• Title/Summary/Keyword: Pulmonary nodules

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Multiple Pulmonary Benign Metastasizing Leiomyoma (다발성 폐 양성 전이성 평활근종)

  • Sa, Young-Jo;Sim, Sung-Bo;Yoon, Hyung-Gue;Yoo, Chang-Young;Moon, Young-Kyu;Park, Jae-Kil;Lee, Sun-Hee
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.777-781
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    • 2008
  • Benign metastasizing leiomyoma is a rare disease that histologically shows features of a benign tumor; however it can metastasize to the lung or other organs. We report here on a case of a 53-year-old Woman with benign metastasizing leiomyoma, and she was admitted to the hospital with symptoms of coughing for 2 months; she showed multiple diffuse nodular opacities of both lungs on a chest radiograph. She had undergone hysterectomy for leiomyoma of the uterus 13 years previously. Thoracoscopic lung biopsy was performed to rule out metastatic lung cancer. The pulmonary nodules appeared benign with a very low mitotic rate and they consisted of smooth muscle cells. The pathologic findings of the pulmonary nodules were consistent with benign metastasizing leiomyoma. The patient has been followed up closely without any specific therapy.

Prediction Models for Solitary Pulmonary Nodules Based on Curvelet Textural Features and Clinical Parameters

  • Wang, Jing-Jing;Wu, Hai-Feng;Sun, Tao;Li, Xia;Wang, Wei;Tao, Li-Xin;Huo, Da;Lv, Ping-Xin;He, Wen;Guo, Xiu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6019-6023
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    • 2013
  • Lung cancer, one of the leading causes of cancer-related deaths, usually appears as solitary pulmonary nodules (SPNs) which are hard to diagnose using the naked eye. In this paper, curvelet-based textural features and clinical parameters are used with three prediction models [a multilevel model, a least absolute shrinkage and selection operator (LASSO) regression method, and a support vector machine (SVM)] to improve the diagnosis of benign and malignant SPNs. Dimensionality reduction of the original curvelet-based textural features was achieved using principal component analysis. In addition, non-conditional logistical regression was used to find clinical predictors among demographic parameters and morphological features. The results showed that, combined with 11 clinical predictors, the accuracy rates using 12 principal components were higher than those using the original curvelet-based textural features. To evaluate the models, 10-fold cross validation and back substitution were applied. The results obtained, respectively, were 0.8549 and 0.9221 for the LASSO method, 0.9443 and 0.9831 for SVM, and 0.8722 and 0.9722 for the multilevel model. All in all, it was found that using curvelet-based textural features after dimensionality reduction and using clinical predictors, the highest accuracy rate was achieved with SVM. The method may be used as an auxiliary tool to differentiate between benign and malignant SPNs in CT images.

Sarcoid-Like Reaction after Complete Remission of Malignancy: CT and 18F-FDG PET/CT Features for the Differential Diagnosis from Lymph Node Metastasis (악성종양의 완전관해 후 발생한 사르코이드증 유사 반응: 림프절 전이와의 감별진단에 유용한 CT와 18F-FDG PET/CT 소견)

  • Hyun Ji Kang;Yookyung Kim;June Young Bae;Jung Hyun Chang;Soo-Hyun Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.903-913
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    • 2021
  • Purpose To identify the imaging features indicative of sarcoid-like reactions in patients with intrathoracic lymphadenopathy after complete remission of malignancies. Materials and Methods This study enrolled five patients with histopathologically confirmed sarcoid-like reactions that developed after cancer remission. The clinical features and findings of CT and 18F-fluorodeoxyglucose (FDG) PET/CT were assessed. Results The underlying malignancies included breast, nasopharyngeal, colon, and endometrial cancer and lymphoma. The time intervals between complete remission of malignancy and the diagnosis of sarcoid-like reaction ranged from 6 to 78 months. CT findings of sarcoid-like reaction included bilateral hilar and mediastinal lymphadenopathies (n = 5), pulmonary nodules (1-15 mm) with peribronchovascular, fissural, or subpleural distribution, and interlobular interstitial thickening in the lungs (n = 4). 18F-FDG PET/CT revealed hypermetabolic uptake in the mediastinal and hilar lymph nodes and both lungs in the absence of extrathoracic uptake (n = 3). The sarcoid-like reactions resolved in all patients after corticosteroid treatment. Conclusion In patients with complete remission of malignancies, newly developed bilateral hilar and mediastinal lymphadenopathies with or without pulmonary nodules of perilymphatic distribution, in the absence of recurrence at the primary tumor site and extrathoracic metastasis, may suggest a sarcoid-like reaction. Such cases warrant histologic evaluation of the lymph nodes to prevent unnecessary systemic chemotherapy.

Diagnostic Efficacy of FDG-PET in Solitary Pulmonary Nodule (고립성폐결절에서 FDG-PET의 진단적 유용성)

  • Kim, Woo-Jin;Yim, Jae-Joon;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1263-1270
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    • 1997
  • Background : Differentiation of malignity and benignity is crucial for management of solitary pulmonary nodule(SPN). Clinical parameters such as patient's age, nodule size, smoking history, doubling time, typical calcification in X-ray and CT findings have been reported as helpful in this purpose. However, in most cases, these parameters are not conclusive. Glucose metabolism is increased in cancer tissues including lung cancer tissues. After uptake of 2-[F-18]-fluoro-2-deoxy-D-glucose(FDG), the glucose analogue, by cancer cell, FDG is trapped in the cell without further metabolism after phosphorylation. Thus, hypermetabolic focus in FDG-positron emission tomography (PET) imaging suggest malignancy. We evaluated the diagnostic efficacy of FDG-PET imaging in distinguishing malignant and benign SPN. Methods : We evaluated 28 patients with SPN from Jan. 1995 to Jan. 1997. CT scan of chest and whole-body FDG-PET imaging were performed in all patients. Histologic diagnosis was confirmed by transthoracic fine needle aspiration and biopsy, bronchoscopic biopsy and open thoracotomy. Results : Of the 28 SPN's, 22 nodules were malignant and 6 nodules were benign. FDG-PET imaging diagnosed all malignant nodules correctly as positive, and diagnosed 4 of 6 benign nodules correctly as negative. One tuberculous granuloma and one aspergilloma showed hypennetabolic focus and were diagnosed falsely positve with FDG-PET imaging. In the diagnosis of SPN with FDG-PET, sensitivity and specificity were 100% and 66.7%, positive predictive value and negative predictive value were 92% and 100%. Conclusion : FDG-PET imaging is highly useful noninvasive diagnostic tool in distinguishing between malignant SPN and benign SPN.

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Three-Dimensional Visualization of Medical Image using Image Segmentation Algorithm based on Deep Learning (딥 러닝 기반의 영상분할 알고리즘을 이용한 의료영상 3차원 시각화에 관한 연구)

  • Lim, SangHeon;Kim, YoungJae;Kim, Kwang Gi
    • Journal of Korea Multimedia Society
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    • v.23 no.3
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    • pp.468-475
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    • 2020
  • In this paper, we proposed a three-dimensional visualization system for medical images in augmented reality based on deep learning. In the proposed system, the artificial neural network model performed fully automatic segmentation of the region of lung and pulmonary nodule from chest CT images. After applying the three-dimensional volume rendering method to the segmented images, it was visualized in augmented reality devices. As a result of the experiment, when nodules were present in the region of lung, it could be easily distinguished with the naked eye. Also, the location and shape of the lesions were intuitively confirmed. The evaluation was accomplished by comparing automated segmentation results of the test dataset to the manual segmented image. Through the evaluation of the segmentation model, we obtained the region of lung DSC (Dice Similarity Coefficient) of 98.77%, precision of 98.45%, recall of 99.10%. And the region of pulmonary nodule DSC of 91.88%, precision of 93.05%, recall of 90.94%. If this proposed system will be applied in medical fields such as medical practice and medical education, it is expected that it can contribute to custom organ modeling, lesion analysis, and surgical education and training of patients.

Chondrosarcoma Apoplexy in Thoracic Spine

  • Kim, Sang Woo;Kim, Min Su;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.46-48
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    • 2013
  • Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

Invasive Pulmonary Aspergillosis in a Whooper Swan (Cygnus c. cygnus) (큰고니에서 발생한 침습성 폐 아스퍼질러스 감염증 1례)

  • Kim, Kyoo-Tae;Cho, Sung-Whan;Son, Hwa-Young;Ryu, Si-Yun
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.472-475
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    • 2006
  • Aspegillosis in free-living birds can be occurred mostly under poor weather and climate. But, captive birds tend to be more susceptible to infection and diagnosis was made usually at post mortem. A two months old Whooper swan(Cygnus c. cygmus) dying suddenly was found in a zoo without prior clinical signs. At necropsy, numerous well- demarcated yellow to white firm nodules were scattered throughout the air sacs and the lungs. Microscopically, granuloma formations were observed in the lung and air sacs. The margin of granuloma was surrounded by connective tissue barrier and was infiltrated with lymphocytes, and also observed giant cell near the granuloma. By Periodic acid Schiff reaction, hyphae were detected in granuloma of lung and air sacs. This case was diagnosed as an invasive pulmonary aspergillosis caused by Aspergillus fumigatus infection in a Whooper swan at a zoo.

Occurrence of canine heartworm disease on three breeding farms in the vicinity of Seoul, Korea (수도권 일대 집단 번식농장 사육견에서의 개심장사상충 감염실태)

  • Seo, Young-woo;Shin, Sung-shik;Kim, Jong-taek
    • Korean Journal of Veterinary Research
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    • v.41 no.1
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    • pp.79-83
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    • 2001
  • Dirofilaria immitis parasitizes mainly in the pulmonary arteries and in the heart of dogs and cats. The parasite is also of public health importance, because it often elicits nodules in the pulmonary parenchyma and in the subcutaneous tissues, or sometimes parasitize itself in the eyes of human. In this study, we investigated the prevalence of heartworm infection among 165 dogs on three breeding farms in the vicinity of Seoul, Korea. Of 165 dogs, 83 dogs (50.3%) were infected with the parasite, as revealed by an antigen-detecting test using the peripheral blood. Of these, 23 dogs (20.2%) contained microfilaria using the peripheral blood, which are potential source of transmission to uninfected animals and to humans in the endemic area. None of infected dogs showed any clinical signs associated with the disease. Since the three farms were located in the vicinity of Seoul, the unexpectedly high infection rate could imply that the possibility of exposure of both animals and humans living in the metropolitan Seoul area to the parasite is higher than in the other area of Korea.

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Humidifier Disinfectant-Associated Lung Injury: Six Years after the Tragic Event

  • Kim, Won-Young;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.351-357
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    • 2017
  • In 2011, a cluster of peripartum patients were admitted to the intensive care unit of a tertiary hospital in Seoul with signs and symptoms of severe respiratory distress of unknown etiology. Subsequent epidemiological and animal studies suggested that humidifier disinfectant (HD) might represent the source of this pathology. Epidemiological studies, animal studies, and dose-response analysis demonstrated a strong association between HD use and lung injuries. The diagnostic criteria for HD-associated lung injury (HDALI) was defined on the basis of the clinical, pathological, and radiological attributes of the patients. The clinical spectrum of HDALI appears to range from asymptomatic to full-blown acute respiratory failure, and some patients have required actual lung transplantation for survival. The overall mortality of the exposed population was not significant, although peripartum patients and children who were admitted to the intensive care unit did show high mortality rates. Persistent clinical findings such as diffuse ill-defined centrilobular nodules and restrictive lung dysfunction were observed in some of the survivors. The findings of this review emphasize the importance of assessment of the level of toxicity of chemical inhalants utilized in a home setting, as well as the need to identify and monitor afflicted individuals after inhalational injury.

Fine Needle Aspiration Cytology of Metastatic Prostatic Adenocarcinoma, Pseudohyperplastic Variant (전이된 가성증식성 전립선 샘암종의 세침흡인 세포소견 -1예 보고-)

  • Kwon, Young-Mee;Park, Won-Seo;Lee, Geon-Kook;Hong, Eun-Kyung
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.183-187
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    • 2008
  • Pseudohyperplastic prostatic adenocarcinoma is a rare histologic variant of prostatic adenocarcinoma that resembles benign nodular hyperplasia. Immunohistochemistry can verify the absence of basal cells, but it is frequently admixed with conventional adenocarcinoma. Because fine needle aspiration cytology is rarely performed in primary prostatic adenocarcinoma, the cytology of the pseudohyperplastic variant has not been described. We experienced a case of metastatic pseudohyperplastic adenocarcinoma in a pulmonary nodule of 75-year-old man. The cytologic smear was mostly composed of large, flat sheets with elongated branching papillae in a clean background. The sheets showed a well-defined honeycomb appearance of tall columnar, regularly arranged monotonous cells with little cytologic atypia. In subsequent prostatic biopsy, pseudohyperplastic variants were identified together with conventional adenocarcinoma of Gleason's grade 3 and 4. The cytologic features of pulmonary nodules were identical to those of pseudohyperplastic components of prostatic adenocarcinoma.