• Title/Summary/Keyword: Visceral pleura

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A Case Report of IgG4-Related Disease Clinically Mimicking Pleural Mesothelioma

  • Choi, In Ho;Jang, Si-Hyong;Lee, Seungeun;Han, Joungho;Kim, Tae-Sung;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.1
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    • pp.42-45
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    • 2014
  • An immunoglobulin G4 (IgG4)-related disease is a recently emerging entity, and a few cases of IgG4-related disease in lung and pleura have been reported. Herein, we report the case of a 74-year-old man with IgG4-related disease of lung and pleura, clinically suspicious of malignant mesothelioma. Chest computed tomography showed diffuse nodular pleural thickening, and microscopic finding disclosed diffuse thickening of visceral pleura with infiltrations of many lymphoplasma cells with increased number of IgG4-positive plasma cells and a few multinucleated giant cells. It is important for pathologists and clinicians to recognize this rare entity and its histologic finding, because it can be confused with malignant tumors on the radiologic examination although it can be treated with steroid therapy.

Visceral Pleural Invasion And Bronchovascular Bundle Thickening to The Same Lobe in NSCLC : Diagnostic And Clinical Significance of $HRCT^1$ (비소세포성 폐암에서 장측 흉막 침윤과 동측 폐엽 기관지혈관속 비후 : 고해상도 전산화 단층 촬영의 진단적 유용성과 임상적 의의)

  • Huh, Yong-Min;Choe, Kyu-Ok;Hong, Yong-Kuk;Kim, Kil-Dong;Jeong, Kyung-Young;Kim, Se-Kyu;Jang, Joon;Kim, Seong-Kyu;Lee, Won-Young;Choi, Byoung-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.66-76
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    • 1999
  • Background : To assess the utility of HRCT in the evaluation of visceral pleural invasion and to determine whether visceral pleural invasion and bronchovascular bundle thickening on the same lobe could be related to the recurrence and survival in non-small cell lung cancer (NSCLC) Method: Eighty one patients, which were fulfilled long-term follow-up at least 18 months (maximum 103 months) among which 434 patients had underwent curative surgical resection for NSCLC from 1986 to 1995, were studied. They were analyzed to evaluate whether the prognostic factors such as the recurrence and survival depend on visceral pleural invasion and bronchovascular bundle thickening to the same lobe. Thirty two patients adjacent to a chest wall or a fissure were evaluated for visceral pleural invasion by HRCT. CT criteria included abutting pleura along the chest wall, abutting and/or compressing fissure, croosing fissure, and pleural tail. Results: The positive predictive value and the negative predictive value of crossing fissure were 100% and 100%, respectively. Two patients showing spiculated interface between a mass and abutting fissure were confirmed to have visceral pleural invasion at surgery. Visceral pleural invasion confirmed at surgery was significant to local recurrence and survival (p<.05. p<.05, respectively). Brochovascular bundle thickening to the same lobe on CT scan was significant to survival (p<.05) but was not significant to local and distant recurrence (p>.05). Conclusion : Visceral pleural invasion and bronchovascular bundle thickening to the same lobe have a role in predicting prognosis such as recurrence and survival in NSCLC. Therefore, the analysis of visceral pleural invasion on CT scan and the pathological analysis of bronchovascular bundle thickening to the same lobe may be necessary to predict the prognosis in NSCLC.

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Spontaneous Pneumothorax associated with Thoracic Endometriosis - Report of a case- (흉부 자궁내막증에 의한 자연 기흉 - 1예 보고 -)

  • Cho Jung Soo;Kim Young Sam;Kim Joung Taek;Baek Wan Ki;Lee Kyung Hi;Kim Lucia;Kim Kwang Ho
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.518-521
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    • 2005
  • Pneumothorax associated with thoracic endometriosis is a rare clinical entity and it is called catamenial pneumothorax if the recurrence of pneumothorax is related to the period of menstruation. Several hypotheses about its pathogenesis are suggested including spontaneous rupture of the bulla, endometrial implants of the visceral pleura, and passage of air from the genital tract through endometrial fenestration of the diaphragm. Pneumothorax is associated with chest pain and dyspnea within 72 hours of the onset of menses in young women and developed usually at right side. We report a case of 32-year-old woman who had bilateral pneumothorax and thoracic endometriosis confirmed histopathologically in the visceral pleura by thoracotomy.

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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    • 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.

Lymphangioleiomyomatosis with Bilateral Chylothorax -1 case report- (양측 유미흉을 동반한 림프관평활근종증)

  • 김시욱;최재성;나명훈;임승평;이영;유재현
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1029-1031
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    • 2004
  • We had expierienced pulmonary lymphangioleiomyomatosis(LAM) with bilateral chylothorax and chylous ascites. A twenty-one-year-old lass with chief complaint of abdominal pain was admitted through the emergency room. She received emergent pelvicoscopic surgery for the rupture of the right corpus luteum. We aspirated 1000ml of the uncoagulated blood. The bleeding point was cautherized electrically. LAM was diagnosed with tissue from the retroperitoneum. Chylous ascites and bilateral chylothorax were occurred despite of various treatments. On thoracotomy, bullous changed lung and lymphatic leakage from visceral and parietal pleura were observed. She died of respiratory insufficiency and general weakness after 6 months from admission.

Histopathological Studies on Enzootic Pasteurellosis of Domestic Rabbits in Korea (가토(家兎)의 Pasteurella성폐염(性肺炎) (Snuffles)에 관(關)한 병리학적(病理學的) 검색(檢索))

  • Kwon, Young Bang;Lim, Chang Hyeong
    • Korean Journal of Veterinary Research
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    • v.8 no.1
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    • pp.18-23
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    • 1968
  • Pathological studies on the Enzootic Pasteurellosis of domestic rabbits were performed and discussed. The chief pathological findings were as follows: Grossly, pneumonic lesions were located mainly in apical and cardiac lobes. The lesions were well demarcated with unaffected surrounding tissue. The pleural surface of pneumonic lesions were usually appeared as yellowish~white fibrinous exudate and, in some cases, abscesses were also shown. Microscopically, various cellular exudates composed mainly of neutrophils, large monocytes and lymphocytes were observed in the alveolar spaces. Some alveolar spaces were filled mostly with fibrinous exudates. Occasionally, thrombosis accompanied with infarcts were encountered in pneumonic lesions. There were deposition of purulo-fibrinous exudates on the visceral pleura.

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Localized Pleural Fibrous Mesothelioma - Report of 3 Cases - (국소형 흉막 중피세포종: 3례 보고)

  • 이석열
    • Journal of Chest Surgery
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    • v.24 no.6
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    • pp.595-604
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    • 1991
  • Pleural mesothelioma is usually divided into two forms of localized and diffuse type. Localized pleural fibrous mesothelioma is uncommon mesodermal neoplasm, which may occurs in both sexes and at the age of 50 years. This type of mesothelioma is usually asymptomatic and detected on routine chest X-ray and made fibrous tissue and shows of collagen fibers microscopically. Most localized fibrous mesothelioma arises from the visceral pleura and is well encapsulated and pedunculated mass. CT findings included well delineated, often lobulated, non-calcified soft tissue masses in close relation to a pleural space, associated pleural thickening, and absence of chest wall invasion and a peripheral or fissure location. Three cases of localized pleural fibrous mesothelioma diagnosed by resectional surgery were reported with the review of literature.

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Bronchopulmonary Sequestration: Report of One Case (Bronchopulmonary Sequestration: 1례 보고)

  • 이홍균;홍기우
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.159-164
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    • 1973
  • Bronchopulmonary sequestration is a congenital malformation characterized by a cystic portion of the lung that derives its arterial blood supply through anomalous aberrant vessel directly of the systemic circulation. An aberrant systemic vessel supplying the lung was reported by Huber in 1777. Although this lesion is uncommon disorder, there are several reports on operative death caused by exanguinating hemorrhage from the aberrant arteries to the bronchopulmonary sequestration to that it has received a great deal of attention. Two type of bronchopulmonary sequestration have been identified: Intralobar pulmonary sequestration is usually contained within the visceral pleura of a pulmonary lobe and its venous drainage to the pulmonary venous system. Extrapulmonary sequestration is usually within the pleural sheath its own and its vasculature drains into the azygos or hemiazygos system. we presented one case of intralobar pulmonary sequestration which led to motor paralysis, chylothorax and hemorrhage that are consequent on postoperative complication.

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Pulmonary Sequestration: Report of 5 Cases (폐격리증-5례 보고-)

  • 조대윤
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.27-34
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    • 1982
  • Pulmonary sequestration Is an unusual congenital malformation characterized by the presence of nonfunctioning lung tissue which usually has no communication with the normal bronchial tree and which receives its blood supply from an anomalous systemic artery instead of a pulmonary arterial branch. Two forms of pulmonary sequestration occur: Intralobar sequestration, in which the abnormal pulmonary tissue is incorporated within the normal lung and shares a common covering of visceral pleura, and extralobar sequestration, in which the abnormal pulmonary tissue is separated from the normal lung and has its own pleural investment. Since 1970, five cases of pulmonary sequestration were operated at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University. 1. Among five cues, one was male and the others were female. 2. All were intralobar type and involved left lower lobe. 3. There was no operative mortality following left lower lobectomy and ligation of the aberrant artery.

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In tralobar pulmonary sequestration associated with A-V fistula (동정맥 누공을 합병한 내엽형 폐 격절증의 치험례)

  • Lee, Jun-Yeong;Ji, Haeng-Ok
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.726-730
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    • 1986
  • Intralobar pulmonary sequestration is a rare congenital malformation characterized by a cystic portion of the lung that derives its arterial blood supply through aberrant vessel directly of systemic circulation. Two forms of pulmonary sequestration occur; intralobar sequestration is usually contained within the visceral pleura of a pulmonary lobe and its venous drainage to the pulmonary venous system. We presented on case of intralobar pulmonary sequestration with A-V fistula. The patient was 8 years old male and chief complaints are mild fever and exertional dyspnea. Aortogram revealed an aberrant artery originated from thoracic aorta just above the diaphragm and its vessel directly communicated pulmonary vein in sequestrated segment. At time of operation, sequestrated lobe measuring 6x5x5cm, well demarcated at the lower lobe was noted. Aberrant, measuring 1.0cm in diameter and 1cm in length and directly connected pulmonary vein. After division and ligation of the aberrant artery, only excision of sequestrated lobe was performed and complication is not during postoperative course.

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