• Korean Journal of Radiology
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• v.22 no.7
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• pp.1124-1131
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• 2021

Objective: To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). Materials and Methods: Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CT-guided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. Results: All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. Conclusion: CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1534-1544
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• 2021

Purpose To examine the effect of lung volume on the size and volume of pulmonary subsolid nodules (SSNs) measured on CT. Materials and Methods A total of 42 SSNs from 31 patients were included. CT examination was first performed at total lung capacity (TLC), and a section containing the nodule was additionally scanned at tidal volume (TV). The diameter and volume of each SSN, as well as the cross-sectional lung area containing the nodule, were measured. The significance of the changes in measurements between TLC and TV within the same individuals was evaluated. Results The lung area and the diameter and volume of SSNs decreased significantly at TV by 12.7 cm², 0.5 mm, and 46.4 mm³ on average, respectively (p < 0.001), compared to those at TLC. Changes in lung area between TV and TLC were positively correlated with the change in SSN diameter (p = 0.027) and volume (p = 0.014). However, after correction (by considering the change in lung area), the changes in SSN diameter (p = 0.124) and volume (p = 0.062) were not significantly different. Conclusion SSN size and volume can be significantly affected by lung volume during CT scans of the same individuals.

• Korean Journal of Veterinary Research
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• v.46 no.3
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• pp.263-265
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• 2006

A 15-year-old intact female poodle dog was referred to a local animal clinic showing signs of dyspnea. A radiographic examination revealed multiple nodules in the lung. The following day, the animal died and a necropsy examination revealed multiple nodular masses of varying sizes in the lung. Microscopically, the tumor cells were composed of round to polygonal cells resembling adipocytes with little or no collagenous stroma. Most of the cells contained clear cytoplasmic vacuoles with the nucleus at the periphery while the other cells contained varying numbers of smaller vacuoles. The immunohisto-chemical evaluation yielded a positive reaction to S-100 and vimentin. Negative results were obtained for pancytokeratin, smooth muscle actin, desmin, epithelial membrane antigen and CD68. This case was diagnosed as a well-differentiated liposarcoma.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.794-799
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• 1989

Sleeve lobectomy for bronchogenic carcinoma is an alternative to pneumonectomy. The extent and location of the tumor must be such that a sleeve procedure is feasible. The conservation of lung tissue benefits both compromised and uncompromised patients. From August 1988 to March 1989, five patients underwent sleeve lobectomy for bronchogenic carcinoma of the lung. The patients included four males and one female ranging in age from 52 years to 66 years. All patients were diagnosed as having squamous cell carcinoma. Operative procedures were right upper sleeve lobectomy in four cases and left upper sleeve lobectomy with pulmonary angioplasty in one case. Complications developed in one patient. An asthmatic attack necessitated ventilator support for one day. Bronchoscopic examinations were performed at two weeks and three months postoperatively in four patients. Anastomosis sites on all patients were intact, but in one case, nodules were noted. Pulmonary function tests were also checked at three months postoperatively, and showed good results. The reimplanted lobe or lobes contribute significantly to the overall remaining lung function. All patients are being followed up with satisfactory results, except one case of suspected local tumor recurrence. We think, therefore, that sleeve lobectomy is a safe and adequate procedure for patients with resectable lung cancer.

• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.56-65
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• 2002

A pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor with a vascular origin. A PEH can arise in many organ systems, such as the lung, liver, bone and soft tissues. It is a borderline malignancy but the clinical course is usually benign. In this report, we describe three cases of PEH. Case 1, a 61-year-old man, had nonspecific chest discomfort and the chest X-ray showed a solitary lung nodule. This nodule was diagnosed by an open lung biopsy. The pathologic findings including abundant necrosis, mitosis and hyperchromatic and pleomorphic nuclei, indicated a malignancy. The electron microscopic study showed Weibel-Palade bodies and the immunohistochemical stain for CD31 showed a positive reaction in the tumor cells, and linear staining along the vascular lumina. Case 2, a 34-year-old man, was admitted for an evaluation of multiple small nodules, incidentally detected a screening chest X-ray. The nodules were diagnosed by a immunohistochemical stain for the factor VIII-related antigen. Case 3, a 34-year-old woman, complained of left pleuritic chest pain. A simple chest film and the chest CT scan revealed multiple bilateral nodules and a left pleural effusion. An immunohistochemical stain for the factor VIII-related antigen was used to diagnose the nodules. Forth-one months after the diagnosis, she died of pulmonary insufficiency.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.34-50
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• 2023

In 2019, the American College of Radiology announced Lung CT Screening Reporting & Data System (Lung-RADS) 1.1 to reduce lung cancer false positivity compared to that of Lung-RADS 1.0 for effective national lung cancer screening, and in December 2022, announced the new Lung-RADS 1.1, Lung-RADS^Ⓡ 2022 improvement. The Lung-RADS^Ⓡ 2022 measures the nodule size to the first decimal place compared to that of the Lung-RADS 1.0, to category 2 until the juxtapleural nodule size is < 10 mm, increases the size criterion of the ground glass nodule to 30 mm in category 2, and changes categories 4B and 4X to extremely suspicious. The category was divided according to the airway nodules location and shape or wall thickness of atypical pulmonary cysts. Herein, to help radiologists understand the Lung-RADS^Ⓡ 2022, this review will describe its advantages, disadvantages, and future improvements.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.88-92
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• 2012

A 37 year old female presented with epigastric pain and weight loss over a period of 3 months. Her abdominal CT finding showed a 4.5 cm size hepatic mass and 4.3 cm size pancreatic head mass with multiple macronodules in the liver. At the same time, her chest CT revealed a 5 cm size necrotic mass in the left lower lobe of the lung with multiple bilateral pulmonary nodules. We diagnosed these lesions as tuberculosis through multiple biopsies. She was treated with anti-tuberculous medication. After taking the medications, her symptoms were improved. Twelve months later, imaging studies indicated an improvement in the patient's health. Here we report a case report of multi-organ macronodular tuberculosis in lung, liver and pancreas.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.72-75
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• 2016

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.267-271
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• 2015

Desmoid tumors are rare soft tissue tumors considered to have locally infiltrative features without distant metastasis until now. Although they are most commonly intraabdominal, very few cases have extra-abdominal locations. The origin of intrathoracic desmoid tumors is predominantly the chest wall with occasional involvement of pleura. True intrathoracic primary desmoid tumors with no involvement of the chest wall or pleura are extremely rare. We recently experienced a case of true intrathoracic desmoid tumor presenting as multiple lung nodules at 13 years after resection of a previous intraabdominal desmoid tumor.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1263-1270
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• 1997

Background : Differentiation of malignity and benignity is crucial for management of solitary pulmonary nodule(SPN). Clinical parameters such as patient's age, nodule size, smoking history, doubling time, typical calcification in X-ray and CT findings have been reported as helpful in this purpose. However, in most cases, these parameters are not conclusive. Glucose metabolism is increased in cancer tissues including lung cancer tissues. After uptake of 2-[F-18]-fluoro-2-deoxy-D-glucose(FDG), the glucose analogue, by cancer cell, FDG is trapped in the cell without further metabolism after phosphorylation. Thus, hypermetabolic focus in FDG-positron emission tomography (PET) imaging suggest malignancy. We evaluated the diagnostic efficacy of FDG-PET imaging in distinguishing malignant and benign SPN. Methods : We evaluated 28 patients with SPN from Jan. 1995 to Jan. 1997. CT scan of chest and whole-body FDG-PET imaging were performed in all patients. Histologic diagnosis was confirmed by transthoracic fine needle aspiration and biopsy, bronchoscopic biopsy and open thoracotomy. Results : Of the 28 SPN's, 22 nodules were malignant and 6 nodules were benign. FDG-PET imaging diagnosed all malignant nodules correctly as positive, and diagnosed 4 of 6 benign nodules correctly as negative. One tuberculous granuloma and one aspergilloma showed hypennetabolic focus and were diagnosed falsely positve with FDG-PET imaging. In the diagnosis of SPN with FDG-PET, sensitivity and specificity were 100% and 66.7%, positive predictive value and negative predictive value were 92% and 100%. Conclusion : FDG-PET imaging is highly useful noninvasive diagnostic tool in distinguishing between malignant SPN and benign SPN.