• Title/Summary/Keyword: 혈관 침범

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Visceral Pleural Invasion And Bronchovascular Bundle Thickening to The Same Lobe in NSCLC : Diagnostic And Clinical Significance of $HRCT^1$ (비소세포성 폐암에서 장측 흉막 침윤과 동측 폐엽 기관지혈관속 비후 : 고해상도 전산화 단층 촬영의 진단적 유용성과 임상적 의의)

  • Huh, Yong-Min;Choe, Kyu-Ok;Hong, Yong-Kuk;Kim, Kil-Dong;Jeong, Kyung-Young;Kim, Se-Kyu;Jang, Joon;Kim, Seong-Kyu;Lee, Won-Young;Choi, Byoung-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.66-76
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    • 1999
  • Background : To assess the utility of HRCT in the evaluation of visceral pleural invasion and to determine whether visceral pleural invasion and bronchovascular bundle thickening on the same lobe could be related to the recurrence and survival in non-small cell lung cancer (NSCLC) Method: Eighty one patients, which were fulfilled long-term follow-up at least 18 months (maximum 103 months) among which 434 patients had underwent curative surgical resection for NSCLC from 1986 to 1995, were studied. They were analyzed to evaluate whether the prognostic factors such as the recurrence and survival depend on visceral pleural invasion and bronchovascular bundle thickening to the same lobe. Thirty two patients adjacent to a chest wall or a fissure were evaluated for visceral pleural invasion by HRCT. CT criteria included abutting pleura along the chest wall, abutting and/or compressing fissure, croosing fissure, and pleural tail. Results: The positive predictive value and the negative predictive value of crossing fissure were 100% and 100%, respectively. Two patients showing spiculated interface between a mass and abutting fissure were confirmed to have visceral pleural invasion at surgery. Visceral pleural invasion confirmed at surgery was significant to local recurrence and survival (p<.05. p<.05, respectively). Brochovascular bundle thickening to the same lobe on CT scan was significant to survival (p<.05) but was not significant to local and distant recurrence (p>.05). Conclusion : Visceral pleural invasion and bronchovascular bundle thickening to the same lobe have a role in predicting prognosis such as recurrence and survival in NSCLC. Therefore, the analysis of visceral pleural invasion on CT scan and the pathological analysis of bronchovascular bundle thickening to the same lobe may be necessary to predict the prognosis in NSCLC.

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Follicular Thyroid Carcinoma Associated with Macroscopic Vascular Invaion and Intraluminal Tumor Thrombosis in Great Cervical Veins : Two Case Reports (경부의 주정맥 침범과 암성 혈전을 보인 여포상 갑상선암 2예)

  • Lim Jun-Sup;Lee Jan-Dee;Yun Ji-Sup;Lim Chi-Young;Nam Kee-Hyun;Chang Hang-Seok;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.1
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    • pp.58-61
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    • 2006
  • Differentiated thyroid carcinomas are rarely associated with macroscopic vascular invasion and intraluminal tumor thrombus in great cervical veins. The best treatment for such cases appears to be a total thyroidectomy with en-block resection of the involved vessels, followed by postoperative radioiodine therapy(RI). We report two cases of follicular thyroid carcinoma with vascular invasion and intraluminal tumor thrombosis in great cervical veins that were successfully treated using complete surgical resection and postoperative RI.

Analysis of Intraoral Squamous Cell Carcinoma Reconstructed with Radial Forearm Flap (전완부 유리 피판으로 재건한 구강내 편평상피암환자의 예후분석)

  • Park Myong-Chul;Soutar David S.
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.53-62
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    • 1994
  • 미세외과 수술에 의한 유리 피판술의 도입은 두경부 종양제거후 재건에 괄목할 만한 진보를 가져왔다. 특히 광범위한 종양의 제거가 필요하며 인근의 조직으로 수복이 어렵고 기능 및 외모상의 재건이 문제가 되는 경우 유리 피판은 절대적인 적응이 된다. 구강은 언어구사 와 연하(deglutition)기능을 담당하므로 재건을 위해서는 얇고 부드러운 조직으로 수복하여 주어야 한다. 전완부 유리피판은 혈관경의 위치가 대부분 일정하고 종양 제거후 결손의 모양에 따라 피판을 계획할 수 있기 때문에 구강암 제거후 가장 많이 이용되는 유리피판이다. 저자는 1982년 부터 1988년까지 영국 글라스고우 소재 서부 스코틀랜드 성형 및 구강외과 병원에서 구강의 편평상피암환자로 암종제거 후, 전완부 피판에 의한 재건 및 방사선 치료를 받은 151명의 치료결과(재발율 및 생존율)를 분석하였다. 절제연의 종양조직의 양성(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001), 경부 임파절 곽청술의 종류(P<0.05) 등은 재발율과 관련하여 통계적으로 유의하였다. 반면에 종양의 구강내 위치, 하악골의 침범여부등은 통계적의의가 없었다. 생존율에 관하여는 종양의 구강내 위치 (P<0.05), 종양절제연 종양여부(P<0.005), 하악골의 침범여부(P<0.05), 경부 임파절의 extracapsular node spread여부(P<0.001) 등이 통계적으로 유의할 만한 요소로 밝혀졌다. 젊은 나이의 환자들에서(50세이하) 특징적으로 높은 사망률을 보였다. 하악골절제방법의 차이는 환자의 생존예후에 통계적으로 유의할 만한 영향을 주지 못했다.

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Mal ignant Fibrous H istiocytoma of the Chest Wall -A Case Report- (흉벽에 발생한 악성 섬유성 조직구종 1례 보고)

  • Kim, Ae-Jung;Gu, Ja-Hong;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.472-476
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    • 1996
  • Malignant flrous histiocytoma is a rare deep-seated pleomorphlc sarcoma, although its incidence Increasing. In this report, we present a case of a malignant fibrous histiocytoma, arising in the left chest wall in a 37-year-ol4 male patient. He underwent radical on bloc resection which include excision of tumor on left upper chest wall with resection of ribs from the first to third, left upper lo ectomy and chest wall reconstruction with Marled Mesh. However, he had local recurrence and distant metastasis within 12 months of the original operation. Malignant fibrous histiocytoma is an agrressive disease entity, with a propensity for early and distant spread.

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Surgical Treatment of Multivalvular Endocarditis with Ventricular Septal Defect (심실중격결손과 동반한 다중판막 감염성 심내막염의 수술적 치료)

  • Kim, Seon-Hee;Je, Hyoung-Gon;Lee, Sang-Kwon;Kim, Sang-Pil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.417-420
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    • 2010
  • As higher mortality rate and frequent incidence of morbidity, early surgical treatment is generally recommended for the multivalvular endocarditis. A 46-year-old female presented with high fever. Echocardiography showed the vegetation on pulmonic valve, tricuspid valve and mitral valve with a ventricular septal defect. Emergency operation was conducted due to uncontrolled infection. We present a clinical success of this rare case with review of the medical literature.

Spontaneous Pneumothorax due to Pulmonary Invasion in Multisystemic Langerhans Cell Histiocytosis (다체계 랑거한스 세포 조직구 증식증에 의해 발생한 기흉)

  • Cho, Kyu-Seok;Kim, Jung-heon;Youn, Hyo-Chul;Kim, Soo-Cheol;Kim, Bum-Shik;Park, Joo-Chul
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.447-449
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    • 2010
  • Langerhans cell Histiocytosis can present as a single or multiple lesion and can affect one or several organ systems. A 41-year-old woman with a history of multisystemic Langerhans cell Histiocytosis invading lung and thyroid was admitted with left-sided spontaneous pneumothorax. Here we report a case of uncommon pulmonary Langerhans-cell Histiocytosis presenting with spontaneous pneumothorax as a multisystemic Langerhans cell Histiocytosis.

Myocardial Hamartoma Involving the Posterior Left Ventricular Wall -Surgical Experience of One Case- (좌심실 후벽을 침범한 심근성 과오종 -수술 치험 1예-)

  • Seo Yeon-Ho;Kim Nan-Yeol;Kim Kong-Soo
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.486-489
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    • 2006
  • A 16 year-old boy was admitted to our department because of mild chest discomfort and mild dyspnea. A mass involving posterior wall of the left ventricle near posterior mitral annulus was found on echocardiography and cardiac MRI. Total excision of the mass was performed via posterior ventriculotomy under the cardiopulmonary bypass. The pathologic diagnosis revealed mature cardiac myocyte hamartoma. There was no evidence of arrhythmia and tumor recurrence during the 1 year of follow up after the surgery.

Inflammatory Pseudotumor of the Entire Left Lung -1 operative case report (좌측 전폐에 발생한 염증성 가성 종양 -수술치험 1례 보고-)

  • 전양빈;이재훈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.437-440
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    • 1997
  • A case of inflammatory pseudotumor of the entire lung In a 61-ycar-old man is prcscntcd. The respiratory symptoms developed 2 months ago and progressed rapidly and the diagnosis of chronic pneumonia with ateletectasis of the entire lung, destroyed lung by tuberculosis and sepsis hAd to be ruled out The operative finding was different from our expectation. This case suggests that the Inflammatory pseudotumor can manifest as a whole lung-involving ass. Inflammatory pseudotumor is a nonneoplastic reactive pulmonary mass lesion that resembles tumor but shows little or no growth. Thc inflammatory pseudotufor usually present as a solitary round lung mass but in this casts progressed rapidly and destroyed the whole lung, which is rare. The patient was discharged with no problem and with outpatient followup.

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Medistinal Teratoma with Pleural and Pericardial Effusion Teratoma with Pleural and Pericardial Effusion (늑막 삼출 및 심막 삼출을 동반한 종격동 기형종)

  • Jeon, Yang-Bin;Sohn, Sang-Tae;Chun, Sun-Ho;Chung, Won-Sang;Kim, Young-Hak;Kim, Hyuk;Kang, Jung-Ho;Jee, Haeng-Ok
    • Journal of Chest Surgery
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    • v.31 no.4
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    • pp.436-439
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    • 1998
  • Mediastinal teratoma is a tumor that thoracic surgeons made an operation much less commonly than other mediastinal masses and most of them are asymptomatic. But very rarely, this tumor invades the pleura and pericardium resulting in pleural effusion, pericardial effusion and cardiac tamponade in severe cases. The mechanism of invasion and perforation of the tumor is unknown and tumor-consisting tissue factor is suspected of a cause. In this case, we operated on a patient whose anterior mediastinal teratoma invaded and perforated pericardium and pleura resulting in pericardial effusion and pleural effusion. The patient was improved and discharged with no problem after resection of mass and involved pericardium.

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Pulmonary Inflammatory Myofibroblastic Tumor with Bronchus Invasion -One case report - (기관지를 침범함 폐 염증성 근섬유 아세포종 - 1예 보고 -)

  • Son, Jin-Sung;Lee, Seock-Yeol;Lee, Chol-Sae;Lee, Kihl-Rho;Oh, Mee-Hye;Lee, Seock-Yeol
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.151-154
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    • 2007
  • A 34-year old man was admitted our hospital because he wished to evaluate the pulmonary mass that was incidentally detected on healthy examination. Bronchoscopy and chest CT showed endobronchial and peribronchial mass of the left lower lobe of the lung. Open thoracotomy and left lower lobectomy of the lung was done. Pulmonary mass was confirmed as a pulmonary inflammatory myofibroblastic tumor with bronchus invasion pathologically. Pulmonary inflammatory myofibroblastic tumor with bronchus invasion is a vary rare. Herein we report a case of pulmonary inflammatory myofibroblastic tumor with bronchus invasion.