor. The incidence is increasing with intensive use of asbestos in developing countries. We need an easily accessible, inexpensive, and reliable method for determining the low survival time prognosis of this tumor. The aim of our study was to investigate the viability of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) as prognostic indicators in MM.Patients and methodsThirty-six patients with MM, whose histopathologic diagnosis and follow-up were performed by our clinic and whose complete archive data were accessible, were included in this retrospective study. The patients’ histopathologic disease types and stages, complete blood count parameters at diagnosis, and survival were recorded.ResultsEighteen of the patients with MM were male and the remaining 18 of them were female; the average follow-up period was 24.83±3.61 months. The PLR levels of the patients were statistically significant (P<0.05). The NLR and PLR area under the receiver operating characteristic curve values were 0.559 and 0.749, respectively (P=0.631 and P=0.044, respectively).ConclusionPLR was a significant prognostic indicator of MM at diagnosis on complete blood count parameters; however, NLR was not a significant prognostic indicator. A large number of prospective studies are needed to prove the reliability of the parameters.