Mediastinal Thymolipoma: An Evaluation of the Clinical and Radiological Features and the Surgical Outcomes in 11 Cases

ABSTRACT Background: Thymolipoma is a rare benign tumour of the mediastinum, accounting for 2%-9% of all thymic tumours. Although many case reports have been published in the literature, few studies have analysed the clinical and radiological features and the surgical outcomes of this tumour. Objective: To evaluate the clinical and radiological features and the surgical outcomes of the patients with thymolipoma. Methods: We reviewed the records of the Pathology Department from the beginning of 2005 to the end of 2013. Results: We identified 11 patients with thymolipoma. There were eight male and three female patients. Their ages ranged from 27 to 72 years, with the mean age of 40 years. All patients described pulmonary or extrapulmonary symptoms. Two patients (18.2%) had myasthenia gravis. Chest X-ray was normal in four patients. Computed tomography of the thorax revealed a mass located in the anterior mediastinum in all patients. It showed fat attenuation in 4 of 11 patients (36.4%). Thymectomy was performed in all patients. The surgical approach was thoracotomy in five, sternotomy in four and video-assisted thoracic surgery in two patients. Thymolipomas ranged in size from 4 to 33 cm. One patient died 2 years after surgery. None of the remaining patients had evidence of recurrence on follow-up. Conclusion: Thymolipoma is a rare tumour of the thymus. It may be associated with myasthenia gravis. Surgical resection is the treatment of choice in the patients with thymolipoma. Complete surgical resection is the cure in most patients.

Social factors associated with pulmonary hydatid cyst in Aegean, Turkey.

BACKGROUND: Pulmonary hydatid cysts are caused by larval forms of the tapeworm Echinococcus granulosus. Hydatid disease, which is endemic in Turkey, is an important health problem in agricultural and stockbreeding areas where there are insufficient environmental health and preventive medicine services. Previous studies on this topic reported that hydatid disease was frequently associated with stockbreeding in rural areas. OBJECTIVES: In this retrospective clinical study, it is aimed to evaluate the social factors associated with pulmonary hydatid cyst in the Aegean region of Turkey. METHODS: Seventy-one pulmonary hydatid cyst cases reported between 1998 and 2010 in four hospitals in the Aegean region for which data were available on social and lifestyle factors were reviewed. RESULTS: In contrast to expectations, we found that pulmonary hydatid disease in the Aegean region was associated with city rather than rural life and with occupations other than stockbreeding. CONCLUSION: The findings are attributed to the presence of uncontrolled dogs in the city and urban environmental pollution. The offices of the public administration have a responsibility to inform citizens about the control of street animals, environmental health, and food hygiene.

W-plasty technique in tracheal reconstruction: a new technique? An experimental study.

BACKGROUND: Tracheal stenosis and dehiscence of anastomosis due to excessive tension are well-known problems after long-segment tracheal resections. The aim of this study was to evaluate the efficacy of the W-plasty technique to prevent these two complications. METHODS: Animals were divided into a study and a control group. Each group consisted of 6 animals. In the control group, we performed a 5-cm tracheal segment resection, and then reconstruction was performed with an interrupted technique with 6/0 Prolene sutures. In the study group, we used the W-plasty technique with 6/0 Prolene interrupted sutures. The animals were sacrificed on the 30th day postoperatively and tracheal resection including the entire anastomosis site was performed. The traction and pullout test was applied to each specimen and all the specimens were analysed histopathologically. The intraluminal diameter and the thickness of the tracheal wall at the level of anastomoses were measured by using a micrometer. The pattern of the reaction and localization were recorded. RESULTS: The traction and pullout test results were 131.6 +/- 4.3 g and 187.5 +/- 6.4 g in the control and the study group, respectively, which was a significant difference (p = 0.004). The intraluminal diameters were 3.3 +/- 1.2 mm and 4.3 +/- 0.9 mm in the control and study group, respectively (p = 0.134). In contrast to the control group, early inflammatory and late fibroblastic reactions were negative in the study group. CONCLUSION: Considering the outcomes of this study, we think that the W-plasty technique has much more advantages than the standard techniques in terms of anastomosis durability and development of stenosis.

Human hepatocyte growth factor levels in patients undergoing thoracic operations.

Human hepatocyte growth factor (hHGF) is the most potent mitogen identified for alveolar type II cells, and may have other important functions in the repair of the alveolar epithelium and compensatory lung growth. A study was conducted to evaluate the changes of serum hHGF levels in patients who underwent thoracic surgical procedures. The patients comprised 17 males and 14 females with a mean age of 47.1+/-13.5 yrs, who underwent either lung resection (LR group) or nonlung resection (nonLR group) thoracic procedures. The changes of hHGF levels were analysed in the pre- and post-operative periods in both groups. The pre-operative hHGF levels did not differ between the LR and the nonLR groups, which were 333.2+/-72.9 pg x mL(-1) and 343.6+/-125.3 pg x mL(-1), respectively. The hHGF levels in the LR group significantly increased up to 433.6+/-128.1 pg x mL(-1) and 430.8+/-128.2 pg x mL(-1) in post-operative days 1 and 3, respectively. However, the same levels in the nonLR group appeared as 333.2+/-77.0 pg x mL(-1) and 311.9+/-73.0 pg x mL(-1), respectively. In conclusion, the increases of serum human hepatocyte growth factor levels following pulmonary resection may imply the important role of human hepatocyte growth factor in lung regeneration or compensatory lung growth in humans.