• Title/Summary/Keyword: Lung Nodules

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Von Recklinghausen`s Disease Involving the Chest (흉부질환을 병발한 Von-Recklinghausen`s Diseas)

  • 이선희
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.766-771
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    • 1988
  • Von Recklinghausen`s neurofibromatosis, tuberous sclerosis and encephalotrigeminal angiomatosis[Sturge-Kalischer-Weber syndrome] are frequently classified under the heading of organic neurocutaneous syndromes. Both neurofibromatosis and tuberous sclerosis are believed to represent instances of simple autosomal dominant heredity. Multiple neurofibroma and cafe*-au-lait spots are the hallmarks of the van-Recklinghausen`s disease. The characteristic features of the fully developed syndrome are [1] pigmentation of the skin, including cafe*-au-lait spots, pigmented freckles and males, and occasionally a generalized darkening of the skin; [2] subcutaneous nodules and deep neurofibromatous tumors and diffuse plexiform growths of neural tissue; [3] skeletal anomalies, especially scoliosis; and [4] predilection to malignancy. In recent years cystic lung disease, usually of the so-called honeycomb lung variety, has been reported on several occasions in patients with tuberous sclerosis. This association has been shown to our sporadically as well as in members of a single family. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochromocytoma, meningocele or, less commonly, parenchymal pulmonary neurofibromatosis. Author have experienced a case of von Recklinghausen`s disease. This case developed a huge neurofibroma in the both side thorax and invaded to the Lt. 7th rib.

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What Should Thoracic Surgeons Consider during Surgery for Ground-Glass Nodules?: Lymph Node Dissection

  • Kim, Hong Kwan
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.342-347
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    • 2021
  • Thoracic surgeons need to be aware of several important points regarding intraoperative lymph node dissection during surgery for non-small cell lung cancer with ground-glass opacities. The first point relates to the need for lymph node dissection during sublobar resection. Since even patients undergoing sublobar resection may benefit from lymph node dissection, it should be selectively performed according to adequate indications, which require further study. Second, there seems to be no difference in postoperative morbidity between systematic sampling and systematic dissection, but the survival benefit from systematic dissection remains unclear. The results of randomized controlled trials on this topic are conflicting, and their evidence is jeopardized by a high risk of bias in terms of the study design. Therefore, further randomized controlled trials with a sound design should investigate this issue. Third, more favorable survival outcomes tend to be positively associated with the number of examined lymph nodes. Minimum requirements for the number of examined lymph nodes in non-small cell lung cancer should be defined in the future. Finally, lobe-specific lymph node dissection does not have a negative prognostic impact. It should not be routinely performed, but it can be recommended in selected patients with smaller, less invasive tumors. Results from an ongoing randomized controlled trial on this topic should be awaited.

Multiple Pulmonary Benign Metastasizing Leiomyoma (다발성 폐 양성 전이성 평활근종)

  • Sa, Young-Jo;Sim, Sung-Bo;Yoon, Hyung-Gue;Yoo, Chang-Young;Moon, Young-Kyu;Park, Jae-Kil;Lee, Sun-Hee
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.777-781
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    • 2008
  • Benign metastasizing leiomyoma is a rare disease that histologically shows features of a benign tumor; however it can metastasize to the lung or other organs. We report here on a case of a 53-year-old Woman with benign metastasizing leiomyoma, and she was admitted to the hospital with symptoms of coughing for 2 months; she showed multiple diffuse nodular opacities of both lungs on a chest radiograph. She had undergone hysterectomy for leiomyoma of the uterus 13 years previously. Thoracoscopic lung biopsy was performed to rule out metastatic lung cancer. The pulmonary nodules appeared benign with a very low mitotic rate and they consisted of smooth muscle cells. The pathologic findings of the pulmonary nodules were consistent with benign metastasizing leiomyoma. The patient has been followed up closely without any specific therapy.

Prognosis for Pneumonic-Type Invasive Mucinous Adenocarcinoma in a Single Lobe on CT: Is It Reasonable to Designate It as Clinical T3?

  • Wooil Kim;Sang Min Lee;Jung Bok Lee;Joon Beom Seo;Hong Kwan Kim;Jhingook Kim;Ho Yun Lee
    • Korean Journal of Radiology
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    • v.23 no.3
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    • pp.370-380
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    • 2022
  • Objective: To compare pneumonic-type invasive mucinous adenocarcinoma (pIMA) confined to a single lobe with clinical T2, T3, and T4 stage lung cancer without pathological node metastasis regarding survival after curative surgery and to identify prognostic factors for pIMA. Materials and Methods: From January 2010 to December 2017, 41 patients (15 male; mean age ± standard deviation, 66.0 ± 9.9 years) who had pIMA confined to a single lobe on computed tomography (CT) and underwent curative surgery were identified in two tertiary hospitals. Three hundred and thirteen patients (222 male; 66.3 ± 9.4 years) who had non-small cell lung cancer (NSCLC) without pathological node metastasis and underwent curative surgery in one participating institution formed a reference group. Relapse-free survival (RFS) and overall survival (OS) were calculated using the Kaplan-Meier method. Cox proportional hazard regression analysis was performed to identify factors associated with the survival of patients with pIMA. Results: The 5-year RFS and OS rates in patients with pIMA were 33.1% and 56.0%, respectively, compared with 74.3% and 91%, 64.3% and 71.8%, and 46.9% and 49.5% for patients with clinical stage T2, T3, and T4 NSCLC in the reference group, respectively. The RFS of patients with pIMA was comparable to that of patients with clinical stage T4 NSCLC and significantly worse than that of patients with clinical stage T3 NSCLC (p = 0.012). The differences in OS between patients with pIMA and those with clinical stage T3 or T4 NSCLC were not significant (p = 0.11 and p = 0.37, respectively). In patients with pIMA, the presence of separate nodules was a significant factor associated with poor RFS and OS {unadjusted hazard ratio (HR), 4.66 (95% confidence interval [CI], 1.95-11.11), p < 0.001 for RFS; adjusted HR, 4.53 (95% CI, 1.59-12.89), p = 0.005 for OS}. Conclusion: The RFS of patients with pIMA was comparable to that of patients with clinical stage T4 lung cancer. Separate nodules on CT were associated with poor RFS and OS in patients with pIMA.

Endobronchial Metastasis of Epithelioid Sarcoma

  • Kim, Seo-Yun;Lee, Ji-Yeon;Lee, Yeon-Joo;Park, Sung-Soo;Koo, Hyeon-Kyoung;Lee, Sang-Min;Yim, Jae-Joon;Yang, Seok-Chul;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.5
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    • pp.423-427
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    • 2011
  • Epithelioid sarcomas are rare soft tissue sarcomas with a high tumor grade and high local recurrence and metastasis rates. Although the lung is the most common site of metastasis, endobronchial metastasis hasn't been reported yet. We now report a case of epithelioid sarcoma with endobronchial metastasis. A 28-year-old man had recurrent pneumothorax and underwent wedge resection. He presented at our hospital with hemoptysis, dyspnea, and chest pain. Chest computed tomography revealed left pneumothorax, multiple lung nodules and endobronchial lesions at the right lower basal lobe. Bronchoscopy showed a hemorrhagic mass obstructing the bronchus of the right lower basal lobe. Magnetic resonance imaging revealed multiple nodular lesions in the left thigh muscles. The bronchoscopic biopsy of the endobronchial lesion and the muscle biopsy of the thigh showed the same feature epithelioid sarcoma. This is the first case report of an epithelioid sarcoma with endobronchial metastasis that was diagnosed by bronchoscopic biopsy.

The Clinical Manifestations of the Five Cases of Lymphangitic Carcinomatosis of the Lung Presented as Diffuse and Interstitial Disease (미만성 간질성 폐질환으로 발현한 폐장의 암종성 림프관염 환자 5예에 대한 임상적 고찰)

  • Sung, Young-Joo;Choi, Soo-Jeon;Lee, Bong-Chun;Kim, Dong-Soon;Seo, Yeon-Lim
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.55-61
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    • 1992
  • Background: The lung is the most common site of metastasis and usually it manifests as a single or multiple nodules in chest X-ray. But less commonly the cancer spreads through the lymphatics and X-ray shows diffuse reticulonodular densities. Sometimes, patient is presented with respiratory symptoms only with interstitial lung infiltration before the signs of primary tumor and in that cases, the differential diagnosis with other interstitial lung disease is required. We have experienced 5 such cases, who were diagnosed as lymphangitic carcinomatosis by transbronchial lung biopsy. Methods: Clinical manifestation, pulmonary function test, modified thin section CT, bronchoalveolar lavage and transbronchial lung biopsy were done. Results: The primary tumor was gastric cancer in 3, lung cancer in 2. Pulmonary function test showed restrictive pattern with low DLco in 2 patients and obstructive pattern in one. Bronchoalveolar lavage showed lymphocytosis in 4 patients and malignant cells were found in one patient. Transbronchial lung biopsy revealed malignant cells localized to the lymphatics (peribronchial, perivascular and perialveolar). Cell type was adenocarcinoma in 4 and squamous cell carcinoma in one. Conclusion: Rarely lymphangitic carcinomatosis can be presented as diffuse interstitial lung disease and easily diagnosed by transbronchial lung biopsy.

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Hemorrhargic Effusion Caused by Chronic Torsion of Right Middle Lung Lobe with Concurrent Ovarian Tumor in a Female Miniature Poodle Dog (난소종양이 병발한 암컷 푸들에서 오른쪽 중간엽 폐염전으로 인한 만성적인 출혈성 흉수 증례)

  • Kim, Tae-Hwan;Hong, Subin;Kim, Minkyung;Shin, Jeong-In;Jang, Yun-Sul;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.530-535
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    • 2015
  • An 11-year-old intact female miniature poodle presented with a four-month history of hemorrhagic effusion. The patient was alert on physical examination, although muffled heart sounds were noted upon auscultation of the right hemithorax. The radiographic finding was pleural effusion. Ultrasonography revealed cystic changes in both ovaries and several nodules in the liver. A refractory opacity in the right lung field, as visualized with computer tomography (CT), was diagnosed as right middle lung lobe torsion with a collapsed bronchus. Five days after diagnosis, a right fifth intercostal thoracotomy was performed to remove the right middle lung lobe; the right middle lung lobe was grossly shrunken as a result of chronic lung lobe torsion. Ovariohysterectomy was also performed. Histopathologic examination revealed papillary adenocarcinoma in both ovaries and suspected metastasized ovarian adenocarcinoma cells in the lung lobe. The patient recovered favorably and had been doing well up to two months post-surgery. However, after four months, the dog presented with respiratory difficulty. The radiographic findings were pleural effusion and collapse of the right cranial and left caudal lung lobes. Malignant cells of epithelial origin were observed in the pleural effusion. The tumor cells were suspected to be metastasized cells from the previously resected lung lobe. Although cancer treatment was recommended, the suggestion was suspended and the dog was discharged from hospital. This was a case of lung lobe torsion that had occurred because of hemorrhagic effusion due to tumor. Although ovariohysterectomy and lobectomy were performed, there was a relapse of hemorrhagic effusion because of metastasized tumor from the previously resected lung lobe.

Pulmonary Nodule Detection based on Hierarchical 3D Block Analysis in Chest CT scans (흉부 CT영상에서 계층적 삼차원 블록 분석을 이용한 폐결절 검출)

  • Choi, Wook-Jin;Choi, Tae-Sun
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.5 no.1
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    • pp.13-19
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    • 2012
  • In this paper, we propose the pulmonary nodule detection method based on hierarchical 3D block analysis. The proposed system consists of two main part. In the first part, we select the block which is need to analysis. In the second part, we analysis the selected blocks. We extract the shape based features of the object in the selected blocks. Support Vector Machine is applied to the extracted features to classify into nodules and non-nodules.

Invasive Aspergillosis Involving the Lungs and Brain after Short Period of Steroid Injection: A Case Report

  • Choi, Young-Rak;Kim, Jeong-Tae;Kim, Jeong-Eun;Jung, Heo-Won;Choe, Kang-Hyeon;Lee, Ki-Man;An, Jin-Young
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.448-451
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    • 2012
  • Invasive pulmonary aspergillosis (IPA) has emerged as a severe infection in patients with immunocompromised hosts. However, recently, several IPA cases, without an apparent predisposition to immunodeficiency, has been reported. A 72-year-old woman was admitted for evaluation of general weakness and poor oral intake. She reported no medical history, except for intraarticular injection of a corticosteroid for joint pain for the duration of two months. A chest radiography revealed multiple cavitary nodules in both lungs. Examination of specimens, obtained by percutaneous needle biopsy, led to a diagnosis of invasive aspergillosis. Brain magnetic resonance imagining revealed numerous peripheral thin enhancing cystic nodules in both cerebral hemispheres. We initiated intravenous administration of amphotercin B. However, the patient died after nine days. Here, we report an invasive aspergillosis case, which involves the lungs and brain after a short period of steroid injection.

Computed tomographic diagnosis of broncholithiasis in a cat

  • Kim, Rakhoon;An, Soyon;Hwang, Gunha;Ryu, Jeongmin;Kim, Minji;Yoon, Jiwon;Noh, Seul Ah;Yu, DoHyeon;Lee, Hee Chun;Hwang, Tae Sung
    • Korean Journal of Veterinary Research
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    • v.62 no.3
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    • pp.23.1-23.5
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    • 2022
  • A 5-year-old castrated male domestic shorthair cat was referred for further investigation of pulmonary nodules incidentally detected on thoracic radiographs. Thoracic radiographs identified ill-defined soft tissue opacity nodules with small faint mineral opacity. Thoracic computed tomography (CT) revealed that bronchial dilation and bronchial wall thickening in bilateral cranial and accessory lung lobes. Round to ellipsoid mineralized concretions were found embedded in the intrabronchial soft tissue attenuation material. Based on radiography, CT, and cytology, the patient was tentatively diagnosed as having broncholithiasis with chronic bronchitis. This report described the CT diagnosis of broncholithiasis, which has been rarely reported in a cat.