• 제목/요약/키워드: Pulmonary nodules

검색결과 237건 처리시간 0.03초

CT-Guided Microcoil Localization of Small Peripheral Pulmonary Nodules to Direct Video-Assisted Thoracoscopic Resection without the Aid of Intraoperative Fluoroscopy

  • Zhen-guo Huang;Cun-li Wang;Hong-liang Sun;Chuan-dong Li;Bao-xiang Gao;He Chen;Min-xing Yang
    • Korean Journal of Radiology
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    • 제22권7호
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    • pp.1124-1131
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    • 2021
  • Objective: To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). Materials and Methods: Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CT-guided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. Results: All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. Conclusion: CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.

Isolated pulmonary cryptococcosis in an immunocompetent boy

  • Bauer, Siegfried;Kim, Ji-Eun;La, Kyong-Suk;Yoo, Young;Lee, Kee-Hyoung;Park, Sang-Hee;Choung, Ji-Tae;Kim, Chul-Whan
    • Clinical and Experimental Pediatrics
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    • 제53권11호
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    • pp.971-974
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    • 2010
  • Pulmonary cryptococcosis is rare in immunocompetent subjects. Here, we present the case of a 16-year-old boy who was referred to our pediatric department for the management of multiple consolidations detected on chest radiography, which was routinely performed when the patient was being evaluated for an ankle fracture. Fine needle aspiration biopsy was performed, and the definitive diagnosis was established as cryptococcal pneumonia. After 8 weeks of antifungal treatment, the pulmonary nodules on the chest radiographs disappeared.

개에 있어서 유전종야의 페전이 진단 1례 (Mammary Mixed Tumor with Pulmonary Metastasis in a Dog)

  • 황학균;조성환;김명철;장석진;김종만;이영원
    • 한국임상수의학회지
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    • 제17권2호
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    • pp.454-458
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    • 2000
  • A 9-years female Pointer with a 5 cm opened mammary mass in the 4th right mam-mary gland was referred to the Veterinary Teaching Hospital, Chungnam National University. Any abnormal sign was not found in physical examination. But there were leukocytosis, neutrophilia, and monocytosis. Values of RBC, hemoglobin, and hematocrit were low in hematologic examination. Several “cannon-ball” like nodules and pulmonary interstitial pattern were found in the thoracic radiogram. Histopathologically, proliferation of epithelial cells and myoepithelial cells and cartilage tissues were found in the mammary gland mass and infitration of spindle myoepithelial tumor cells was observed in pulmonary nodules. This dog was diagnosed as mammary mixed tumor with Pul- monary metastasis.

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고립성 폐결절의 임상적 고찰 (Clinical Analysis for Solitary Pulmonary Nodule)

  • 허선;안병희;오봉석;김상형;이동준
    • Journal of Chest Surgery
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    • 제24권12호
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    • pp.1185-1191
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    • 1991
  • The clinical and pathological analysis of solitary pulmonary nodules were estimated in 35 patients with nodules who were surgically resected at the Dept. of Thoracic and Cardiovascular Surgery of Chonnam National University Hospital from July 1978 to Aug. 1989. The results were as follows: 1. Mean age of patients was 43.5 years extending from 11 years to fi7 years old and male to female ratio was 6: l. 2. Preoperative symptoms were complained of dull pain in the chest, cough, hemoptysis and general weakness in 69% of patients. 3. The histopathologic findings of surgically resected nodules showed benign nodule in 51% and malignancy 49%. The most frequent diseases were granuloma[67%] in benign nodules and squamous cell carcinoma[76%] in malignancy. In topographical region of nodules in the lung, benign granuloma was more prevalent in upper lobes, while malignancy was slightly more frequent in lower lobes. 4. The incidence of malignancy by age was extremely rare in patients with less than 35 years old, but in greater than 35 years of age, malignancy comprised up to 67% of patients. 5. Complications of thoracotomy were minor bleedings, wound infections and chest pain not to be required any reoperation except one patient died of sudden onset of arrhythmia after pneumonectomy.

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고립성 폐결절에서 양, 악성 감별을 위한 화상적 고찰 (Radiologic Evaluation for Differentiating Benign from Malignant Solitary Pulmonary Nodule)

  • 박재길;사영조;정정임
    • Journal of Chest Surgery
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    • 제36권12호
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    • pp.943-951
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    • 2003
  • 폐 말초에 발생한 고립성 결절의 증례가 점차 늘고 있다. 저자들은 이러한 폐결절에 대하여 방사선학적으로 양, 악성의 감별이 어느 정도 유용한가를 알아보고자 하였다. 대상과 방법: 직경 3cm 이하의 폐 말초에 발생한 고립성 병변증례 134예에 대하여 술전에 시행된 고해상 CT (HRCT)에서 결절 내부의 성상과 경계부 형태, 그리고 주변 폐실질과의 관계에 대하여 관찰하였다. 결과: GGA 면적비가 50% 이상인 경우는 선암과 일부 전이성 폐암 그리고 염증성 병변에서만 관찰되었으며, 90% 이상인 경우는 선암에서만 존재하였다. 반면에 비선암성 폐암과 양성 폐종양, 그리고 결핵종에서는 모두 GGA 면적비가 50% 이하였는데, 특히 10% 미만이 대부분이었다. Air bronchogram, spiculation, lobulation, vascular involvement, 그리고 pleural indentation의 소견들은 주로 악성 병변에서 관찰되었는데, 특히 원발성 선암에서 30% 이상의 고발현도를 보였다. 결론: 대부분의 원발성 폐선암은 HRCT에서 특징적인 소견들을 보이고 있다. 따라서 이러한 소견들에 유의한다면 다른 병변들과의 감별에 많은 도움이 될 것으로 생각되었다.

Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies

  • Noh, Gi Tark;Lee, Kyoung Ju;Sohn, Hee Jung;Lee, Kyung Han;Heo, Won Seok;Koh, Byung Sung;Han, Un Mi;Bae, Young A
    • Journal of Yeungnam Medical Science
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    • 제33권1호
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    • pp.72-75
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    • 2016
  • Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Evolution of Interferon-Gamma Release Assay Results and Submillisievert Chest CT Findings among Close Contacts of Active Pulmonary Tuberculosis Patients

  • Yoon, Soonho;Mihn, Do-CiC;Song, Jin-Wha;Kim, Sung A;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • 제83권4호
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    • pp.283-288
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    • 2020
  • Background: Latent tuberculosis (TB) infection among TB contacts is diagnosed using plain chest radiography and interferon-gamma release assays (IGRAs). However, plain chest radiographs often miss active TB, and the results of IGRA could fluctuate over time. The purpose of this study was to elucidate changes in the results of the serial IGRAs and in the findings of the serial submillisievert chest computed tomography (CT) scans among the close contacts of active pulmonary TB patients. Methods: Patients age 20 or older with active pulmonary TB and their close contacts were invited to participate in this study. Two types of IGRA (QuantiFERON-TB Gold In-Tube assay [QFT-GIT] and the T-SPOT.TB test [T-SPOT]) and submillisievert chest CT scanning were performed at baseline and at 3 and 12 months after enrollment. Results: In total, 19 close contacts participated in this study. One was diagnosed with active pulmonary TB and was excluded from further analysis. At baseline, four of 18 contacts (22.2%) showed positive results for QFT-GIT and T-SPOT; there were no discordant results. During the follow-up, transient and permanent positive or negative conversions and discordant results between the two types of IGRAs were observed in some patients. Among the 17 contacts who underwent submillisievert chest CT scanning, calcified nodules were identified in seven (41.2%), noncalcified nodules in 14 (82.4%), and bronchiectasis in four (23.5%). Some nodules disappeared over time. Conclusion: The results of the QFT-GIT and T-SPOT assays and the CT images may change during 1 year of observation of close contacts of the active TB patients.

세침흡인 세포검사로 진단한 폐의 포상 연부육종 - 1예 보고 - (Alveolar Soft Part Sarcoma of The Lung Diagnosed by Fine Needle Aspiration Cytology - A Case Report -)

  • 김대수;오영륜;고영혜
    • 대한세포병리학회지
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    • 제9권2호
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    • pp.187-191
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    • 1998
  • Alveolar soft part sarcoma(ASPS) is a rare malignant neoplasm with a distinct clinicopathologic entity of which fine needle aspiration(FNA) cytologic findings have been described in only a few reports. Although patients usually present with an isolated soft-tissue mass in the extremity, metastasis can occur in about 13 % of total cases and the most frequent metastatic site is the lung. We have recently experienced a FNA cytologic case of ASPS in the lung. A 23-year-old female patient was admitted to this hospital due to 2-month-history of cough She had been good in health before the visit. Chest computed tomography revealed multiple, variable sized, bilateral pulmonary nodules. Physical examination and other staging work up revealed no other lesions except for pulmonary nodules. A percutaneous transthoracic FNA was performed from the pulmonary nodules. The smear was cellular and most cells were arranged singly. In addition, a few clusters lined by thin-walled vasculature with a pseudoalveolar pattern were present. Some of the tumor cells were large and polygonal lo oval with abundant granular or vacuolated cytoplasm. Most cells were naked nuclei showing finely granular chromatin pattern with prominent central nucleoli.

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Multifocal nodular lymphoid hyperplasia of the lung

  • Lee, Gil Tae;Kim, Eun Kyoung;Cho, Eirie;Lee, Seung-Sook;Kim, Seo Yun;Kim, Cheol Hyeon;Kim, Hye-Ryoun
    • Journal of Yeungnam Medical Science
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    • 제34권1호
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    • pp.84-87
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    • 2017
  • Nodular lymphoid hyperplasia (NLH) is a benign lymphoproliferative disease that can affect the lung. Because of its rarity, little is known about the etiology and natural history of NLH. Most cases are usually asymptomatic and found incidentally on imaging studies. Imaging finding of NLH has shown most commonly as a solitary lesion, although multifocal pulmonary nodules may be seen. Surgical resection has proved curative in the cases previously described. We report a rare case of NLH in a 55 year-old man who presented with bilateral multiple pulmonary nodules on chest radiography. Open biopsy was performed from the upper and lower lobe of the left lung. The lesions were pathologically diagnosed as pulmonary NLH. Multifocal residual nodules in both lungs remain stable without spontaneous regression during the 3 years of follow-up.

Surgical Treatment of Primary Pulmonary Myopericytoma

  • Mun, Jeong Min;Kim, Jong In;Ko, Taek Yong;Park, Sung Dal
    • Journal of Chest Surgery
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    • 제51권3호
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    • pp.220-222
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    • 2018
  • Myopericytoma is a benign tumor that occurs in soft tissues. Myopericytoma in the lungs is very rare. We report the case of a 63-year-old woman presenting with cavitary masses in the left lung and multiple tiny nodules in both lungs. She underwent surgery, and a histological examination revealed primary pulmonary myopericytoma.