• Title/Summary/Keyword: 폐 침윤

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Primary T-cell Lymphoma of the Lung Presenting with Bilateral Hilar Lymphadenopathies and Diffuse Pulmonary Infiltration (폐문 임파절 종대를 동반한 양측성 미만성 폐침윤)

  • Kim, Bo Kyoung;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.203-208
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    • 1997
  • Non-Hodgkin's lymphoma arising in lung comprises 0.5% of primary lung tumor and 3% of extranodal lymphoma. The most common radiographic abnormalities of pulmonary lymphoma include pulmonary nodule and consolidation, but hilar lymphadenopathy is rarely observed Recently we experienced primary pulmonary T-cell lymphoma presenting with bilateral hilar lymphadenopathies and diffuse pulmonary infiltration A 39-year-old man was admitted to the hospital because of fever, cough, and severe dyspnea. Chest PA obtained on admission revealed bilateral hilar lymphadenopathies and diffuse bilateral pulmonary infiltration. The diagnosis of sarcoidosis was strongly suggested and empirical treatment with corticosteroids resulted in dramatic clinical and radiological improvement for a short time. Eventually, CT-guided lung biopsy was performed and the specimen disclosed primary pulmonary Non-Hodgkin's lymphoma of T-cell origin, diffuse small lymphocytic with focal plasmacytoid differentiation.

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Role of Invasive Procedures in the Diagnosis and Management of Pulmonary Infiltrates in Patients with Leukemia (백혈병 환자에서 발생한 폐침윤의 진단 및 치료에 있어 침습적 검사의 역할)

  • Kang, Soo-Jung;Park, Sang-Joon;An, Chang-Hyeok;Ahn, Jong-Woon;Kim, Ho-Cheol;Lim, Si-Young;Suh, Gee-Young;Kim, Ho-Joong;Kwon, O-Jung;Lee, Hong-Ghi;Rhee, Chong-H.;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.448-463
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    • 2000
  • Background : Pulmonary infiltrate is a frequent cause of morbidity and mortality in patients with leukemia. It is often hard to obtain a reliable diagnosis by clinical and radiologic findings alone. The aim of this study was to evaluate diagnostic and therapeutic benefits of invasive procedures for new lung infiltrates in leukemia. Methods : Patients with leukemia who developed new lung infiltrates from December 1994 to March 1999 were included in this study. These patients were classified into the empirical group who received empirical therapy only and into the invasive group who underwent bronchoscopy or surgical lung biopsy for the diagnostic purpose of new lung infiltrates. A retrospective chart review was done to find the etiologies of new lung infiltrates, the yield of invasive procedures, outcome as well as predicting factors for survival. Results : 1) One hundred-two episodes of new lung infiltrates developed in 90 patients with leukemia. Invasive procedures were performed in 44 episodes while 58 episodes were treated with empirical therapy only. 2) Invasive procedures yielded a specific diagnosis in 72.7%(32/44), of which 78.1% had infectious etiology. Therapeutic plan was changed in 52.3%(23/44) of patients after invasive procedures. None of them showed procedure-related mortality. 3) The overall survival rate was 62.7%(64/102). Survival rate in the invasive group (79.5%) was significantly better than that in the empirical group (50.0%) (p=0.002). 4) Upon multivariate analysis, the performance of invasive procedures, no need for mechanical ventilation and achievement of complete remission of leukemia after induction chemotherapy were the independent predicting factors for survival in patients with leukemia and new lung infiltrates. Conclusion : Bronchoscopy and surgical lung biopsy are useful in the diagnosis of new lung infiltrates in patients with leukemia. However, survival benefits of invasive procedures should be considered together with disease status of leukemia and severity of respiratory compromise.

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Ameliorating Effects of Moxifloxacin on Endotoxin-Induced Acute Lung Injury in Rats (흰쥐에서 내독소로 유도된 급성 폐손상에서 moxofloxacin의 개선효과)

  • Lee, Young-Man;Chae, Whi-Gun
    • Journal of Life Science
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    • v.21 no.8
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    • pp.1100-1108
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    • 2011
  • The immunomodulating effects of moxifloxacin seem to be effective in downregulating inflammatory reactions. This presumed effect was tested in endotoxin (ETX)-induced acute lung injury (ALI) in rats. After moxifloxacin treatment (10 mg/kg) of ETX-given rats, lung myeloperoxidase (MPO) activity, bronchoalveolar-lavage (BAL) protein, and the number of neutrophils in the BAL cells were measured. Light and electron microscopic structures were also examined. Electron microscopic $CeCl_3$ histochemistry for the detection of hydrogen peroxide in the lungs and immunohistochemistry of cytosolic phospholipase A2 (cPLA2) in the lung tissues and BAL cells were performed. To examine the expression of TNF${\alpha}$ in the lungs, western blotting was carried out with the lung tissues. ETX had accumulated neutrophils in the lungs, which was followed by lung leak. Oxidative stress occurred, and increased expression of cPLA2 in the lung tissues and BAL cells was observed in the ETX-given rats. Simultaneously, the expression of TNF${\alpha}$ was enhanced by ETX. Moxifloxacin, however, decreased all these parameters, indicating that ALI may have been ameliorated. Moxifloxacin appears to ameliorate ETX-induced ALI partially through the suppression of cPLA2 in the lungs of rats.

Role of Endogenous Histamine on the Pathogenesis in the Endotoxin-Induced Acute Lung Injury (내독소로 유도되는 급성폐손상의 발병기전에서 내인성 히스타민의 역할)

  • Kim, Tae-Hyung;Kim, Eun-Kyung;Yoon, Ho Joo;Kim, Mi Jung;Choi, Jeoung Eun;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.91-103
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    • 2003
  • Background : Histamine is widely distributed in the lung. It increases capillary permeability and the P-selectin expression on vascular endothelial cell surfaces. We studied the role of endogenous histamine on the pathogenesis of endotoxin-induced acute lung injury (ALI) in rats. Methods: We instilled either normal saline (control group) or lipopolysaccharide (3 mg/Kg, LPS group) to tracheas of Sprague-Dawley rats. H1-receptor blocker (mepyramine, 10 mg/Kg, H1RB group), H2-receptor blocker (ranitidine, 10 mg/Kg, H2RB group), and H3-receptor blocker (thioperamide, 2 mg/Kg, H3RB group) were administered through vein or peritoneum along with intratracheal LPS administration. Statistical significance was accepted at p<0.05. Results : LPS increases the histamine level in BAL fluid significantly at 2 h after the treatment compared with control group. LPS significantly increases protein concentration, PMN cell count in bronchoalveolar lavage (BAL) fluid, and myeloperoxidase (MPO) activity in the lung tissue at 6 h compared to control group. PMN cell count in BAL fluid and MPO activity in lung tissue were significantly lower in H2RB-group compared to LPS-group. However, protein concentration in BAL fluid showed no significant differences between the LPS alone and LPS with histamine receptor blockade. Conclusions : Endogenous histamine might be involved in the recruitment of PMNs in LPS-induced ALI via H2 receptor. However, its role in ALI would not be significant in this model.

Effects of Opuntia Ficus-indica on Ovalbumin-induced Asthma Model (Ovalbumin으로 유도된 천식 마우스 모델에서 백련초의 효과)

  • Ra, Je-Hyeon;Shen, Feng-Yan;Jung, Sung-Ki;Kim, Jin-Ju
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.788-798
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    • 2009
  • Objective : This study was undertaken to investigate effects of Opuntia ficus-indica (OP)extract on an asthma murine model. Methods : The total number of cells and eosinophils in BALF and the infiltration of inflammatory cells into lung tissues were determined by hematoxylin and eosin staining. Results : The number of OVA-induced total cells and eosinophils, a phenomenon of asthma, were decreased by treatment of the animals with OP extract (200 mg/kg) (respectively, p < 0.001 and p<0.01). Furthermore, we showed that OP extract reduced the increased immune cell infiltration induced by ovalbumin (p < 0.01). The levels of interleukin (IL)-4 in BAL fluid were measured by enzyme-linked immunosorbent assay, because the eosinophilia is associated with a T helper (Th) 2 response including IL-4. The level of OVA-induced IL-4 was decreased by OP extract in BAL fluid (p < 0.05). We investigated whether OP extract reduced nitrite (NO) production on lipopolysaccharide (LPS)-stimulated RAW 264.7 sells, because asthma is an inflammatory disease. The level of LPS-induced NO production was decreased by OP extract (50, 100 and 200 mg/ml) on RAW 264.7 cells (respectively, p < 0.05, p<0.01 and p<0.05). Conclusions : Our results indicate that OP extract has an inhibitory effect on lung eosinophilia of asthma and suggest that OP extract is a therapeutic candidate in the treatment of inflammatory disease, including asthma.

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A Case of Idiopathic Hypereosinophilic Syndrome Associated with Pulmonary Infiltration (폐 침윤을 동반한 특발성 과호산구 증후군 1례)

  • Rhu, Hon-Mo;Kweon, Young-Soo;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo;Kim, Dong-Sug;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.375-380
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    • 1994
  • The idiopathic hypereosinophilic syndrome consists of peripheral blood eosinophilia of $1500/mm^3$ or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed no response. However the hydroxyurea showed good response.

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Invasive Thymoma Originating from Right Pleura with Normal Thymus A case Report (흉막에서 발생한 침습성 흉선종,정상 흉선을 가진 예)

  • 박희철;옥창석
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1381-1384
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    • 1996
  • Thymoma Is an anterior mediastinal tumor, arising from the thymus, but occasionally has ectopic focus such as neck, trachea, thyroid, pulmonary hilum, lung parenchyme and pleura. Forty-two year old male patient was admitted due to progressive development of shortness of breath in 4 months. He had a history of exposure to asbestos for About 10 years duration In recent 15 years. Radiologically, multiple pleural masses were seen rom apex to diaphrAgm, with no evidence of anterior mediastinal mass,with fluid in right pleural cavity. Closed thoracotomy drainage with open biopsy were performed. Effusion cell block showed many T cell marker positive Lymphocytes & some epithelial cells compatible with thymoma, and the tissue also showed cortical type thymoma. Pleuropneumonectomy and thymectomy followed by 60 Gy radiation therapy were done and the patient is well 8 months postoperatively. The pleura is markedly thickened by the invasion of thymoma and the interstitial space of the lung tissue,but the normal appearance of thymus was present in remote area (Masaoka classification IVa). We report a case of ectopic invasive thymoma arising from the right pleura with intact thymus.

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Pulmonary Mycoses in Immunocompromised Hosts (면역기능저하 환자에서 폐진균증에 대한 임상적 고찰)

  • Suh, Gee-Young;Park, Sang-Joon;Kang, Kyeong-Woo;Koh, Young-Min;Kim, Tae-Sung;Chung, Man-Pyo;Kim, Ho-Joong;Han, Jong-Ho;Choi, Dong-Chull;Song, Jae-Hoon;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1199-1213
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    • 1998
  • Background : The number of immunocompromised hosts has been increasing steadily and a new pulmonary infiltrate in these patients is a potentially lethal condition which needs rapid diagnosis and treatment. In this study we sought to examine the clinical manifestations, radiologic findings, and therapeutic outcomes of pulmonary mycoses presenting as a new pulmonary infiltrate in immunocompromised hosts. Method : All cases presenting as a new pulmonary infiltrate in immunocompromised hosts and confirmed to be pulmonary mycoses by pathologic examination or by positive culture from a sterile site between October of 1996 and April of 1998 were included in the study and their chart and radiologic findings were retrospectively reviewed. Results : In all, 14 cases of pulmonary mycoses from 13 patients(male : female ratio = 8 : 5, median age 47 yr) were found. Twelve cases were diagnosed as aspergillosis while two were diagnosed as mucormycosis. Major risk factors for fungal infections were chemotherapy for hematologic malignancy(10 cases) and organ transplant recipients(4 cases). Three cases were receiving empirical amphotericin B at the time of appearance of new lung infiltrates. Cases in the hematologic malignancy group had more prominent symptoms : fever(9/10), cough(6/10), sputum(5/10), dyspnea(4/10), chest pain(5/10). Patients in the organ transplant group had minimal symptoms(p<0.05). On simple chest films, all of the cases presented as single or multiple nodules(6/14) or consolidations(8/14). High resolution computed tomograph showed peri-lesional ground glass opacities(14/14), pleural effusions(5/14), and cavitary changes(7/14). Definitive diagnostic methods were as follows : 10 cases underwent minithoracotomy, 2 underwent video-assisted thoracoscopic surgery, 1 underwent percutaneous needle aspiration and 1 case was diagnosed by culture of abscess fluid. All cases received treatment with amphotericin B with 1 case each being treated with liposomal amphotericin B and itraconazole due to renal toxicity. Lung lesion improved in 12 of 14 patient but 4 patients died before completing therapy. Conclusion : When a new lung infiltrate develops presenting either as a nodule or consolidation in a neutropenic patient with hematologic malignancy or in a transplant recipient, you should always consider pulmonary mycoses as one of the differential diagnosis. By performing aggressive work up and early treatment, we may improve prognosis of these patients.

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