• Korean Journal of Radiology
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• 제20권8호
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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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• 제7권1호
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• pp.47-60
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• 1974

During the past 10 years 114 patients with empyema have been treated in hospital of Chonnam University. There were 87 males and 27 females ranging from 20 days to 70 years of age. The etiology was pyogenic pneumonia in 36.7%, tuberculosis in 22.7%, paragonimiasis in 8.8%, post-thoracotomy in 5.4%, post-trauma in 4.4%, lung abscess in 3.5%, malignancy in 3.5%, post-esophageal operation in 1.8%, and sterile in 10.5%. The over-all mortality rate was 2% [3 patients]. The majority of deaths occurred in patients with associated systemic illness [liver cirrhosis in I, and renal tuberculosis in I] and resistant tuberculosis for anti-tuberculosis drugs in one patient. Adequate drainage and obliteration of the pleural space continues to be the most important aspect of treatment and can frequently be achieved by closed chest tube thoracostomy in acute empyema especially in children. The more chronic thick-walled or loculated cavities require open drainage [open window therapy], decortication, thoracoplasty, sterilization, and myoplasty for closure of tracheobronchial fistula.

• 대한영상의학회지
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• 제81권5호
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• pp.1109-1120
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• 2020

흉막의 종괴는 다양한 양성과 악성 종양이 있고 종양은 아니지만 종양 같은 질환들에 의해 발생한다. 일차 흉막 종양에는 고립섬유종양, 악성중피종, 그리고 원발성 흉막 비호지킨 림프종이 있다. 흉막에 발생하는 가장 흔한 종양은 전이성 질환이며, 림프종, 백혈병, 다발성 골수종 등의 혈액 종양을 가진 환자에서 드물게 나타난다. 흉수는 주로 흉막의 악성 질환과 연관이 있다. 드물지만 흉막 종양이 만성 농흉에서 생길 수 있으며, 그중 가장 흔한 것은 비호지킨 림프종이다(농흉과 연관된 림프종). 종양이 아닌 흉막 종괴로는 다양한 양성 질환에서 보일 수 있으며, 여기에는 결핵, 석면 흉막판, 그리고 흉막 유리체가 포함된다. 이 임상화보에서 저자들은 흉막의 다양한 양성과 악성 종양 및 종양성 질환들에 대한 특징적인 전산화단층촬영 소견에 대해 알아보고자 한다.

• Tuberculosis and Respiratory Diseases
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• 제66권2호
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• pp.127-131
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• 2009

기형종은 주로 전 종격동에서 발생하는 양성 종양으로 대부분 무증상이며 검사에서 우연히 발견된다. 드물게 기형종이 파열하여 여러 합병증을 일으키는 것으로 알려져 있으며 합병증은 급성 증상을 동반한다. 저자들은 급성 증상없이 만성적인 경과를 보인 기형종 파열 1예를 경험 하였다. 환자는 왼쪽 폐에 다량의 흉수가 있었는데 배액관 삽입으로 증상이 호전되었으며 지속적으로 흉수의 carcinoembryonic antigen (CEA) 및 carbohydrate antigen 19-9 (CA19-9)이 증가되어서 악성 흉수를 동반하는 종양과 구별이 어려웠다. 본 증례는 이차 감염에 의한 농흉을 치료하기 위해 흉강경으로 확인하기 전까지는 확진이 어려웠고, 매우 높은 흉수 내 악성 종양 표지자 수치를 보인 증례가 국내에는 보고되지 않았으므로 유사 증례의 문헌 고찰과 함께 보고한다.