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Clinical Study of 61 cases Benign Lung Tumor (폐양성 종양 61례의 외과적 고찰)

  • 박종원
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.272-289
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    • 1989
  • Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.

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The Clinical Analysis of Parotid Gland Tumors (이하선 종양에 관한 임상적 고찰)

  • Gong Gwun-O.;Kim Jung-Gyu;Choi Kyung-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.235-240
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    • 1997
  • Parotid tumors constitute about 70 to 80% of all salivary tumors. Two thirds of parotid neoplasms are benign. Women are affected more often than men. Plemorphic adenoma or benign mixed tumor is the most common parotid neoplasm, accounting for 50% of all parotid tumors. The clinical presentation is a discrete, slowly enlarging mass, rarely accompanied by pain or facial paralysis. We reviewed 69 cases of the parotid tumors admitted and treated at Department of Surgery, Kosin University Hospital from Jan, 1970 to June, 1994. The results were as follows: 1) Over all sex ratio was 1 : 1.56(M : F). The sex ratio of benign and malignant tumor was 1 : 1.43(M : F) and 1 : 2.2. 2) The mean duration of symptom was 4.6 years. 3) In the peak incidence of age, Benign tumor was in 4th decade, malignant tumor was in 2nd decade. 4) The chief complaint was painless palpable mass in 65 cases(94%) and pain in 4 cases(6%). 5) The mean size of mass was 2.5cm in diameter and the ratio of lesion site was 37 : 32(Rt : Lt). 6) Superficial parotidectomy was the most common procedure(43%). 7) According to histopathologic findings of 69 cases, Benign tumor was 56 cases(81%) and malignant tumor was 13 cases (19%). In the benign cases, pleomorphic adenoma was the most common(44 cases(65%)). In the malignant, mucoepidermoid ca. was the most common(5 cases (37%)). 8) Postoperative complication occured in 9 cases(13%), facial palsy was in 7 cases, and wound hematoma was 2 cases.

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A Clinical Study of Surgically Managed Thyroid Nodule (외과적으로 처치한 갑상선 결절)

  • Hong Kwan-Uye;Lee Myung-Bok;Moon Chul;Kim Ik-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.91-101
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    • 1994
  • Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

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Study for the Availability of Ultrasonogram Guided Fine Needle Aspiration for Patients with Thyroid Gland Disease

  • Kim, Han-Yong;Dong, Kyung-Rae
    • International Journal of Contents
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    • v.5 no.1
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    • pp.33-36
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    • 2009
  • Since the diagnosis of malignancy and benign of thyroid gland diseases is difficult only by using ultrasonogram opinions, the combination of fine needle aspiration (FNA) has been generalized trend for precise pathological diagnosis. Therefore, the current study aimed to know about its availability. The study subjected 500 patients who received the FNA along with the ultrasonogram screening for thyroid gland from October, 2007 to April, 2008. As the equipments for the study, Philips HDI-3500 and Philips UITRAMARKer-9 (UM-9) were used to conduct the comparative analysis of pathological results that were obtained through the inspection of ultrasonogram screening and through ultrasonogram guided FNA. Among the 464 patients who were found to be benign from the ultrasonogram screening inspection, II cases of the FNA diagnosis results judged to be malignancy, and 13 cases of the FNA diagnosis resulted to be benign among 36 patients who were diagnosed to be malignancy. The cases observed as solid from the opinions of ultrasonogram screening were often found to be malignancy, and most of the malignancy results were observed to show the hypoechoic pattern. Among the patients diagnosed with malignancy from the diagnosis of FNA, the 32 patients were found to have the papillary carcinoma, and the benign type was observed to be goiter and hyperplasia in 263 patients, which took up 52.6%. The ultrasonogram screening test that is performed for the purpose of diagnosing thyroid gland diseases, it is distinctively an useful inspection to diagnosis the presence, size and shape of nodules. However, the results of performing of FNA for those of nodules which were observed to be benign from the ultrasonogram were often came up with malignancy and there were cases that the nodules diagnosed with malignancy were diagnosed as benign from the FNA diagnosis.

A Study on Physiological Index, Anxiety and Depression by the Severity of Lower Urinary Tract Symptoms in Patients with Benign Prostatic Hyperplasia (전립선비대증 환자의 하부요로증상의 중증도에 따른 생리학적 지수 및 불안, 우울)

  • Kim, Jung Kyoun;Kim, Jin Bum;Song, Min Sun
    • Journal of Korean Biological Nursing Science
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    • v.18 no.3
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    • pp.127-134
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    • 2016
  • Purpose: The purpose of this study was to investigate the physiological index, anxiety and depression by the severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia. Methods: This research was conducted from the 4th to the 27th of May in 2016 on112 patients with benign prostatic hyperplasia. The data were analyzed using a chi-square test, ANOVA, and Pearson Correlation Coefficients. Results: The results demonstrated a difference depending on the dysuria period of each lower urinary tract symptom, marital status, occupation and perceived health state of the patient. The physiological index by lower urinary tract symptoms showed a difference in the maximum flow rate, amount of post-void residual urine and Prostate-Specific Antigen (PSA), and anxiety and depression factors also revealed a difference. Lower urinary tract symptoms showed a positive correlation to the amount of post voided residual urine and PSA, a negative correlation to the maximum flow rate and also indicated a positive correlation to depression. Conclusion: The results of the study belonging to the moderate and severe categories were high when the result was based on the categorization of subjects with benign prostatic hyperplasia with lower urinary tract symptoms. Considering that depression levels increase as the symptom intensifies and the anxiety score is also high with mild symptoms, psychological support intervention is needed when a pattern of benign prostatic hyperplasia appears.

A Case of Benign Fibrous Mesothelioma of the Pleura (흉막의 양성 섬유성 중피종 1예)

  • Lee, Sung-Keun;Kim, Doe-Min;Jan, Kyong-Sun;Park, Sae-Jong;Keun, Jae-Sung;Kim, Woing-Su;Kang, Jong-Yuel;Kim, Myung-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.432-437
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    • 1999
  • Benign fibrous mesothelioma of the pleura is a relatively rare neoplasm originated from pleural mesothelial cell, often asymptomatic or presenting with a specifical sign. One of the main problems, concerns the preoperative differential diagnosis, mainly because it is difficult to differentiate between benign and malignant type. A 62-year old woman presented with recurrent chest pain. The chest radiography in a patient was suspected localized pleural mesothelioma. The chest computed tomography scan showed that mass like lesion of well marginated ovoid shape with homogenous attenuation on anterior-basal segment of right lower lobe. After resection of a pleural mass by thoracoscopic extirpation from right hemithorax, Localized benign fibrous mesothelioma of the pleura was confirmed by pathology and immunohisto-chemical staining. We report here one case of pleural benign fibrous mesothelioma with some considerations on its diagnosis and treatment.

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The effect of Picibanil sclerotherapy for benign neck cysts (양성 경부 낭종에서의 Picibanil(OK-432)을 이용한 경화치료 효과)

  • Hong, Ji-Won;Boo, Sung-Hyun;Park, Jae-Hong;Kim, Myung-Gu
    • Korean Journal of Bronchoesophagology
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    • v.14 no.2
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    • pp.31-37
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    • 2008
  • Background and Objectives: In most cases of benign neck cysts, surgical excision has been considered as treatment of choice. However, sometimes complete excision is very difficult, and recurrences has been occured due to insufficient surgery frequently. In this point of view, non-surgical treatment has been attempted with sclerosing agents such as picibanil(OK-432). In this study, we evaluated the efficacy of picibanil sclerotherapy for benign neck cysts. Materials and methods: We retrospectively reviewed 53 patients(27 males, 26 females) who had undergone sclerotherapy with picibanil for benign neck cysts such as ranula, lymphangioma, thyroglossal duct cyst and branchial cyst. Information was gathered with respected to age, sex, number of injections, side effect and outcome of treatment. All patients were treated with intralesional aspiration of cystic contents and injection of picibanil, and followed on neck ultrasonography or neck CT. Results: 53 patients received sonoguided sclerotherapy using picibanil(OK-432). 31 patients(41.3%) showed total shrinkage, near total shrinkage(more than 90% of volume) in 7 patients(9.3%), marked shrinkage(more than 70%) in 5 patients(6.6%) and partial shrinkage(less than 70%) in 17 patients. 15 patients(20%) reaveled no response and 8 patients showed recurrences with repeated sclerotherapy. The side effects of therapy were observed by symptoms such as fever, localized pain and odynophagia. However, these complications disappeared after several days in all cases. Conclusions: We recognized that picibanil(OK-432) sclerotherapy for benign neck cyst is a safe and effective procedures as a primary treatment before considering surgery.

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Macrophage Migration Inhibitory Factor (MIF) Concentration in the Serum of Patients with Ovarian Cysts for Differential Diagnosis of Endometrioma (자궁내막종의 감별진단을 위한 난소낭종 환자의 혈청 Macrophage Migration Inhibitory Factor (MIF) 농도의 진단적 유용성에 대한 연구)

  • Kim, Man Ki;Kim, Yu Re;Hong, Seong Hwa;Park, Yeon Jin;Ji, IL Woon;Jeong, Eun Hwan;Kim, Hak Soon
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.3
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    • pp.287-293
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    • 2005
  • Objective: To evaluate the usefulness of serum concentrations of macrophage migration inhibitory factor (MIF) of patients with ovarian cysts for differential diagnosis of endometrioama. Method: From Jan. 2003 to Dec. 2004, preoperative serum MIF levels were assessed in 28 women with endometrioma, 32 with benign epithelial tumor, 23 with functional and simple cysts, 22 with benign mature cystic teratoma, and 25 women without ovarian tumor as control. MIF levels were determined using an ELISA (Quantikine Human MIF immunoassay, R&D Systems, Inc., USA). Results: Mean MIF levels were higher in all groups with benign tumors than control (all p<0.01), but there was no significant difference between benign tumor groups (p=0.95). There was no significant correlation between MIF levels and tumor volume, body mass index (BMI) (p=0.635, 0.674 respectively) Serum MIF level had significant correlation with count of WBC and neutrophils (p=0.008, 0.024 respectively), but had no correlation with count of lymhocytes and monocytes (p=0.688, 0.294 respectively). Conclusions: This study showed a marked increase in MIF concentrations in the peripheral blood of patients with endometrioma, but there was no significant difference with other benign tumors. Serum MIF level had significant correlation with count of WBC and neutrophils. These suggest serum MIF level has no usefulness for differential diagnosis of endometrioma from other benign ovarian cysts.

A Clinical Analysis of Surgically Managed Thyroid Nodule (외과적으로 치료한 갑상선 결절에 대한 임상적 고찰)

  • Jung In-Kyu;Kim Lee-Su;Choi Won-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.1
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    • pp.16-24
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    • 1993
  • During 7 years, from Jan. 1986 to Dec. 1992, authors studied 208 cases of the surgically managed thyroid nodules at the Department of General Surgery, Han Kang Sacred Heart Hospital and obtained the following results. 1) Among the total 208 cases, male to female ratio was 1:11.2 in benign thyroid diseases and 1:9 in malignant thyroid diseases. The benign disease was prevalent between second and forth decade comparing with malignant disease between third and fifth decade. 2) The most common duration of illness was 3 months(26.0%). 3) Palpable neck mass was the most common chief complaint(100%). Palpitation. fatigue, and sweating were common complaints in patient with benign disease, and fatigue, palpitation, and sweating in malignant disease in decreasing order of frequency. 4) 55.8 % of lesions were in right lobe, 33.2% in left lobe, 5.8% in diffuse type, 4.8% in bilateral lobes, and 0.5% in isthmus. 5) The most common size of nodule was between 2.0cm and 3.9cm in diameter, which consisted of 55.1% of benign disease and 48.0% of malignant disease. 6) 86.5% of thyroid function test showed euthyroidism, 10.1% hyperthyroidism, and 3.4% hypothyroidism. 7) Thyroid scanning of 176 patients revealed cold nodules in 92.5% of benign diseases and in 92.9% of malignant diseases. 8) The most common benign disease was adenomatous hyperplasia(62.7%), and the most common malignant disease was papillary adenocarcinoma(80.0%). 9) Fine needle aspiration cytology was performed in 91 cases, and it showed 69.0% of sensitivity, 90.3% of specificity, and 83.5% of accuracy. 10) Frozen biopsy was performed in 109 cases. and it showed 93.9% of sensitivity, 100.0% of specificity, and 98.2% of accuracy. 11) The most commonly performed operation was unilateral lobectomy(including unilateral lobectomy with isthmectomy)(79.1%) in benign disease. and total thyroidectomy(62.0%) in malignant disease. 12) Postoperative complication showed 5 cases of wound infection (2.4%), 3 cases of transient hypoparathyroidism(1.4%), 3 cases of transient hoarseness(1.4%), 2 cases of postoperative bleeding(1.0%), 1 case of permanent hypoparathyroidism(0.5%), 1 case of permanent hoarseness(0.5%), and 1 case of postoperative pneumonia (0.5%).

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The Prognostic Factors of Solitary Pulmonary Nodule (고립성 폐결절의 예후에 관여하는 인자)

  • Jeong, Yun-Seop;Kim, Ju-Hyeon
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.425-435
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    • 1989
  • The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

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