• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.245-251
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• 2001

Recently we have experienced one case of pulmonary lymphangioleiomyomatosis(LAM). A 49 year-old woman visited the outpatient department complaining of longstanding dyspnea, which was aggravated by exercise. Although the chest PA film showed nothing more than a slight increase in interstitial marking, a lung HRCT revealed multiple cystic lesions of a similar size that were scattered through out the whole field in both lungs. An abdominal CT detected an angiomyolipoma located in the midbody of the left kidney. Video-assisted thoracic surgery(VATS) was performed for the pathologic diagnosis. On gross examination of the biopsy lung, a pulmonary LAM was confirmed by a finding of smooth muscle proliferation in the interstitum of the lung. After the final diagnosis, oral medroxyprogesterone was prescribed and she is presently in a stable condition.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.616-622
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• 2003

Leiomyoma of the bronchus is a very rare benign tumor of the lung. Leiomyoma is usually found in the young and the middle age. The symptom depends on the location of the tumor, it's size, and changes in the lung distal to the lesion. Obstructive symptoms due to leiomyoma could be similar to those of asthma and bronchitis, and therefore delayed diagnosis is common. The treatment of leiomyoma is conservative since there have been no reports of recurrence after limited resection. Recently bronchoscopic tumor resection has been applied to selected cases. We experienced two cases of bronchial leiomyoma initially misdiagnosed as bronchial asthma which were successfully excised by resection, end-to-end anastomosis and bronchoplasty. To prevent destructive changes of lung distal to obstruction and to preserve the pulmonary function, early diagnosis and appropriate treatment are important points of consideration.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.390-395
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• 2015

Primary anaplastic large cell lymphoma (ALCL) of the lung is highly aggressive and quite rare. We report here a case of anaplastic lymphoma kinase-positive endobronchial ALCL, that was initially thought to be primary lung cancer. A 68-year-old woman presented with hemoptysis, dyspnea, and upper respiratory symptoms persisting since 1 month. The hemoptysis and and bronchial obstruction lead to respiratory failure, prompting emergency radiotherapy and steroid treatment based on the probable diagnosis of lung cancer, although a biopsy did not confirm malignancy. Following treatment, her symptoms resolved completely. Chest computed tomography scan performed 8 months later showed increased and enlarged intra-abdominal lymph nodes, suggesting lymphoma. At that time, a lymph node biopsy was recommended, but the patient refused and was lost to follow up. Sixteen months later, the patient revisited the emergency department, complaining of persistent abdominal pain since several months. A laparoscopic intra-abdominal lymph node biopsy confirmed a diagnosis of ALCL.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.51 no.4
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• pp.390-394
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• 2001

Lymphocytic interstitial pneumonia(LIP) is characterized by a massive infiltration of the interstitium of the lung by mature lymphocytes, plasma cells and reticuloendothelial cells. LIP may be associated with autoimmune diseases including Sj$\check{o}$grens syndrome, SLE, myasthenia gravis, pernicious anemia, autoimmune hemolytic anemia, and HIV or an EB virus infection. There is a possibility of LIP progressing to a pulmonary or systemic lymphoma. The therapeutic response to corticosteroids and/or immunosuppressive drugs varies. Here we report a case of LIP that was diagnosed by an open lung biopsy and clonality study. The patient was a 36 year-old man without autoimmune disease or HIV infection. He was admitted as a result of severe hypoxemia showing $PaO_2$ of 48.3mmHg. The patient was treated with corticosteroids after the diagnosis and had fully recovered without a sequalae or relapse.

• Tuberculosis and Respiratory Diseases
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• v.39 no.4
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• pp.366-369
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• 1992

A chest x-ray of 68 year old male showed pneumonic consolidation of right lower lung field with blunting of right cardiac border. Computerized tomography of chest revealed infiltrative mass with V-shaped calcification just below right main bronchus. This finding has to be made into differential diagnosis of numerous pulmonary diseases including, mycobacterial disease, neoplasm, lymphadenopathies, and foreign bodies. Initial bronchoscopic findings suggest endobronchial mass lesion on right intermediate bronchus but endobronchial biopsy fail to prove malignant cell or underlying illness. But repeated endobronchial biopsy shows metallic material in the right Intermediate bronchus and we remove it with alligator jaws forcep under bronchoscopy. He was well after discharge.

• Tuberculosis and Respiratory Diseases
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• v.46 no.4
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• pp.455-465
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• 1999

Background: Even though lung cancer has become a major cancer in Korea, national survey for lung cancer has not been available except several reports from individual hospitals. Methods: Korean Academy of Tuberculosis and Respiratory Diseases retrospectively investigated the characteristics of lung cancer diagnosed from January 1997 to December 1997 at general hospitals over 400 beds. Results: Among 3,794 patients, 76.8% are smokers and 89.8% of male patients are smokers. Squamous cell carcinoma is the leading type of lung cancer(44.7%) followed by adenocarcinoma(27.9%). Smoking rate in adenocarcinoma was significantly lower than in squamous cell carcinoma and small cell cancer. Cough is the most common symptom, however, 7.2% are asymptomatic. Bronchoscopic biopsy has a main role in the diagnosis of squamous cell carcinoma and small cell cancer but percutaneous needle biopsy has more important role in adenocarcinoma. Two-thirds of NSCLC patients were found in unresectable advanced stages. Conclusion: In contrast to other countries, squamous cell carcinoma is still the most frequent type of lung cancer. High proportions of smoker and advanced, unresectable lung cancer urge us to develop the program for cessation of smoking and early detection.

• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.375-380
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• 2010

Lymphoid interstitial pneumonia (LIP) is a rare benign lymphoproliferative interstitial lung disease. LIP has been associated with autoimmune disorders, HIV, viral infections, and so on. Once underlying systemic diseases have been excluded, a diagnosis of idiopathic LIP can be made. Although 6 cases of pathologically confirmed LIP have occurred in Korea, thus far none has been associated with primary Sjogren's syndrome. A 44-year-old man was admitted to hospital due to a dry cough and dypsnea on exertion that had been ongoing for 2 months. A chest radiography showed multiple and variable-sized cystic lesions, on both lungs and both interstitial infiltration and consolidation in both lower lung fields. Tests for autoantibody showed positive results of anti-nuclear antibody and anti-Ro/La antibody. The patient underwent a video assisted thoracoscopic surgery biopsy and pathologically confirmed LIP. We report the first known case of LIP-associated with primary Sjogren's syndrome in Korea.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.595-600
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• 1999

Background: The estimation of ADA activity in pleural fluid has been proved useful tool in the diagnosis of tuberculous pleural effusions. However, there is controversy about its usefulness when estimated in bronchial washing fluid in the patients with pulmonary tuberculosis. This study aims at evaluating the usefulness of measuring ADA activity in bronchial washing fluid of tuberculous patients as biochemical marker in the early diagnosis of the disease. Methods: We examined the difference of ADA activity in bronchial washing fluid among the group I(tuberculosis group), group II(lung cancer group) and group III(control group). Results: There was significantly higher bronchial washing fluid ADA level in tuberculosis group compared to the lung cancer and control groups(p<0.01). Conclusion: These results suggest that bronchial washing fluid ADA activities seem to be a useful tool in the diagnosis of pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.69 no.6
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• pp.442-449
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• 2010

Background: Melanoma antigen genes (MAGE) are expressed in many human malignant cells and are silent in normal tissues other than in testis and in placenta. But MAGE expression in benign lung diseases, such as pulmonary tuberculosis or cases with severe inflammation, needs further evaluation to overcome false-positive findings. We evaluated detection rates of the melanoma antigen genes (MAGE) RT-nested PCR in bronchoscopic washing samples from patients with benign lung disease, as well as in patients with malignancies. Methods: Bronchial washing fluid from 122 patients was used for cytological examination and MAGE gene detection using RT-nested-PCR of common A1-6 mRNA. We compared the results from the RT-nested PCR and the pathologic or bacteriologic diagnosis. We also analyzed the expression rate and false positive rate of MAGE gene. Results: Among 122 subjects, lung cancer was diagnosed in 23 patients and benign lung disease was diagnosed in 99 patients. In patients with lung cancer, the positive rate of MAGE expression was 47.8% (11/23) and in benign lung disease group, the expression rate was 14.1% (14/99). Among benign lung disease group, the expression rate of MAGE gene (25.0%) in patients with pulmonary tuberculosis (11/44) was especially high. Conclusion: MAGE A1-6 RT-nested PCR of bronchial washing fluid can be used as a complementary method in lung cancer, but that test results in a high false positive rate in tuberculosis patients.