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New Paradigm for Patients with Pulmonary Nodule Expecting Thoracoscopic Resection (흉강경수술이 예상되는 폐결절 환자에서의 새로운 방침)

  • 조민섭;심성보;왕영필;조건현;서종희;곽문섭;이선희;김학희;문석환
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.748-753
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    • 2003
  • Background: The pulmonary nodules (PN), when indicated, need thoracoscopic resection, especially in cases of non-diagnostic or technically infeasible PCNA (percutaneous needle aspiration). In the difficult situations of small or deeply seated PN, several techniques facilitating thoracoscopy have been used for detecting them. Our new protocol for managing PN was developed and prospectively reviewed. Material and Method: In the procedure of PCNA, we firstly placed the tip of the needle in the center of, or just in contact with PN under CT guidance, and loaded one or two segments of platinum radiomarker inside the needle after removing the stylet. Then, we forced the radiomarker to move to the tip of the needle by pushing the stylet. Finally, if the tip of the needle was not within PN, it was reoriented to the their center to obtain the sample for PCNA. Result: Between May 1999 and May 2000, radiomarkers were successfully placed in 28 PN of 26 patients, with the exception of one. In 18 (85%) of 21 nodules needing throacoscopy, intraoperative fluoroscopy was used to detect them or guide stapling resection during thoracoscopy. Conclusion: The advantages of this technique are that there is that there is no need for further localization for thoracoscopy even in cases of unsuccessful PCNA, and it was more effective in respect to both cost and time. Therefore, this strategy for PN expecting thoracoscopy will be helpful to patients and medical staff alike.

Dedifferentiated Parosteal Osteosarcoma of the Femur - A Case Report - (대퇴골에 발생한 역분화성 방골성 골육종 - 증례보고 -)

  • Park, Hye-Rim;Park, Yong-Koo;Jang, Joon-Dong;Nam, Eun-Sook;Sohn, Jin-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.70-75
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    • 1999
  • We present a case of parosteal osteosarcoma of the femur with secondary dedifferentiation. This 57-year-old woman was radiologically diagnosed as a parosteal osteosarcoma in 1987. In 1992, excisional biopsy revealed a classical parosteal osteosarcoma with diploidy DNA pattern. In 1998, she revisited due to a recurrent tumor with pathologic fracture. The resected specimen showed a classic parosteal osteosarcoma with area of dedifferentiation, showing high-grade spindle cell sarcoma. This dedifferentiated area revealed aneuploidy cell population on DNA flow cytometry. This case reminds us that not all parosteal osteosarcomas are low-grade lesions. Some low-grade lesions may dedifferentiate to become high-grade tumors after inadequate excision.

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Secondary Chondroblastic Osteosarcoma from Polyostotic Fibrous Dysplasia Initially Misdiagnosed as Low Grade Chondrosarcoma Provoking Fallacy in Treatment Strategy (저 악성도 연골육종으로 악성 변화한 섬유성 이형성증으로 오진하여 치료방침의 오류가 발생한 연골 모세포형 골육종 - 증례 보고 -)

  • Lee, Seung-Jun;Koh, Jae-Soo;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.62-67
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    • 2008
  • Malignant degeneration of fibrous dysplasia is rare and involves transformation into osteosarcoma, fibrosarcoma and chondrosarcoma. The most frequent sites involved in malignant transformation were craniofacial bones, proximal femur, humerus, pelvis, tibia and scapula in a decreasing order of frequency. An 41-year-old man with a history of polyostotic fibrous dysplasia presented with increasing left arm pain. Plain radiograph showed expansile destructive lesion along the humeral shaft. As initial biopsy report was low grade chondrosarcoma, he underwent marginal resection. However, he developed local recurrence 7 month later and subsequent pathologic finding was chondroblastic osteosarcoma. We report one case of secondary chondroblastic osteosarcoma from polyostotic fibrous dysplasia initially misdiagnosed as low grade chondrosarcoma that caused fallacy in treatment strategy.

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Pulmonary Infarction Associated with Fracture of Right Clavicle and Multiple Ribs (우측 쇄골 및 늑골골절과 동반된 폐경식 1례)

  • 김수성;이종임
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.941-944
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    • 1997
  • Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both l ng fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

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Clinical Evaluation of the Mediastinal Tumors (종격동 종양의 임상적 고찰)

  • 이준복;서성구
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1148-1151
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    • 1996
  • For the purpose of clinical analysis In mediastinal tumors, 51 patients with mediastinal tumor who were surgically treated from February 1984 to February 1994 in Chunan hospital of Soonchunhyang university were reviewed. There were 21 male and 30 female patients in the study. Age ranges from 11 months to 75 years, with the mean 39.4$\pm$ 18.8 years. Symptoms and signs were asymptom(21.6%), chest d scomfort(19.6%), dyspnea(15.7%), ptosls(15.7%), general weakness(13.7%) and chest pain(9.8%). The most frequent tumor location was anterosuperior mediastinum(60.8%) followed by posterior(25.5%) and middle(13.7%) mediastinum. In the pathological viewpoint, thymoma(33.3%) was the most frequent type followed by neurogenic tumor(25.5%) an'd germ cell tumor(19.6%). All of benign tumors(46 cases) were completely removed and malignant tumors(5 cases) were treated with rAdiotherapy after operation. The postoperative complications were 2 wound dehesences, 1 pneumothorax, 1 vocal cord palsy and 1 prolonged mechanical ventilation.

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Surgical Treatment for Primary Pulmonary Paraganglioma - A case report - (폐에 발생한 원발성 부신경절종의 수술치험 - 1예 보고 -)

  • Lee Choong-Won;Bang Jung-Heui;Roh Mee-Sook;Kim Ki-Nam;Choi Phil-Jo
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.718-721
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    • 2006
  • We describe the case of primary pulmonary paraganglioma in a 37-year-old woman who presented recurrent, severe cough. Computed tomography revealed a lobulated inhomogeneous enhanced mass with endobronchial protruding lesion suspected to be lung neoplasm, located in the upper lobe of the left lung. Bronchoscopic biopsy showed chronic inflammation with granulation tissue which was not in accord with the radiologic findings. Subsequently, a left lower sleeve lobectomy was peformed. Histological analysis of the resected tumor proved to be compatible with pulmonary paraganglioma. Primary pulmonary paragangliomas are very uncommon tumors. So we report this case with literature review.

Oral Amelanotic Malignant Melanoma in a Dog: Melan A Immunohistochemical Findings (개에서 발생한 구강 멜라닌결핍 악성흑색종 예 : Melan A 면역화학조직 염색 고찰)

  • Kang, Min-Hee;Park, Chul;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.612-615
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    • 2009
  • A 10-year-old intact male mixed breed dog was presented with a three-month history of massive oral mass. Physical examination revealed extending mass from the right upper gingiva. No metastasis was found at the time of presentation. Histopathologic examination of biopsied tissue from the oral mass was consistent with a neuroendocrine tumor with generalized epithelioid cells and few spindle cells. There were highly mitoses and no visible melanin granules with H&E staining. Immunohistochemical staining for Melan A was performed on section of tumor and was strongly positive. Diagnosis was made as amelanotic malignant melanoma based on histopathology with Melan A immunohistochemistry. This case study indicates that the Melan A immunohistochemical staining may be valuable to diagnose amelanotic malignant melanoma in dogs.

GINGIVAL FIBROMATOSIS IN MIXED DENTITION (혼합 치열기 어린이의 치은 섬유종증)

  • Han, Hyo-Jeong;Kim, Jin;Kim, Seong-Oh;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.4
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    • pp.696-700
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    • 2004
  • Gingival fibromatosis is a non-inflammatory oral disease, characterized by slowly progress enlargement of the free and attached gingiva. Gingival fibromatosis may have familial tendency. Gingival enlargement usually begins with the eruption of the permanent dentition but can also develop with the eruption of the primary dentition. In this case, a 6-year-old female had gingival enlargement at birth. There was no familial, medical and pharmacologic history of gingival overgrowth. Treatment is gingivectomy with a rigorous program of oral hygiene. Recurrence of gingival fibromatosis may well be inevitable. Therefore there is no general aggrement as to the timing of surgical intervention. Generally the best time is when all the permanent teeth have erupted. However early intervention can improve oral function and esthetic and psychologic effect.

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Endobronchial Chondroid Hamartoma - A case report- (기관지 내 연골성 과오종 -1예 보고-)

  • Lee Song Am;Kim Jun Seok;Lee Tae Hoon;Lim So Dug;Hwang Eun Gu;Kim Yo Han;Hwang Jae Joon
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.240-243
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    • 2006
  • Pulmonary hamartoma is a common benign tumor of the lung, but endobronchial hamartoma is a rare tumor. Although bronchoscopic rcemoval or removal by bronchotomy or sleeve resection with preservation of the lung may be possible, when irreversible lung damage has occurred because of chronic obstruction and pneumonitis, pulmonary resection may be indicated. We herein report a case of endobronchial hamartoma which was treated by left upper lobectomy. A 42-year-old female with 3-week history of cough and left chest pain visited our hospital. Bronchoscopy showed total occlusion of the orifice of the left upper lobe bronchus by a lobulated endobronchial tumor and bronchoscopic biopsy was failed due to bleeding. A left upper lobectomy was performed because of severe consolidation of the left upper lobe by chronic obstruction. The patient was discharged on postoperative 14th day.

A Case Report: A Rare Case of Extraocular Sebaceous Carcinoma on the Chin in 22-Year-old Asian Young Man (증례보고: 22세의 젊은 아시아인의 턱에서 진단된 안구외부위 피지샘암종의 진단 1례)

  • Hong, Joon Shik;Shin, HeaKyeong;Jung, Gyu Yong;Lee, Joon Ho
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.1
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    • pp.53-56
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    • 2021
  • Sebaceous carcinoma (SC) is a rare malignant tumor, with an estimated incidence of approximately 1 to 2 per 1,000,000 per year. Approximately 75% of SCs are reported to occur in eyelids. Most of these tumors are diagnosed at age 40 or over and exhibit a wide variety of patterns in addition to the general appearance previously reported. SC is difficult to diagnose clinically, but can be diagnosed by accompanying biopsy. In cases of SC, additional examinations, such as endoscopy and computed tomography, may be necessary because of its association with Muir-Torre Syndrome. We present the case of a 22-year-old Asian man who complained of a rapidly growing chin tumor. The tumor was treated by surgical resection and adjuvant radiation therapy.