• Journal of Chest Surgery
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• v.13 no.1
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• pp.26-33
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• 1980

The incidence of the empyema thoracis has been drastically reduced with the advent of antimicrobial drugs. Empyema thoracis is however still dealt with one of major problems in thoracic surgery because of difficulties in the management of associated bronchopleural fistula. During the period of January 1975 to June 1979, 145 patients of empyema thoracis were treated in the Department of Thoracic Surgery, Busan National University Hospital. This reports dealed especially with the incidence, etiology and management of chronic empyema thoracis with B.P.F. and estimated the results of intercostal myoplasty. The results: 1 ] Among 145 empyema thoracis patients, 33 patients [22.7%] had bronchopleural fistula. 2] Male predominated in general with the ratio of 4:1 and in empyema thoracis with B.P.F. male predominance was further more prominent with the ratio of 10:1. Peak incidence of chronic empyema thoracis lay on 3rd and 4th decade. 3] The most common causation of empyema thoracis was pneumonia [77.3%] in children and tuberculosis [48.8%] in adult. 4] The most common causative organism of empyema thoracis was staphylococcus aureus [52.5%]. 5] Among 40 cases of resection for pulmonary tuberculosis, 4 cases developed empyema thoracis with B.P.F. [10%], and resection for another underlying pathology was 2.1%. 6] In contrast to good prognosis of acute empyema thoracis, chronic empyema thoracis with B.P.F. was improved only 66.6% of cases. 81.5% of chronic empyema without B.P.F. were cured completely. 7] Intercostal myoplasty were performed in 21 cases of empyema thoracis with B.P.F. and of which 15 cases showed that fistula were closed. 8] The over all mortality rate in empyema thoracis was 8.7%. The mortality rate of chronic empyema thoracis with and without B.P.F. was 15.2% and 5.3% respectively.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.188-192
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• 2004

Treatment of huge chronic tuberculous empyema with cardiopulmonary dysfunction. Drainage of empyemal space by closed thoracostomy in chronic tuberculous empyema is generally contraindicated because of the possibility of empyema necessitatis and ascending infection. But in case that serious cardiopulmonary dysfunction is present, drainage of empyema and decompression is necessary. We experienced a case in which chronic tuberculous empyema was big enough to cause mediastinal shifting and cardiopulmonary failure. Immediate drainage of pleural cavity with tube thoracostomy was performed. Afterward, pleuropneumonectomy was done following cyclic irrigation for one month. The patient had successful postoperative course without any evidence of complication or relapse of infection.

• Journal of Chest Surgery
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• v.26 no.7
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• pp.571-574
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• 1993

We present a rare case of malignant lymphoma developing from the wall of chronic empyema thoracis. A 54-year old man with a 35 year history of tuberculosis empyema was admitted due to right chest pain and general weakness for 2 months. Under the impression of chronic empyema thoracis with destroyed right lung and tumor on posterior costophrenic sulcus, pleuropneumonectomy including tumor was performed as a single procedure through a right thoracotomy. The tumor arose from the thickened pleura, and it was histologically and immunologically diffuse large cell[non-cleaved] B-cell non-Hodgkin`s lymphoma [NHL]

• Korean Journal of Radiology
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• v.20 no.8
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• pp.1293-1299
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• 2019

Objective: The purpose of this study was to evaluate the diagnostic performance of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) for chronic empyema-associated malignancy (CEAM). Materials and Methods: We retrospectively reviewed the ¹⁸F-FDG PET/CT images of 33 patients with chronic empyema, and analyzed the following findings: 1) shape of the empyema cavity, 2) presence of fistula, 3) maximum standardized uptake value (SUV) of the empyema cavity, 4) uptake pattern of the empyema cavity, 5) presence of a protruding soft tissue mass within the empyema cavity, and 6) involvement of adjacent structures. Final diagnosis was determined based on histopathology or clinical follow-up for at least 6 months. The abovementioned findings were compared between the ¹⁸F-FDG PET/CT images of CEAM and chronic empyema. A receiver operating characteristic (ROC) analysis was also performed. Results: Six lesions were histopathologically proven as malignant; there were three cases of diffuse large B-cell lymphoma, two of squamous cell carcinoma, and one of poorly differentiated carcinoma. Maximum SUV within the empyema cavity (p < 0.001) presence of a protruding soft tissue mass (p = 0.002), and involvement of the adjacent structures (p < 0.001) were significantly different between the CEAM and chronic empyema images. The maximum SUV exhibited the highest diagnostic performance, with the highest specificity (96.3%, 26/27), positive predictive value (85.7%, 6/7), and accuracy (97.0%, 32/33) among all criteria. On ROC analysis, the area under the curve of maximum SUV was 0.994. Conclusion: ¹⁸F-FDG PET/CT can be useful for diagnosing CEAM in patients with chronic empyema. The maximum SUV within the empyema cavity is the most accurate ¹⁸F-FDG PET/CT diagnostic criterion for CEAM.

• Journal of Chest Surgery
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• v.50 no.2
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• pp.123-125
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• 2017

Malignant tumors associated with chronic empyema have been reported in the literature, and a majority of these tumors are lymphomas. Epithelial tumors originating from the post-pneumonectomy space in patients with chronic empyema are extremely rare. Here, we present the cases of 2 patients with squamous cell carcinoma arising from the pleural cavity after pneumonectomy for chronic empyema.

• Journal of Korean Neurosurgical Society
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• v.45 no.1
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• pp.53-56
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• 2009

The authors present a case of subdural empyema in a macrocephalic patient. A 23-year-old male was admitted due to headache and fever. One month ago, he had mild head injury by his coworkers. Physical examination showed a macrocephaly and laboratory findings suggested purulent meningitis. Neuroimaging studies revealed a huge size of epidural space-occupying lesion. Under the impression of epidural abscess, operation was performed. Eventually, the lesion was located at subdural space and was proven to be subdural empyema. Later, histological examination of the specimen obtained by surgery demonstrated finings consistent with the capsule of the chronic subdural hematoma. Two weeks after operation, Propionibacterium acnes was isolated. The intravenous antibiotics were used for total of eight weeks under monitoring of the serum level of the C-reactive protein. Follow-up brain computed tomography (CT) scan showed the presence of significant amount of remaining subdural lesion. However, he has complained of minimal discomfort. It is suggested that the subdural empyema occurred with preexisting chronic subdural hematoma after head injury about one month prior to admission and it took a long time to treat Propionibacterium acnes subdural empyema with systemic antibiotics, at least over eight weeks.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.252-258
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• 2017

Objectives: The purpose of this case report is to describe the clinical effectiveness of Korean medicine, especially Jungcheonwhadam-tang and Bopyeoyangyeong-jun, in a patient with chronic thoracic empyema while receiving treatment for this condition. Methods: The patient who had been diagnosed with empyema complained of a cough, with sputum. The patient was diagnosed with pe-ong (肺癰) based on his symptoms and x-ray findings. He was treated with a range of Korean medicines, including a herbal decoction, acupuncture, moxibustion, and cupping. A visual analogue scale and percentage pain reduction scale were administered after treatment. Results: After 20 days of the treatment, the patient's cough decreased by 80%, and sputum decreased by 50%. Conclusion: According to this study, Korean medicine, including Jungcheonwhadam-tang and Bopyeoyangyeong-jun, is effective in the treatment of chronic thoracic empyema.

• Journal of Chest Surgery
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• v.24 no.9
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• pp.945-949
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• 1991

The treatment of acute and chronic empyema with bronchopleural fistula is remained as serious postoperative complication in thoracic surgery. Although several operative procedures for the treatment of postpneumonectomy empyema have been reported, the method of treating empyema, and in particular empyema associated with fistula, remains controversial. Recently some successful results have been reported by use of the omentum in the patients with thoracic empyema resulting from bronchial fistula. We have performed one-stage operations using the omentum and chest wall muscles in 2 patients, one was acute, and the other was chronic case. Their postoperative courses were uneventful

• Journal of Chest Surgery
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• v.23 no.3
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• pp.566-571
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• 1990

The Bronchial stump disruption in bronchopleural fistula with empyema thoracis after pneumonectomy has remained one of the most dreaded complications of thoracic surgery. Management of chronic bronchopleural fistula still poses a therapeutic dilemma in spite of various surgical techniques that have been attempted to control this complication. Only recently, transsternal transpericardial approach for repair of the postpneumonectomy bronchopleural fistula has been utilized in some cases. The patient was a 31 year-old woman who was admitted to our hospital on August 18th, 1989 due to right postpneumonectomy bronchopleural fistula with empyema thoracis for 5 years since she had undergone right pneumonectomy due to pulmonary tuberculosis at E-hospital in 1984. Transsternal transpericardial closure of the fistula was employed and then the thoracic catheter was removed two months later, after the empyema cavity was sterilized by the Clagett method. So, we think this surgical technique is a relatively simple and effective method to the control of chronic postpneumonectomy bronchopleural fistula with empyema thoracis.

• Journal of Chest Surgery
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• v.48 no.1
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• pp.82-85
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• 2015

Pyothorax-associated lymphoma is a relatively rare type of lymphoma that occurs in patients who have long histories of tuberculous pleuritis or induced pneumothorax. It is a type of non-Hodgkin's lymphoma of mainly the B-cell phenotype and is strongly associated with Epstein-Barr virus infection. A majority of these cases have been reported in Japan, although some cases have occurred in Western countries. Here, we describe a case of pyothorax-associated lymphoma in a patient with a 30-year history of chronic tuberculous empyema. The patient underwent decortication under the impression of chronic empyema with fistula. The histopathologic diagnosis was a diffuse large B-cell lymphoma associated chronic inflammation.