• Journal of Chest Surgery
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• v.53 no.3
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• pp.114-120
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• 2020

Background: Evidence is lacking on whether the resection of lung parenchymal cancer improves the survival of patients with unexpected pleural metastasis encountered during surgery. We conducted a single-center retrospective study to determine the role of lung resection in the long-term survival of these patients. Methods: Among 4683 patients who underwent lung surgery between 1995 and 2014, 132 (2.8%) had pleural metastasis. After excluding 2 patients who had incomplete medical records, 130 patients' data were collected. Only a diagnostic pleural and/or lung biopsy was performed in 90 patients, while the lung parenchymal mass was resected in 40 patients. Results: The mean follow-up duration was 29.8 months. The 5-year survival rate of the resection group (34.7%±9.4%) was superior to that of the biopsy group (15.9%±4.3%, p=0.016). Multivariate Cox regression analysis demonstrated that primary tumor resection (p=0.041), systemic treatment (p<0.001), lower clinical N stage (p=0.018), and adenocarcinoma histology (p=0.009) were significant predictors of a favorable outcome. Interestingly, primary tumor resection only played a significant prognostic role in patients who received systemic treatment. Conclusion: When pleural metastasis is unexpectedly encountered during surgical exploration, resection in conjunction with systemic treatment may improve long-term survival, especially in adenocarcinoma patients without lymph node metastasis.

• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.262-266
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• 2011

A 4-year-old intact male, Maltese dog weighing 2.2 kg was presented for evaluation of tachypnea and hyperthermia. On initial evaluation, the dog was dyspneic, but alert and responsive. Muffled heart sound was noted with auscultation of the right hemithorax. The radiographic findings were consolidation of the right middle lung lobe, pleural effusion, and abdominal fluid accumulation. Thoracic computed tomography confirmed a contrast-enhancing mass within the right middle lung lobe. Surgical exploration of the thoracic cavity was performed using a right fifth intercostal thoracotomy. Examination of the right lung lobe revealed $360^{\circ}C$ torsion of the right middle lung lobe at the level of the hilus, in a clockwise direction. Lung lobectomy was performed using a thoracoabdominal stapling device with 2.5-mm vascular staples. Full-thickness intestinal biopsy by exploratory laparotomy was taken from the jejunum for histological assessment. Histopathologic examination of the full-thickness intestinal biopsy revealed distended lacteal located within the submucosa of the jejunum. Intestinal lymphangiectasia was resolved with prednisone and low fat diets. Subsequent communication with the owner revealed that the patient was in good health 6 months post-discharge.

• Tuberculosis and Respiratory Diseases
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• v.69 no.4
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• pp.284-287
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• 2010

We report the case of a 68-year-old man with a stromal tumor of uncertain malignant potential (STUMP), which had metastasized to the lung. The patient complained of an enlarged mass in the anterior chest. Chest computed tomography (CT) showed a sternal abscess with multiple nodules in both lungs. A thoracoscopic lung biopsy of the nodules and incision/drainage of the sternal mass were performed simultaneously. CT of the pelvis revealed an enlarged prostate with irregular cystic lesions in the pelvis. Prostate biopsy was done and demonstrated hypercellular stroma with minimal cytological atypia, a distinct pattern of STUMP. The sternal abscess proved to be tuberculosis and the lung lesion was consistent with STUMP, which had spread from the prostate. However, to our knowledge, the tuberculous abscess might not be assoicated with STUMP in the lung. The patient refused surgical prostatectomy and was discharged with anti-tuberculosis medication. On one-year follow up, the patient had no evidence of disease progression.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.333-337
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• 2021

The clinical significance of ground-glass nodules (GGNs) has been investigated in extensive clinical research for many years. The natural history of GGNs is known to be closely related to their size, proportion of solid components, and size progression over time. Based on these data, several guidelines for GGN management have been published worldwide. The indications for nonsurgical biopsy or surgical resection of GGNs are as follows: pure GGNs between 5 and 10 mm in size if they increase in size or show development of a solid component at follow-up, pure GGNs >10-15mm that remain stable but persistent, part-solid nodules >8 mm persisting at follow-up, or part-solid nodules with a solid component >6 mm at follow-up. Newly updated data considering geographical or racial factors and recent developments in surgical techniques may improve the surgical indications for GGNs in the near future.

• Journal of Chest Surgery
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• v.18 no.1
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• pp.86-91
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• 1985

A clinical analysis was performed on 11 cases of metastatic lung cancer experienced at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during the 15 year period from 1970 to 1984. Of the 1lpatients of metastatic lung cancer, 4 patients were male and 7 patients were female and the age ranged from 27 years to 60 years old with the average of 38.8 years old. The sites of primary tumor were uterus and ovary in 5 patients, breast in 2, sarcoma in 2, rectum in 1 and testis in l.\ulcorner Tumor free intervals in each patients were as followed; unrecognition of primary site in 2 patients, simultaneous discovery of primary tumor and metastasis in 3, 14 months in 1, 4 years in 4 and 5 years in Twelve thoracotomies were performed in 11 patients and performed procedures were as followed; pneumonectomy in 1 patient, lobectomy in 7, wedge resection in 2, decortication and wedge resection in 1 and biopsy only in 1. Of the 11 patients, 4 patients died within one year after operation, 2 patients died within 2 years and 2 patients are alive over 5 years after operations. Other 3 patients are alive 2 months, 4 months and 9 months after operation at present.

• Journal of Chest Surgery
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• v.23 no.6
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• pp.1225-1232
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• 1990

From March 1986 to June 1990, the percutaneous Fine Needle Aspiration Biopsy[FNAB] of 102 thoracic lesions were performed with Westcott needle [slotted 20G or 22G thin needle], for the purpose of identifying and diagnosing thoracic lesions. There were 94 lung lesions [67 malignant tumors, 27 benign lesions] and 8 mediastinal and chest wall lesions. The results of FNAB were compared with sputum cytology and bronchoscopic examinations. The sputum cytologic examinations were performed in 54 cases of malignant lung tumor and the malignant cell was found at the 18 cases [33%]. We bronchoscopic examinations were performed in 24 cases and the malignant cell was found at the 12 cases [55%]. The positive diagnostic rate of malignancy was 100% by FNAB. Among them, 55 cases [82%] were diagnosed by cytologic examinations and 43 cases[64%] by both. The specific diagnoses for benign lung lesions in 15 cases[55%] and for mediastinal and chest well lesions in 5 cases[62%]. The 7 patients[6.9%] developed the pneumothorax and 5 of them required the treatment. Therefore, the FNAB of thoracic lesions may be a preferred diagnostic method because of its safety, simplicity and accuracy.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.225-227
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• 1981

A 31-year-old female visited O.P.D. of internal medicine, Kyung Hee Medical center, with the chief complaint of generalized weakness and headache. She took a routine chest P-A and there was a 6.5 x 7.5 cm sized round mass in the right middle lung field. She admitted to the Dept. of Thoracic and Cardiovascular Surgery under the impression of malignant bronchogenic carcinoma with the remit of bronchoscopy and sputum cytology and tomogram. Middle and lower lobectomy of right lung was performed and postoperative surgical biopsy revealed out the plasma cell granuloma. The plasma cell granuloma may occur as a solitary nodule in the lung or be associated with systemic disease, plasma protein imbalance, or nonspecific local inflammatory reaction . More than two third of the reported patients were less than 30 year of age. Grossly the lesion appears reddish-brown and microscopic features include pallisade or a cartwheel distribution of plasma cells with Russel bodies and amyloid. Local excision or lobectomy has been curative in most cases.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.306-309
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• 2014

Synovial sarcoma (SS) is a highly malignant tumor that accounts for 10% of all soft-tissue sarcomas. Primary SS arising from the lung is extremely rare, and the prognosis is poor. We report a case of pulmonary SS presenting with a mass lesion invading the right upper and middle lobes, extending to the mediastinum and the chest wall. After tru-cut biopsy, surgical resection was performed. The final diagnosis was SS (biphasic type) based on histological and immunohistochemical findings. There are no guidelines for optimal treatment due to the rarity of these tumors. Current treatment includes surgery and adjuvant chemotherapy and/or radiotherapy.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.373-379
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• 1993

Primary lung cancer has increased markedly in its incidence and prevalence rate recently in Korea. In frequency, it occupies the second rank cancer preceded by stomach cancer in korean male. From February 1986 to December 1992, we have operated on 55 cases of primary lung cancer in Korea Veterans Hospital and followed them. The results are as follows; 1. The peak incidence of age of primary lung cancer was 6th decade and 5th decade and those were 87.3% of study group, mainly in male. 2. Symptoms were cough [63.6%], dyspnea [41.8%], chest pain and discomfort [38.2%], blood tinged sputum and hemoptysis [21.8%]. Symptoms were frequently encountered before hospitalization and asymptomatic cases were 9.1% of study group. 3. Methods of diagnostic confirmation were bronchoscopic biopsy [52.7%], percutaneous needle aspiration[PCNA][21.8%], sputum cytolgy [12.7%], open biopsy [12.7%]. 4. Histopathologically, squamous cell carcinoma [76.4%] was the most frequent cancer and adenocarcinoma [10.9%], giant cell cancer [7.3%], and the others in order. 5. Methods of operation were pneumonectomy [32.7%], bilobectomy [18.2%], lobectomy [27.3%], lobectomy and segmenectomy [1.8%], exploration [20%], and overall resectability was 80%. 6. Operative mortality was 5.5% [3 cases] and there were 5 cases of complication. 7. Postoperative long-term follow up reveals that the cumulative survival rates in 6 months, 12 months, 26 months, 34 months, 43 months, 64 months were 89.5%, 71.7%, 66.7%, 57.2%, 50.8%, 42.3% respecively.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.17-21
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• 2008

Endoscopic ultrasonography (EUS) has been developed for the diagnosis of various gastrointestinal diseases or extra-gastrointestinal diseases, and extended to interventional approach. In fields of mediastinal diseases, EUS is an effective diagnostic method for the staging of esophageal cancer, lung cancer and other mediastinal diseases. Recently, EUS guided fine needle aspiration or biopsy makes the histologic diagnosis possible in various mediastinal diseases, and would reserve many avoidable surgical cases.