• Tuberculosis and Respiratory Diseases
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• v.71 no.5
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• pp.363-367
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• 2011

Lymphoepithelioma-like carcinoma (LELC) of the lung is a very rare tumor. Originally described in the nasopharynx as lymphoepithelioma, this carcinoma has also been found in the stomach, esophagus, thymus, cervix, urinary bladder, skin, and salivary glands. Histologically, it is an undifferentiated carcinoma that has a syncytial appearance with tumor cells and is infiltrated by numerous lymphocytes, macrophages, and plasma cells. LELC of the lung occurs more commonly in Asians, particularly Chinese. Many studies have reported the association between Epstein-Barr virus (EBV) and LELC of the lung in Asian patients. A 45-year-old man had a solitary pulmonary nodule on a routine chest X-ray examination. As a malignant tumor was suspected, surgical resection was performed to establish the correct diagnosis. The pathology of the excised tumor demonstrated LELC of the lung. This is the first report of LELC of the lung in Korea.

• Journal of Chest Surgery
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• v.24 no.12
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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.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.59-62
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• 2023

A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.266-272
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• 1999

Coccidioidomycosis is a fungal infection acquired by inhalation of the arthrospore of Coccidioides immitis, and endemic disease in specific geographic areas, such as south central California, south Arizona. Nevada, and New Mexico. Approximately 60 percent of infected people is asymptomatic and the remainders mostly exhibit respiratory complaints, from flu-like coughing to overt pneumonia. Usually the infection due to Coccidioides immitis is self-limited. Symptoms resolve within several weeks but radiographic abnormalities could be resolved more slowly. If the radiographic abnormalities persist more than 8 weeks, the term' chronic pulmonary coccidioidomycosis' is designated. They take forms of nodules, cavities or progressive pneumonia. When manifested as nodule(s), lung malignancy is suspected as a possible diagnosis and histologic confirmation is needed. Here, we report a case of chronic pulmonary coccidioidomycosis manifested as solitary pulmonary nodule in a Korean woman who has traveled in Arizona, which is diagnosed finally by lobectomy and histologic examination.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.519-526
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• 1996

Background : Clinical and Radiographic studies to differentiate benign from malignant pulmonary nodules have previously focused on clinical status and the morphologic and the computed tomographic attenuation characteristics of the lung nodules. Distinctive differences in the vascularity and pathophysiology of malignant versus benign pulmonary nodules were identified. We evaluated the diagnostic method for differentiating malignant from benign solitary pulmonary nodule by contrast enhancement on the spiral CT. Method : Sixteen patients with solitary pulmonary nodule were examined(Tuberculoma 8, primary lung cancer 8). Serial thin section on the spiral CT was performed before and after(45second, 2min, 5min) the onset of the injection of 100mL of nonionic contrast material(2mL/sec). Results : There was no difference in size of nodule and pre-contrast CT number (Hounsfield unit) between benign and malignant nodules. At forty-five second after the onset of the injection, malignant neoplasms($19.6{\pm}7.9$ HU) enhanced significantly more than tuberculomas($4.9{\pm}9.4$ HU, p=0.008). At 2minute and 5 minute after, malignant neoplasms($34.0{\pm}19.2$HU, $34.0{\pm}15.4$HU) enhanced significantly more than tuberculomas ($6.7{\pm}9.7$HU, p=0.007 and $7.7{\pm}11.5$HU, p=0.011). On cut-off value 20HU(contrast enhancement) 2minute after the injection of contrast media, sensitivity was 87% and specificity was 87%. No correlation between the contrast enhancement and size of the nodules was observed. Conclusion : Studies with the use of an intravenously administered noniodinated contrast medium in examining the enhancement properties of lung nodules was performed. The contrast enhancement was useful in differential diagnosis of solitary pulmonary nodules.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.155-158
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• 2015

Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

• Safety and Health at Work
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• v.12 no.2
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• pp.268-271
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• 2021

Lung granulomas are uncommon in Thailand. The disease typically develops from an occupational environment and is mostly caused by infection. Herein is a case report of a female patient, aged 48, working as a nurse in an Accident and Emergency Department at a hospital. Eighteen years prior to admission the patient was diagnosed with myasthenia gravis and pulmonary tuberculosis. The chest X-ray and CT scans showed a solitary pulmonary nodule in the lower left lung. The patient received an open thoracotomy with a left lobectomy. Granulomatous and nonseptate hyphae were found in the pathology diagnosis. The patient was thus diagnosed as having a lung granuloma. The galactomannan antigen test was positive. The solitary pulmonary nodule-found from the use of a Polymerase Chain Reaction (PCR) test-was an Aspergillus spp. The fungus culture was collected from air samples. The air samples were collected by the impaction technique using a microbial air sampler. Three types of Aspergillus spp. were found as well as Penicillium spp. and Monilia sitophila. The Aspergillus spp. was a match for the patient's disease. The patient was diagnosed as having a lung granuloma possibly Aspergillus nodule which was caused by airborne Aspergillus spp. from the occupational environment.

• Korean Journal of Radiology
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• v.22 no.7
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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.

• Tuberculosis and Respiratory Diseases
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• v.63 no.3
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• pp.268-272
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• 2007

A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.412-415
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• 2021

Primary intrapulmonary thymomas (PITs) are defined as thymomas arising in intrapulmonary locations, without an associated mediastinal component. They are rare lesions, the diagnosis of which can be very difficult. We present a case of PIT in an asymptomatic 74-year-old woman in whom pulmonary nodules were found on pulmonary angiography performed for an episode of pulmonary embolism. She underwent wedge resection and the pathology report revealed a PIT. We also summarize this patient's clinicopathological features and discuss the diagnosis, pathogenesis, and treatment of PIT.