• 제목/요약/키워드: Multiple pulmonary nodules

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A Case of Pulmonary Mycobacterium kansasii Disease Complicated with Tension Pneumothorax

  • Boo, Ki Yung;Lee, Jong Hoo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.356-359
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    • 2015
  • Pneumothorax is an extremely rare complication of non-tuberculous mycobacterial infection. A 52-year-old man presenting with difficulty breathing and chest pain was admitted to our hospital. A right-sided pneumothorax was observed on chest radiography and chest computed tomography showed multiple cavitating and non-cavitating nodules with consolidation in the upper to middle lung zones bilaterally. Serial sputum cultures were positive for Mycobacterium kansasii, and he was diagnosed with pulmonary M. kansasii disease complicated by tension pneumothorax. After initiation of treatment including decortications and pleurodesis, the patient made a full recovery. We herein describe this patient's course in detail and review the current relevant literature.

Pulmonary Blastomycosis in a Monkey (원숭이의 폐장 Blastomycosis 1예)

  • Rim, Byung-Moo;Han, Du-Seok
    • Korean Journal of Veterinary Research
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    • v.23 no.1
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    • pp.91-94
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    • 1983
  • An adult male rhesus monkey (Macaca mulata) developed anorexia, ataxia, dullness, coughing, and some elevated body temperature and died a week after the initiation of such symptoms. At necropsy the monkey's physical condition was found to be normal. Body weight was 18.3kg and the only notable gross lesion was the appearance of acute pneumonia with multiple nodules. Histopathologic observation of the tissues obtained from this animal revealed the features of acute primary pulmonary blastomycosis.

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Diffuse Large B-Cell Lymphoma Manifesting as Miliary Nodules in the Lung: A Case Report (폐의 좁쌀 결절로 발현된 림프종 사례: 증례 보고)

  • Hyo Ju Na;Hyeyoung Kwon;Song Soo Kim;Hyung Kyu Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1391-1396
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    • 2023
  • Malignant lymphoma has various pulmonary manifestations on chest CT, including nodules, masses, areas of consolidation, and ground-glass opacity. These presentations can pose a diagnostic challenge, as they mimic other disease patterns. Herein, we report a case of diffuse large B-cell lymphoma (DLBCL) manifesting as miliary nodules in a 67-year-old male initially presenting with dyspnea and fever. Radiologic findings included diffuse, bilateral, multiple tiny nodules consistent with metastasis, miliary tuberculosis, and fungal infection. However, further investigations, including laboratory tests, imaging, and biopsies, led to the diagnosis of DLBCL involving the lungs. Herein we reported a rare case of lymphoma involvement of the lung presenting as miliary nodules. Accurate diagnosis relies on a comprehensive evaluation of the clinical history, physical features, laboratory test results, and imaging findings.

A Case of Spindle Cell Hemangioendothelioma Involving the Lung, Mediastinum and Brain (폐, 종격동 및 뇌를 침범한 방추세포형 혈관내피종 1예)

  • Kim, Hwan-Tae;Kim, In-Ho;Lee, Bong-Choon;Kang, Chang-Il;Yoon, Hye-Kyoung
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.301-307
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    • 1993
  • Intravascular bronchioloalveolar tumor is now recognized as a pulmonary form of hemangioendothelioma(HE). HE is an unusual tumor of adult life which is characterized by proliferation of an "epithelioid" or "spindle" endothelial cell. In the lung it usually presents as multiple bilateral slowly growing nodules less than 2 cm in diameter. The aetiology and pathogenesis of this disease are unknown. Spindle cell HE occurs at any age, but approximately one half of patient are 25 years of age or younger and males are affected twice more frequently than females. On light microscopic examination, the tumor show mild cellular atypia, nearly absent mitoses and electron-microscopic studies reveal evidence of endothelial cell differentiation. Intracytoplasmic localization of Factor VIII-related antigen is demonstrated on immunohistochemical study, which confirmed the endothelial origin of the tumor. No effective therapy is yet known for HE, but survival of this tumor can be quite long. However, one half of the patient have died, usually of progressive pulmonary insufficiency. This 19-yr-old male complained of Rt. chest pain and intermittent hemoptysis. Simple chest film and chest CT scan showed the Rt. pleural effusion, variable sized bilateral pulmonary nodules, irregular large heterogenous tumor with well enhancement and extensive necrosis in the anterior mediastinum. The mediastinal mass was biopsied and diagnosed as spindle cell HE by light microscopic finding and immunohistochemical studies.

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Pulmonary Cryptococcosis in Immunocompetent Patients: CT Findings

  • Lee, Jae-Kyo
    • Journal of Yeungnam Medical Science
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    • v.21 no.1
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    • pp.74-81
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    • 2004
  • Purpose: To evaluate the computed tomography (CT) findings of pulmonary cryptococcosis in immunocompetent patients. Materials and Methods: CT scans of 25 patients with biopsy-proven cryptococcosis [surgery (n=3), percutaneous needle biopsy (n=21), and bronchoscopic biopsy (n=1)] were analyzed. Thirteen patients were men and 12 patients were women, with a mean age of 53.7 years. Presenting symptoms were cough, sputum, and dyspnea and 12 patients presented with incidentally found chest radiographic abnormalities. Results: Nodule or multiple conglomerate nodules (n=10, 40%) and segmental or lobular consolidation (n=9, 36%) were most common, followed by mixed patterns (n=5, 20%). Predilection sites were lower lobe (n=21/37, 57%) and subpleural areas (n=23, 92%). Air bronchograms within consolidations (n=11/14, 79%) with mild volume loss (n=10/14, 71%) were common. While interlobular septal thickening (n=11, 44%) and cavitation or central low-attenuations (n=11, 44%) were relatively common, lymphadenopathy (n=2, 8%) or free pleural effusions (n=1, 4%) were uncommon. Conclusion: Nodules or airspace consolidation with a predilection of lower lobe and subpleural area are the most common appearances of pulmonary cryptococcosis in immunocompetent patients.

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Benign Metastasizing Pulmonary Leiomyoma with Hemoptysis (객혈을 동반한 양성 전이성 폐 평활근종 1예)

  • Park, So Young;Lim, Eun Ju;Jang, Ji-Sun;Kim, Chang-Hwan;Jee, Hyun Keun;Cho, Sung Jin;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.92-96
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    • 2006
  • A benign metastasizing pulmonary leiomyoma(BMPL) is a rare disease that is usually detected years after a hysterectomy or myomectomy. Despite the benign pathological appearance, these tumors can metastasize and become clinically malignant. Recently, we experienced case of BMPL with hemoptysis. A 43-year-old woman, who had undergone a hysterectomy due to uterine leiomyoma 8 years ago, visited our department complaining of intermittent hemoptysis. A chest CT showed bilateral multiple nodular lesions. Video-associated thoracoscopy was performed. The resected small nodular lesion revealed the proliferation of spindle cells without mitosis or nuclear atypism. The lesions tested positive to the smooth muscle marker (actin) by immunohistochemical staining. Therefore, the multiple nodules were considered as benign metastasizing pulmonary leiomyoma from a uterine leiomyoma. GnRH analogue therapy was initiated. A chest CT showed that the size and number of pulmonary lesions did not change after 3 months, and the patient was symptom free.

Two Cases of Pulmonary Involvement of Immunoglobulin G4 Related Autoimmune Disease (면역글로불린 G4 연관 자가 면역 질환의 폐 침범 2예)

  • Yoo, Jung-Wan;Roh, Jae-Hyung;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Song, Jin Woo
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.359-363
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    • 2009
  • Immunoglobulin G4 (IgG4) related autoimmune diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation of numerous IgG4-positive lymphoplasma cells of varying origin, and a positive response to steroid treatment. Autoimmune pancreatitis, sclerosing cholangitis, and retroperitoneal fibrosis are representative presentations of IgG4 related autoimmune disease. Herein, we describe 2 patients (40-years-old woman and 47-years-old man) diagnosed with pulmonary involvement of IgG4-related autoimmune disease. The patients were admitted for an evaluation of the lung mass or multiple lung nodules found on chest radiography. Surgical lung biopsies were performed and pathologic finding revealed lymphoplasmacytic sclerosing inflammation with numerous IgG4 positive cells. The patients had elevated serum total IgG and IgG4 levels. Treatment consisted of high dose methylpredinisolone (1 mg/kg/day) and demonstrated good responsiveness. However, one patient experienced 2 relapses while being tapered off of steroid treatment.

A Case of Mycobacterium abscessus Lung Disease in a Patient with H1N1 Influenza Pneumonia (H1N1 Influenza 폐렴 환자에서 발생한 Mycobacterium abscessus 감염 1예)

  • Jung, Kyoung-Won;Yu, Hoon;Lee, Tae-Hoon;Kwon, O-Sung;Choi, Suk-Won;Kang, Se-Hun;Shim, Tae-Sun;Kim, Dong-Soon;Song, Jin-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.3
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    • pp.207-211
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    • 2010
  • Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days' ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.

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.

Pulmonary Cryptococcosis That Was Suspected to be Metastatic Lung Cancer (전이성 폐암으로 추정된 폐효모균증)

  • Kim, Jong In;Cho, Sung Rae;Kye, Yeo Kon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.123-126
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    • 2009
  • Cryptococcosis is a subacute or chronic inflammation that's caused by infection from cryptococcus neoformans in the soil or dust that's contaminated by pigeon droppings. Pulmonary cryptococcosis occurs in immunocompromised patients, and particularly in HIV positive patients, but it rarely occurs in immunocompetent individuals. It is most often detected as asymptomatic single or multiple nodules that are found by chest X-ray examination. In these situations, the diagnosis for most cases is made by the histology of the resected lesion. We report here on a case of solitary nodular pulmonary cryptococcosis that occurred in a 32 years old female patient who underwent thyroidectomy for treating her thyroid cancer.