Background: Cytological examination of pleural effusions is very important in the diagnosis of malignant lesions. Thoracentesis is the first investigation to be performed in a patient with pleural effusion. In this study, we aimed to compare traditional with cell block methods for diagnosis of lung disease accompanied by pleural effusion. Materials and Methods: A total of 194 patients with exudative pleural effusions were included. Ten mililiters of fresh pleural fluid were obtained by thoracentesis from all patients in the initial evaluation. The samples gathered were divided to two equal parts, one for conventional cytological analysis and the other for analysis with the cell block technique. In cytology, using conventional diagnostic criteria cases were divided into 3 categories, benign, malignant and undetermined. The cell block sections were evaluated for the presence of single tumor cells, papillary or acinar patterns and staining with mucicarmine. In the cell block examination, in cases with sufficient cell counts histopathological diagnosis was performed. Results: Of the total undergoing conventional cytological analyses, 154 (79.4%)were reported as benign, 33 (17%) as malignant and 7 (3.6%) as suspicious of malignancy. With the cell block method the results were 147 (75.8%) benign, 12 (6.2%) metastatic, 4 (2.1%) squamous cell carcinoma, 18 (9.3%) adenocarcinoma, 5 (2.6%) large cell carcinoma, 2 (1%) mesothelioma, 3 (1.5%) small cell carcinoma, and 3 (1.5%) lymphoma. Conclusions: Our study confirmed that the cell block method increases the diagnostic yield with exudative pleural effusions accompanying lung cancer.

Pulmonary hyalinizing granuloma is a very rare benign condition, which usually manifests as solitary and sometimes as multiple pulmonary nodules. Deposition of immune complexes in the lung parenchyma due to hypersensitivity reactions is implicated in the etiology of pulmonary hyalinizing granuloma. A 59-year-old female patient who presented to our clinic with complaints of chest pain and cough had bilateral, multiple, and rounded lesions with regular margins suggesting metastatic lung disease. A transthoracic needle biopsy of the nodule was performed in the left pulmonary anterior segment. Biopsy showed no malignancy. Since no diagnosis was made by the biopsy, the patient underwent a video-assisted thoracic surgery. The wedge biopsy reported pulmonary hyalinizing granuloma. We aimed to present the diagnosis and treatment stages of our patient who was diagnosed with pulmonary hyalinizing granuloma in the light of literature review.

The present study showed that MTV and mSUV of FDG PET/CT scans of the tumor, but not SUVmax, had a significant impact on survival time of patients with NSCLC. Based on this result, we believe that we might have more accurate information about the survival time of our patients if we also evaluate mSUV and MTV in combination with mSUV, which is frequently used for diagnosis and monitoring of patients with NSCLC during our daily practice.

Single-port VATS is a feasible and minimally invasive technique with a low incidence of chronic pain for the treatment of hyperhidrosis. A few patients may experience compensatory sweating and recurrence of hyperhidrosis. The degree of patient satisfaction with the midterm surgical results is high.

Chylothorax is characterized by fluid accumulation in the pleural cavity containing chylomicrons due to disruption of lymphatic drainage in the thoracic ductus and development of chylothorax. A 60-year-old male patient presented to our clinic with shortness of breath and displayed bilateral pleural effusion and diffuse mediastinal lymph nodes in his computed chest tomography images. There were no thickening and nodular formation on the pleural surfaces. PET-CT showed no pathological FDG uptake. Thoracentesis showed a chylous effusion. Drainage reduced during monitoring could not be stopped; therefore, surgical intervention was considered. The patient underwent right thoracotomy. There were no pathological findings in the parietal and visceral pleura during the surgery. Initially lymphoma was considered. Perioperative samples were collected from the mediastinal lymph node. The pathology analysis reported metastasis of malignant mesothelioma. Evaluation of a repeated chest computed tomography showed nodular formations on the pleural surfaces. Mediastinal lymph nodes compressed the ductus thoracicus, resulting with chylothorax. The present case, with malignant mesothelioma, bilateral chylothorax, and mediastinal lymph node without any pleural involvement during initial diagnosis, is rare and will hence contribute to the literature.