• Title/Summary/Keyword: Chest computed tomography

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Management of Idiopathic Interstitial Pneumonia Treated only with Traditional Korean Medicine: a Case Report

  • Kang, Ji-Young;Han, Jong-Min;Kim, Jun-Young;Jung, In-Chul;Kang, Wee-Chang;Oh, Young-Seon;Lee, Jin-Woo;Park, Yang-Chun
    • The Journal of Korean Medicine
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    • v.35 no.4
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    • pp.104-109
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    • 2014
  • Objectives: To present the case of a 76-year-old man diagnosed with idiopathic interstitial pneumonias (IIPs) treated exclusively with traditional Korean medicine (TKM). Methods: The patient was treated with the revised Sasammaekmundong-tang (rSMT), acupuncture, and pharmacopuncture from September 2013 to May 2014 in our outpatient clinic. We prescribed rSMT three times a day for 4 months. Acupuncture and pharmacopuncture were performed twice a week for 9 months. To evaluate therapeutic efficacy, we recorded the patient's chief complaints at each visit, and pulmonary function test was performed at intervals of three months. Chest radiography and chest computed tomography were performed before and after treatment, respectively. Results: During the course of the treatment, dyspnea, cough, sputum, and overall pulmonary function improved. Conclusions: We suggest that traditional Korean medicine (TKM) for IIPs patients might be effective in the control of the main symptoms of IIPs and in the recovery of respiratory function.

Lung Cancer Presented as Painful Swelling of Lower Legs (하지의 통증 및 부종을 주소로 내원한 환자에서 발견된 폐암1예)

  • An, Jin Young;Lee, Jang Eun;Park, Hyung Wook;Lee, Jeong hwa;Yang, Seung Ah;Park, Young Kun;Lee, Sang Rok
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.4
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    • pp.398-402
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    • 2006
  • Trousseau's syndrome comsists of migratory thrombophlebitis and thromboembolic disorders of the venous and arterial systems in a malignancy or occult cancer. The overall incidence has been reported to vary from 1 to 11%. Pancreatic, lung, prostate, and stomach cancer is associated with the greatest risk of thromboembolic events. We encountered a 49-year-old man who presented with painful swelling of his lower legs. The chest radiograph showed increased opacity of the Left middle lung fields and Doppler sonography showed a thrombus in the left superficial femoral vein. Chest Computed Tomography showed a 5cm sized left hilar mass invading the pericardium with lymphadenopathy. The bronchoscope biopsy demonstrated an adenocarcinoma of the lung. Platinum based chemotherapy and anticoagulant therapy with warfarin was carried out. The patient was later discharged with an improvement in the painful swelling of his lower legs.

Prostatic Stromal Tumor of Uncertain Malignant Potential (STUMP) Presenting with Multiple Lung Metastasis

  • Lee, Hea-Yon;Kim, Jin-Jin;Ko, Eun-Sil;Kim, Sei-Won;Lee, Sang-Haak;Kang, Hyeon-Hui;Park, Chan-Kwon;Min, Ki-Ouk;Lee, Bae-Young;Moon, Hwa-Sik;Kang, Ji-Young
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.4
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    • pp.284-287
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    • 2010
  • We report the case of a 68-year-old man with a stromal tumor of uncertain malignant potential (STUMP), which had metastasized to the lung. The patient complained of an enlarged mass in the anterior chest. Chest computed tomography (CT) showed a sternal abscess with multiple nodules in both lungs. A thoracoscopic lung biopsy of the nodules and incision/drainage of the sternal mass were performed simultaneously. CT of the pelvis revealed an enlarged prostate with irregular cystic lesions in the pelvis. Prostate biopsy was done and demonstrated hypercellular stroma with minimal cytological atypia, a distinct pattern of STUMP. The sternal abscess proved to be tuberculosis and the lung lesion was consistent with STUMP, which had spread from the prostate. However, to our knowledge, the tuberculous abscess might not be assoicated with STUMP in the lung. The patient refused surgical prostatectomy and was discharged with anti-tuberculosis medication. On one-year follow up, the patient had no evidence of disease progression.

Colobronchial Fistula as a Late Complication of Esophagocologastrostomy (식도-결장-위 문합술후 만기 합병증으로 발생한 결장-기관지루)

  • Lee, Chul-Burm;Han, Sung-Ho;Hahm, Shee-Young;Jee, Heng-Ok;Kim, Hyuk;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.77-81
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    • 2002
  • We report a case of colobronchial fistula, which is an extremely rare complication of esophagocologastrostomy A 53-year-old man developed recurrent respiratory symptoms 30 months after colon interposition for corrosive esophageal and gastric strictures. Chest radiographs and computed tomography showed an aspiration pneumonia and total atelectasis of the left lower lobe(LLL). Esophagoscopy and barium esophagogram revealed fistula between the colon just below the esophagocolostomy and superior segment of the LLL. The colobronchial fistulectomy and left lower lobe lobectomy were performed. This rare complication should be considered in patients who develop recurrent productive cough whenever they drink or eat something after esophagocologastrostomy.

Radiation dose and Lifetime Attributable Risk of Cancer Estimates in 64-slice Multidetector Computed Tomography (64-절편 다행검출 CT 검사에서의 환자선량과 암 발생의 Lifetime Attributable Risk(LAR) 평가)

  • Kang, Yeong-Han;Park, Jong-Sam
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.244-252
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    • 2011
  • This study was to estimate the radiation dose associated with 64-slice multidetector CT(MDCT) in clinical practice and quantify the potential cancer risk associated with these examinations. Lifetime attributable risks(LAR) were estimated with models developed in the national Academies' Biological Effects of Ionizing Radiation VII report. Mean effective dose were 1.48mSv in Brain axial scan, 7.66mSv in chest routine contrast, 12.17mSv in coronary angiogram, 24.52mSv in Dynamic abdomen scan. LAR estimates for brain routine varied from 1 in 7463 for man to 1 in 4926 for women. In chest routine with contrast, LAR varied from 1 in 1449 for men to 1 in 952. LAR of Abdomen dynamic CT varied from 1 in 453 for men to 1 in 298 for women. So, 64-slice MDCT scan is associated with non-negligible LAR of cancer. Doses can be reduced by careful attention to scanning protocol.

A rare type of single coronary artery with right coronary artery originating from the left circumflex artery in a child

  • Kim, Jong Min;Lee, Ok Jeong;Kang, I-Seok;Huh, June;Song, Jinyoung;Kim, Geena
    • Clinical and Experimental Pediatrics
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    • v.58 no.1
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    • pp.37-40
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    • 2015
  • The presence of a single coronary artery is a rare congenital anomaly; such patients often present with severe myocardial ischemia. We experienced the case of a 13-year-old girl with the right coronary artery originating from the left circumflex artery. She visited our Emergency Department owing to severe chest pain; her cardiac enzyme levels were elevated, but her initial electrocardiogram (ECG) was normal. Echocardiography showed normal anatomy and normal regional wall motion. When she presented with recurrent chest pain on admission, the ECG showed significant ST-segment elevation in the left precordial leads and inferior leads with ST-segment depression in aVR lead, suggesting myocardial ischemia, and her cardiac enzyme levels were also elevated. We performed coronary angiography that showed a single right coronary artery originating from the left circumflex artery without stenosis. We confirmed the presence of a single coronary artery using coronary computed tomography. In addition, the treadmill test that was performed showed normal results. She was discharged from the hospital without any medications but with a recommendation of a regular followup.

Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies

  • Noh, Gi Tark;Lee, Kyoung Ju;Sohn, Hee Jung;Lee, Kyung Han;Heo, Won Seok;Koh, Byung Sung;Han, Un Mi;Bae, Young A
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.72-75
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    • 2016
  • Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Diagnosis and Treatment of Bronchial Foreign Body by Ventilating Bronchoscopy (환기형 기관지경술을 이용한 기도내 이물의 진단과 치료)

  • Kim, Beom-Gyu;Kang, Jin-Wook;Kim, Young-Jae;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.8 no.2
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    • pp.36-42
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    • 2002
  • Aspirated and ingested foreign bodies continue to present challenges to otolaryngologists. The major discussions were the accurate diagnosis and speedy, safe removal of foreign body. Many diagnostic tools have been tried and removal of foreign bodies has been facilitated by technical improvements with rod lens telescope, video endoscope, flexible fiberoendoscope and safer anesthesia. In spite of these advances, more than 3000 children's death occur per year in the world because of foreign bodies and untold number of parients survive with variable sequelae. In these study, 59 consecutive cases of children and adults with tracheobronchial foreign bodies were reviewed from 1992 to 2001. We studied the history, symptoms, ausculatory radiologic, bronchoscopic finding and post operative complications. 71% (42 cases in 59 cases) of patients had foreign body aspiration history or choking crisis. In 64% (38cases) cough was observed. 81% (48cases) had abnormal finding in chest auscultation and 78% in chest X-ray. Computed tomography was done in 12 cases, all were founded foreign body shadow. Main site of foreign body was right main bronchus (41%, 24cases) and most frequent foreign body was peanut (36% , 21cases) . 4 experienced ICU(intensive care unit) care. 2 cases were failed to remove foreign. In these cases 1 cases was improved by steroid therapy and physical therapy and the other was treated with thoracotomy. We concluded the morbidity and motality were much correlated with speedy decision making and experienced skill of operator.

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Pulmonary Artery Sarcoma - One Case Report - (폐동맥에서 발생한 육종 - 1례보고 -)

  • Kim, Hyeong-Ryul;Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.692-696
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    • 2002
  • Pulmonary artery sarcoma is a rare disease and hard to diagnose; therefore, suspicion is very important for the diagnosis and treatment. Surgical resection is almost always needed because of progressive right heart failure. Adjuvant chemotherapy and radiation therapy are still controversial. We report a case of a 42-year-old man who had a right pulmonary arterial tumor Curative resection was impossible because the tumor invaded the left pulmonary artery. Palliative endarterectomy was performed followed by radiation therapy. The patient refused the chemotherapy. Until the postoperative 6th month, the residual tumor was stable. However, 15 months later, follow-up chest computed tomography revealed a metastatic pulmonary nodule at left lower lobe and the increased residual tumor. The patient received chemotherapy with limited tumor response. The metastatic nodule and residual tumor did not increase but bone scan revealed a rib metastasis at postoperative 24 months. He will be receiving additional chemotherapy.

VATS Rib Resection in Benign Bone Tumor (늑골의 양성 종양환자에서 흉강경을 이용한 늑골 절제술)

  • Park, Chang-Ryul;Kim, Jeong-Won;Lee, Yong-Jik;Joo, Seok;Jung, Jong-Pil;Kim, Dae-Young
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.454-457
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    • 2010
  • A 42 year old male was admitted for a bony mass on the posterior arc of the left $6^{th}$ rib, which was detected in a multiphasic health screening test. According to the chest computed tomography scan and bone scan, osteochondroma was suspected. He underwent VATS rib resection. There was no vessel or nerve injury. The patient was discharged without any complication on the $4^{th}$ post operative day. The pathological diagnosis was benign fibrous histiocytoma. Generally, posterolateral thoracotomy is needed for rib resection, but we found that there was no difficulty in doing this kind of surgery under a thoracoscopic approach, which has the advantage of better cosmesis.