• Title/Summary/Keyword: Pulmonary infiltration

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A Case of Pulmonary Histiocytosis-X Associated with Bilateral, Recurrent, and Spontaneous Pneumothorax (양측성, 재발성 자연기흉을 동반한 폐 조직구증 1예)

  • Hong, Sa-Joon;Ahn, Kang-Hyun;Lee, Won-Yeon;Kong, Sue-Jung;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.152-157
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    • 1994
  • Histiocytosis-X is a tenn used to define three diseases with similar morphologic characteristics : Letterer-Siwe diseae, Hand-Schuller-Christian disease and Eosinophilic granuloma. In general, they differ in terms of their age of onset, severity of clinical course and site of involvement. Eosinophilic granuloma typically is seen in young adults. Eosinophilic granuloma is diagnosed in the presense of diffuse pulmonary infiltrate, bony involvement. However, the pulmonary radiologic findings of eosinophilic granuloma are variable accordinary to stage of disease. therefore pathologic diagnosis of involving site is essential for confirmative diagnosis of eosinophilic grananuloma. Pathologically. the three disease are characterized by granulomatous infiltration of alveolar septa and bronchial walls and often involvement of bone. The hallmark of this disease is proliferation of the Langerhans' cell. The identifying feature is the X-body or Birbeck granule that is present in Langerhans' cells and histiocytic cells found in the lung of EG patient. We report a case of bilatera1, recurrent and spontaneous pneumothoraces in a 21 year old man with pulmonary histiocytosis-X, which is confirmed by eosinophilc granuloma in bone marrow biopsy and ultrastructural examination in cells obtained from BAL.

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A Case of Mycoplasma Pneumonia Presenting with RUL Collapse (우상엽 무기 폐로 발현된 마이코플라즈마 폐렴 1예)

  • Cho, Byung Hyun;Choi, Hye Sook;Cho, Chang Hyun;Kim, Yee Hyung;Choi, Cheon Woong;Park, Myung Jae;Yoo, Jee-Hong;Kang, Hong Mo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.511-514
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    • 2007
  • Mycoplasma pneumoniae is a common pathogen of community-acquired pneumonia. Mycoplasma pneumonia causes upper and lower respiratory tract symptoms in all age groups, with the highest attack rates in subjects 5 to 20 years old. In patients with mycoplasma pneumonia, the most common radiographic findings may be reticulonodular or interstitial infiltration, which have a predilection for the lower lobes. Findings that show lung collapse on a chest X-ray are very rare. We report a case of mycoplasma pneumonia that showed right upper lobe collapse.

A Case of Giant Cell Interstitial Pneumonia (거대세포 간절성 폐렴(Giant Cell Interstitial Pneumonia) 1예)

  • Kang, Kyeong-Woo;Park, Sang-Joon;Suh, Gee-Young;Han, Joung-Ho;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Choi, Jae-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.260-267
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    • 2000
  • Giant cell interstitial pneumonia. a synonym for hard metal pneumoconiosis, is a unique form of pulmonary fibrosis resulting from an exposure to hard metal dust. A case of biopsy-proved giant cell interstitial pneumonia in the absence of appropriate history of exposure to hard metal dust is reported. The patient presented with clinical features of chronic interstitial lung disease or idiopathic pulmonary fibrosis. He worked in a chemical laboratory at a fertilizer plant, where he had been exposed to various chemicals such as benzene and toluene. He denied having any other hobby in his house or job at work, which may have exposed him hard metal dust. High-resolution CT scan revealed multi-lobar distribution of ground glass opacity with peripheral and basal lung predominance. The retrieved fluid of bronchoalveolar lavage contained asbestos fiber and showed neutrotphil predominance. Surgical lung biopsy was performed for a definite diagnosis. Lung specimen showed alveolar infiltration of numerous multinucleated giant cells with mild interstitial fibrosis. Upon detailed examination of the lung tissue, one asbestos body was found. An analysis for mineral contents in lung tissue was performed. Compared with the control specimen, the amount of cobalt and several hard metal components in the lung tissue of this patient was ten times higher. We speculated that the inconsistency between occupational history and the findings of pathologic and mineralogical analyses could be explained by the difference in individual immunologic reactivity to hard metal dust despite the relatively small amount of unrecognized environmental exposure(ED: It's hard to understand what this phrase is trying to say).

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A Case of Primary Extranodal NK/T Cell Lung Lymphoma Presenting as Multiple Patchy Pulmonary Infiltrations (다발성 반점형 폐침윤으로 발현한 원발성 NK/T 세포 폐림프종)

  • Jung, Gum Mo;Kwak, Jin Young;Choi, Hyun Jong;Park, Hyo Suk;Chang, Myoung;Lee, Kwang Min;Kim, Nam Don;Park, Yong Jin;Kim, Kwi Wan
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.636-642
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    • 2003
  • Primary lung lymphoma is an uncommon tumor, which constitutes 0.5% of primary lung cancer, and 3% of extranodal lymphoma. The most frequent radiologic presentation of pulmonary parenchymal lymphoma is single mass or nodule. But we have experienced a case which was radiologically presented as patchy lung infiltration at first, and then progressive multiple reticulonodular infiltrations in lung. A 48-year-old woman was admitted to the hospital because of fever and cough. Chest PA obtained on admission revealed multiple patchy infiltration. Eventually, open lung biopsy was performed and the specimen disclosed extranodal NK/T cell lymphoma, and in bone marrow aspiration, hemophagocytosis was present. We report a case of primary extranodal NK/T cell lung lymphoma presented as patchy lung infiltrations, which was treated with chemotherapy.

Two Cases of Silicone-induced Pulmonary Embolism (Silicon 주사후 발생한 폐색전증 2예)

  • Jung, Bock-Hyun;Suh, Young-Ill;Lee, Jae-Myoung;Song, Sook-Hee;Kim, Ho-Joong;Lee, Myoung-Koo;Hyun, In-Gyu;Jung, Ki-Suck;Shin, Hyung-Sick
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.610-615
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    • 1993
  • Silicone (polydimethylsiloxane) has widely been used in breast augmentation and other cosmetic procedures. Despite the stability of its chemical nature, local and systemic adverse reactions associated with silicone have been reported. There were several patients who suffered from pulmonary embolism associated with injection of silicone. Silicone-induced pneumonitis and sudden death after subcutaneous injection of silicone has been also described. However, there is no case in the literature of clinically diagnosed silicone-induced pulmonary embolism in Korea. We experienced 2 women who developed respiratory symptoms after illicit subcutaneous injection of silicone for the purpose of colporrhaphy. One patient was admitted because of dyspnea, chest pain, hemoptysis and bilateral pulmonary infiltration after repeated injection of silicone. Pulmonary function test initially showed severe restrictive pattern and transbronchial lung biopsy disclosed numerous oil-like material filling the alveolar septal capillaries and macrophages. High resolution C. T., bronchoalveolar lavage, transbronchial lung biopsy and pulmonary angiogram disclosed abnormalities compatible with silicone fluid-induced pulmonary embolism. The other patient expired shortly after arrival in the emergency room. It is suggested that illicit injecion of silicone fluid carries serious respiratory problems and can induce pulmonary embolism followed by acute respiratory failure.

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Chronic Obstructive Pulmonary Disease in a Dressage Horse (마장마술마에서 발생한 만성폐쇄성폐질환 증례)

  • Jeong, Hyo-Hoon;Ahn, Kei-Myung;Kim, A-Ram;Roh, Ha-Jung;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.194-197
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    • 2010
  • A 14-year-old gelded dressage horse weighing 500 kg was presented to the Equine Medical Center of the Seoul Racecourse of Korea Racing Authority (KRA) due to coughing and mucopurulent nasal discharge. The horse was initiated with empirical antibiotic in the first place. However, the clinical signs did not improve but were rather exacerbated even after 3 weeks of therapy. Extensive diagnostic procedures including transtracheal wash (TTW) fluid cytology were undertaken. The localized wheezes and crackles were auscultated and an increase in the amount of mucopurulent exudate in trachea was observed at endoscopy. Infiltration of neutrophils was observed in the TTW fluid cytology implying chronic obstructive pulmonary disease (COPD). Therefore, the systemic glucocorticoid therapy was to be given for 3 weeks with improved ventilation provided at the same time. The respiratory symptoms started to improve in 7 days of therapy and were fully resolved by when the therapy was terminated. The horse is clinically normal now and being monitored for development of any signs of chronic obstructive pulmonary disease.

A Case of Focal Reexpansion Pulmonary Edema after Chest Tube Insertion (흉관 삽관 후 발생한 국소성 재팽창성 폐부종 1예)

  • Chung, Hye Kyoung;Jang, Won Ho;Kim, Yang Ki;Lee, Young Mok;Hwang, Jung Hwa;Kim, Ki-Up;Uh, Soo-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.1
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    • pp.59-62
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    • 2009
  • Reexpansion pulmonary edema is not a common phenomenon after chest tube insertion but some reports from 0% to 14%. There are various resulting complications, including acute respiratory distress syndrome. We report a case of focal reexpansion pulmonary edema after chest tube insertion. A 49-year-old male came to the hospital due to ongoing dyspnea and left chest pain for 3 days. On chest X-ray, the patient had a left pneumothrax. We planned to insert a chest tube for symptom relief. To determine whether or not the chest had expanded as a result of the chest tube insertion, the patient underwent repeated chest X-rays the following day. The patient experienced brief respiratory symptoms upon initial suction; a chest PA showed patchy consolidated infiltration at the inserted site. After 5 days of conservative management, the recovered completely.

Massive pulmonary hemorrhage in enterovirus 71-infected hand, foot, and mouth disease

  • Lee, Dong Seong;Lee, Young Il;Ahn, Jeong Bae;Kim, Mi Jin;Kim, Jae Hyun;Kim, Nam Hee;Hwang, Jong Hee;Kim, Dong Wook;Lee, Chong Guk;Song, Tae Won
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.112-115
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    • 2015
  • Hand, foot, and mouth disease (HFMD) is an acute, mostly self-limiting infection. Patients usually recover without any sequelae. However, a few cases are life threatening, especially those caused by enterovirus 71 (EV71). A 12-month-old boy was admitted to a primary hospital with high fever and vesicular lesions of the mouth, hands, and feet. After 3 days, he experienced 3 seizure episodes and was referred to our hospital. On admission, he was conscious and his chest radiograph was normal. However, 6 hours later, he suddenly lost consciousness and had developed a massive pulmonary hemorrhage that continued until his death. He experienced several more intermittent seizures, and diffuse infiltration of both lung fields was observed on chest radiography. Intravenous immunoglobulin, dexamethasone, cefotaxime, leukocyte-depleted red blood cells, fresh frozen plasma, inotropics, vitamin K, and endotracheal epinephrine were administered. The patient died 9 hours after intubation, within 3 days from fever onset. EV71 subgenotype C4a was isolated retrospectively from serum and nasopharyngeal swab by real-time reverse transcription-polymerase chain reaction. Here, we report a fatal case of EV71-associated HFMD with sudden-onset massive pulmonary hemorrhage and suspected encephalitis.

Deficiency of Sphingosine-1-Phosphate Receptor 2 (S1P2) Attenuates Bleomycin-Induced Pulmonary Fibrosis

  • Park, Soo-Jin;Im, Dong-Soon
    • Biomolecules & Therapeutics
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    • v.27 no.3
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    • pp.318-326
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    • 2019
  • Sphingosine 1-phosphate (S1P) levels are often found to be elevated in serum, bronchoalveolar lavage, and lung tissue of idiopathic pulmonary fibrosis patients and experimental mouse models. Although the roles of sphingosine kinase 1 and S1P receptors have been implicated in fibrosis, the underlying mechanism of fibrosis via Sphingosine 1-phosphate receptor 2 ($S1P_2$) has not been fully investigated. Therefore, in this study, the roles of $S1P_2$ in lung inflammation and fibrosis was investigated by means of a bleomycin-induced lung fibrosis model and lung epithelial cells. Bleomycin was found to induce lung inflammation on day 7 and fibrosis on day 28 of treatment. On the $7^{th}$ day after bleomycin administration, $S1P_2$ deficient mice exhibited significantly less pulmonary inflammation, including cell infiltration and pro-inflammatory cytokine induction, than the wild type mice. On the $28^{th}$ day after bleomycin treatment, severe inflammation and fibrosis were observed in lung tissues from wild type mice, while lung tissues from $S1P_2$ deficient mice showed less inflammation and fibrosis. Increase in TGF-${\beta}1$-induced extracellular matrix accumulation and epithelial-mesenchymal transition were inhibited by JTE-013, a $S1P_2$ antagonist, in A549 lung epithelial cells. Taken together, pro-inflammatory and pro-fibrotic functions of $S1P_2$ were elucidated using a bleomycin-induced fibrosis model. Notably, $S1P_2$ was found to mediate epithelial-mesenchymal transition in fibrotic responses. Therefore, the results of this study indicate that $S1P_2$ could be a promising therapeutic target for the treatment of pulmonary fibrosis.

The Clinical Value about Pulmonary Tuberculosis of Indirect Chest Radiography in Physical Examination for Conscription (징병 신체 검사시 집단 흉부 간접 방사선 촬영의 폐결핵 관련한 진단적 유용성)

  • Park, Sung Bin;Choi, Byeong-Kyoo;Ha, Keun Woo;Seo, Joon Beom
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.356-360
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    • 2005
  • Background : This study examined the clinical utility of using indirect chest radiography during a physical examination of new conscripts for determine the presence of pulmonary tuberculosis. Methods : Over an eight-month period, this study examined 25386 people who underwent a physical examination after conscription. The abnormal findings on mass miniature radiography were followed-up using direct chest radiography. The positive predictive value of mass miniature radiography and direct chest radiography was compared. The incidence, degree of infiltration and clinical outcome of active pulmonary tuberculosis were also evaluated during a follow-up examination. Results : The positive rate of mass miniature radiography was 1.19% (n=302). Various lesions were identified: Parenchymal lesions (n=109), mediastinal lesions (n=6), cardiovascular lesions (n=45), pleural lesions (n=49), bony lesions (n=90) and miscellaneous lesions (n=7). The incidence of active pulmonary tuberculosis by mass miniature radiography was 0.26% (n=67). The first diagnosis was made in 50 people; active pulmonary tuberculosis (n=42), pneumonia (n=1), a mediastinal mass (n=1), a rib fracture (n=2) and a pneumothorax (n=4). Most cases of active pulmonary tuberculosis were mildly infiltrated and either improved or were cured by the follow-up examination. Conclusion : Although mass miniature radiography in a physical examination after conscription has limitations, but it is a useful means for detecting the presence of early disease, particularly in active pulmonary tuberculosis.