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Objectives: Venous thromboembolis is a clinical condition that often occurs from deep vein thrombosis of lower extremity. The incidence of deep venous thrombosis in the etiology of pulmonary thromboembolism may be as high as 90%. Doppler ultrasonography of lower extremities is recommended generally to determinate the etiology of pulmonary thromboembolism. The aim of this study is to present the importance of upper extremity thrombosis in pulmonary thromboembolism. Materials and Methods: Between 2010-2012, 236 patientsfollowed with the diagnosis of pulmonary thromboembolism were included in the study. Lower and upper extremity doppler examination was performed to all patients to determinate the cause. Results: The mean age of patients is 64,7± 16,9 (22-95); 56,8% (134) were female, 43,2% (102) were men. According to the classification of pulmonary thromboembolism , 37 (15,7%) patients had massive, 103 (43,6%) patients had submassive, 96 (40,7%) patients had nonmassive embolism. Lower extremity deep venous thrombosis was detected in 109 (46,2%) patients, both lower and upper extremity in 10 (4,2%) patients and only upper extremity in 20 (8,4%) patients. Eventually, deep venous thrombosis was detected in 129 (54,6%) patients. Thrombosis of the upper extremity was detected in 20 (16,8%) patients. Conclusions: Upper extremity thrombosis has been found as important as lower extremity thrombosis in the etiology of venous thromboembolism. Upper extremity thrombosis does not always occur in patients with malignancy or central venous catheters It should be kept in mind that, in hospitalized patients with peripheral vascular vein catheter, the upper extremity thrombosis may also occur.

Reactive airway dysfunction syndrome (RADS) is a disease that causes bronchial hyper-reactivity with asthma-like symptoms within 24 hours, and it causes high-level irritant exposure in patients who did not have any previous lung disease. In general, the patient's radiological findings are normal, although some changes are often seen. Pulmonary edema is rarely seen radiologically. In a 43-year-old female patient's thorax computed tomography (CT) scan after the inhalation of a mixture of hydrochloric acid and sodium hypochloride, ground glass opacities, which implies bilaterally pulmonary edema, are detected. This case is presented because RADS is rarely accompanied by pulmonary edema.

Cardiac sarcoidosis is an infiltrative, granulomatous inflammatory disease of the myocardium. Generally, it can be difficult to diagnose cardiac sarcoidosis clinically because of the non-specific nature of its clinical manifestations. This property can be based on the presence of any clinical evidence of sarcoidosis in the other organs. We present two cases of cardiac sarcoidosis so as to demonstrate its different clinical manifestations. The first patient displayed no cardiac symptoms; the electrocardiogram showed an incidental right bundle branch block. Her cardiac magnetic resonance imaging (CMRI) revealed late-phase opaque material enhancement involving the inferior and inferoseptal segment of the left ventricle. The second patient was severely symptomatic in terms of cardiac involvement, and a transthoracic echocardiogram revealed global hypokinesia and septal brightness; his ejection fraction decreased to 45%. These cases highlighted the challenges encountered in the diagnosis and treatment of cardiac sarcoidosis. CMRI should be considered in all patients who have suspected findings for cardiac involvement.

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