• Title/Summary/Keyword: Pulmonary involvement

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Two Cases of Microscopic Polyangiitis with Honeycomb Lung (봉소상 폐(Honeycomb Lung) 소견을 보인 현미경적 다발성 혈관염 2예)

  • Hahn, Hye-Sook;Hwang, Jun-Kyu;Jung, Hyuk-Sang;Song, Suk-Ho;Joo, Kwon-Wook;Park, Gye-Young;Lee, Jong-Ho;Oh, Young-Ha;Lee, Hyoun-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.550-556
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    • 2002
  • Microscopic polyangiitis is a systemic small-vessel vasculitis that is associated primarily with necrotizing glomerulonephritis and pulmonary capillaritis. A recurrent and diffuse alveolar hemorrhage due to pulmonary capillaritis is the main clinical manifestation of lung involvement. Recently, and interstitial lung disease that mimics idiopathic pulmonary fibrosis was reported to be rarely associated with microscopic polyangiitis. Here we report two patients with microscopic polyangiitis who showed a honeycomb lung at the time of the initial diagnosis with a brief review of relevant literature.

Single Nodular Pulmonary Amyloidosis: Case Report

  • Lee, Seung Hyun;Ko, Young Chun;Jeong, Jong Pil;Park, Chan Woo;Seo, Seok Ho;Kim, Jong Taek;Park, Dae Won;Bak, Cheol Min;Moon, Seung Ki;Jo, Shin Hyoung;Kim, Se Mi;Jung, Ah Lon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.4
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    • pp.385-389
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    • 2015
  • Amyloidosis is defined as the presence of extra-cellular deposits of an insoluble fibrillar protein, amyloid. The pulmonary involvement of amyloidosis is usually classified as tracheobronchial, parenchymal nodular, or diffuse alveolar septal. A single nodular lesion can mimic various conditions, including malignancy, pulmonary tuberculosis, and fungal infection. To date, only one case of nodular pulmonary amyloidosis has been reported in Korea, a case involving multiple nodular lesions. Here, we report and discuss the case of a patient having single nodular amyloidosis.

A Case of Pulmonary Hemorhage Associated with Henoch-Schönlein Purpura

  • Sim, Yun Su;Choi, Moon Young;Oh, Ji Young;Lee, Jin Hwa;Moon, Jin Wook;Choi, Kyu Bock;Ahn, Jae Ho;Kim, Yoo Kyung;Sung, Sun Hee;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.226-228
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    • 2009
  • Henoch-$Sch\ddot{o}nlein$ purpura (HSP) is an immunologically mediated systemic vasculitis of small blood vessels that primarily involves the skin, gastrointestinal tract, joints and kidneys. HSP is a common vasculitic syndrome in children who, in most cases, achieve complete recovery. Pulmonary hemorrhage is a very rare manifestation of HSP. The authors present a case of a 46-year-old male presenting with pulmonary hemorrhage and renal involvement and the diagnosis of HSP. The patient responded to prednisolone therapy.

A Pulmonary Sarcoidosis Manifesting as a Rare Atypical Pattern and Distribution (드문 비전형적인 형태와 분포를 보인 폐 유육종증 1예)

  • Hong, Sun-Hwa;Kang, Eun-Young;Woo, Ok Hee;Yong, Hwan Seok;Oh, Yu-Whan;Shin, Bong Kyung;Shim, Jae Jeong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.3
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    • pp.236-239
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    • 2008
  • A unique case of atypical pulmonary sarcoidosis in a 62-year-old man complaining of dyspnea is presented. Chest CT scan showed an unusual pattern and distribution of pulmonary sarcoidosis manifesting mainly as reticular densities, interlobular septal thickening, and ground-glass opacities, in the subpleural and lower lung predominancy. However, a surgical lung biopsy revealed classical findings of sarcoidosis. Knowledge of this atypical pulmonary involvement may improve understanding sarcoidosis as the great masquerader.

Total ginsenosides suppress monocrotaline-induced pulmonary hypertension in rats: involvement of nitric oxide and mitogen-activated protein kinase pathways

  • Qin, Na;Yang, Wei;Feng, Dongxu;Wang, Xinwen;Qi, Muyao;Du, Tianxin;Sun, Hongzhi;Wu, Shufang
    • Journal of Ginseng Research
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    • v.40 no.3
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    • pp.285-291
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    • 2016
  • Background: Ginsenosides have been shown to exert beneficial pharmacological effects on the central nervous, cardiovascular, and endocrine systems. We sought to determine whether total ginsenosides (TG) inhibit monocrotaline (MCT)-induced pulmonary hypertension and to elucidate the underlying mechanism. Methods: MCT-intoxicated rats were treated with gradient doses of TG, with or without $N^G$-nitro-$\small{L}$-arginine methyl ester. The levels of molecules involving the regulation of nitric oxide and mitogen-activated protein kinase pathways were determined. Results: TG ameliorated MCT-induced pulmonary hypertension in a dose-dependent manner, as assessed by the right ventricular systolic pressure, the right ventricular hypertrophy index, and pulmonary arterial remodeling. Furthermore, TG increased the levels of pulmonary nitric oxide, endothelial nitric oxide synthase, and cyclic guanosine monophosphate. Lastly, TG increased mitogen-activated protein kinase phosphatase-1 expression and promoted the dephosphorylation of extracellular signal-regulated protein kinases 1/2, p38 mitogen-activated protein kinase, and c-Jun NH2-terminal kinase 1/2. Conclusion: TG attenuates MCT-induced pulmonary hypertension, which may involve in part the regulation of nitric oxide and mitogen-activated protein kinase pathways.

Clinical Features of Dermatomyositis/Polymyositis(DM/PM) with Lung Involvement (폐를 침범한 피부근염/다발성근염의 임상적 양상)

  • Park, Gun-Min;Choi, Chang-Min;Um, Sang-Won;Hwang, Yong-Il;Yim, Jae-Joon;Lee, Jae-Ho;Yoo, Chul-Gyu;Lee, Choon-Taek;Chung, Hee-Soon;Song, Young-Wook;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.354-363
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    • 2001
  • Background : Although lung involvement has been reported in 5 to 46% of dermatomyositis/polymyositis(DM/PM) patients, reports of the condition in Korea are rare. This study evaluated the clinical features of lung involvement in DM/PM patients. Methods : The medical records, laboratory results and radiologic findings of 79 DM/pM patients, who attended the Seoul National University Hospital (SNUH) between 1989 and 1999, were reviewed retrospectively. Results : A total 79 patients of whom 24 patients(33%) showed lung involvement, were enrolled in this study. More patients with lung involvement were female(F:M=11:1), and older compared with those without lung involvement. Patients with lung involvement presented with dyspnea(79%), coughing(67%), an elevated ESR, and CK/LD. Anti-Jo 1 antibody test was positive in 30%, which is significantly higher in patients with lung involvement. A simple chest X-ray of the patients with lung involvement exhibited reticular opacity(50%), reticulonodular opacity(30%), patchy opacity(29%), nodular opacity(13%) and linear opacity(4%). HRCT(n=24) showed ground glass opacity(75%), linear or septal thickening(50%), patchy consolidation(42%), honey-combing(33%) and nodular opacity(17%). The pulmonary function test showed a restrictive ventilatory pattern(77%) and a lower diffusing capacity(62%). The patients were followed up during a mean duration of $30{\pm}28$ months. They were treated with steroid only(50%) or a combination of steroids and cytotoxic agents(46%). Muscle symptoms were improved in 89% with treatment, but an improvement in the respiratory symptoms or in the pulmonary function test was rare. Patients with lung involvement had a higher mortality rate(21%) than those without lung involvement(10%) during the follow-up periods. Conclusion : DM/PM patients with lung involvement were mostly female, older and had a higher positive rate Anti-Jo 1 antibodies, but there was no significant difference in prognosis.

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Malignant mesothelioma mistaken for tuberculous pleurisy (결핵성 흉막염으로 오인된 악성중피종)

  • Yang, Ji-Young;Song, Min-Joo;Park, So-Jung;Cheon, Jaekyung;Yoo, Jung-Wan;Choi, Chang-Min;Kim, Yong Hee
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.50-54
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    • 2015
  • Malignant mesothelioma is a common, primary tumor that can invade pleura, and is associated with previous exposure to asbestos. However, it poses considerable difficulties regarding its diagnosis and treatment, and thus, accurate history taking with respect to exposure to asbestos, and radiologic and pathologic examinations are essential. In addition, the involvement of a multidisciplinary team is recommended in order to ensure prompt and appropriate management using a framework based on radiotherapy, chemotherapy, surgery, and symptom palliation with end-of-life care. Because lymphocyte-dominant, exudative pleural effusion can occur in malignant mesothelioma, adenosine deaminase values may be elevated, which could be mistaken for tuberculous pleurisy, and lead to an incorrect diagnosis and suboptimal treatment. The authors describe a case of malignant mesothelioma initially misdiagnosed as tuberculous pleurisy. As evidenced by the described case, malignant mesothelioma should be considered during the differential diagnosis of patients with lymphocyte-dominant, exudative pleural effusion with a pleural lung lesion.

Clinical Characteristics and Prognostic Factors of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴의 임상상 및 예후 예측인자에 관한 연구)

  • Oh, Heung-Kook;Seo, Ji-Young;Kim, Dong-Kyu;Choi, Jeong-Eun;Mo, Eun-Kyung;Park, Myung-Jae;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1072-1082
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    • 1997
  • Background : To characterize the clinical features and determine the prognostic factors of severe community-acquired pneumonia. This study is the first of its kind in Korea. Methods : Recruited were 40 patients diagnosed as severe community-acquired pneumonia in Hallym University Hospital from January 1, 1989 through July 31, 1996. Patients were analysed retrospectively for age, sex, underlying disease, respiration rate, hypoxemia, requirement of mechanical ventilation, involvement on chest radiograph, shock, and the serum concentration of BUN and albumin. All parameters were compared between survived and dead group. Results : Male to female ratio was 2.07 : 1. The mean age was $63.1{\pm}17.5$years(range 25~90years) with 65% of patients aged equal to or more than 60. The major underlying diseases were old pulmonary tuberculosis(12.5%), chronic obstructive pulmonary disease(7.5%), bronchial asthma(5%), bronchiectasis(2.5%), and diabetes mellitus(22.5%). Microbiologic diagnosis was made in 26 out of 40 patients(65%). The most common causative organism was S. pneumoniae(17.5%, 7/40) followed by S. aureus(15.0%, 6/40), K. Pneumoniae(12.5%, 5/40), M. tuberculosis(7.5%, 3/40), H. influenzae(2.5%, 1/40), coagulase negative staphylococcus(2.5%, 1/40), P. aeruginosa(2.5%. 1/40), E. cloaceae(2.5%, 1/40), and E. coli(2.5%, 1/40). M. pneumoniae was detected in no patient. The most frequent drugs administered in single or combination therapy were aminoglycosides(75%, 30/40), second- and third-generation cephalosporin(40%, 16/40 and 27.5%, 11/40), macrolides(27.5%, 11/40), and amoxicillin/clavulanic acid(22.5%, 9/40). Of the 40 patients, 14 died of severe community-acquired pneumonia(37.5%). Among them, seven patients (50%) expired within 72h of hospital arrival. According to multivariate analysis, mortality was significantly associated with requirement of mechanical ventilation, bilateral pulmonary involvement, and serum albumins$\leq$3.0g/dl. Conclusion : An understanding of the clinical characteristics and prognostic factors in severe community-acquired pneumonia identified in this study will optimize therapeutic approach in this disease and help decreasing its notorious mortality rate.

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A Case of the Wegener's Granulomatosis (Wegener씨 육아종)

  • 조정욱;황명순;윤치훈;이상도;김선우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.13.4-13
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    • 1981
  • The Wegener's granulomatosis is a rare disease of unknown etiology characterized by ulcerative, necrotic lesion of the upper respiratory tract, progressive pulmonary and renal involvement, and death in a period six months. Relentless progression with rapid death resulting from renal involvement and failure is the usual outcome, but limited forms with confinement to the upper respiratory tract are seen. The authors, recently, have observed a case of Wegener's granulomatosis which was confirmed as pathologically, so present this case with a brief review of the literature.

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Difference in F-18 FDG Uptake According to the Patterns of CT-Based Diagnosed Pulmonary Lymphangitic Carcinomatosis in Patients with Lung Cancer (폐암환자에 있어 CT상으로 진단된 폐림프관성암종증의 형태에 따른 F-18 FDG 섭취의 차이)

  • Jun, Sung-Min;Kim, Yong-Ki;Kim, In-Ju;Kim, Seong-Jang;Nam, Hyun-Yeol;Kim, Bum-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.292-300
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    • 2008
  • Purpose: Our purpose was to evaluate F-18 FDG uptake in pulmonary lymphangitic carcinomatosis (PLC) according to CT findings and histology of lung cancer. Materials and Methods: Thirty-three lung cancer patients with PLC were enrolled in this retrospective study. All the patients had a CT-based diagnosis of PLC. Chest CT findings of PLC were classified on the basis of involvement of axial interstitium. We categorized the involvement of axial interstitium as group 1, and the involvement of peripheral interstitium only as group 2. Visual and semiquantitative analyses by F-18 FDG PET/CT were performed in the PLC lesions. At first, we analyzed the F-18 FDG uptake in the PLC by visual assessment. If abnormal uptake was seen in the PLC, we drew regions of interest in the PLC lesions to obtain the maximum SUVs (maxSUVs). Results: Of the 33 patients, 22 had abnormal F-18 FDG uptake in the visual assessment. There was no significant difference in the frequency of abnormal F-18 FDG uptake between group 1 and group 2 (p=0.17), although the frequency of group 1 tended to be higher than group 2 (15/19 (78.9%) in group 1, 7/14 (50.0%) in group 2). However, group 1 had a higher maxSUV than group 2 (p<0.01, group 1: $2.9{\pm}1.4$, group 2: $1.5{\pm}0.6$). There was no significant difference in the frequency of abnormal F-18 FDG uptake and maxSUV among the histology of the lung cancers. Conclusion: The involvement of axial interstitium in the PLC by lung cancer has a higher maxSUV than the involvement of only peripheral interstitium.