• Journal of Chest Surgery
• /
• 제29권1호
• /
• pp.112-114
• /
• 1996

Localized fibrous tumor of the pleura (LFTP) is of submesothelial fibrous origin, which has been called pleural fibroma and has been confused with mesothelioma. We experienced a case of LFTP in a twenty nine year old man. The tumor arose from the right parietal pleura with long stalk. Chest X-ray and CT scan showed a 6$\times$5$\times$4cm well-defined mass in the right costophrenic angle. Wo evidence of metastasis was noted. Exploratory thoracotomy with enbloc excision of 6$\times$5$\times$4cm mass was done. The fine needle aspiration cytology and histopathologic features indicated the tumor to be malignant, and biologic behavior was discussed.

• 대한한방내과학회지
• /
• 제41권6호
• /
• pp.1255-1264
• /
• 2020

Objective: The purpose of this study was to report the effect of Korean medicine on a patient with non-small cell lung cancer with pleural metastasis who had been treated with afatinib. Method: A 61-year old female patient with non-small cell lung cancer with pleural metastasis was treated with acupuncture and herbal medicines, including Yijung-tang, Haengso-tang, Samchulkunbi-tang, Paeamju-bang (Feiai zhu fang), to control various symptoms caused by afatinib. The degree of pain was assessed by a numeric rating scale (NRS) and the quality of life was determined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and the EORTC 13-item lung cancer-specific module (EORTC LC-13). Results: After receiving acupuncture and herbal medicines, the patient showed improvement in her back and chest pain, according to the NRS score. Similarly, the Korean medicinal treatments significantly relieved her nausea, vomiting, diarrhea, hemoptysis, and alopecia. However, the EORTC QLQ-C30 assessment suggested that Korean medicinal treatments did not significantly improve the global health status of this patient. Conclusion: Korean medicine could be useful in relieving some of the symptoms occurring after conventional afatinib treatments.

• Nuclear Medicine and Molecular Imaging
• /
• 제42권sup1호
• /
• pp.39-45
• /
• 2008

PET or PET/CT 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 diagnosis of 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 sensitivity for lymph node staging, the specificity 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 FOG uptake of primary tumor is low, distant metastasis also tends to show low FDG uptake reducing its detection on PET. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET or PET/CT.

• Journal of Chest Surgery
• /
• 제57권2호
• /
• pp.136-144
• /
• 2024

Background: Early non-small cell lung cancer (NSCLC) that abuts adjacent structures requires careful evaluation due to its potential impact on postoperative outcomes and prognosis. We examined stage I NSCLC with invasion into adjacent structures, focusing on the prognostic implications after curative surgical resection. Methods: We retrospectively analyzed the records of 796 patients who underwent curative surgical resection for pathologic stage IA/IB NSCLC (i.e., visceral pleural invasion only) at a single center from 2008 to 2017. Patients were classified based on tumor abutment and then reclassified by the presence of visceral pleural invasion. Clinical characteristics, pathological features, and survival rates were compared. Results: The study included 181 patients with abutting NSCLC (22.7% of all participants) and 615 with non-abutting tumors (77.3%). Those with tumor abutment exhibited higher rates of non-adenocarcinoma (26.5% vs. 9.9%, p<0.01) and visceral/lymphatic/vascular invasion (30.4%/33.1%/12.7% vs. 8.5%/22.4%/5.7%, respectively; p<0.01) compared to those without abutment. Multivariable analysis identified lymphatic invasion and male sex as risk factors for overall survival (OS) and disease-free survival (DFS) in stage I NSCLC measuring 3 cm or smaller. Age, smoking history, vascular invasion, and recurrence emerged as risk factors for OS, whereas the presence of non-pure ground-glass opacity was a risk factor for DFS. Conclusion: NSCLC lesions 3 cm or smaller that abut adjacent structures present higher rates of various risk factors than non-abutting lesions, necessitating evaluation of tumor invasion into adjacent structures and lymph node metastasis. In isolation, however, the presence of tumor abutment without visceral pleural invasion does not constitute a risk factor.

• Tuberculosis and Respiratory Diseases
• /
• 제65권1호
• /
• pp.49-51
• /
• 2008

저자들은 악성흉막삼출증을 동반한 다계열형성이상 급성골수백혈병 1예를 보고하고자 한다. 73세 남자환자가 열감과 우측흉통을 주소로 내원하여 시행한 흉막천자 흉막액의 세포진 검사에서 2개월 전에 진단받은 다계열형성 이상 급성골수백혈병 진단 당시에 골수에서 보였던 모세포가 다수 관찰되었다. 환자는 고령과 전신쇠약감으로 복합화학요법을 시행하지 않고 hydroxyurea 투여와 함께 보존적 치료만 계속해 왔다. 환자는 다계열형성이상 급성골수백혈병을 진단받은 후 4.5개월 만에 사망하였다. 급성백혈병환자에서 흉막삼출액의 존재는 흉막전이의 가능성을 높여주고 예후에 주는 영향도 완전히 배제할 수 없으므로 흉막삼출액의 악성유무를 가리는 일은 중요하리라고 생각된다.

• 대한암한의학회지
• /
• 제10권1호
• /
• pp.93-98
• /
• 2005

Angiocentric T-cell lymphoma is a rare form of peripheral T-cell lymphoma. The disease typically manifests clinically as an aggressive, progressively destructive disorder often with a fatal outcome. It is the aim of the present paper to derive further studies evaluating the effectiveness of Korean traditional medicine on angiocentric T-cell lymphoma with intra-abdominal metastasis. A patient with high fever, weight loss, night sweat and general weakness(B symptoms) was diagnosed as angiocentric T-cell lymphoma and chemotherapy was done more than 10 times. But the response to chemotherapy was poor, finally the lymphoma involved liver and spleen. The abdominal CT showed the hepatosplenomegaly, diffuse lymphoma of liver and spleen, massive ascites, minimal pleural effusion. Then the patient gave up the chemotherapy and only herb medications (Bohyunsoamtang-A,B) were administered. The ascites, high fever and hepatosplenomegaly gradually reduced to normal. He survived for 7 years after first diagnosis, which is much longer than average survival time in angiocentric T-cell lymphoma with B symptoms. This case may give us a possibility of that Korean traditional herb medications offer potential benefits for patients with angiocentric T-cell lymphoma, and more researches are needed.

• 대한한방부인과학회지
• /
• 제35권1호
• /
• pp.91-104
• /
• 2022

Objectives: The purpose of this study is to report the effect of combination treatment of Traditional Korean medicine (TKM) and chemotherapy on a ovarian cancer with lung metastasis patient. Methods: One ovarian cancer with lung metastasis patient was treated by TKM in conjunction with Carboplatin/paclitaxel since Feb. 2020. Repeat cycle every 3 weeks for 6 times. The patient has been treated with TKM at the same time. To evaluate the patient, symptoms were measured by Numeric Rating Scale (NRS), Eastern Cooperative Oncology Group (ECOG) and tumor size was measured by scanning with Computed Tomography (CT). Blood tests including cancer biomarker were conducted during treatment. Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), version 5.0. Results: After treatment with Carboplatin/paclitaxel and TKM during 2 months, the size of the ovarian cancer was decreased(Partial Response, PR), size and malignant pleural effusion at right lung disappeared. And no evidence of newly developed metastatic lesions. After 2 months, the tumor response was stable disease while improving the performance and other symptoms. Conclusions: This case provides us conjunctive treatment with Conventional and Eastern medicine may have substantial benefit for patients with end-stage ovarian cancer.

• Tuberculosis and Respiratory Diseases
• /
• 제50권1호
• /
• pp.84-93
• /
• 2001

연구배경 : 소세포폐암은 항암화학요법과 방사선 치료의 병행 이외에도 수술적 치료, 골수이식 등 환자의 생존율을 개선시킬 가능성이 있는 새로운 치료법이 소개된 이후 전통적인 소세포폐암 분류를 재평가하고자 하는 노력이 시도되고 있다. 저자등은 국한성병기 소세포폐암의 표준 치료인 항암화학요법과 방사선조사 병용치료시 단일 방사선 조사 범위내에서 효과적으로 방사선 치료를 할 수 있는지에 대한 논란의 여지가 많은 쇄골상관절종 침범과 악성흉막삼출의 예후인자로서의 의의를 조사하고자 하였다. 방법 : 1994년 1월부터 1998년 6월까지 계명대학교 및 경북대학교 의과대학 병원에서 조직학적으로 소세포폐암으로 확진된 252명 중 병기판정과 추적 관찰이 가능한 215예를 대상으로 후향적으로 분석하였다. 결과 : 쇄골상관절종의 경우는 전체환자 대상군과 치료 대상군 모두 림프절 침범 음성군이 양성군보다 전체 생존 기간의 중앙값이 긴 경향을 보였으나 통계적 유의성은 없었다. 악성흉흉막삼출의 경우 전체환자 대상군으로 조사시에는 악성흉막삼출 음성군이 양성군보다 전체생존기간의 중앙값이 유의하게 걸었으나 치료 대상군만으로 한정하여 조사하였을 정우에는 양군간의 통계적 유의성이 관찰되지 않았다. 쇄골상관절종과 악성흉막삼출 모두 원격전이와는 관련성이 없었고 병기와 운동수행능력이 독립적으로 생존기간에 영향을 미치는 유의한 예후인자였다. 결론 : 소세포폐암에서 쇄골상관절종 침범 음성군과 악성흉막삼출 음성군이 양성군보다 생존기간이 긴 경향을 보였으나 치료 유무에 상관없이 전체환자군에서 악성흉막삼출 유무에 따른 생존기간의 차이 이외에는 통계적으로 유의한 생존기간의 차이를 보이지 않아서 쇄골상 관찰종 침범과 악성흉막삼출은 예후인자로서의 역할은 적을 것으로 사료되나 더 많은 환자를 대상으로 추가적조사가 필요하리라 생각된다.

• 대한한방내과학회지
• /
• 제34권4호
• /
• pp.466-477
• /
• 2013

Objectives : To report and demonstrate the effect of decreasing ascites volume by SB intraperitoneal injection to a refractory ascites patient with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis. Methods : Two cycles of intraperitoneal and intravenous SB injection were conducted. Each injection cycle was made up of 4 days. Nine vials of SB were injected to the patient every day. To compare the volume of ascites between pret- and post-treatment, follow-up computed tomography was done on June 3, 2013. To observe other therapeutic effects of SB injection, laboratory tests were conducted periodically. Results : On the follow-up computed tomography images, the amount of ascites and pleural effusion had decreased compared to the April 30, 2013 computed tomography images. The levels of aspartate transaminase, alanine aminotransferase and lactate dehydrogenase decreased significantly from May 9, to May 30, 2013. The amount of oral intake increased constantly during hospitalization. The patient's symptoms such as abdominal distension, abdominal pain and dyspnea were improving until discharge. Conclusions : Even if thiese results cannot be applied to every synchronous colorectal cancer liver metastasis patient, we demonstrated that SB intraperitoneal injection has ascites-decreasing effect to refractory ascites patients with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis.

• Journal of Chest Surgery
• /
• 제55권5호
• /
• pp.405-412
• /
• 2022

Background: Malignant pleural mesothelioma (MPM) is an aggressive pleural malignancy, and despite all multimodal treatment modalities, the 5-year overall survival rate of patients with MPM is less than 20%. In the present study, we aimed to analyze the surgical and prognostic outcomes of patients with MPM who received multimodal treatment. Methods: In this retrospective, single-center study, the records of patients who underwent surgery for MPM between January 2010 and December 2020 at our department were reviewed retrospectively. Results: Sixty-four patients were included in the study, of whom 23 (35.9%) were women and 41 (64.1%) were men. Extrapleural pneumonectomy, pleurectomy/decortication, and extended pleurectomy/decortication procedures were performed in 34.4%, 45.3%, and 20.3% of patients, respectively. The median survival of patients was 21 months, and the 5-year survival rate was 20.2%. Advanced tumor stage (hazard ratio [HR], 1.8; p=0.04), right-sided extrapleural pneumonectomy (HR, 3.1; p=0.02), lymph node metastasis (HR, 1.8; p=0.04), and incomplete multimodal therapy (HR, 1.9; p=0.03) were poor prognostic factors. There was no significant survival difference according to surgical type or histopathological subtype. Conclusion: Multimodal therapy can offer an acceptable survival rate in patients with MPM. Despite its poor reputation in the literature, the survival rate after extrapleural pneumonectomy, especially left-sided, was not as poor as might be expected.