• Title/Summary/Keyword: Lung Diseases/diagnosis

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Transthoracic Fine Needle Aspiration Biopsy in Localized Pulmonary Lesions: Diagnostic Accuracy and Complications (국소적 흉부 병변에서 세침 흡입 생검의 진단 성적 및 합병증)

  • Yang, Suck-Chul;Kim, Yeon-Soo;Kim, Soon-Kil;Kim, Tae-Wha;Lee, Kyung-Sang;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Jeon, Seok-Chol;Lee, Jung-Dal
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.685-694
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    • 1995
  • Introduction: Transthoracic fine needle aspiration biopsy(TNAB) has shown to be a resonably safe, simple, and accurate procedure in diagnosis of intrathoracic lung lesions. We reviewed the results of 1,005 TNAB of chest lesions performed on 930 patients with 20 or 22-gauze needles over a period of 10 years. Methods: From November 1983 to June 1995, 1,005 cases in 930 patients with an undiagnosed lung lesion underwent TNAB at the Hanyang University Hospital: 66% were men and 34% were women. Most of the patients were 40~60 years old and the youngest patient was 3 years of age. Result: 540 patients had various malignant chest lesions and 322 patients had benign pulmonary lesions. The diagnostic accuracy of TNAB was 96.1 percent in malignant diseases with one false positive result and 90.1% in benign diseases. A definitive diagnosis was not obtained in the remaining 68 patients. The most common diagnoses among 519 malignancy chest lesions with TNAB were the following: squamous cell lung carcinoma, 31.7%; adenocarcinoma, 24.7%; small cell lung carcinoma, 16.7%; metastatic cancer, 14.2%; large cell lung carcinoma, 6.2% and so on. Complications included pneumothorax in 12.3% necessitating chest tube drainage in 0.6%. Minor hemoptysis occurred in 3.6%. There was no death directly attributable to the procedure. Conclusion: We concluded that TNAB permits a direct approach to all kinds of localized lung lesions with a high degree of accuracy and without major complications.

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Application of Wide Latitude Film to Radiographic Diagnosis in Small Animal (소동물 X-선 진단에 있어서 광범위 관용도 필림의 이용에 관하여)

  • Choi Min-Cheol
    • Journal of Veterinary Clinics
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    • v.9 no.2
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    • pp.473-481
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    • 1992
  • To elucidate the applicability of the wide latitude X-ray film for radiographic diagnosis and treatment of diseases in small animals, the quality of the wide latitude film was compared with that of the standard latitude film which is commonly used in veterinary clinic. The images of head, neck, thorax, abdomen, extremities and joints were radiographed with the wide latitude and standard latitude film in fourteen dogs. In soft tissues such as abdominal organs, lung, skin, mammary glands, the clearer and higher contrast of the image was observed on the wide latitude film. And these advantages were more apparent in pneumoeritoneography. Therefore. it can be suggested that the wide latitude film is practically useful for the evaluation of the images of soft tissues, and also can be used on hard tissue radiography with the same quality as the standard latitude film.

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Pulmonary Arteriovenous Malformation and Its Vascular Mimickers

  • Hyoung Nam Lee;Dongho Hyun
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.202-217
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    • 2022
  • Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.

A 32-Year-Old Female with Incidentally Detected Multifocal Cystic Pulmonary Lesions on Chest Computed Tomography (흉부 CT에서 우연히 발견된 다발성 낭성 폐병변을 가진 32세 여성)

  • Hee-Young Yoon
    • The Korean Journal of Medicine
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    • v.99 no.1
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    • pp.25-31
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    • 2024
  • Lymphangioleiomyomatosis (LAM) is a rare condition that exclusively affects women and is characterized by lung parenchymal destruction and the formation of cysts due to infiltration by LAM cells. It can also impact the lymphatic system, leading to the development of fluid-filled cystic structures and abdominal involvement, including renal angiomyolipomas (AML) or lymphangioleiomyoma. LAM can occur sporadically or be associated with tuberous sclerosis complex. Common symptoms include respiratory issues such as dyspnea, pneumothorax, chylothorax, along with other manifestations like renal AML and lymphatic involvement. The diagnosis of LAM relies on a combination of clinical, radiological, and laboratory findings, and treatment options vary depending on symptoms and patient status, with mTOR inhibitors being considered as a treatment option. This case outlines the diagnostic journey and clinical course of a 32-year-old female patient with LAM.

Correlation Between NT-proBNP and Pulmonary Arterial Pressure in COPD Patients (만성 폐쇄성 폐질환 환자에서 뇌나트륨이뇨펩티드와 폐동맥압과의 상관관계에 관한 연구)

  • Hwang, Yong Il;Park, Geun Min;Kwon, Sung Youn;Yoon, Ho Il;Lee, Choon-Taek;Han, Sung Koo;Shim, Young Soo;Lee, Jae Ho
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.346-352
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    • 2007
  • Background: Pulmonary hypertension is one of the cardiovascular complications of in COPD. However, a diagnosis of pulmonary hypertension requires an invasive test, such as right heart catheterization. NT-proBNP is a cardiac hormone that is elevated when a cardiac volume or pressure overload is present. It was hypothesized that NT-proBNP might play a role in detecting of pulmonary hypertension in COPD patients. Method: The 31 COPD patients, who underwent all of NT-proBNP, echocardiography, and spirometry in Seoul National University Bundang Hospital during the period from November 2003 to July 2005, were retrospectively analyzed. Result: Of the 31 COPD patients, 9 patients had pulmonary hypertension. A significant positive correlation was observed between the NT-proBNP and pulmonary arterial pressure (r=0.589, p=0.002). However, there was no significant correlation observed between the $FEV_1$ and NT-proBNP and $FEV_1$ and pulmonary arterial pressure. Conclusion: NT-proBNP might indicate the presence of pulmonary hypertension in COPD patients.

Characteristics of Lung Cancer in the Elderly (노령환자 폐암의 임상적 특징)

  • Jung, Kyung-Hae
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.660-668
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    • 1999
  • Background: Lung cancer continues to increase and one half of all cases of lung cancer occur in patients age 65 years and older. However, it seems that lung cancer is less treatable in elderly patients because of co-morbid illness or poor tolerance of surgery and chemotherapy. The intention of this study is to seek an adequate treatment approach for lung cancer in the elderly through an understanding of its characteristics. Method: The clinical data of 207 patients who were diagnosed with histologically proven lung cancer at the department of internal medicine in Seoul Municipal Boramae Hospital between September 1994 and August 1998 were retrospectively analyzed according to their age groups; group I$\geq$65 years(n=122) and group II<65 years(n=85). Results: The peak incidence of age was 7th decade(36.2%) and male age 65 years and older were 42% of all patients. Although dyspnea was more common in group I(26%) than in group II(11%)(p=.0l), there were no significant difference in other symptoms, stage, and histologic type between two groups. Group I significantly had more patients with poor performance(ECOG 3&4) than group II(35.2% vs.12.9%, p=.000). The percentage of patients with non-small cell carcinoma received supportive care only was significantly higher in group I than in group I(74% vs. 35%, p=.000). However, survival of patients who had curative intent treatment was similar between two groups(median survival 11.3 mos vs. 23 mos, p>.05). The histologic subtype, stage and performance status were significant prognostic factors affecting survival, but age itself was not. Conclusion : Lung cancer is prevalent in the elderly and aggressive diagnosis and treatment should be considered in elderly patients with good performance status.

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A Case of Small Cell Lung Cancer Metastasis to the Gingiva (치은으로 전이된 소세포 폐암 1예)

  • Lee, Kyu-Seung;Lee, Yun-Seon;Kwon, Seon-Jung;Ahn, Jin-Young;Kim, Myung-Hoon;Park, Hee-Sun;Kang, Dong-Won;Kim, Geun-Hwa;Jeong, Seong-Su;Song, Kyu-Sang;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.1
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    • pp.65-69
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    • 2001
  • The incidence of lung cancer and its mortality rate are increasing in Korea. At the time of diagnosis, 40% patients of lung cancer patients had metastatic lesions. The common metastatic sites are the contralateral lung, bone, liver, adrenal gland and the brain. Metastasis to oral mucosa is rarely encountered in lung cancer and metastasis to the gingiva is more uncommon. Approximately 1% of malignant carcinomas in the oral cavity are the result of metastases, and 10-25% of metastatic cancers originate from lung cancer. Clinically metastatic gingival lesions are benign including hemangioma, pyogenic granuloma, giant-cell granuloma or a peripheral fibroma. Often metastases to the gingiva are diagnosed too late and by the time they are detected, they have metastases to other organs. Here we report a case of small cell lung carcinoma that had metastased to the gingiva with review of relevant literature.

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A Case of Sj$\ddot{o}$gren's Syndrome with Interstitial Lung Disease and Multiple Cystic Lung Disease (간질성 및 다낭성 폐질환이 동반된 쇼그렌 증후군 1례)

  • Jang, Dai-Yong;Shin, Byung-Chul;Jung, Ki-Young;Kim, Jong-O;Yang, Jong-Tae;Joo, Yoo-Chul;Lee, Seung-Il
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.597-602
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    • 2001
  • A 47-years-old woman presented with a 2-month history of a dry mouth and dry cough. The patient had been taking medication for Sj$\ddot{o}$gren's syndrome for approximately 7 years. The chest radiography showed multiple cystic lesions and a hazy density in both lower lung fields. The HRCT showed a diffuse ground glass like appearance and multiple variable sized cystic lesions in both lung fields. After medication, the symptoms were aggravated. Bronchoscopy was preformed with a transbronchial lung biopsy. The biopsies showed an infiltration of lymphocytes, neutrophils, monocytes and histiocytes through the interstitial space of the alveola and a widening of the alveolar septa. However, the histological findings of the cysts were not obtained. Sj$\ddot{o}$gren's syndrome is a slowly progressive inflammatory autoimmune disease, which is characterized by lymphocyte mediated destruction of the exocrine glands, with pulmonary involvement in approximately 19-65%, High-resolution CT is a sensitive technique for assessing the pulmonary involvement in patients with Sj$\ddot{o}$gren's syndrome. Although a lung biopsy is not always necessary for establishing a diagnosis of an interstitial lung disease in Sj$\ddot{o}$gren's syndrome. A lung biopsy may reveal a wide spectrum of changes ranging from a mild inflammatory response to end stage fibrosis with honeycombing. Because of the predominantly peribronchiolar inflammatory infiltration and inspissated secretions the cysts were suspected to have been formed by the ball-valve phenomen. However, no definite evidence was obtained.

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Clinical Characteristics of Lung Cancer Diagnosed in Chonnam National University Hospital(CNUH) Since 2000 (전남대학교 병원에서 2000년 이후 진단된 폐암의 임상 특성)

  • Lim, Jung Hwan;Ban, Hee Jung;Oh, In Jae;Kim, Soo Ok;Son, Jun Gwang;Jeong, Jong Pil;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.427-432
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    • 2006
  • Background: Lung cancer has been the leading cause of cancer death in South Korea since 2000. This study examined the clinical characteristics of lung cancer patients diagnosed in a community hospital from the year 2000 to 2005, and compared these results with previously reported statistical data. Method: The lung cancer data in a form of an electronic medical record was downloaded from the hospital medical information system. The clinical characteristics of the 1,509 patients with lung cancer were analyzed retrospectively. Result: The mean age of the patients was 63.7 years. 82.5% and 74.5% of the patients were men and smokers, respectively. Squamous cell carcinoma (41.6%) was the most common pathology type followed by adenocarcinoma(32.3%) and small cell carcinoma(13.9%). When 604 patients who were diagnosed from 2000 to 2003 were compared with 905 patients diagnosed from 2004 to 2005, the age of patients increased significantly (61.5 years vs. 65.1 years; p<0.001) and the proportion of adenocarcinomas was significantly higher(29.3% vs. 34.4%; p=0.046). Conclusion: Among the major histology types of lung cancer, the incidence of adenocarcinoma has been increasing recently. The age of the lung cancer patients at diagnosis is getting older. This is despite the fact that the distributions of the initial anatomic stages have not changed significantly.

Allergic Bronchopulmonary Aspergillosis Presenting as Recurrent Mass-like Consolidation

  • Choe, Yeong Hun
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.133-136
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    • 2015
  • Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitive disease showing various radiographic and clinical manifestations. Its clinical course has not been fully understood. Here I describe a case of a 23-year-old immunocompetent man with frequently relapsing ABPA. He was asthmatic. He visited our hospital because of a chronic cough. Laboratory examination showed eosinophilia with increased total and Aspergillus-specific IgE as well as positive skin reaction to Aspergillus fumigatus. Radiologic feature was a dense consolidation. Histology showed organizing pneumonia with eosinophilic infiltration. On the diagnosis of ABPA, he was treated with systemic steroid and itraconazole. Although treatment response was excellent, he suffered from recurrent ABPA three times thereafter in the form of fleeting mass-like consolidation.