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Mediastinoscopy (종격동경 검사에 관한 연구: 56례 보고)

  • 김주현
    • Journal of Chest Surgery
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    • v.15 no.4
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    • pp.467-472
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    • 1982
  • Fifty six consecutive cases of mediastinoscopy are analysed. The procedure was performed without any complication and mortality. It is concluded that the mediastinoscopy is a safe procedure and causes little disturbance to the patient. The value of mediastinoscopy as a diagnostic procedure for mediastinal and pulmonary hilar masses is shown. In my series, mediastinoscopy was performed in 17 cases, which could not be diagnosed by other means, for purpose of diagnostic procedure. A histologic diagnosis was obtained in 11 of the 17 patients [64.7%]. The findings are 6 cases of tuberculosis, 2 cases of metastatic carcinoma, 1 case of primary carcinoma, and one case of noncaseating granuloma. The histologic diagnosis of carcinoma in patients believed to have non-resectable tumors could be obtained in 4 of the 7 cases [57.1%]. Three cases out of 32 patients with presumably resectable bronchial carcinoma were found to have mediastinal lymph node metastases. Two patients of 29 cases refused to be operated on. The remaining 27 cases had thoracotomy and resection was undertaken in all but 9 cases [33.3%].

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동측폐에 발생한 선암과 편평상피세포암의 수술 1례

  • 오재상
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.66-71
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    • 1980
  • This is one case report of coexisting two histologically different carcinomas in the different lobes of the right lung, which operated the right pneumonectomy in the Dept. of Thoracic and Cardiovascular Surgery Hanyang University Hospital. The 43 years old male patient complained coughing, blood tinged sputum and weight loss. The chest films [PA and lateral view] showed a small round hazy shadow in the posterior segment of the right upper lobe and irregular hazy densities in the right middle lobe and hilar area. Histopathologically, the tumor in the posterior segment of the right upper lobe was consisted of a tissue of adenocarcinoma and the tumor in the right middle lobe was consisted of a tissue of well-differentiated bronchial squamous cell carcinoma.

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Sensorimotor Polyneuropathy Associated with Sarcoidosis (사르코이드증에 동반된 다발신경병증)

  • Ahn, Seog-Weon;Kim, Dong-Wook;Hong, Yoon-Ho;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.5 no.1
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    • pp.39-41
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    • 2003
  • Sarcoidosis is a multisystemic granulomatous disease of unknown etiology ogenesis, and most frequently presented with bilateral hilar lymphadenopathy, pulmonary infiltration, skin and eye lesion. However, neurological involvement including peripheral neuropathy is relatively rare. We report a patient who had sensorimotor polyneuropathy without other systemic symptoms or organ involvements frequently reported in sarcoidosis. Laboratory investigation suggestive of sarcoidosis lead to sural nerve biopsy for confirmation, which demonstrated noncaseating granulomatous changes. Sarcoidosis shoud be included in the differential diagnosis in subacute polyneuropathy even if there is no usual symptoms or signs suggestive of the systemic disease.

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A case of pulmonary disease with unilateral hyperlucent lung (일측성 방사선 과투시성을 보인 폐질환)

  • Ohn, Joon-Sang;Seo, Jee-Young;Park, Mi-Ran;Rheu, Nam-Soo;Cho, Dong-Ill
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.1042-1047
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    • 1996
  • The Swyer-James syndrome is a relatively uncommon disease entity presented with unilateral hyperlucent lung due to hypoplasia of a pulmonary artery and bronchiectasis of the affected lung. The main finding is a hyperlucent lung with small hilar shadows on the chest X-ray. Pulmonary angiography is the standard method for diagnosis. We report a case of the Swyer-James syndrome with a brief review of literature.

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Coexistent Mediastinal and Intrapulmonary Leiomyomas -A case report- (종격동과 폐실질내 공존한 평활근종 -1례 보고-)

  • 김창수;김병균;장인석;옥창대;김성호
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1281-1283
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    • 1996
  • We describe the case of a 58-year-old woman who has coexisting intrapulmonary and mediastinal leiomyomas. Initially, she was seen with a single mass in the right lower hilar area in a simple chest roentgenogram. But computed tomography demonstrated another mass in the right posterior mediastinum. Microscopic examination and immunohistochemical staining of the resected specimens showed the characteristics of the leiomyoma.

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Rare variant of type V choledochal cyst masquerading as a biliary cystadenoma

  • Murugappan Nachiappan;Srikanth Gadiyaram
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.289-292
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    • 2022
  • Cystic lesions of the liver are commonly encountered in routine clinical practice with a reported prevalence of 15%-18%. They may range from a benign simple developmental cyst to a malignancy. Therefore, an accurate diagnosis is essential for adequate management. Cystic tumors of the liver are classified based on the content (mucin containing or not), presence of ovarian stroma, and biliary communication. Biliary cystadenoma are a group of hepatobiliary neoplasia which by definition must be multilocular, lined by a columnar epithelium, and have a densely cellular ovarian stroma. We report a case of a cystic lesion in the hilar region of the liver, which had features of biliary cystadenoma on the preoperative imaging. However, on exploration was found to be a diverticular variant of type V choledochal cyst arising from both hepatic ducts. We have discussed the preoperative imaging features, intraoperative cholangiogram, and the management of this cystic lesion.

Postoperative Radiation Therapy in Non-Small-Cell Lung Cancer (비소세포성 폐암의 수술후 방사선 치료)

  • Park, Charn-Il;Kim, Jong-Hoon;Kim, Joo-Hyun
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.195-201
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    • 1988
  • Sixty patients with proven lung cancer were retrospectively studied to determine whether postoperative radiation therapy improves survival. Patterns of treatment failure and 5 year survival were assessed according to extent of tumor spread, histology, type of operation, positive resection margin and radiation dose. Of the 60 patients, excluding S patients who received incomplete treatment or poor pulmonary function,55 patients received postoperative radiation therapy following curative resection. The overall survival at 5 years was $39\%$. The hilar and mediastinal lymph node involvement had an influence on survival. The authors recommend that patients with resection. lung cancer involving the hilar and mediastinal lymph nodes may require postoperative radiotherapy to reduce the local recurrence and improve survival.

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Pulmonary Sarcoidosis Diagnosed by Endobronchial Ultrasound Fine Needle Aspiration (초음파 기관지 내시경 세침흡인을 이용하여 진단한 폐 사르코이드증)

  • Kim, Won-Young;Chang, You-Jin;Lyu, Ji-Won;Park, Young-Soo;Jang, Se-Jin;Song, Jin-Woo;Oh, Yeon-Mok;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.5
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    • pp.267-272
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    • 2010
  • Background: Pulmonary sarcoidosis often involves mediastinal or hilar lymph nodes in the lung parenchyma. Mediastinoscopy is the gold standard for diagnosis, but it is invasive and expensive. Transbronchial needle aspiration using conventional bronchoscope is less invasive than mediastinoscopy, but its diagnostic accuracy is in question due to the blind approach to targeting lymph nodes. Transbronchial needle aspiration (TBNA) via endobronchial ultrasound (EBUS) has high diagnostic value due to direct visualization of lymph nodes and to its relatively safeness. The purpose of this study was to assess the usefulness of EBUS-TBNA in the diagnosis of pulmonary sarcoidosis. Methods: Twenty-five patients with symptoms of sarcoidosis were enrolled into this study. Core tissue was obtained for a definitive diagnosis. Endobronchial biopsy, transbronchial lung biopsy, and bronchoalveolar lavage were performed to verify diagnosis. For patients without a confirmed diagnosis after the above procedures were performed, the additional procedures of mediastinoscopy or video-associated thoracoscopic surgery were performed to confirm a final diagnosis. Results: A total 25 EBUS procedures were done and 50 lymph nodes were aspirated. Thirty-three (37) out of 50 lymph nodes were consistent with non-caseating granuloma, confirming sarcoidosis as the final diagnosis. Sarcoidosis was the final diagnosis for all 25 patients, and 21 required EBUS-TBNA for a final diagnosis. There were no complications associated with the procedure. Conclusion: EBUS-TBNA is already a well-known procedure for diagnosing mediastinal or hilar lymphadenopathy. We used EBUS-TBNA for the diagnosis of pulmonary sarcoidosis and our results showed 84% diagnostic accuracy and no complications related to the procedure. EBUS-TBNA is a reliable and practical diagnostic modality in the diagnosis of pulmonary sarcoidosis.

Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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Clinical Evaluation of Flexible Fiberoptic Bronchoscopy in The Diagnosis of the Lung Cancer (폐암진단에 있어서 Flexible fiberoptic bronchoscopy의 임상적 의의)

  • 이종태
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.206-211
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    • 1980
  • One hundred and thirteen patients underwent diagnostic fiberoptic bronchoscopy to exclude the presence of the lung cancer at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital from January 1979, to July 1980. Sixty five cases of these patients were studied for passible lung cancer by bronchoscopic examination. Patients varied in age from 24 to 75 years, with the highest concentration lying in the sixth decade (49%). male was predominated with sex ratio of 6.3 : 1. Forth three (75.4%) of 57 cases impressed as definitive, and 8(14.5%) of 55 cases impressed as negatibe lung cancer were subsequently proved to have had lung cancer. Positive bronchoscopic biopsy was found in 10 of 14 lung cancers which were situated in the left main bronchus and in 11 of 13 neoplasms involving the right upper lobe bronchus. epidermoid cell carcinomas were most frequent(82.4%). Bronchial biopsy detected 34(79%) of 43 hilar cancers and 1.3(59%) 22 periphera neoplasms, in those patients who had fiberoptic bronchoscopic examinations. In the present series of 65 cases, the lesion was so far advanced when first seen that it was considered inoperable in 31 (47.7%) and operable 34(52.3%), 19(55.9%) of these refusing surgery. fifteen were explored of whom 12(80%) were resectable.

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