• Journal of Chest Surgery
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• 제37권11호
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• pp.937-941
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• 2004

상피모양혈관내피종은 혈관에서 기인하는 매우 희귀하고 악성도가 낮은 종양이다. 폐에 발생하는 상피모양혈관내피종은 세계적으로 약 50예가 보고되어 있다. 폐 상피모양혈관내피종은 여자에서 더 많이 발생하며 흔히 양측폐야에 다발성 결절들이 관찰된다. 3개월 가량의 우측 흉막통을 주소로 내원한 41세 남자가 굴곡기관지경생검에서 샘암종으로 보고되었고 당시 TNM병기는 IIIa였다. 추적관찰기간 중 다시 기관지경생검을 시행하였고 과오종으로 보고되었다. 수술 후 조직병리검사에서 폐 상피모양혈관내피종으로 최종 진단되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5899-5902
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• 2015

Background: To compare the current histologic distribution of lung cancer in Lebanon to the worldwide trends, according to the 2004 WHO Classification. Materials and Methods: 1,760 patients with a pulmonary pathology examination at Hotel-Dieu de France University Hospital between July 2009 and July 2014 were included. Results: Some 676 out of the total investigated patients (38.4%) had a lung tumor. In 665 (98.4%) the tumors were malignant, with a mean age at diagnosis of 63.8 years and a male/female (M/F) sex ratio of 1.7:1. Among the malignant tumors, 86.2% were epithelial tumors with a mean age at diagnosis of 64.8 years and an M/F sex ratio of 1.9. Other malignant tumors consisted of metastatic tumors (10.2%), lymphoproliferative tumors (2.1%) and mesenchymal tumors (1.5%). Most common carcinoma subtypes were adenocarcinoma (48.0%), squamous cell carcinoma (23.0%) and small cell carcinoma (13.3%). Carcinoid tumors were the only carcinoma subtype with an M/F sex ratio below 1 (0.7). Salivary gland tumors were the carcinoma with lowest mean age at diagnosis (45.5 years). Conclusions: The histologic distribution of lung tumors in Lebanon is similar to that in developed countries. We believe this resemblance is due to common smoking habits, known to be responsible for the increase of lung adenocarcinoma at the expense of other subtypes.

• Tuberculosis and Respiratory Diseases
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• 제63권1호
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• pp.83-87
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• 2007

원발폐암과 특발성폐섬유화증(idiopathic pulmonary fibrosis)이 병발하는 경우는 비교적 흔하여, 폐암의 발생률이 일반 인구보다 특발성폐섬유화증 환자에서 더 높다고 알려져 있으나, 비특이적간질성폐렴(non-specific interstitial pneumonia)이 원발폐암과 병발한 경우는 매우 드물다. 이에 저자 등은 최근에 우연히 발견된 원발폐암과 병발한 비특이적간질성폐렴 환자에서 원발폐암의 치료 후에 비특이적간질성폐렴이 저절로 호전된 예를 경험하였기에 보고하는 바이다.

• 대한수의학회지
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• 제44권4호
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• pp.621-624
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• 2004

A 13-year-old female Miniature Pincher was euthanized after suffering from respiratory insufficiency and seizure. At necropsy, firm tan masses approsimately 4 to 5 cm in diameter were noted at the right caudal love and left cranial lobe of the lung. On cross sections of the cerebellum and the verebrum, several compressive firm round masses, 0.5 to 1 cm in diameter, were noted. similar looking nodules were also present in the mediastinal lymph nodes. Histopathologically, the neoplastic masses consisted of cuboidal shape epithelial cells that form glandular structure. The neoplastic cells have hyperchromatic nuclei with prominent nucleoli and moderate amount of cytoplasm. The degree of mitosis was high (4-6/400X). Multiple areas of necrosis, hemorrhage, and tumor emboli were also noted. Metastasis to the mediastinal lymph nodes, pancreas, and brain was confirmed. Based on the gross and histopathologic examinations, a diagnosis of primary metastatic pulmonary adenocarcinoma was made. Clinicaly recognized neurological signs were therefore due to brain metastasis.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1044-1047
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• 1997

폐모세포종은 매우 드문 원발성 폐 종양으로 종괴를 구성하는 선상구조나 간엽조직 성분이 미분화된 태생기때 조직으로 구성되어 있는 종양으로 주로 성인 및 소아에서 발생한다. 본교실에서는 단순 흉부 사진에서 우측폐 하엽에 약 5Cm크기의 이상음영을 보이는 31세 남자에 발생한 폐모세포종 1례를 경험하고 이를 보고하고자한다. 수술전 임상 진단은 원발성 페종양으로 생각되었다. 수술 소견상 직경 6$\times$5$\times$4cm 크기의 단단하고 등근 종괴가 우측폐중엽에 국한되어 있었으며 부분적으로 폐상엽, 심막과 횡격막에 부착되었다. 우측 폐중됩 절제술 및 폐상엽 부분절제와 광범위한 임파절 절제를 동반하여 부분적으로 심막과 횡격막을 절제하였다. 병리조직학적으로 이상성 폐모세포종으로 진단되었다. 이상성 폐모세포종의 예후는 분화가 좋은 태아 선암종에 비해 나쁘며 외과적 절제술 이외에 특별한 치료는 없다. 폐모세포종의 임상적 경과 및 예후와 상세한 분류를 위해서는 가능한한 많은 증례를 수집할 필요가 있다고 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.149-155
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• 1995

연구목적: Cytokeratin 19는 기관지의 상피세포와 같은 단순 또는 가중층상피세포에 국한된 40KD의 산성 분자로 면역조직학적 검사를 통해 cytokeratin 19가 폐암 조직에서 많이 발현되는 것으로 알려져 있다. Cytokeratin 19에 특징적인 단일 클론 항체 BM 19-21과 KS 19-1을 이용한 면역방사계수법, CYFRA 21-1을 이용하여 cytokeratin 19분절이 폐암 특히 편평상피세포암의 진단에 유용한 표지자가 될 수 있다는 보고가 있어 폐암 표지자로서 CYFRA 21-1의 유용성을 조사해 보기 위하여 본 연구를 하였다. 방법: 저자 등은 영남대학교 의과대학 부속병원 내과에 1993년 4월부터 1994년 8월까지 입원한 원발성 폐암 환자 39명(편평상피 세포암 19명, 선암 11명, 소세포암 9명)을 폐암군으로, 비악성 호흡기질환자 15명(폐결핵 8명, 만성 폐색성 폐질환 3명, 폐렴 2명, 만성 폐색성 폐질환과 폐결핵이 동반된 환자 2명)을 대조군으로 하여 새로운 폐암 표지자의 가능성이 있는 CYFRA 21-1의 유용성을 조사하였다. CYFRA 21-1의 측정은 면역방사계수측정 kit인 ELSA-CYFRA 21-1을 사용하였다. 결과: 폐암의 조직학적 분류에 따른 CYFRA 21-1의 혈중 측정치는 편평상피세포암이 $20.2{\pm}4.7ng/ml$, 선암이 $7.2{\pm}1.6ng/ml$, 비소세포암이 $15.5{\pm}4.7ng/ml$로 모두 대조군의 $1.7{\pm}0.5ng/ml$보다 유의하게 증가되어 있었다(p<0.01). 또한 비소세포암중 편평상피세포암에서 선암보다 유의하게 증가되어 있었다(p<0.05). 그러나 소세포암에서는 $2.9{\pm}0.9ng/ml$로 대조군과 유의한 차이가 없었다. CYFRA 21-1의 정상 범위를 3.3ng/ml 이내로 하였을때 소세포암에서는 민감도 11.1%, 특이도 65.2% 였으나, 비소세포암에서는 민감도 70.0%, 특이도 62.5%였고 이 중 편평상피 세포암인 경우 민감도 73.7%, 특이도 75%였으며 선암인 경우 63.6%, 78.9%로 산출되었다. 결론: CYFRA 21-1은 비소세포암의 종양 표지자로 유용성이 있을 것으로 생각되며, 특히 편평상피 세포암의 진단에 도움이 될 것으로 생각되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4629-4635
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• 2014

Background: Diffusion-weighted imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. However, it is uncertain whether DWI has advantages over FDG-PET for distinguishing malignant from benign pulmonary nodules and masses. Materials and Methods: One hundred-forty-three lung cancers, 17 metastatic lung tumors, and 29 benign pulmonary nodules and masses were assessed in this study. DWI and FDG-PET were performed. Results: The apparent diffusion coefficient (ADC) value ($1.27{\pm}0.35{\times}10^{-3}mm^2/sec$) of malignant pulmonary nodules and masses was significantly lower than that ($1.66{\pm}0.58{\times}10^{-3}mm^2/sec$) of benign pulmonary nodules and masses. The maximum standardized uptake value (SUVmax: $7.47{\pm}6.10$) of malignant pulmonary nodules and masses were also significantly higher than that ($3.89{\pm}4.04$) of benign nodules and masses. By using optimal cutoff values for ADC ($1.44{\times}10^{-3}mm^2/sec$) and for SUVmax (3.43), which were determined with receiver operating characteristics curves (ROC curves), the sensitivity (80.0%) of DWI was significantly higher than that (70.0%) of FDG-PET. The specificity (65.5%) of DWI was equal to that (65.5%) of FDG-PET. The accuracy (77.8%) of DWI was not significantly higher than that (69.3%) of FDG-PET for pulmonary nodules and masses. As the percentage of bronchioloalveolar carcinoma (BAC) component in adenocarcinoma increased, the sensitivity of FDG-PET decreased. DWI could not help in the diagnosis of mucinous adenocarcinomas as malignant, and FDG-PET could help in the correct diagnosis of 5 out of 6 mucinous adenocarcinomas as malignant. Conclusions: DWI has higher potential than PET in assessing pulmonary nodules and masses. Both diagnostic approaches have their specific strengths and weaknesses which are determined by the underlying pathology of pulmonary nodules and masses.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.182-186
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• 2012

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.

• Tuberculosis and Respiratory Diseases
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• 제46권2호
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• pp.281-284
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• 1999

The lung is one of the most frequent sites of metastasis for extrathoracic tumors. Certain malignancies show a particular tendency to metastasize to lung, and in 15 to 25% of these cases, lung involvement is the only manifestation of metastatic disease. The most common presentation is the form of multiple bilateral nodules or masses of varying sizes. Lymphangitic metastasis is comprising 6 to 8% of all pulmonary metastasis. A striking variant of parenchymal involvement occures when dyscohesive tumor cells fill alveoli to produce a tumoral pneumonia. Carcinomatous lymphangitis of prostate origin is infrequent and usually carries a poor prognosis, and tumoral pneumonia of it is extremely rare. We report herein a case of prostate carcinoma metastasizing to lung, simulates atypical pneumonia, and disclosed by acute chest illness.

• Asian Pacific Journal of Cancer Prevention
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• 제15권16호
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• pp.6799-6804
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• 2014

Background: Chemotherapy is the mainstay of treatment for the majority of patients with advanced non-small cell lung cancer (NSCLC) without driver mutations and many receive therapies beyond first-line. Second-line chemotherapy has been disappointing both in terms of response rate and survival and we know relatively little about the prognostic factors. Materials and Methods: One thousand and eight patients with advanced NSCLC who received second-line chemotherapy after progression were reviewed in Shanghai Pulmonary Hospital, China, from September 2005 to July 2010. We analyzed the effects of potential prognostic factors on the outcomes of second-line chemotherapy (overall response rate, ORR; progression free survival, PFS; overall survival, OS). Results: The response and progression free survival of first-line chemotherapy affects the ORR, PFS and OS of second-line chemotherapy (ORR: CR/PR 15.4%, SD 10.1%, PD2.3%, p<0.001; PFS: CR/PR 3.80 months, SD 2.77 months, PD 2.03 months, p<0.001; OS: CR/PR 11.60 months, SD 10.33 months, PD 6.57 months, p=0.578, p<0.001, p<0.001, respectively). On multivariate analysis, better response to first-line therapy (CR/PR: HR=0.751, p=0.002; SD: HR=0.781, p=0.021) and progression within 3-6 months (HR=0.626, p<0.001), together with adenocarcinoma (HR=0.815, p=0.017), without liver metastasis (HR=0.541, p=0.001), never-smoker (HR=0.772, p=0.001), and ECOG PS 0-1 (HR=0.745, p=0.021) were predictors for good OS following second-line chemotherapy. Conclusions: Patients who responded to first-line chemotherapy had a better outcome after second-line therapy for advanced NSCLC, and the efficacy of first-line chemotherapy, period of progression, histology, liver metastasis, smoking status and ECOG PS were independent prognostic factors for OS.