• Journal of Chest Surgery
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• v.30 no.7
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• pp.708-712
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• 1997

We report on nine years experience of surgical treatment of mediastinal tumors in 47 patients. Their ages ranged from 5 o 67 years with an average of 36.4 years and the sex ratio of male and female was 1:1.5. The most frequent symptom was chest pain(27.7%), followed by ptosis(14.9%), general weatuless(12.8%) and eight patients(17.0%) were asymptomatic. The most prevalent location of the tumor was anterosuperior mediastinum(63.8%). Pathologically, thymoma(32.9%) was the most common tumor, followed by cyst(21.3%), neurogenic tumor(17.0%), germ cell tumor(12.8%), and mesenchymal tumor(6.4%). Complete removal was achieved in 41 cases of all benign tumors and 3 cases of malignant tumors. All the malignant tumor patients were treated with chemotherapy, radiotherapy or both after surgery. Postoperative complications developed in 4 cases and there was no operative death.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.910-915
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• 1999

Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.13-19
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• 2014

Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis. Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival. Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multi-station N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate. Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.807-811
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• 2002

Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.

• The Korean Journal of Cytopathology
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• v.14 no.1
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• pp.12-16
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• 2003

Ganglioneuroma is a well-differentiated, benign tumor of the sympathetic nervous system. These tumors belong to a family of neoplasm that exhibit a wide range of differentiation, with neuroblastoma at one end and ganglioneuroma at the other. Because it share morphologic features with other both benign and malignant neural tumors, accurate preoperative diagnosis is often difficult. Nonetheless, it is critical for proper management. Fine needle aspiration cytology (FNAC) in the diagnosis of the ganglioneuroma has been a little documented. We describe a case of mediastinal ganglioneuroma in a 33-month-old girl. The diagnosis was suggested on FNAC and was confirmed by histopathologic examination later.

• Journal of Chest Surgery
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• v.35 no.12
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• pp.906-908
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• 2002

A 60-year-old male was admitted to our hospital complaining of general weakness. Chest radiography showed lung mass on left lower lobe. After left lower lobectomy and mediastinal lymph node dissection, The mass was pathologically diagnosed as large cell neuroendocrine carcinoma. Pulmonary large cell neuroendocrine carcinoma is rare. Herein we report a case of large cell neuroendocrine carcinoma in lung.

• Journal of Chest Surgery
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• v.27 no.11
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• pp.938-941
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• 1994

Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen, then have symptoms of back pain,lower extremity tingling sensation. CT scan or MRI demonstrated a Dumbbell-shaped mass density compressing spinal canal, enlargement of the foramen, erosion of bone, and intervertebral widening. We report the analysis of the 18 cases of neurogenic tumors on posterior mediastinum and Dumbbell type tumors are 3 cases among the 18 cases. The neurilemmomas were 12 cases[67%], the ganglioneuroma were 5 cases[28%], and neuroblastoma was one case[5%]. The successful removal was done in all cases, a standard thoracotomy and laminectomy was done in Dumbbell type tumors.There was no postoperative neurological complications.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.768-771
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• 1999

A 45 year old man was admitted for further examination of an abnormal shadow of the right posterior mediastinum. The patient suffered from dysesthesia in the right thoracic wall of dermatome T7. CT scan and MRI revealed that two separate tumors had developed in the right paravertebral area linked to the vertebral canal via an intervertebral foramina. One-stage removal of the tumors were performed safely through the right posterolateral thoracotomy following the resection of the rib head and vertebral pedicle. The tumors were confirmed as histologically neurilemomas. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.487-490
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• 2014

Cellular schwannoma is an uncommon variant of schwannomas that can occur in a peripheral nerve. Although cellular schwannomas typically do not differ in prognosis from regular schwannomas, they are known to cause local recurrence when not completely resected. Here, we report the case of a patient with cellular schwannoma of the posterior mediastinum, which recurred after 13 years.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.851-854
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• 2000

Tuberculomas of the lung are rare in children and one of the more common lesions presenting a solitary pulmonary nodule roetgenorgraphically. We are reporting of a 3-year-old child with a tuberculoma in left upper lobe. The patient was initially diagnosed as the benign mediastinal tumor but in the end as tuberculoma in left uper lobe. Wedge resection including the mass was done. The tumor had brown smooth external surfaces on sectioning including the mass was done. The tumor had brown smooth external surfaces on sectioning show pale gray and soft cut surface was shown. In light electromicroscopy chronic granulomas with multinucleated giant cells and central caseous necrosis were observed which are the characteristics of tuberculoma. The postopeative course was smooth and uneventful and patient has been well for 4 months postoperatively.