Pulmonary hydatid disease diagnosed by bronchoscopy: a report of three cases.

Pulmonary hydatid disease is an important clinical problem where echinococcal infection is endemic. Bronchoscopy is unnecessary in patients with pulmonary hydatid disease who present with a typical clinical picture and radiological appearance. However, it may be performed when a tumour is suspected or when the radiological picture is atypical. This case report presents three patients with pulmonary hydatid disease diagnosed by bronchoscopy. All patients were male, aged between 24 and 30 years, presented with pulmonary symptoms and had an abnormal CXR. Bronchoscopy showed whitish membraneous material in all three patients and biopsy confirmed the diagnosis of hydatid disease. Cystectomy was performed in two patients and right pneumonectomy was performed in the third because of pulmonary artery involvement. Bronchoscopy may be valuable in the diagnosis of pulmonary hydatid cyst disease in patients with atypical clinical and radiological presentations.

Delays in the diagnosis and treatment of primary lung cancer: are longer delays associated with advanced pathological stage?

We aimed to investigate the delays from the first symptom to thoracotomy and to examine whether the delays cause the stage advancement in lung cancer. This prospective study included 138 patients with non-small cell lung carcinoma who underwent thoracotomy. Clinical files of the patients were analyzed and a questionnaire was created to obtain information from the patients. The mean duration values were 81.3 days for the application interval, 61.3 days for the referral interval, 20.3 days for the diagnostic interval, and 21.9 days for the treatment interval. The application interval was longer than 30 days (patient delay) in 50 patients (37.9 %). The mean interval from the first visit to doctor to thoracotomy was 97.2 days. There was a doctor delay in 102 (73.9 %) patients; a referral delay in 83 patients (60.1 %), a diagnostic delay in 47 patients (36.4 %), and a treatment delay in 96 patients (69.6 %). The mean total duration was 176.2 days. Ninety-four patients (71.2 %) had a total delay. Mean total delay was 184.5 days in pathologic stage I, 187.3 days in stage II, 167.7 days in stage IIIA, 142.6 days in stage IIIB, and 150.3 days in stage IV (p>0.05). Delays during the course between the first symptom and thoracotomy in lung cancer patients were a common problem among our patients. Prolonged durations in the application and referral of patients are the most significant cause of delays. Presence of delay or length of delay did not correlate with pathologic tumour stage in this study.

Pulmonary glomus tumour: a case initially diagnosed as carcinoid tumour.

Pulmonary glomus tumours are rare lesions, with few cases reported previously. Herein, we present the clinical and pathological features of a case of pulmonary glomus tumour. A 29-year-old female patient presented to our clinic complaining of cough, dyspnoea and left-sided chest pain. Computed tomography (CT) of the thorax revealed a nodular lesion causing obstruction of the left main bronchus. Fibreoptic bronchoscopy demonstrated a polypoid mass occluding the left main bronchus 10 mm distal to the main carina. Bronchoscopic biopsy was interpreted histologically as carcinoid tumour. Bronchotomy plus mass extirpation was performed with left thoracotomy. Microscopically, a tumoral structure composed of uniform cells with a round centrally located nucleolus and narrow eosinophilic cytoplasm was seen. Thin-walled vessels lined with endothelium were interspersed between tumoral structures. The cells were stained chromogranin and cytokeratin negative and strongly vimentin positive. The pathological diagnosis for the thoracotomy specimen was pulmonary glomus tumour. Follow-up chest CT was negative for recurrent tumour and the patient remains free of disease 17 months after surgery.