• International Journal of Vascular Biomedical Engineering
• /
• 제4권1호
• /
• pp.27-30
• /
• 2006

Background; Pleural micro-metastasis of lung cancer is detected by touch print cytology or pleural lavage cytology, but its prognostic impact has not elucidated yet. We hypothesize that recurrence may depend on the amount of tumor cells disseminated in pleural cavity, if the invasiveness of all cancer is the same. To predict the amount of tumor cells disseminated in pleural cavity, we need pleural surface area, distributed pattern of cells and concentration of cells per unit area. Human pleural surface area has not reported yet. In this report, we calculate the normal human pleural surface area using CT image data processing. Methods; Twenty persons were checked CT scan, and we obtained the data from each image. In order to calculate the pleural surface, the outline of lung was firstly extruded from CT image data using home-made Digitizer program. And the distance between CT images was calculated from the extruded outline. Finally a normal human pleural surface was calculated from function between the distance of consecutive CT images and the calculated length. Results; Their mean age is $65{\pm}12$ years old (range $26{\sim}77$), body weight is $62{\pm}9\;kg\;(48{\sim}80)$, and height is $167{\pm}6\;cm\;(156{\sim}176)$. The number of images used is $36{\pm}7\;(24{\sim}51)$. Pleural surface area is $211,888{\pm}35,756\;mm^2\;(143,880{\sim}279,576)$. Right-side pleural surface area is $107,932\;mm^2$ and Lt is $103,955\;mm^2$. Costal, mediastinal and diaphragmatic surfaces of right-side pleura are $77,483\;mm^2,\;39,057\;mm^2,\;and\;8,608\;mm^2$ respectively, and left-side are $72,497\;mm^2,\;35,578\;mm^2,\;and\;4,120\;mm^2$ respectively. Conclusion; Normal human pleural surface area is calculated using CT image data at first and the result is about $0.212\;m^2$.

• Tuberculosis and Respiratory Diseases
• /
• 제63권2호
• /
• pp.188-193
• /
• 2007

악성 흉수의 원인은 폐암, 유방암, 및 악성 림프종, 백혈병이 그 대부분을 차지하며 내분비 종양에 의한 악성 흉수는 매우 드물며 특히 유두상 갑상선 암에 의한 흉수는 거의 없다. 저자들은 유두상 갑상선 암이 폐 전이를 거치지 않고 유방 전이를 거쳐 흉막 전이 일으킨 것으로 보이는 1예를 경험하였기에 보고하는 바이다. 아울러 원인이 명확하지 않은 악성 흉수의 원인 감별에 유두상 갑상선 암도 고려 대상으로 할 필요가 있다고 생각한다.

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

• Tuberculosis and Respiratory Diseases
• /
• 제71권5호
• /
• pp.355-358
• /
• 2011

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful, safe diagnostic modality for evaluating mediastinal and hilar lymphadenopathy. We report a 51-year-old male who presented with a left renal mass and multiple pleural masses without lung parenchymal lesions. The pleural masses were thought to be metastatic tumors or malignant mesothelioma. The patient underwent two percutaneous needle biopsies of the pleural mass, but the specimens were insufficient for a histopathological diagnosis. Because one pleural mass was adjacent to the right main bronchus, we decided to perform EBUS-TBNA for the pleural mass. As a result, sufficient core tissue was obtained with no complications, and the histopathological findings were consistent with metastatic papillary renal cell carcinoma. To our knowledge, this is the first case of using EBUS-TBNA for a pleural mass.

• Nuclear Medicine and Molecular Imaging
• /
• 제40권3호
• /
• pp.141-147
• /
• 2006

PET detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after being diagnosed with gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivities for lymph node staging, the specificities of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FDG uptake of the primary tumor is low, the distant metastasis is also known to show low FDG uptake reducing its detection. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET.

• 동의생리병리학회지
• /
• 제23권3호
• /
• pp.710-714
• /
• 2009

Several studies showed that the survival rate of stage IIIB disease with malignant pleural effusion is worse than stage IIIB disease without malignant effusion. But, malignant pleural effusion was considered T4. To analyze changes the survival time for malignant pleural effusion, in the seventh revision of TNM classification for lung cancer. The records of all patients had to have either a histological or cytological diagnosis of non-small cell lung cancer (NSCLC), who were admitted to Wonkwang university hospital between January 2004 and December 2006 were reviewed retrospectively. We evaluated the survival time of 187 patients with advanced lung cancer with and without malignant pleural effusion. This included the pleural effusion or nodule M1 a (pleural dissemination, currently classified as T4), nodule(s) in the other lung M1 a (contralateral lung nodule, currently classified as M1), nodule(s) with the same lobe as the primary tumor T3 (currently classified as T4), other T4 factors T4 (T4 MO anyN), and extrathoracic sites of disease M1b (distant metastasis, currently classified M1). Among the 187 patients, T4anyNMO was 57 patients in the current TNM classification. In the next edition of the TNM classification, T4MOanyN-T4 (excluding same lobe nodules) was 12 patients, pleural dissemiantion-M1a was 45 patients, contralateral lung nodule(s)-M1a was 7 patients, and metastatic disease-M1b was 55 patients. We compared the survival time for these groups. Survival time was 11 months, 8 months, 11 months, and 4 months. The survival time of malignant pleural effusion was shorter than other T4 factors without pleural effusion. But, there was no remarkable difference in statistics due to small cases (p=0.23). We strongly suggest that malignant pleural effusion in advanced NSCLC will be categorized with metastatic disease.

• Tuberculosis and Respiratory Diseases
• /
• 제41권1호
• /
• pp.36-41
• /
• 1994

저자들은 호흡곤란을 주소로 내원한 44세 남자에서 기관지 내시경검사, 흉막생검, 복부초음파검사, 흉부단층촬영을 시행한 결과 흉막삼출을 동반하는 폐의 전이성 맥관육종을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한수의학회지
• /
• 제56권4호
• /
• pp.273-276
• /
• 2016

Pericardial mesothelioma is a rare neoplasm in dogs. This report describes a case of pericardial mesothelioma in a 13-year-old Shih Tzu that presented with a clinical history of dyspnea. Hemorrhagic pericardial effusion and chylous pleural effusion with reactive mesothelial cells were identified by radiograph and cytology. Necropsy revealed multiple round nodules throughout the pericardium and regional lymph nodes in addition to chylothorax. Histopathology revealed invasive neoplasm on the pericardial surface with metastasis to the lymph nodes. The neoplastic cells were immunopositive to both cytokeratin and vimentin. Diagnosis of pericardial mesothelioma with regional lymph node metastasis was made.

• Tuberculosis and Respiratory Diseases
• /
• 제62권3호
• /
• pp.217-222
• /
• 2007

저자들은 악성흉수 환자에서 가장 많은 치료법으로 선택되고 있는 talc 늑막유착술 이후에 급성 저산소증으로 사망한 환자 2예를 경험하였다. Talc 늑막유착술은 안전하고 효과적인 치료이지만, talc를 5 g 이상 사용하거나, 전신상태가 불량하거나, 반복적인 늑막유착술을 시행한 경우나, 양측에 흉수가 있거나, 늑막유착술 전 2주 이내에 항암요법이나 방사선치료를 한 경우나 폐실질에 전이성병변이 있을 때 예후가 불량하므로 talc 늑막유착술 환자를 선정할 때 주의하여야 하겠다.

• Journal of Chest Surgery
• /
• 제28권11호
• /
• pp.1049-1053
• /
• 1995

Although neoplastic involvement of the pericardium is frequently present postmortem, cardiac manifestations before death are uncommon, and cardiac tamponade as the initial presentation of cancer is rare. We are presenting a metastatic pericardial tumor with cardiac tamponade of unknown primary neoplasm. The patient brought to hospital in a state of unconscious. The chest x-ray film showed cardiomegaly with a globular heart shape and right pleural effusion. We underwent an anterior thoracotomy and pericardial window was created. The histopathologic finding of pericardium, pleural and pericardial effusion show a metastatic adenocarcinoma. The patient subsequently received adjuvent radiotherapy and chemotherapy, but he expired on the postoperative 132 day.