• Journal of Chest Surgery
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• 제22권5호
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• pp.800-805
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• 1989

The roentgenologic appearance of carcinoma of the lung may vary considerably from case to case. And when it forms cavitary lesion, it is frequently confused with benign lesions and treated conservatively. Twenty-seven patients with cavitary bronchogenic carcinoma were treated in our St. Marys Hospital during the period 1984-1989. There were 24 males and 3 females. They ranged in age from 43 to 76 years. Symptoms of cough, blood-streaked sputum or pleuritic chest pain were present in all patients one month to 6 months before hospital admission and 7 patients among them were delayed in recognition of the malignancy from z month to 3 months. Of 27 malignancies with cavity, 22[81.5 %] were squamous cell ca., 3[11.1%] were large cell ca., and 2[7.4%] were adenoca. And of 22 squamous cell carcinomas, 5 were well differentiated, 13 were moderately and 4 were poorly. All lobes except Rt. middle lobe were involved [RUL 2 cases, RLL 13 cases, LUL 3 cases and LLL 9 cases]. We explored 16 patients and performed 7 lobectomy, 4 bi-lobectomy, 2 pneumonectomy and 3 08zC. Post-operative follow-up examination of the resected 13 patients indicated one and two year survival rates of 69.1 %[9/13 cases] and 37.5%[3/8 cases] respectively, and now 6 survivors whose post-operative periods were from 4 months to 37 months.

• Korean Journal of Radiology
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• 제22권1호
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• pp.139-154
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• 2021

Magnetic resonance imaging (MRI) has become a crucial tool for evaluating mediastinal masses considering that several lesions that appear indeterminate on computed tomography and radiography can be differentiated on MRI. Using a three-compartment model to localize the mass and employing a basic knowledge of MRI, radiologists can easily diagnose mediastinal masses. Here, we review the use of MRI in evaluating mediastinal masses and present the images of various mediastinal masses categorized using the International Thymic Malignancy Interest Group's three-compartment classification system. These masses include thymic hyperplasia, thymic cyst, pericardial cyst, thymoma, mediastinal hemangioma, lymphoma, mature teratoma, bronchogenic cyst, esophageal duplication cyst, mediastinal thyroid carcinoma originating from ectopic thyroid tissue, mediastinal liposarcoma, mediastinal pancreatic pseudocyst, neurogenic tumor, meningocele, and plasmacytoma.

• Korean Journal of Radiology
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• 제1권1호
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• pp.33-37
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• 2000

Objective: To describe the radiologic findings of migrating lobar atelectasis of the right lung. Materials and Methods: Chest radiographs (n = 6) and CT scans (n = 5) of six patients with migrating lobar atelectasis of the right lung were analyzed retrospectively. The underlying diseases associated with lobar atelectasis were bronchogenic carcinoma (n = 4), bronchial tuberculosis (n = 1), and tracheobronchial amyloidosis (n = 1). Results: Atelectasis involved the right upper lobe (RUL) (n = 3) and both the RUL and right middle lobe (RML) (n = 3). On supine anteroposterior radiographs (n = 5) and on an erect posteroanterior radiograph (n = 1), the atelectatic lobe(s) occupied the right upper lung zone, with a wedge shape abutting onto the right mediastinal border. On erect posteroanterior radiographs (n = 6), the heavy atelectatic lobe(s) migrated downward, forming a peri- or infrahilar area of increased opacity and obscuring the right cardiac margin. Erect lateral radiographs (n = 4) showed inferior shift of the anterosuperiorly located atelectatic lobe(s) to the anteroinferior portion of the hemithorax. Conclusion: Atelectatic lobe(s) can move within the hemithorax according to changes in a patient s position. This process involves the RUL or both the RUL and RML.

• Journal of Chest Surgery
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• 제36권6호
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• pp.444-447
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• 2003

기관분기부에 침범한 악성 종양의 치료로 이용되는 소매 전폐 절제술은 수술 후 높은 유병률과 사망률을 동반하나 기관 분기부위의 악성 종양이 일측 폐를 완전히 허탈시키고 반대편 기관지의 허탈의 가능성이 있는 경우는 좋은 수술적 방법이 될 수 있다. 본 64세된 남자환자는 과거력에서 13년 전에 승모판 협착증 및 삼첨판 폐쇄 부전증으로 타 병원에서 승모판 치환술 및 삼첨판륜 성형술을 시행 받았으며 2년 전에는 성대에 생긴 유두종으로 종양절제술을 시행받았다. 최근에는 혈담을 주소로 내원하여 기관지내시경 및 흉부 컴퓨터단층촬영에서 하부 기관부터 좌측 주 기관지까지 약 3.5 cm의 악성 편평상피세포암이 관찰되었으며 좌측 주 기관지를 완전히 막고 있는 소견이 있었고 grade III의 삼첨판 폐쇄부전이 있었다. 심폐 바이페스 없이 순차적 양측 후측방 개흉술을 통해 좌측 소매 전폐절제술을 시행하였고 수술 후 병리 조직검사에서 T4N0M0인 악성 편평상피세포암으로 확인되었고 수술 후 특별한 문제없이 퇴원하였다.

• 대한세포병리학회지
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• 제12권1호
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• pp.17-23
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• 2001

To evaluate the role of sputum and bronchial washing for the diagnosis of lung carcinoma, we studied the sensitivity of both cytologic techniques using the biopsy confirmed cases from 228 patients. Among them, 123 cases were squamous cell carcinomas, 42 cases were adenocarcinomas, 48 cases were small cell carcinomas, one case was large cell carcinoma, and 14 cases were other types of carcinoma including poorly differentiated carcinomas. Three hundreds and ninety two sputa and 173 sputa were obtained in the pre- and post-bronchoscopic periods. Bronchial washing had been taken once in each patient. The overall sensitivity of the sputum cytology was 0.52 and that of the bronchial washing 0.63, while it increased to 0.83 when a combination of both techniques. Squamous cell carcinomas were diagnosed to the great extent in which sensitivities were 0.59 and 0.74, in sputum and bronchial washing, respectively. The post-bronchoscopic sputa showed higher sensitivity (0.44) than pre-bronchoscopic sputa (0.30). The sensitivity on sputa increased from 0.34 to 0.49 when three samples were examined compared to the single examination. The accuracy of cell typing was 94.0% in sputa and 93.8% In bronchial washing. Repeated sputum examination including post-bronchoscopic sputa is warranted to Improve sensitivity and a complementary role of both cytologlc techniques can be postulated by these data.

• Journal of Chest Surgery
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• 제29권8호
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• pp.905-909
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• 1996

1991년부터 1994년까지 75례의 폐 절제술을 시행하여 기관지 절주를 봉합하는 방법에 따라2군으로 나누었다. 49명의 환자에서 51례의 자동 조직 봉합기를 사용하였고(Group I) 24례에서 단속 수봉합 하였다.(Group II). 환자의 구성은 악성종양 3)례 (Groups:Group II, 22:11), 기관지확장증 23례 (18:5), 양성 종양 5례 (3:2), 국균증 5례 (2.3), 결핵 3례 (2:1), 기관지 선종 2례 (0:2) 등이 었다. 수술 수기는 21례의 전폐절제술(18:3), 13례의 쌍엽절제술(11:2), 26례의 폐엽절제술(14 12), 11례의 폐구역절제술(6:5)과 4례의 폐엽절제술 및 폐구역절제술(4:0)을 시행하였다. 자동 조직 봉합기를 사용한 군에서 수봉합 군보다 통계학적으로 유의하게 술후 흉관 배액량이 적었고 (p=0.047) 흉관 제거 시기가 더 빨랐다(p=0.005). 그러나 통계 학적으로 유의하지는 않았지만 술후 공기 누출 기간도 짧았고3p=0.2821 기관지 흉막루의 발생 빈도도 더 적었다.

• Journal of Chest Surgery
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• 제11권2호
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• pp.129-134
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• 1978

Two hundred and seventeen patients underwent diagnostic rigid bronchoscopy or bionchofiberscopy to evaluate the cytologic diagnosis in the lung cancer patient at the department of chest surgery of Yon-Sei university, college of the medicine from 1971 to 1977 year. One hundred and twenty cases of these patients were taken rigid bronchoscopy and ninety four cases of these patient were taken bronchofiberscopy. Cytologic examination of the sputum was done in 214 cases and sputum cytology was positive in 50 cases [23.4%]. Rigid bronchoscopy was made in 120 cases and this bronchoscopic cytology including bronchial washing and bronchial biopsy was positive in 34 cases [28.5%]. Bronchofiberscopy was performed in 94 cases and was positive in 45 cases [47.5%]. Histopathologically, 41 cases [43.6%] were epidermoid cell carcinoma, 8 cases [8.5%]of undifferentiated cell type, 12 cases [12.8%]of adenocarcinoma, 8 cases [8.5%]of alveolar cell type, and the 25 cases were undetermined. Cytologic examination of the sputum lacks the accuracy of the bronchoscopies in terms of both localization and accurate histologic indentification of the type of neoplasm. Rigid bronchoscope has the advantage of permitting identification of a tumor in a central location and of providing a sufficient amount of biopsy material for accurate diagnosis of carcinoma. However, it has the disadvantage of limiting examination to the larger, more central portions of the tracheobronchial tree. Bronchofiberscope had the advantage of examine upper lobe as well as other portions of the tracheobronchial tree which could not be visualized with the rigid bronchoscopy. A positive diagnosis in bronchofiberscopy was obtained in the highest rate, 47. 8% [45 cases]. A1 last, if a bronchogenic carcinoma is suspected on the basis of either symptoms of an abnormality on the chest film the diagnostic work-up-sputum cytology, bronchial washing, bronchoscopic biopsy, scalene node biopsy, thoracentesis and mediastinoscopy explothoracotomy etc-should precede in an attempt not only to obtain the higher positive diagnosis but also to obtain a tissue diagnosis and to evaluate the stage of the disease and to ascertain the appropriate mode of therapy.

• Journal of Chest Surgery
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• 제40권11호
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• pp.793-797
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• 2007

Communicating bronchopulmonary foregut malformation (CBPFM)은 매우 드문 선천성 기형으로 격리된 호흡계 조직과 식도 또는 위장 사이의 누관이 특징적이다. 원시위장관에서 기원한 부속의 폐조직이 모든 종류의 bronchopulmonary furegut malformation 발생의 중요한 요인이 된다. 반복되는 폐렴이 있는 환자의 chest X-ray에서 낭성 병변이 보인다면 CBPFM을 생각해봐야 하며, 진단적 방법으로 식도조영술, 기관조영술, 컴퓨터 단층촬영, 자기공명영상 그리고 혈관조영술 등이 도움이 된다. 치료는 수술적 제거가 권장되며 예후도 좋다. 좌측 완전 심낭결손증과 동반되었으며, 이중식도에 연결된 외엽성 폐격리증과 기관지성 낭종을 보인 CBPFM 1예를 보고한다.

• 대한세포병리학회지
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• 제15권2호
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• pp.75-80
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• 2004

To analyze the accuracy and usefulness of sputum cytology as a screening method, 103 cases of histologically proven lung cancer registered from 1998 to 2000 at Kangbuk Samsung Hospital were retrospectively examined. We reviewed the original cytologic and surgical diagnoses for the cases, and the cytology slides of all cytologically negative cases. The overall sensitivity of sputum cytology was 0.83 ; the sensitivity of prebronchoscopy sputum cytology for bronchogenic carcinoma was 0.87. Central tumor location (P=0.002), tumor size (>2.4 cm), (P=0.027) and the number of sputum samples $(\geq3)$ (P=0.001) were associated with a positive cytologic diagnosis. Of the 18 cytologically negative cases, 9 cases(38% of smears) were determined to be insufficient for diagnosis, due strictly to low cellularity and saliva. After a review of the cytology slides of cytologically negative cases, we identified several atypical clusters in one case of bronchioloalveolar carcinoma. This negativity was thus attributed to an interpretation error (1/18, 5.6%). Our results suggest that its sensitivity is more strongly related to the specimen adequacy and the times of sampling than to interpretation error. In terms of sensitivity, specificity, accessibility, cost, and morbidity associated with the screening tests, sputum cytology was found to be an accurate effective screening method for lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1989-1993
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• 2013

Background: Lung cancer is the most frequent cancer among men and second highest among women overall, including in Turkey. Cigarette smoking is the most important etiologic factor for the development of cancer in both men and women. Objective: To determine the lung cancer incidence in Northeastern Anatolia Region of Turkey with a focus on clinical properties, cancer subtypes, the relationships of tumors with cigarette smoking and radiological properties of the lesions. Materials and Methods: In a retrospective study design, 566 lung cancer cases diagnosed at the Pathology Department of Ataturk University in Erzurum over the last seven years extending from January 2006 to June 2012 were investigated. The results were compared with statistical analyses. Results: The most common histopathological subtype of primary bronchogenic carcinoma in our study was found to be the squamous cell carcinoma, 46.1% (261 out of 566), and the second was small cell lung carcinoma 15.7% (89 out of 566). Based on our data, an overall male predominance was noted with a male/female ratio of 6.1/1. While 296 (52.2%) of the patients were found to be smokers at the time of diagnosis, 125 (22.0%) were nonsmokers and 145 (25.6%) were ex-smokers. Smoking status was found to have a strong correlation with primary lung cancer (p<0.05), and there were significant differences between males and females (p<0.001). Conclusion: Although relative prominence of subtypes of lung cancers differ between Turkish and other populations, lung cancer overall remains as an important health problem in Turkey. Our findings stress the critical need for effective cancer prevention programs such as anti-smoking campaigns.