• Title/Summary/Keyword: 횡격막 병변

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Primary Malignant Fibrous Histiocytoma of the Diaphragm -One Case Report- (횡격막의 원발성 악성 섬유성 조직구종 -1례 보고-)

  • 김대현;김범식;조규석;박주철
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.118-121
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    • 2003
  • A 25-year-old female patient was adimitted due to discomfort in the right chest and left epigastric area. Chest X-ray and chest CT showed a round 4$\times$4$\times$4cm sized mass located in the right lower lobe and abutted on the right diaphragm and metastatic lesions in the right lower lobe and right middle lobe. In exploratory thoracotomy, we discovered a mass originating from the right diaphragm which directly invaded the right lower lobe and metastatic subpleural lesions in the right lower lobe and right middle lobe. The mass was diagnosed as sarcoma by frozen section biopsy and we removed the mass by on bloc resection of the right diaphragm and right lower lobe. Metastatic subpleural lesions in the right lower lobe and right middle lobe were removed by wedge resection. The mass was malignant fibrous histiocytoma of the diaphragm in permanent pathologic examination and chemotherapy was done as adjuvant measure. We report one extremely rare case of malignant fibrous histiocytoma of the diaphragm with literature.

Treatment of Bilateral Diaphragmatic Paralysis after Resection of Thymic Carcinoma -One case report- (흉선암 절제술 후 발생한 양측성 횡격막 마비의 치유 -1예 보고-)

  • 김재욱;김승우;류지윤;김욱성;장우익;진재용;김민경;김태식;김연수
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.985-990
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    • 2003
  • Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, corvical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an on-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.

Pulmonary Epithelioid Hemangioendothelioma Association with Subcutaneous Metastasis -Surgical experience of one case- (피하전이를 일으킨 폐 유상피 혈관내피종)

  • 이해영;조성호;변정훈;김종인;박진경;천봉권;조성래
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1025-1028
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    • 2004
  • Epithelioid hemangioendothelioma (HE) is a very rare malignant tumor that is pathologically benign tumor originating from endothelial cell but clinically presents metastasis and recurrence. A 29-year-old asymptomatic man, preoperatively diagnosed as lung cancer in the left lower lung, underwent a lobectomy, a wedge lung resection of left upper lung, and partial resection of diaphragm. Left lower lobar lesion was confirmed as pulmonary epithelioid hemangioendothelioma, but the lesions of the left upper lung and diaphragm were remained calcified by spontaneous regression of HE. We report a case of subcutaneous metastasis that occurred two times at 10 months and 19 months after previous surgical treatment of pulmonary EH.

Left Diaphragmatic Eventration Diagnosed as Congenital Diaphragmatic Hernia by Prenatal Sonography (선천성 횡격막 헤르니아로 오인된 좌측 횡격막 내장탈출 2예)

  • Yeom, Jung-Sook;Park, Ji-Sook;Park, Eun-Sil;Seo, Ji-Hyun;Lim, Jae-Young;Park, Chan-Hoo;Woo, Hyang-Ok;Jung, Eun-Jung;Jo, Jae-Min;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.92-97
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    • 2006
  • Congenital diaphragmatic eventration is the abnormal elevation of the diaphragm into the thoracic cavity. Sometimes, it is not easy to differentiate congenital diaphragmatic eventration from diaphragmatic hernia by either prenatal sonography or postnatal chest radiography. However, differential diagnosis of both diseases is practical because of different prognosis and surgical approaches. Careful interpretation of postnatal serial chest X-rays is mandatory to differentiate between both diseases. We report two neonates with congenital diaphragmatic eventration of left diaphragm that initially misdiagnosed as diaphragmatic hernia by prenatal sonography and postnatal chest radiography.

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Isolated and Ectopic Mediastinal Paragonimiasis without Any Pulmonary or Pleural Lesion (폐나 흉막 병변을 보이지 않는 단독으로 종격동에 발생한 폐흡충증)

  • Ra, Yong-Joon;Ahn, Hyo-Yeong;Kim, Yun-Seong;Choi, Kyung-Un
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.553-556
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    • 2010
  • A 55-year-old female presented to Pusan National University Yangsan Hospital with left neck and shoulder pain. An anterior mediastinal mass was detected on chest CT and there were no other specific lesions in the lung or pleural cavity. An infected pericardial cysts was suspected and excision was performed through a left-sided VATS approach. The patient was discharged on the second post-operative day with left diaphragm palsy and praziquantel was prescribed after paragonimaisis was confirmed on pathology. The patient has not shown any particular problems at my outpatient clinic.

Clinical Application for Video-Thoracoscopy in Lung Cancer Surgery Patients (폐암 수술환자에서 흉강경수술의 적용)

  • 김광호;한재열;윤용한;백완기;이응석;김형진
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.392-396
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    • 2002
  • Background: Video-thoracoscopy is known to be an useful method to provide accurate pre-resectional staging in patients with lung cancer in addition to the conventional radiologic studies and mediastinoscopy, for the pleural cavity is inspected directly and biopsy specimens call be obtained. This study is undertaken to evaluate how video-thoracoscopy can be used in deciding pre-resectional stage Material and Method: Video-thoracoscopy was performed in patients with lung cancer who were scheduled for surgical resection based on the radiologic staging and mediastinoscopic biopsy. 37 patients were included in this study. Pre-thoracoscopically 18 cases were in TNM stage 1, 7 in stage 2, and 12 in stage 3. Result: In 15 of 37 cases, video-thoracoscopy could not be performed effectively due to heavy adhesions in the pleural cavity, diaphragmatic and chest wall invasion of tumor and bulky tumor mass es. Mediastinal lymph nodes were positive postresectionally in 6 of these 15 cases. In 22 cases, video-thoracoscopy was performed as usual. Positive mediastinal lymph nodes were identified in 2 cases and exploratory thoracotomy was prevented. Surgical resection were carried out in remaining 20 cases and 5 cases among them had positive mediastinal lymph nodes. Conclusion: We believe that it is difficult to perform pre-thoracotorny video-thoracoscopy for all lung cancer patients for there were many cases that thoracoscory could not be undertaken doe to heavy adhesions in the pleural cavity, tumor involvement of the chest wall and/or diaphragm and bulky tumor mass. However we think it is helpful in preventing unnecessary exploratory thoracotomy for some patients with lung cancer whom pre-thoracotomy video-thoracoscopy was carried out.

Bilateral Intralobar Pulmonary Sequestration with Horseshoe Lung A near suggestion about the treatment of pulmonary sequestration (마제상폐를 보이는 양측성 엽내형 폐격리증의 외과적 치료 -폐격리증치료에 대한 새로운 제안-)

  • 박종빈;김용희
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.226-230
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    • 1997
  • This is a case report of surgical management of a bilateral intralobar pulmonary sequestration with horseshoe lung presenting with frequent U I with productive sputum. Simple chest X-ray showed pneumonic consolidation and infiltration on both lower lobes, and chest CT revealed multiple cystic lesions compatible with pulmonary sequestration. The aortography demonstrated two anomalous systemic arteries arising from the thoracic aorta just above the diaphragm to both sequestrums. Left lower lobectomy was performed through the left thoracotomy with ligations and divisions of the both systemic feeding arteries to the left and right sequestrum, and division of the isthmic portion of horseshoe lung without removal of right sequestrum. The patient was discharged on the postoperative loth day and followed-up till now without any sequelae and symptoms of residual right sequestration. The recent follow-up chest CT 5 months after the operation revealed spontaneous regression of the residual right sequestrum. Authors would suggested that only division of aberrant artery to sequestrum without lobectomy may be applied in uncomplicated ca e of intrapulmonary seqilestration.

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Abdominal Maduromycosis in a dog (개의 복강(腹腔) Maduromycosis)

  • Bak, Ung-Bok;Cheong, Chang-Kook;Lim, Chang-Hyeong
    • Korean Journal of Veterinary Research
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    • v.22 no.1
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    • pp.67-74
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    • 1982
  • A massive mycetoma was observed in the abdominal cavity of a 3-year-old spayed female Labrador Retriever dog originated from France. The mycetoma lesion involved adhesion with one-half of the spleen, several portions of the small and large intestine, and the diaphragem. Histologically the distinct hypertrophy of the intestinal muscle layer, wide-spread deposition of the hemosiderin through the affected abdominal organs and thrombosis of splenic arterioles with atheromatous change were recognized as persistant, debilitating changes of the affected organs. From the histological appearance of the fungal colonies it was presumed that the causative fungus to be identified as Allescheria boydii.

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Korean Clinical Imaging Guidelines for the Appropriate Use of Chest MRI (한국형 흉부 MRI 영상 진단 정당성 권고안)

  • Jiyoung Song;Bo Da Nam;Soon Ho Yoon;Jin Young Yoo;Yeon Joo Jeong;Chang Dong Yeo;Seong Yong Lim;Sung Yong Lee;Hyun Koo Kim;Byoung Hyuck Kim;Kwang Nam Jin;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.562-574
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    • 2021
  • MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.