Emine OSMA, Aydanur KARGI, Atila AKKOÇOĞLU, Onur TURAN

Recurrence and metachronous lung cancer developıng after chemotherapy ın a patıent wıth small cell lung carcınoma

Akciğer Tüberküloz'u (TB ) ülkemizde önemli derecede morbitide ve mortaliteye neden olmaktadır. Mycobacterium tüberculosis complex'in infeksiyonu oldukça heterojendir. Farklı radyolojik görünümle karşımıza çıkan ve metastatik akciğer kanserini taklit eden akciğer TB olgusunun sunulması uygun görüldü.Elli dokuz yaşında erkek hasta nefes darlığı, göğüs ağrısı şikayeti ile başvurduğu merkezimizde çekilen PA akciğer grafisinde; bilateral multipl sayıda nodüler lezyonlar, üst zonlarda hiperlüsensi saptandı. Bilgisayarlı toraks tomografisinde; bilateral multipl sayıda, multisentrik özellikte lezyonlar ve büllöz amfizem görünümü mevcuttu. Biyokimyasal ve hematolojik laboratuar bulguları normal sınırlar içerisinde idi. Yapılan bronkoskopide bronşiyal sistem doğal olarak izlendi. Balgam ve bronş lavaj sıvısında ARB negatif olarak bulundu. Tüm vücut malignite taramalarında patoloji saptanmadı. Hastaya sağ mini torakotomi ile nodul eksizyonu yapıldı. Patoloji sonucu amfizem, interstisyel pnömoni bulguları ve kazeifiye granulomatöz hastalık olarak raporlandı.Radyografide yaygın nodüler lezyonları olan olguların ayırıcı tanısında granülomatöz hastalıklar mutlaka düşünülmeli, ülkemiz şartlarında akciğer TB'unun hala ilk sıralarda değerlendirilmesi gerektiği unutulmamalıdır.

Küçük hücreli akciğer kanserli bir olguda tedavi sonrası rekürrens ve metakron tümör gelişmesi

Small cell lung cancer (SCLC) is a kind of disease with a good response to chemotherapy, however it usually recurs in a short time and the most important reason of mortality is relapses. A sixty-two-year old male patient was diagnosed as SCLC, with an inoperable lesion in left lung. After 6 cycles of carboplatin and etoposide chemotherapy and radiotherapy, there was a total regression of the lesion. In following months, there was a new right pulmonary mass seen in thorax computed tomography (CT) which had the diagnosis of adenocarcinoma by transthoracic needle biopsy. It was accepted as a metachronous lung carcinoma and a new chemotherapy regimen including carboplatin and gemsitabine was administered, which created a total regression of the tumour for the second time. Nine months later, a mass invasing mediastinum was recognized in the same location with firstly diagnosed tumour, SCLC.This situation was named as recurrence of SCLC and the prior chemotherapy was administered again. We want to present this interesting case with the unexpected behaviour of tumour that contains both metachronous cancer and recurrence in a short time, and with the perfect response to the platin-based chemotherapy at every attack of the tumour.

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