Bülent ÇİFTÇİ, Dilek SAKA, Sezer Canan SEZER, Selçuk Özlem SÖNMEZ, Tuğrul ŞİPİT

İntratorasik lenfoma olgularımızın özellikleri

Bu çalışmada; Ocak 1999-Ağustos 2001 tarihleri arasında intratorasik lenfoma tanısı alan 18 hasta tanısal yaklaşımda yol göstermesi amacıyla retrospektif olarak incelenmiştir. Hastaların 12 (%66.6)'si erkek, 6 (%33.4)'sı kadın olup, yaş ortalaması 46.47 ± 17.31 yıl idi. Başvuru sırasında önde gelen yakınmalar nefes darlığı, öksürük, kilo kaybı ve ateşti. Laboratuvar tetkiklerinde sık görülen patolojik bulgular hemoglobin, hematokrit düşüklüğü (%72.2) ve laktat dehidrogenaz yüksekliği (%44.4) olmuştur. Radyolojik olarak 18 (%100) hastada mediastinal lenf nodu büyümesi, 8 (%44.4) hastada bilateral ve 6 (%33.3) hastada unilateral olmak üzere hiler dolgunluk, 3 (%16.6) hastada kitle,1l (%5.5) hastada konsolidasyon görünümü, 2 (%11.1) hastada atelektazi ve 3 (%16.6) hastada pleural sıuı ile uyumlu görünüm saptanmıştır. Histopatolojik tanılar; 11 (%61.1) hastada lenf nodu biyopsisi, 2 (%11.1) hastada bronş biyopsisi, 1 (%5.5) hastada pleura biyopsisi, 3 (%16.6) hastada lenf nodu. ve bronş biyopsisi, 1 (%5.5) hastada lenf nodu ve pleura biyopsisi ile konmuştur. Histopatolojik tanıların 11 (%61.1) 'i Hodgkin hastalığı (dokuzu nodüler sklerozan, ikisi mikst selüler tip), 7 (%38.9) 'si ise non Hodgkin lenfoma olarak raporlanmıştır. Olgular tanı konulduktan sonra medikal onkoloji kliniğince takip ve tedavi edilmek üzere ilgili merkezlere yönlendirilmiştir. Bu bulgular; nodal ve ekstranodal olarak, farklı intratorasik yerleşim gösterebilmeleri nedeniyle lenfomaların, ayırıcı tanıda göz önünde bulundurulmaları gerektiğini göstermektedir.

The features of cases of intrathoracic lymphomas

In this study, 18 patients who had been diagnosed as Intrathoracic lymphoma between January 1999 and August 2001 had been evaluated retrospectively to guide the diagnostic aproaches. 12 (66.6%) of the patients were male and 6 (33.4%) were female. The mean age was 46.47 ± 17.31. The leading symptoms were dispnea, cough, weight loss and fever. The most frequently seen laboratory findings were decreased hemoglobin and hematocrite rates (72.2%) and increased Lactate Dehidrogenase levels (44.4%). Radiologically, 18 (100%) patients had mediastinal lymph node enlargement, 8 (44.4%) pa-tients had bilateral and 6 (33.3%) had unilateral hilar enlargement, 3 (16.6%) patients had appearance of mass lesion, 1 (5.5%) had appearance of consolidation, 2 (11.1%) patients had atelectasis, 3 (16.6%) patients had appearance of pleural effusion. Histopathological diagnosis were undertaken with lymph node biopsies in 11(61.1%) patients, with bronchial biopsies in 2 (11.1%) patients, with pleural biopsy in 1 (5.5%) patient, with lymph node and bronchial biopsies in 3 (16.6%) patients, with lymph node and pleural biopsies in 1 (5.5%) patient. U (61.1%) patients were diagnosed as Hodgkin Disease (nine as nodular type, two as mixed cellular type). 7 (38.9%) patients were diagnosed as Nonhodgkin Lymphoma. After taking diagnosis the patients were sent to medical oncology clinics for follow up and therapy. These findings showed that different locations of Intrathoracic lyrnphomas could be seen with nodal or extranodal presentations so it must be taken into account in differential diagnosis of other pathological conditions.

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