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To investigate micrometastasis by using epithelial cytokeratin marker in non-small cell lung cancer (NSCLC) patients with tumor negative mediastinoscopic lymph node biopsies. Micrometastasis were investigated by immunohistochemical staining in 20 patients who were diagnosed as NSCLC with ipsilateral mediastinal lymph nodes (RN2) in CT scan and with negative histopathologic mediastinoscopic lymph node biopsy (pN0). Frozen section was studied with hematoxylin-eosin (HE), a routine histopatological method in lymph nodes taken by mediastinoscopy and in absence of metastasis; resection was applied with thoracotomy in the same session. We studied micrometastasis in lymph nodes, which are taken out by mediastinoscopy and dissected during resection, using both HE and immunohistochemical staining with cytokeratin. All patients were male and median age was 60.9 (51-74) years. In 16 cases epidermoid carcinoma, in 2 cases adenocarcinoma and in 2 cases bronchioloalveoler carcinoma were diagnosed as histopathological types. Cervical mediastinoscopy was performed in 20 patients who were diagnosed as RN2 by thorax CT radiologically, and complete resection was done in pN0 patients. Sixty lymph nodes, 40 of them taken by mediastinoscopy and 20 taken during resection, were stained immunohistochemically in 20 NSCLC patients. Only one lymph node from a single patient was positive after staining. After postoperative staging, 18 patients were at a lower stage, one patient was at the same stage, and one patient with micrometastasis was at an advanced stage. Immunohistochemical staining may be useful in detecting micrometastasis in NSCLC. Standard cervical mediastinoscopy is still gold standard in preoperative staging. Efficiency can be increased by combining mediastinoscopy, a gold standard method in staging, with immunohistochemical methods. © 2013 OMU.

Foreign body aspiration can be a lite-threatening emergency requiring immediate intervention. In our country and especially in adults, the prevalence of foreign bodies aspiration is high. In this study, the aim is to evaluate results of the treatment, as well as pointing the importance of bronchoscopic treatment, and etyology and clinics of tracheobronchial foreign bodies in adults. Between January 1998 and December 2003, at Ondokuz Mayis University Medical School, Department of Thoracic Surgery, 53 patients were examined with a suspicion of tracheobronchial foreign body aspirations, retrospectively. The diagnosis was made on history, physical examination, radiological methods and bronchoscopy. The age interval of the patients was 14 to 58 and the mean age was 24±1.6 years. Nine (17%) of them were male and 44 (83%) of them were female. Eighteen (34%) patients were symptomatic on admission and the most frequent symptom was cough (17%). The most common radiographic abnormality found in 81% of the cases was a radiopaque foreign body. All 53 patients had bronchoscopic evaluation, and at 50 (94%) of them foreign bodies were identified. Only in three cases a foreign body was not found during the bronchoscopy. In 3 (5.6%) cases, in which rigid + flexible bronchoscopy were unsuccessful, thoracotomy + pneumotomy was applied. Foreign bodies were localized in the right bronchial tree in 24 (48%) cases, in the left bronchial tree in 18 (36%) cases and in the trachea in 8 (16%) cases. The majority of the foreign bodies were turban pins, in 40 (80%) cases. Early diagnosis and treatment is important in tracheobronchial foreign body aspiration. Tracheobronchial foreign bodies can be successfully removed with bronchoscopy. Aspired foreign bodies vary from region to region and country to country.