Spindle cell sarcomatoid carcinoma: first case reported in the trachea.

A 78-years-old man presented with weight loss, dyspnea, cough and hemoptysis. He was an ex-smoker with a smoking history of 30 pack-years. Imaging studies revealed an endoluminal carinal mass and a tumoral mass arising from the posterior wall of the trachea was observed bronchoscopically. Endoscopic argon plasma coagulation was performed to take biopsies and to regain the airway passage. Recanalisation of the right and left main bronchi and the trachea was achieved together with resection of more than 90% of the tumoural mass. Microscopically, the tumor was composed of fascicular pattern of spindle cells with atypical mitotic figures and nuclear pleomorphism, positively reactive to epithelial membrane antigen supporting a diagnosis of tumour with epithelial differentiation. These findings supported the diagnosis of a spindle cell sarcomatoid carcinoma of trachea. Spindle cell carcinoma cases are reported in many sites, such as head and neck region, larynx, digestive tract, breast, kidney, genital tract, skin and lung, but to our knowledge, not in trachea. Primary malignant tracheal tumours consist mainly of squamous cell carcinoma and adenoid cystic carcinoma and generally have an aggressive course with poor prognosis. We report the first presentation of a spindle cell sarcomatoid carcinoma of trachea together with the clinical course of the patient.

[The comparison of nicotine replacement therapy and behavioral education in smoking cessation: a study of naturalistic follow-up]. / Sigarayi birakmada nikotin replasman tedavisi ve davranis egitimi yöntemlerinin karsilastirilmasi: dogal izlem çalismasi.

In this study, we aimed to compare quitting smoking rates after behavioral education (BE) and/or nicotine replacement therapy (NRT). 610 patients applied between October 1999-April 2002 have been acknowledged and evaluated by a questionnaire including demographic variables, smoking history, smoking habits and attitudes, motivation; biochemical assay and spirometric measures were examined. One-year follow-up results and demographic variables of patients who recruited to treatment (n= 435) were analyzed by chi-square, Student-t test, one-way ANOVA and post-hoc tests. 375 (66.8 %) case were given NRT and BE; only BE (Fagerstrom < 6, not want to use of NRT, medical and economic reasons) was recommended to 186 (33.2 %) case. There was not difference between NRT and BE groups with regards to age, sex, packet year, smoking beginning age except Fagerstrom score. Smoking cessation rates for 1-year were 31.5 % in NRT group, 24.2 % in BE group, and 29.1 % in whole group (x(2)= 3.19, p> 0.05). Quitting rates were similar between age, sex, education, occupation, and complaint groups. Two groups were not statistically different with regards of smoking history and nicotine dependence. The most frequent side effect was skin reactions (7 %). The economical and medical burden of smoking increase as time goes on. According to our results, NRT and behavioral education are both efficient in smoking cessation.