Figen Öztürk Ergür

Background: Bronchial carcinoids are rare; endobronchial therapy may be parenchyma-sparing in selected patients. Aim/Objectives This study aimed to evaluate outcomes of endobronchial therapy and to describe a decision framework for patient selection. Methods: We retrospectively analyzed patients with bronchial carcinoid tumors treated with endobronchial therapy between 2015 and 2022. Lesion morphology, degree of airway stenosis, tumor size, histological subtype, procedural outcomes, complications, recurrence, and long-term follow-up were evaluated within a structured clinical decision-making framework. Results: A total of 43 patients were included. Endobronchial therapy was successfully applied in selected cases with low procedure-related morbidity. During long-term follow-up, durable local control was observed in most patients. Lesion morphology and degree of airway obstruction emerged as key factors guiding treatment decisions. Conclusion: These findings support a pragmatic, decision-oriented framework to guide patient selection for endobronchial therapy in bronchial carcinoid tumors. erj;68/suppl_70/PA6363/F1 F1 F1 Figure 1 Clinical decision framework for bronchial carcinoid tumors. erj;68/suppl_70/PA6363/F2 F2 F2 Figure 2 Representative bronchoscopic images before and after endobronchial therapy.

Hypersensitivity pneumonitis (HP) is a complex interstitial lung disease with heterogeneous presentations. In some patients, radiological coexistence of emphysema and fibrosis creates a distinct functional phenotype that complicates disease progression and management. To evaluate the functional impact of combined emphysema and fibrosis in HP patients and to identify clinical predictors associated with this dual pathology. We retrospectively analyzed 215 patients diagnosed with HP between 2010 and 2023. Demographic data, exposure history, radiological findings (HRCT), and pulmonary function parameters (FVC, DLCO, FEV₁) were collected. Patients were classified into three groups: fibrotic HP, non-fibrotic HP, and combined emphysema with fibrosis (CE-HP). Statistical analyses were performed using SPSS v22.0. Of the 215 patients, 68 (31.6%) had fibrotic HP and 42 (19.5%) presented with CE-HP. Patients with CE-HP were significantly older (mean 66.2 ± 9.1 years) and more often male and smokers (p < 0.05). FVC and DLCO values were lower in CE-HP compared with non-fibrotic and fibrotic groups. A moderate negative correlation was found between extent of emphysema and DLCO (r = -0.56, p < 0.001). In multivariate analysis, age > 65 years, male gender, and smoking history were independent predictors of CE-HP development. The coexistence of emphysema and fibrosis in HP represents a distinct clinical phenotype with significant functional impairment. Recognition of this dual pathology is crucial for accurate prognostication and individualized management strategies.

Objective: In COVID-19, prothrombotic clotting abnormalities and thromboembolism are frequent complications that could be contributed to morbidity and mortality. We aimed to determine the incidence of pulmonary thromboembolism (PTE) at the time of diagnosis of COVID-19 and to evaluate the association of D-dimer levels with in patients with COVID-19. Materials and Methods: Patients who were diagnosed with COVID-19, had elevated D-dimer levels (> 500 mg/L) and underwent pulmonary CT angiography (CTA) were included. Data were reviewed retrospectively. Patients were divided into two groups based on the presence or absence of a diagnosis of PTE, univariate and multivariate analyses were performed. Results: 687 patients with COVID-19 were included. PTE was identified in 11.4% of the patients (n=78) using pulmonary CTA. There were significantly more male patients in the PTE group (60.3% vs. 39.7). PTE patients had significantly higher D-dimer levels (1535 mg/L; range: 960-3710). Age, gender, and D-dimer were found as independent predictors for a diagnosis of PTE in the multi-logistic regression analysis. Also, a ROC analysis performed to evaluate the diagnostic value of D-dimer in PTE showed an area under curve (AUC) of 0.651 (0.585-0.718).A cut-off value of 1000 ng/mL provided diagnostic utility. Conclusion: COVID-19 has constituted a predisposition to thromboembolism. Age-adjusted D-dimer levels, which have recently become prominent for suspected PTE, do not appear to be beneficial in patients with COVID-19. The results of this study suggest a cut-off of 1000 ng/mL can be utilized in these patients.