• Title/Summary/Keyword: Hilar

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A Case of Pulmonary Eosinophilic Granuloma Involving Mediastinal Lymph Node (종격동 임파절 침범을 동반한 폐 호산구성 육아종 1예)

  • Kwak, Seung-Min;Kim, Se-Kyu;Shin, Dong-Hwan;Chung, Kyung-Young;Jang, Joong-Hyun;Lee, Hong-Lyeol;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.424-430
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    • 1993
  • Pulmonary eosinophilic granuloma or histiocytosis X is a chronic interstitial lung disease characterized by proliferations of Langerhans cells and, therefore, not truly histiocytosis. Both histiocytes and Langerhans cells are believed to be related to the mononuclear phagocyte system. In Eosinophilic granuloma, extra-pulmonary such as mediastinal or hilar lymph nodes involvement is very rare in adult. We report a case of young man with eosinophilic granuloma involving lung and anterior mediastinal lymph node simultaneously which is confirmed by open thoracotomy.

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A ROENTGENOGRAPHIC STUDY OF NORMAL PAROTID GLANDS USING ISOBARIC SIALOGRAPHY (등압타액선조영촬영법을 이용한 정상성인의 이하선에 관한 연구)

  • Ahn Hee Moon;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.20 no.1
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    • pp.91-102
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    • 1990
  • The aim of this study was to establish the diagnostic criteria of normal parotid glands in adults revealing the anatomical shape, its variations and the postitional relationships of the gland. Materials included 96 lateral and anterior-posterior sialograms of selected person from 23 to 28 years of age. Results were as follows: 1. The average length and lateral displacement of main duct was 48.43㎜ and l6.88㎜. The mean lumen diameter of that was 0.91㎜ in distal end and 1.40㎜ in hilar end in parotid glands. 2. The average angle of main duct to the inferior border of mandib was 34.32 degree. In configurations of main duct, modified curvilinear type was. most prevalent and followed by curvilinear, reverse sigmoid, sigmoid type. 3. The mean caliber of parotid gland was the longest in superior-inferior. 4. The interlobar ducts showed relatively well defined in all cases, its average number was 5.72. Arrangement of these ducts showed at random. Accessory lobe showed 87.5% in the all cases, its average number was 1.7. 5. There were no difference between the well and poorly defined acinar fillings in the glandular parenchyme. 6. There were no differences between right and left parotid glands in size and shape of main duct and parenchymal portion, but there were great variations in each individuals.

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A Case of Sarcoidosis Accompanied by Azoospermia (무정자증을 동반한 Sarcoidosis 1예)

  • Cho, Young-Soo;Park, Jae-Nam;Suh, Jung-Eun;Rhu, Nam-Soo;Cho, Dong-Ill;Kim, Jae-Won
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.179-185
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    • 1991
  • We experienced a case of sarcoidosis accompanied with azoospermia due to the involovement of epididymis, besides the generalized involvement of the para tracheal and hilar lymph nodes, skin and lung. Final diagnosis of sarcoidosis was established by pathological evidence of noncaseating granuloma from the involved organs, typical radiological findings and consistent clinical features. A movable, nontender $1.5{\times}0.8\;cm$ sized nodule was palpated on epididymis, and multiple small nodules were noticed in both testis and epididymis by scrotal ultrasonogram. Semen analysis showed azoospermia initially. After treatment with prednisolone for 12 months, sperm was increased to 64,800,000/ml, and 70% of them were motile when they were measured at 15 minutes after ejaculation. The patient's condition became better and the typical radiological findings of involved organs were improved as well. As far as we studied, sarcoidosis is known to involve multiple organs, but epididymal sarcoidosis is very rare. So we report a case of sarcoidosis involving epididymis which caused azoospermia.

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Video-Assisted Thoracic Surgery Lobectomy

  • Kim, Hong Kwan
    • Journal of Chest Surgery
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    • v.54 no.4
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    • pp.239-245
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    • 2021
  • Video-assisted thoracoscopic surgery (VATS) has been established as the surgical approach of choice for lobectomy in patients with early-stage non-small cell lung cancer (NSCLC). Patients with clinical stage I NSCLC with no lymph node metastasis are considered candidates for VATS lobectomy. To rule out the presence of metastasis to lymph nodes or distant organs, patients should undergo meticulous clinical staging. Assessing patients' functional status is required to ensure that there are no medical contraindications, such as impaired pulmonary function or cardiac comorbidities. Although various combinations of the number, size, and location of ports are available, finding the best method of port placement for each surgeon is fundamental to maximize the efficiency of the surgical procedure. When conducting VATS lobectomy, it is always necessary to comply with the following oncological principles: (1) the vessels and bronchus of the target lobe should be individually divided, (2) systematic lymph node dissection is mandatory, and (3) touching the lymph node itself and rupturing the capsule of the lymph node should be minimized. Most surgeons conduct the procedure in the following sequence: (1) dissection along the hilar structure, (2) fissure division, (3) perivascular and peribronchial dissection, (4) individual division of the vessels and bronchus, (5) specimen retrieval, and (6) mediastinal lymph node dissection. Surgeons should obtain experience in enhancing the exposure of the dissection target and facilitating dissection. This review article provides the basic principles of the surgical techniques and practical maneuvers for performing VATS lobectomy easily, safely, and efficiently.

Extrahepatic Bile Duct Duplication with Intraductal Papillary Neoplasm: A Case Report (이중 담관 기형과 동반된 담관 관내 유두종 : 증례 보고)

  • Gayoung Jeon;Juwan Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.964-970
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    • 2021
  • Extrahepatic duct duplication is an extremely rare congenital anomaly. Hilar cholangiocarcinoma with extrahepatic bile duct duplication was reported; however, intraductal papillary neoplasm of the bile duct (IPNB) with extrahepatic bile duct duplication has not been reported to the best of our knowledge. We report a rare case of IPNB with extrahepatic bile duct duplication of a 64-year-old female. The patient underwent extended right hepatectomy, and the results of a subsequence histopathological examination were consistent with an IPNB with extrahepatic bile duct duplication. We report this rare case with radiologic imaging findings and a brief review of the current literature.

Cholangiocarcinoma: An-eight-year Experience in a Tertiary-Center in Iran

  • Mohammad-Alizadeh, Amir Houshang;Ghobakhlou, Mehdi;Shalmani, Hamid Mohaghegh;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5381-5384
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    • 2012
  • Background and Aim: Cholangiocarcinoma (CCA) is an uncommon malignancy of the bile duct, occurring in nearly 2 out of 100,000 people. It is a type of adenocarcinoma that originates in the mucous glands of the epithelium, or surface layers of the bile ducts. The aim of this study was to evaluate the clinical features, diagnostic results and factors associated with survival, morbidity and mortalityof cholangiocarcinoma cases in Iranian patients. Method: In this retrospective study the hospital medical records of 283 patients with a primary or final diagnosis of cholangiocarcinoma who had been admitted to gastroenterology ward of our hospital from 2004 to 2011 were retrospectively reviewed. Results: 283 patients (180 male, 63%, and 103 female, 38.6%) with a mean age of $59.7{\pm}14.4$ years were studied. The most frequent symptoms were painless jaundice (190, 66.9%), abdominal pain (77, 27%), pruritus 133 (46.8%) and weight loss (169, 59.5%). The most frequent associated risk factors and diseases were as follows: gallstones (72, 25.4%), diabetes (70, 24.6%), HBV infection (52 (18.3%), HCV infection 43 (15%), primary sclerosing cholangitis (16, 5.6%) and smoking (120, 42.3%). The most frequent type of cholangiocarcinoma in ERCP and MRCP was hilar. The mean survival time was $7.42{\pm}5.76$ months. Conclusion: The mean survival time in our study was lower than one year. Moreover the most frequent risk factors and associated diseases were smoking, gallstones and diabetes. Painless jaundice, abdominal pain and weight loss were the most clinical features related to cholangiocarcinoma. Additionally survival time did not correlate with risk factors, associated diseases and clinical presentations, but was linked to biliary metallic stenting and surgery.

A Case of Parahilar Lymph Node Enlargement (폐문부의 림프절 종대 1예)

  • Lee, Hee Jung;Son, Ji Woong;Choi, Eugene;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.209-212
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    • 2005
  • Sarcoidosis, a multisystemic granulomatous disorder of unknown causes, which presents with bilateral hilar adenopathy, pulmonary infiltration, and cutaneous, ocular, bones, and nervous and reticuloendothelial systems involvement, commonly involves young adults of both sexes. Herein, the case of a 70-year-old male, with progressive hoarseness of two weeks' duration and mild dyspnea, is reported. A fiberoptic bronchoscopy, performed to investigate the hoarseness, revealed paralysis of the left vocal cord, but with no other local abnormality. Two nodules, as pathologic findings, showed noncaseating epithelioid cell granulomas. We note a rare case of sarcoidosis, with vocal cord palsy, in Korea.

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.

A Significant Discrepancy of Uptake between I-131 MIBG and F-18 FDG in a Patient With Malignant Paraganglioma (I-131 MIBG와 F-18 FDG 섭취의 불일치를 보였던 악성 부신경절종 1례)

  • Kim, Jong-Su;Kim, Hyun-Keun;Choi, Kyu-Young;Park, Hyung-Ki;Kim, Eun-Sil;Kim, Yun-Kwon;Kim, So-Yon;Kim, Young-Jung;Lee, Hyo-Jin
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.247-251
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    • 2007
  • A 38-year-old man who was diagnosed with malignant paraganglioma underwent computed tomography (CT) and I-131 metaiodobenzylguanidine (MIBG) san. CT showed extensive lymph node enlargement in right iliac area and retroperitoneum with severe hydronephrosis and mass on posterior bladder wall. However, I-131 MIBG scan didn't showed abnormal uptake. He also underwent F-18 fluorodeoxyglucose (FDG) positron emisson tomography/CT for localizing accurate tumor site. F-18 FDG PET/CT showed multiple metastases of left supraclavicular, hilar, mediastinal para-aortic, inguinal, right iliac lymph nodes, lung, vertebrae, and pelvis. There are a few reports showing that the F-18 FDG PET/CT is helpful for staging and localizing tumor site of patients who are diagnosed with negative on the MIBG scans. Thus, we report a case with paraganglioma which showed negative I-131 MIBG scan, but revealed multiple intense hypermetabolic foci in F-18 FDG PET/CT.

Clinical Value of Bronchoscopic Examination in the Diagnosis of Cancer of the Lung (기관지경검사의 폐암진단에 관한 임상적 의의)

  • 이종국;이성행;이성구
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.143-150
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    • 1973
  • Two-hundred and eighteen patients were taken bronchoscopy to evaluate the value of bronchoscopic diagnosis in the lung cancer patient at the Department of Thoracic Surgery of the Kyung-pook University Hospital. Ninety-eight eases of these patients were studied for possible lung cancer by bronchoscopic examination, biopsy and bronchial cytologv. The results were obtained as follows: Two-hundred and eighteen patients were taken bronchoscopy to evaluate the value of bronchoscopic diagnosis in the lung cancer patient at the Department of Thoracic Surgery of the Kyung-pook University Hospital. Ninety-eight eases of these patients were studied for possible lung cancer by bronchoscopic examination, biopsy and bronchial cytologv. The results were obtained as follows: 1) Forty-five (55.5%) of 81 cases impressed as definitive, and six (35. 3%) of 17 cases impressed as probable lung cancer were subsequently proved to have lung cancer. This represents a total of 51 cases (52. 0%) of 98 patients. 2) Twenty-six (51.0%) of 51 patients were proved by bronchoscopic biopsy and cytology. 3) The positive rates of bronchoscopic biopsy were higher in the lesions on tile intermediate bronchus, carina and main stem bronchi by bronchoscopy, and also in the hilar than in peripheral lesions by X-ray finding and in histologically undifferentiated cell carcinoma than in adenocarcinoma. 4) The positive diagnosis rates of bronchoscopic aspirate were not correlated to the locations of cancer lesions. 5) Thirty- nine percent of 51 case3 were visualized definitive tumor mass and obstructive lesions under bronchoscopy. 6) Patient of lung cancer varied in age from 27 to 77 years, with highest concentration lying in the 5th decade (43.0%). Forty-seven patients were men and 4 were women giving a proportion of men to women, 12: 1 7) Sixty-five percent of proved lung cancer patients were diagnosed as operable cases. Fifty-three percent of explored patients were resected. These results conclude that bronchoscopy is of a considerable value as a diagnostic procedure in these lung cancer patients.

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