• Tuberculosis and Respiratory Diseases
• /
• v.61 no.5
• /
• pp.484-489
• /
• 2006

A primary pulmonary leiomyosarcoma is a very rare pulmonary malignancy that arises from smooth muscle of either the bronchial or arterial walls. Common symptoms of the tumor are cough, dyspnea, chest pain and hemoptysis. The diagnosis of a primary pulmonary sarcoma can be established only after extensive clinical and radiologic examinations have failed to identify an alternative primary source. The only effective treatment for the tumor is a complete surgical resection when feasible. The type of resection is dictated by the local anatomic extent of the tumor. We report a case of a 21-year-old male with a primary endobronchial leiomyosarcoma who presented with massive hemoptysis. A necrotic ulcerative endobronchial lesion was observed in the orifice of left lower lobe bronchus on a bronchoscopic examination. He was treated with a complete sleeve resection of the left lower lobe. Three months later, local recurrence of the tumor was noticed on the follow up bronchoscopy and a then left pneumonectomy was then performed. Fifteen months later, the patient died from empyema with a bronchopleural fistula that was associated with tumor recurrence at the stump of the pneumonectomy.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.6
• /
• pp.1308-1317
• /
• 1997

Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

• Journal of Chest Surgery
• /
• v.37 no.12
• /
• pp.1015-1018
• /
• 2004

Lymphangioleiomyomatosis (LAM) is a rare disease in women in childbearing age leading to progressive respiratory failure. LAM is characterized by an abnormal harmartomatous proliferation of smooth muscle cells surrounding the blood vessels, lymphatics and airways in the lung. This proliferation leads to airway obstruction, cystic alveolar change and lymphatic obstruction. Patients present with dyspnea, pneumothorax, cough, chest pain, hemoptysis, and chylous effusion. Although lung transplantation is the only therapeutic modality in end-stage LAM with respiratory failure, there has not been any report of successful treatment in Korea. We report one case of successful left single lung transplantation in a 40 year old woman suffering from end-stage LAM.

• Journal of Chest Surgery
• /
• v.35 no.8
• /
• pp.616-620
• /
• 2002

Tracheal bronchus is a aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and nay be related to inflammatory conditions affecting the lung, including recurrent pneumonia and bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but neither clinical nor radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6-month followup period.

• Journal of Chest Surgery
• /
• v.35 no.4
• /
• pp.315-317
• /
• 2002

Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

• Journal of Chest Surgery
• /
• v.20 no.1
• /
• pp.128-138
• /
• 1987

The Hippocratic aphorism, "the spitting of pur follows the spitting of blood, consumption follows the spitting of this, and death follows consumption," gives ancient documentation to the significance of hemoptysis in the intrathoracic disease. Hemoptysis is still one of the most alarming and startling of all symptoms. For most patients and not a few doctors, the expectoration of blood signals either pulmonary tuberculosis or cancer. But with the advent of modern thoracic surgical methods, differential diagnosis has become doubly important and appropriate treatment has provided the patients with full recovery or improvement of hemoptysis. Author reviewed 72 cases of patients with a chief complaint of hemoptysis, who were performed open thoracotomies in the Dept. of Thoracic and Cardiovascular Surgery, Pusan National University Hospital for 5 years from April 1980 to March 1985. The results were as follows: 1. The mean age of hemoptysis patients was 35.1 year old with a range from 16 to 64, and hemoptysis was most prevalent in the twenties and male dominant. 2. The most common underlying lung disease of hemoptysis was bronchiectasis [37.5%]. 3. The monthly peak frequency of hemoptysis was in the February [25.[%]. 4. Left lower lobe was the most common site of developing hemoptysis. 5. Lobectomy was the most frequent operative method of all open thoracotomies. 6. The hemoptysis caused by lung cancer recurred most frequently [21.4%], and the prognosis of operation was desperate. 7. The common postoperative complications of hemoptysis patient were re-hemoptysis [24%], bleeding [20%], and atelectasis [16%], and immediate postoperative mortality rate was 2.8%. was 2.8%.

• Journal of Chest Surgery
• /
• v.30 no.10
• /
• pp.1036-1039
• /
• 1997

Primary pulmonary artery sarcoma is a rare tumor and commonly misdiagnosed as pulmonary embolism. The prognosis of these tumors is very poor. The Median length of survival without surgical resection is approximately 1.5 months, but surgical resection has lengthened survival time to approximately 1 year. We encountered a case of primary pulmonary artery sarcoma, with a 55 year-old woman whose symptoms were exertional dysp ea, right chest pain, and hemoptysis. A preoperative chest CT scan revealed mass lesion mimicking pulmonary embolism. Pulmonary angioplasty and right Pneumonectomy were Performed on partial cardiopulmonary bypass. Postoperatively the mass was confirmed as undifferenciated sarcoma histopathologically. The symptoms were somewhat improved, but the patient died of unknown causes about 3 months after surgery.

• Herbal Formula Science
• /
• v.16 no.2
• /
• pp.255-261
• /
• 2008

Hemoptysis is a common clinical symptom responsible for about 10% of the patients who has the pulmonary disease. In Korea, pulmonary tuberculosis is still the most common cause of the hemoptysis. This study is a chlinical report of Korean Traditional Medical Therapy for the patient of hemopysis with old pulmonary tuberculosis. The patient was suffering from hemoptysis, headache, sweating, feeling of uneasiness and fatigue. After administration of herbal medicines (Bokryungbosim-tang, Yukmijihwangwon-gagambang) and acupunture treatment for 34days, these symptoms of the patient were improved. Thus, we concluded that Oriental Medical Treatment can improve the symptoms of the patient who is suffering from hemoptysis.

• Journal of Chest Surgery
• /
• v.35 no.2
• /
• pp.153-156
• /
• 2002

Synchronous primary lung cancers in the same lobe are rare. Cavitating adenocarcinoma as single lung lesion is unusual. We experienced cavitating adenocarcinoma and squamous cell carcinoma in the same lobe of the lung. The patient was a 74-year-old male with chief complaints of hemoptysis. CT scan showd a central mass in right upper lobar bronchus, obstructive pneumonia, and lung abscess in the right upper lobe. Pathologically, the central mass was a 2.3$\times$1$\times$1 cm sized squamous cell carcinoma, and lung abscess was revealed as a 37272 cm sized adenocarcinoma. The patient was discharged without any specific problem after right peumonectomy.

• Journal of Chest Surgery
• /
• v.36 no.11
• /
• pp.878-882
• /
• 2003

Tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and may be related to inflammatory conditions affecting the lung, including recurrent pneumonia, bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but either clinical or radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6month follow-up period.