• Tuberculosis and Respiratory Diseases
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• v.59 no.6
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• pp.670-673
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• 2005

An 81-year-old man underwent bronchoscopy to investigate the cause of his dyspnea symptoms. A benign natured mass was observed in the bronchus and was excised. The pathology examination revealed a fibroepithelial polyp. He has been asymptomatic since the simple bronchoscopic excision. A fibroepithelial polyp is a benign tumor with a mesodermal origin. It is commonly found in the skin, urogenital area and chest, but is extremely rare in the respiratory system. We report a case of a fibroepithelial polyp in the bronchus, which was treated with a bronchoscopic excision, with a brief review of the relevant literature.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.792-799
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• 1985

Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.54-57
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• 2012

Neurilemmoma is a benign and slowly growing neurogenic tumor. Intrathoracic neurilemmoma often develops in the chest wall and posterior mediastinum, but endobronchial neurilemmoma is extremely rare. The diagnosis of endobronchial neurilemmoma with preoperative imaging findings is challenging and is usually made via postoperative pathological examination. These authors encountered a case of primary endobronchial neurilemmoma in a 52-year-old woman who had no symptoms. A $3.0{\times}2.6$ cm mass in the right lower lobe projecting into the mediobasal segmental bronchus was shown in the results of the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the chest. Benign neurilemmoma was confirmed via bronchoscopic biopsy, and surgical resection (sleeve bronchial excision and end-to-end anastomosis) was performed.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.17-24
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• 1977

The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tube has produced, apparently with increasing frequency, three lesions which have serious ceminical manifestations such as tracheal stenosis, tracheomalasia, and localized tracheal erosion. Extensive resection and reconstruction of the trachea must be necessary because conservative treatment has generally failed in the fully developed stenotic lesion. of the mediastinal trachea following extensive resection is best accomplished by direct anastomosis of the patient`s own tracheobronchial tissue. Any replacement of the mediastinal trachea must be air tight and laterally rigid, and must heal dependably. A variety of materials has been used for substitution following circumferential excision of tracheal segments within the mediastinum. These attempts have often failed because of early leak or late stenosis. We have successfully performed circumferential resection and primary end-to-end anastomosis of the trachea for 4 cases of post-intubation tracheal stenosis located a few centimeter below the tracheostomy stoma in the period of 3 years between 1974 and 1976. The lesion in one patient was found in the upper trachea which was approached anteriorly through a cervicomediastinal incision with division of the upper sternum. Other three located in the lower half of the trachea were operated through a high transthoracic incision with appropriate hilar mobilization in addition to cervical flexion for the development of the cervical trachea into the mediastinum. There were no hospital death, but suture line granulations occurred in two patients were managed by bronchoscopic removal of granulations without difficulties.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.76-79
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• 2006

Primary malignant melanoma of the lung is extremely rare. A 46-year-old lady was admitted with two month history of dry cough and blood-tinged sputum. Chest CT showed 4.5 $\times$ 5.0 cm sized mass at the right lower lobe. Repeated bronchoscopic and percutaneous biopsies showed no definite diagnosis. Preoperative evaluations revealed no systemic metastais. So, we tried the surgical approach. Right lower lobectomy and lymph node dissection was done. The mass and lymph node were confirmed as primary malignant melanoma. The patient presented with right hemiparesis 40 days after operation. Brain MRI showed 1.5$\times$2.0 cm sized mass lesion on the left parietal lobe. Mass excision was done. However, she expired 8 months later.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.792-797
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• 1996

A 59-year-old woman was admintted to the hospital because of intermittent fever and right side chest pain. She has a same episode eight months before this entry. Chest CT scan demonstrated ill-defined parenchymal consolidation containing dilated bronchi of right lower lung field, but no endobronchial mass in the bronchial trees. Fiberoptic bronchoscopy seeking the cause of recurrent pneumonia revealed a small, round mass nearly completely obstructing me lumen of basal segmental bronchus of right lower lobe. The diagnosis of bronchiolar papilloma was made from the biopsy specimens of the bronchoscopic examination. The patient was treated with right lower lobectomy because of irreversible secondary changes below the obstructed bronchus. This thoracotomic excision resulted in complete relief of symptoms and the postoperative course was uneventful for 12 months. Here we report a extremely rare umor with a brief review of literatures.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.350-354
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• 1996

Pulmonary mucormycosis is a very rare but often fatal opportunistic fungal infection caused by the order Mucorales in class Zygomycetes. Reported overall mortality exceeds 70% and the diagnosis is often made post-mortem. We experienced 2 cases of typical form of pulmonary mucormycosis. One patient was a poorly controlled diabetic and the other suffered from acute Iymphocytic leukemia (ALL). The former was diagnosed by a bronchoscopic biopsy and the latter by a pathologic examination from the percutaneous drain of a subphrenic abscess. Both of them underwent a surgical excision of the involved lung tissue. The patient with diabetes mellitus was successfully treated by surgical resection and discharged without complications. The other with ALL underwent a second operation and was transferred to the department of internal medicine for further management of his relapse of lettkemia. Recent literat re suggests that early aggressive diagnostic effort and treatment including surgical resection in the case of localized forms of the disease results in a good prognosis.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1058-1066
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• 1998

Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.