Pulmonary hamartoma, the most common benign tumor of the lung, is most often presented as a solitary pulmonary nodule of a peripheral localization. We report a case of a large, centrally located, invisible in chest X-ray, hystopathologicaly (PH) verified hamartoma. A 63-year-old male was admitted for hospital treatment with obvious symptoms and signs of right-sided lobar pneumonia. His treatment was started with a combination of antibiotics Ceftriaxone and Ciprofloxacin. Because of his obviously bad condition with wheezing and bronchial secret in his lungs, an urgent bronchoscopy was performed. A huge amount of bronchial secret was found in his bronchial tree and, surprisingly, a tumor in the upper left lobe. For further evaluation computed tomography (CT) scan was performed and it verified right pneumonia but, it also revealed large (13.3 x 11.2 mm) endobronchial tumor in upper left lobe which wasn't clinically or radiographically presented. From a bronchobiopsy, we received an inconclusive PH finding. It was concluded that the best treatment is a surgical sleeve resection lobectomy, which was performed. Definite pathohistological finding was hamartoma and the patient was successfully healed.
The aim of the study was to evaluate whether obstructive sleep apnea (OSA) contributes directly to left ventricular (LV) diastolic and regional systolic dysfunction in newly diagnosed OSA with normal left ventricle ejection fraction. Methods. 125 consecutive patients were prospectively enrolled in the study. Control group consisted of 78 asymptomatic age-matched healthy subjects who did not have any cardiovascular and respiratory diseases. All patients had undergone overnight polysomnography and standard transthoracic and tissue Doppler imaging echocardiogram. Results. The E/A ratio and the peak E wave at mitral flow were significantly lower and the peak A wave at mitral flow was significantly higher in OSA patients compared with control subjects. Left ventricle isovolumetric relaxation time (IVRT) and mitral valve flow propagation (MVFP) were significantly longer in OSA patients than in controls. Tissue Doppler derived S′ amplitude of lateral part at mitral valve (S′Lm) and E′ wave amplitudes both at the lateral (E′Lm) and septal parts of the mitral valve (E′Sm) were significantly lower in OSA patients compared to controls. Conclusion. Newly diagnosed OSA patients with normal global LV function have significantly impaired diastolic function and regional longitudinal systolic function. OSA is independently associated with these changes in LV function.
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