• Title/Summary/Keyword: 흉막 종양

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Video-Assisted Thoracic Surgery: A Review of 52 Surgical Procedures (비디오 흉강경을 이용한 흉부수술 -52례 경험-)

  • Gang, Chang-Hui;Lee, Jun-Bok;Lee, Gil-No
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1138-1142
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    • 1996
  • Video-assisted thoracic surgery is a new modality that allows visualization of and access to the intrathoracic organs without making a thoracotomy Incision. 52 patients underwent thoracic procedures using this technique. There were pneumothorax in 40 patients, diffuse interstital lung disease in 6 patients, hyperhidrosis in 3 patients, pulmonary tuberculoma in 1 patient, aspergilloma in 1 patient and localized fibrous tumor of pleura in 1 patient. We had performed a variety of procedures(36 wedge resections with mechanical pleurodesis, 8 wedge resections only, 4 mechanical pleurodeses, 3 bilateral sympathectomys and 1 segmentectomy). The period of chest tube indwelling and postoperative hospitalization were 2.00 $\pm$ 1.32 days(range : 0~6 days) and 3.55 $\pm$ 1.45 days(range : 1~8 days). Four postoperative complications occurred(2 pleural effusion, 1 recurrent pneumothorax and 1 high fever). Conversion to open thoracotomy was done in 1 p tient due to massive air leakage. Patients undergoing video-assisted thoracic surgery seem to have reduced postoperative pain, shorter hospitalization, and quicker recovery times.

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Clinical Implication of Malignant Pleural Lavage Cytology (PLC) in Primary Lung Cancer (원발성 폐암에서 악성 흉강 세척액의 임상적 의미)

  • 김용희;박승일;김동관;공경엽
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.252-260
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    • 2004
  • The purpose of study is to evaluate the clinical implication of malignant Pleural Lavage Cytology (PLC) in primary lung cancer. 315 patients were examined with pleural lavage cytology in Asan Medical Center between November 1998 and August 2002. The patients were chosen from primary lung cancer patients with no pleural effusion according to preoperative radiologic examination; no tumor invasion into the chest wall and no diffuse pleural adhesion in intraoperative findings, The pleural cavity and lung were washed with 100 $m\ell$ of warm normal saline. The 315 patients consisted of 237 men and 78 women. The incidence of malignant PLC was found in 28 patients (8.9%). For patients in early stages (I & II), survival rate was 93.9% in positive malignant PLC and 85.7% in negative malignant PLC. 31 patients (13.6%) had local or distant recurrences; 2-year recurrence-free rate was 90.1% in negative PLC and 87.5% in positive PLC. The survival and recurrence-free rate in each stage were not statistically associated with the result of PLC. Median follow-up was 16.4 months from the surgery. To access implication of malignant PLC in primary lung cancer, a long-term follow-up and further study are required.

Synovial Sarcoma Arising from the Chest Wall in a Child (소아의 흉벽에서 발생한 윤활막 육종)

  • Kim, Seok;Park, Ki-Sung;Bae, Chi-Hoon
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.470-473
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    • 2010
  • Synovial sarcoma is a malignant soft-tissue tumor that most commonly occurs in the extremities of young adults. There have been several cases of synovial sarcomas of the pleural and lung reported, but synovial sarcoma arising from the chest wall in childhood is very rare. Here we report a case of synovial sarcoma arising from the chest wall in a 3 year-old female patient. The tumor was completely resected. No adjuvant therapy was given. The patient is well 3 years after the operation.

A Case of Localized Fibrous Tumor of the Pleura (흉막에 발생한 국소성 섬유성 종양 1예)

  • Kim, Yong-Hwan;Rha, Suk-Joo;Kwack, Moon-Sub
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.3
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    • pp.388-393
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    • 2000
  • Localized fibrous tumor of the pleura is very rare. Most of them are benign, but some are malignant. This clause does not relate with the rest of the sentence. The single best predictor of clinical benignity is whether the tumor can be totally resected. We experienced a case of localized fibrous tumor of the pleura in a 57 year old man with right chest pain and cough. He was informed of a $8{\times}5cm$ mass in his right lower lung field, which was benign 3 years ago. Preoperative chest x-ray showed an increased hazy density at right lower lung field, and CT scan showed a $12{\times}8cm$ huge mass, which was located in right lower thorax. Left thoracotomy was done to excise a $12{\times}8{\times}5cm$(1200gm) sized large mass delete. The patient was discharged without any complications postoperatively.

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Synovial Sarcoma of the Anterior Chest Wall: A Case Report (앞가슴벽에 생긴 윤활막육종: 증례 보고)

  • Mingook Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1227-1233
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    • 2020
  • Synovial sarcoma is a malignant soft tissue tumor that usually involves the extremities, particularly near the knees; a synovial sarcoma originating in the chest wall is extremely rare. We describe a 26-year-old woman diagnosed with a synovial sarcoma originating in the chest wall, based on CT and MRI findings. Contrast-enhanced CT images revealed a small, well-defined enhancing mass with calcification, in the subpleural area. This lesion was initially diagnosed as a benign tumor; however, the patient developed sudden severe pain with spontaneous bleeding and hemothorax, suggesting the possibility of malignancy. MRI revealed a multilobulated mass with a fluid-fluid level, which characterizes a synovial sarcoma.

Usefulness of the Pleural Fluid Adenosine Deaminase with Lymphocyte/Neutrophil Ratio in the Diagnosis of Tuberculous Pleurisy for a Region of Intermediate Prevalence of Tuberculosis (중등도 결핵 유병률 지역에서 결핵성흉막염 진단에 있어 흉수 아데노신 탈아미노효소와 림프구/호중구 비의 유용성)

  • Kim, Chang Hwan;Mo, Eun Kyung;Park, Sung Hoon;Hwang, Yong Il;Jang, Seung Hun;Park, Yong Bum;Kim, Cheol Hong;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.437-443
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    • 2009
  • Background: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). Methods: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. Results: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA ($\geq$40 IU/L). When we considered ADA $\geq$40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and posttest posttest probability 74.5%. However, when we considered ADA $\geq$40 IU/L combined with the L/N ratio $\geq$0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. Conclusion: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.

Endobronchial Metastasis of Extrapulmonary Malignancies (폐외 악성 종양의 기관지내 전이)

  • Kim, Do-Hoon;Park, Moo-Suk;Chung, Jae-Ho;Cheong, Jae-Hee;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.285-293
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    • 2002
  • Background : The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. Materials and Methods : The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. Results : The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. Conclusion : An endobronchial metastasis is an ominous finding, and is associated with advanced-stage diseases. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.

Surgical Resection of the Pulmonary Mucormycosis in the Diabetic Patient -1 case report- (당뇨병환자에서 발생한 폐모균증의 외과적 절제)

  • 김석기;서연호;김민호
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.915-918
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    • 2000
  • 폐모균증은 드물지만 치명적인 기회감염성 진균증으로 혈액종양, 신부전, 또는 당뇨와 같이 면역기능이 저하된 환자에서 주로 발생한다. 환자는 3년전부터 당뇨병 및 갑상선기능 항진증을 앓아온 32세 남자로 1개월간의 기침, 발열 및 좌측 흉통을 주소로 내원하였다. 기관지 내시경하 경기관지 폐생검상 폐모균증 진단되어 좌폐하엽절제술을 시행하였다. 술후 21일째 흉부방사선 사진 소견상 다수의 국소적인 흉막삼출로 흉강경을 이용한 배약술을 시행하였다. 환자는 술후합병증이 없이 흉강경배액술후 23일째 퇴원하였다. 기왕의 문헌보고에 의하면, 한쪽폐에 국한된 모균증을 가진 수술가능한 환자에서는 조기에 과감한 수술적 처치가 생존율을 높이는 것으로 제안하고 있다.

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Localized Fibrous Tumor of the Pleura (흉막에 발생한 국소성 섬유성 종양)

  • 김대영;손제문
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.112-114
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    • 1996
  • Localized fibrous tumor of the pleura (LFTP) is of submesothelial fibrous origin, which has been called pleural fibroma and has been confused with mesothelioma. We experienced a case of LFTP in a twenty nine year old man. The tumor arose from the right parietal pleura with long stalk. Chest X-ray and CT scan showed a 6$\times$5$\times$4cm well-defined mass in the right costophrenic angle. Wo evidence of metastasis was noted. Exploratory thoracotomy with enbloc excision of 6$\times$5$\times$4cm mass was done. The fine needle aspiration cytology and histopathologic features indicated the tumor to be malignant, and biologic behavior was discussed.

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그람양성군 감염증에 대한 Teicoplanin과 Vancomycin의 임상 효과 및 그 안전성에 관한 비교 연구

  • 최강원;우준희;오명돈
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1992.05a
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    • pp.57-57
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    • 1992
  • Teicoplanin은 actinoplanes teicomyceticus의 발효산물로서 vancomycin과 같은 glycopeptide 계열의 항균제이며, 그 작용기전은 세포벽 합성과정중 peptidoglycan의 중합을 억제하는 것으로 vancomycin과 유사하나 vancomycin과 달리 근육에 주사할 수 있으며 "red man's syndrome"이 생기지 않고 vancomycin보다 반감기가 길다. 그람양성균 감염증에 대한 teicoplanin의 효능 및 안전성을 조사하기 위하여, 그람양성균에 의한 감염증 또는 그람양성균과 그람음성균에 의한 혼합감염증이 확인되거나 의심되었던 환자 46명을 대상으로 teicoplanin과 vancomycin을 투여하였다. 투약 환자중 임상적인 반응을 평가할 수 있는 환자의 수는 vancomycin의 경우 투약환자 22명중 21명, teicoplanin의 경우 24명중 19명이였다. Vancomycin군중 임상적 반응의 평가에서 제외된 1명은 수술 후 흉막강에 MRSA 에 의한 농양으로 투약 29일째에 뇌출혈로 사망하였던 예로, 추적-배양검사에서는 MRSA가 제거 되었다. Teicoplanin군에서는 항균제 투여 중 간경변증에 의한 식도출혈 1예, 수술후 위장관 출혈 1예, 뇌 색전중 1예가 사망하였고, 1예는 Teicoplanin에 의한 심한 피부발진으로, 다른 1예는 봉와직염의 임상진단이 조직검사결과 악성종양의 근육침범으로 밝혀져 투약을 중단하였다.

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