• Journal of Chest Surgery
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• 제56권4호
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• pp.286-289
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• 2023

A 58-year-old woman presented with an incidental asymptomatic mass occupying the entire right lower thorax. A radiologic study demonstrated a huge cystic mass, initially suggestive of an exophytic echinococcal cyst. After unsuccessful catheter drainage, the patient was referred for surgery, and curative resection of the lung-, heart-, and diaphragm-compressing mass was performed under video-assisted thoracoscopic surgery. Culture studies revealed no growth of parasitic, bacterial, or fungal infections, and the final pathological result confirmed a primary pleural cyst. Thoracic cystic masses mostly manifest as bronchogenic or pericardial cysts, while primary pleural cysts have rarely been reported. We present a rare case of a huge pleural cyst that initially mimicked an echinococcal cyst.

• Journal of Chest Surgery
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• 제44권1호
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• pp.86-88
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• 2011

Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum or lung parenchyma. An isolated bronchogenic cyst of the diaphragm is very rare. Our case was a 56-year-old female patient who presented with pleuritic chest pain in her right chest. Chest and abdominal computed tomography revealed a large lobulated cystic mass that was accompanied with pleural effusion in the right lower hemithorax. The tumor showed focally calcified areas in the wall and abutted against the diaphragm. We performed complete excision of the cyst including a portion of the diaphragm attached to it. The pathological diagnosis was established as the bronchogenic cyst originating from the diaphragm. We report this case with a review of the literature.

• Journal of Chest Surgery
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• 제6권2호
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• pp.175-180
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• 1973

Aneurysmal bone cysts of rib continue to interest the clinicians because of their rarity. We experienced a case of aneurysmal bone cyst of Rt 10th rib, which was occupying the Rt pleural cavity as a huge mass. This case was treated surgically with good result. In addition, general concept of aneurysmal bone cyst with brief review of literatures was disclosed here.

• Tuberculosis and Respiratory Diseases
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• 제70권4호
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• pp.338-341
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• 2011

Hydatid disease is caused by the larval stage of taenia $Echinococcus$, which endemic in the Mediterranean region. Recently, the prevalence of the disease has increased worldwide due to an increase in the frequency of travel and immigration. As the infested larvae migrate through the bloodstream, the final destination is most commonly the liver or lungs; direct pleural invasion is very rare. A 50-year-old diabetic Korean man presented with an incidentally noted 2 cm right pleural nodule. On follow up imaging after three months, its size had increased. To confirm the diagnosis of the lesion, surgical excision was performed. Histopathological examination showed the diagnosis of a hydatid cyst. The patient had no history of overseas travel, but lives in an urban area where many foreign workers from endemic countries reside. This is the first reported case of primary pleural hydatid disease in a non-endemic country.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.299-301
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• 2011

A case of a symptomatic spinal extradural meningeal cyst (SEMC) in Klippel-Trenaunay syndrome (KTS) is introduced. A 38-year-old woman presented with right L2 radiculopathy. She underwent operations for varicose veins in both her lower extremities. She had port-wine nevi on her trunk and extremities. The edematous change in both legs had waxed and waned. Magnetic resonance imaging showed an $11.8{\times}13$ mm extradural meningeal cyst growing through the intervertebral foramen in L2-3. Multiple meningeal cysts were located in the dorsal aspect of the spinal cord from T3 to T10. A $5.8{\times}6.2$ mm cyst was also found in left pleural cavity. The extradural meningeal cyst was completely excised and the preoperative symptom was improved. KTS is a congenital disorder due to a mesodermal abnormality, which may predispose the dura to weakness. The SEMC may occur through the dural defect or weakened point.

• Journal of Chest Surgery
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• 제26권6호
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• pp.475-482
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• 1993

90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

• Journal of Chest Surgery
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• 제42권2호
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• pp.263-267
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• 2009

혈성 흉수를 동반한 췌흉강루는 췌가성낭포 파열 혹은 췌관 폐쇄에 의해 생기는 드문 질환이다. 만성 음주력이 있는 48세 남자가 다량의 우측 총수로 내원하였다. 흉수 내 아밀라제와 리파제가 상승되어 있었고, 전산화 단층촬영에서 췌가성낭포 파열에 의한 췌흉강루로 진단되었다. 최초 치료로 흉관 배액, 금식, 총정맥영양 및 췌장액 분비억제제 등의 보존적 치료를 시행하여 증상이 호전되었으나, 이후 출혈성 췌가성낭포가 커지고 혈성 흉수가 재발하여 수술적 치료를 하였다. 환자는 특별한 합병증 없이 수술 후 27일째 퇴원하였다.

• Pediatric Infection and Vaccine
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• 제25권1호
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• pp.54-59
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• 2018

기생충 감염은 소아 인구에게서 드물기 때문에 진단이 어려울 수 있다. 환아는 6개월 동안 간헐적인 상복부 통증과 양손과 양측 팔 모두에 발생한 홍반성 발진을 동반한 늑막 삼출을 주소로 내원하였다. 환아는 검사상 혈청 호산구증가와 현저한 삼출성, 호산구성 흉막삼출액이 확인되었다. 동시에 폐렴 미코플라스마에 대한 높은 항체가 때문에 항생제 치료를 받았으나 흉막삼출은 호전되지 않았다. 환아의 분변에서 시행한 기생충 알의 검사상 음성이었으나 혈청 및 흉막삼출액의 기생충 특이 항원에 대한 면역효소측정법에서 폐흡충 특이 IgG에 대해 양성을 보였다. Praziquantel의 치료 후 호흡기 증상, 흉수 및 피부 증상이 호전되었다. 이에 만성 복통과 홍반성 발진을 주소로 내원한 소아 환자에서 폐흡충에 의한 흉막삼출액을 진단 및 치료하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제39권8호
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• pp.655-658
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• 2006

중피낭종은 드문 종격동질환으로서 주로 우측 심장횡격막 각에서 잘 발생한다. 그러나 드물게는 비전형적인 위치에서 발생하며 특히 후 종격동에서의 발생은 매우 드물다. 교통사고로 내원한 30세 여자환자에서 우연히 심낭과 척추체 사이의 후 종격동에 위치하는 큰 낭종이 발견되었다. 낭종은 장축이 18 cm에 이르는 매우 큰 크기였으며 주로 좌측 흉강 쪽으로 커져 있었으나 환자는 증상을 호소하지 않았다. 반대측 흉강으로의 박리에 어려움이 있어서 작은 수술창을 동반한 비디오흉강경 수술로 완전 절제를 시행하였다. 장기 관찰에서 재발 없이 경과는 양호하였다.

• Journal of Chest Surgery
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• 제1권1호
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• pp.19-24
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• 1968

A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.