• Title/Summary/Keyword: ChestCT

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A Case of Graves' Disease Coexistent with Pulmonary Sarcoidosis (폐 사르코이드증에서 동반된 그레이브스병 1예)

  • Jo, Ki Won;Koh, Jang Hyun;Lee, Mi Young;Jung, Feel Moon;Shin, Young Goo;Yong, Suk Joong;Chung, Choon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.417-420
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    • 2007
  • Sarcoidosis is a multisystemic granulomatous disease with an of unknown etiology, involving bilateral hilar lymphadenopathy, pulmonary, skin and eye lesions. However, involvement of the endocrine system in sarcoidosis is quite rare, and the coexistence of both diseases is extremely unusual. We describe a 60-year-old woman presenting with sarcoidosis and Graves' disease. She was admitted for evaluation of dry cough, dyspnea, palpitation and general weakness. Both thyroid glands were enlarged diffusely. The thyroid function tests showed suppressed serum thyrotropin and an increased thyroid hormone level. The levels of the TSH receptor antibody, anti-thyroglobulin antibody and anti-microsomal antibody were higher than normal. The radionuclide scan($^{131}I$) showed increased iodine uptake. The chest X-ray revealed pulmonary hilar enlargement and high resolution CT showed both hilar lymph nodes enlargement and tiny parenchymal nodules. The transbronchial lung biopsy showed a noncaseating granuloma without necrosis. We report this case of pulmonary sarcoidosis plus Graves' disease with a review of the relevant literatures.

A Case of Bronchiolitis Interstitial Pneumonitis (Bronchiolitis Interstitial Pneumonitis 1예)

  • Chi, Su Young;Ryu, Kyoung Ho;Lim, Dae Hun;Shin, Hong-Joon;Ban, Hee Jung;Oh, In-Jae;Kwon, Yong Soo;Kim, Kyu-Sik;Lim, Sung-Chul;Kim, Young-Chul;Choi, Yoo-Duk;Song, Sang-Yun;Seon, Hyun Ju
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.364-368
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    • 2009
  • Bronchiolitis interstitial pneumonitis (BIP), an unclassified and newly described interstitial pneumonia, has a combined feature of prominent bronchiolitis, interstitial inflammation, and fibrosis. It is distinct from bronchiolitis obliterans or bronchiolitis obliterans organizing pneumonia (BOOP). BIP has a better prognosis than common cases of interstitial pneumonia. However, BIP has a poorer prognosis than BOOP. BIP's response to corticosteroids is not as successful as BOOP's response to this treatment. We encountered the case of a 31-year-old woman with BIP with an initial presentation of dyspnea and a cough that had lasted for 3 months. The patient's chest CT scan demonstrated patchy ground glass opacities and multiple ill-defined centrilobular nodules in both lungs, suggesting military tuberculosis or nontuberculous mycobacterial infection. A video-assisted thoracoscopic lung biopsy resulted in the diagnosis of BIP. Clinical symptoms, pulmonary lesions, and pulmonary function tests were improved after oral glucocorticoid therapy.

Diffuse Alveolar Damage Associated with Polymyositis (다발성 근염에 동반된 Diffuse Alveolar Damage 1예)

  • Park, Tae-Eung;Lee, Se-Young;Lee, Kwang-Hi;Jung, Sung-Hwan;Uh, Soo-Taek;Lim, Kun-Il;Park, Choon-Sik;Jin, Byung-Won;Park, Jai-Sung;Choi, Deuk-Lin;Jin, So-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.400-406
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    • 1995
  • Interstitial pneumonitis may be the presenting manifestation of polymyositis-dermatomyositis (PM-DM), or may occur later in the evolution of disease. The clinical picture is characterized by non-productive cough, dyspnea and hypoxemia. The chest radiograph demonstrates interstitial infiltrates with predilection for the lung bases, often with an alveolar pattern in addition. We experienced a case of polymyositis associated with diffuse alveolar damage(DAD) that was proven in open lung biopsy. The patient was a 52 year-old woman who was presented with 6 months' duration of generalized ache, edema on ankle and wrist, non-productive cough and mild dyspnea. She had typical symptoms and physical findings of interstitial pneuminitis, and elevated muscle enzyme levels in serum with characteristic histologic findings of myositis on muscle biopsy. She also had typical interstitial lung disease pattern on high resolution CT and restrictive pattern on pulmonary function tests. The findings of open lung biopsy was compatible with diffuse alveolar damage(DAD). She failed to respond to the therapeutic trials with corticosteroid and cyclophosphamide, and finally expired due to acute respiratory distress syndrome.

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Asymmetrical diffuse Interstitial Lung Lesions with Multiple Lymphadenopathy (다발성 임파절 이상증을 동반한 비대칭적 폐 간질성 병변)

  • Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee;Kim, Hyuk;Choi, Yo Won;Jeon, Seok Chol
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.651-656
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    • 1996
  • We have experienced a case of sarcoidosis appearing asymmetrical diffuse interstitial lung lesions with multiple lymphadenopathy. This patient was a 57 year-old female who had been in good health until 2 months ago. At that time she noted the onset of an exertional dyspnea and weakness. Pulmonary function tests showed moderate obstructive pattern with mild decreased DLco. In the chest CT, multiple lymphadenopathy with small nodular lesions are scattered, and the impression was a metastatic lymph nodes with lymphangitic carcinomatosis. In bronchofiberscopy, we noted luminal narrowing by extrinsic compression in the right middle and lower lobe bronchi. And microscopic examination of by bronchofiberscopic biopsy showed chronic inflammation. Thus we performed subcarinal and tight supraclaviclar lymph nodes aspiration biopsy cytology, and that revealed class 0 and class 1, respectively. Finally, we performed an excisional biopsy for the right scalene lymph node, which revealed the specimen as a noncaseating granuloma. The angiotensin convecting enzyme level was overt two folds compared to normal value. And the patient had negative PPD skin test and hyperglobulinemia. After 18 weeks treatment with prednisone, the signs and symptoms which the patient clad suffered from, disappeared.

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A Case of Pulmonary Paragonimiasis Presented as Solitary Pulmonary Nodule and Suspected as Lung Cancer on 18F-Fluorodeoxyglucose Positron Emission Tomography (양전자 방출 단층촬영에서 폐암으로 의심되었던 고립 폐 결절 형태의 폐흡충증 1예)

  • Moon, Jae Young;Jung, Ki Hwan;Kim, Je Hyeong;Park, Hyung Joo;Kim, Young Sik;Shin, Chol
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.133-137
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    • 2008
  • Pulmonary paragonimiasis continues to be a diagnostically challenging parasitic disease, despite a drastically decreased prevalence in South Korea during the past decade. Pulmonary paragonimiasis is characterized by fever, chest pain, and chronic cough with hemoptysis. Numerous radiographic and computed tomographic findings including the presence of pneumothorax, pleural effusion, and parenchymal lesions such as nodular or infiltrative opacities have been reported. The clinical and radiological manifestations of paragonimiasis can resemble those of lung cancer, tuberculosis or a metastatic malignancy. Furthermore, this disease can mimic lung cancer as seen on $^{18}F$-fluorodeoxyglucose positron emission tomography (FDG-PET). We report a case of pulmonary paragonimiasis in a 48-year old man that presented with a solitary pulmonary nodule and was suspected as a lung cancer based on FDG-PET imaging.

Mesenchymal Chondrosarcoma of the Calcaneous (종골에 발생한 간엽성 연골육종 - 1예 보고 -)

  • Sung, Ki-Sun;Son, Jeong-Gyeong;Cho, Eun-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.219-223
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    • 2005
  • Mesenchymal chondrosarcoma is very rare and mostly occurs in lower extremity, especially femur, head and face, and pelvis in order. An eleven-year old male patient suffered from left heel pain for several months and underwent biopsy at another hospital. A Malignant bone tumor was suspected, so the patient was transferred to our hospital. We reviewed the outside pathologic slide, which revealed the diagnosis of mesenchymal chondrosarcoma. It was treated by a below knee amputation. Three months later, a chest computed tomography (CT) revealed multiple metastatic nodules in both lungs. All metastatic nodules were surgically excised and the patient received postoperative chemotherapy. As far as our knowledge, mesenchymal chondrosarcoma in the calcaneus is the first case in the world. Thus, we report a case of mesenchymal chondrosarcoma in the calcaneus with thorough review of documents.

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Tuberculous Cervical Lymphadenitis (경부 결핵성 임파선염)

  • Kim Joong-Kyu;Lee Choong-Han
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.3-8
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    • 1995
  • Tuberculous cervical lymphadenitis is one of common cause of neck mass in young adult in Korea. Tuberculous cervical lymphadenitis known as scrofula was being treated by the 'Royal Touch' in the 5th century and by surgery in the 17th century, yet the principle of the treatment is still controversal. We report the clinical evaluation and therapeutic result about 121 tuberculous cervical lymphadenitis. The result were as follows: 1) The annual incidence(1985-1994) was 30.5 % (37 cases: 1985-1986), 17.7 % (21 cases: 1990-1992). 19.8%(24 cases: 1994). 2) The age of highest incidence was 20-29 year old age group in 41.3% (50 cases) and female predominated over male by 1.8 : 1. 3) The duration of disease was less than 6 months, in 85.9% (104 cases). 4) The most commonly involved LN group was superficial cervical group in 69.4% (84 cases), and difference between Rt & Lt, was not significant. 5) The most common symptom and local finding(P/E) were, painless swelling of LN in 74.3 % (90 cases) and single mass in 59.5 % (72 cases). 6) In seasonal variation, 85.9% (104 cases) was spring and summer. 7) Procedures except biopsy for evaluation were chest PA, AFB smear & culture(sputum), Mantoux test, USG, CT and, Associated extracervical tuberculous lesions were lung, axilla, breast. 8) In operation method (involving biopsy), Excision was 68.5 % (83 cases), neck dissection was 6.6% (8 cases). 9) The Modality, Duration and side effect of antituberculous medication: INH-Rifampin­Ethambutol was 66.1 % (88 cases), duration was 1 year in 84.3% (102 cases), side effects were severe GI trouble (24.8%), liver function damage (3.3%). 10) 3 cases recurred on the same site after 2 yrs(2 cases) and 4 months(1 case) and its treatment was curretage or I & D, with antituberculous medication.

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One case Treated Cerebral Infarction with Aphasia by Jihwangumja (지황음자(地黃飮子)를 투여(投與)한 중풍(中風) 실어증(失語症) 환자 치험1례)

  • Shin Woo-Jin;Hong Hyun-Woo;Kim Ji-Yun;Jeong Jae-Ook;Seo Sang-Ho;Kim Jong-Hwan;Jang Ja-Won;Park Dong-Il
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1014-1022
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    • 2003
  • Aphasia is speech disorder caused by injuries on the speech nerve center. It usually occur due to a disease in the right cerebral cortex and is divided into the various aphasia such as Global aphasia, Broca's aphasia, Wernicke's aphasia, conduction aphasia, Anomic aphasia, etc. Jihwangumja is used the cerebral infarction with Aphasia due to deficiency syndrome of kidneys. The purpose of this study is to examine the efficacy of oriental treatment for cerebral infarction with aphasia by Jihwangumsa. In the hospital, the patient showed the symptoms of mental disorder, Rt. hemiparesis G3/G4, aphasia, chest discomfort, obstipation, frequent urination, etc. The case showed that acute infarction on Lt. fronto-temporo-parietal lobe in Brain-CT. We identified the patient's clinical conditions and treated accordingly. As a result of treatment, symptoms were markedly improved and he was discharged. Further elaboration of oriental diagnostic classification could possibly lead to the fundamental treatment.

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A Case Report of a Patient with Hemoptysis Diagnosed with Bronchiectasis Treated with Hyunggaeyungyo-tang Plus Gamijihwang-tang (형개연교탕합가미지황탕(荊芥連翹湯合加味地黃湯)으로 호전된 객혈을 호소하는 기관지확장증 환자 1례)

  • Do, Ha-yoon;Kim, Jae-hyo;Yu, Chang-hwan;Kim, Eui-joong;Kim, Kwan-il;Lee, Beom-joon;Jung, Hee-jae
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.822-830
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    • 2018
  • Objective: This case report describes the treatment of hemoptysis in a bronchiectasis patient with Hyunggaeyungyo-tang plus Gamijihwang-tang. Methods: The hemoptysis in this patient was suspected to result from bronchiectasis, which was diagnosed with a chest CT at another hospital. She was treated with a herbal medicine, Hyunggaeyungyo-tang, plus Gamijihwang-tang. The effectiveness of the treatment was evaluated by measuring the amount of hemoptysis and by a visual analogue scale (VAS) to determine the patient's quality of life. Results: After administration of Hyunggaeyungyo-tang plus Gamijihwang-tang, the severity of hemoptysis decreased, based on the amount of hemoptysis and the VAS scores. Conclusions: Hyunggaeyungyo-tang plus Gamijihwang-tang is a potent therapeutic agent for the treatment of hemoptysis.

da Vinci Robot-Assisted Esophagectomy for Esophageal Cancer: A Case of Esophago-gastrostomy through the Retrosternal Route - A case report - (식도암 환자에서 da Vinci 로봇을 이용한 식도암 수술 (흉골하 통로를 통한 식도-위 문합술) - 1예 보고 -)

  • Jeong, Sang-Seok;Choi, Pill-Jo;Woo, Jong-Soo;Kim, Si-Ho;Bang, Jung-Hee;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.396-400
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    • 2009
  • Operations using the da Vinci robot have performed in for many surgeries, but the adoption of robotics to general thoracic surgery has been slow. The patient (age 74, male) visited our hospital complaining of hiccups and dysphagia. The CT scan and endoscopic biopsy revealed esophageal cancer (squamous cell carcinoma). We performed transthoracic esophagectomy using a da Vinci robot and this was followed by gastric tube mobilization via laparoscopy. Cervical esophago-gastric anastomosis was done using the hand-sewn method. The gastric tube was brought into the neck through the retrosternal route. The patient was discharged without any complications. We report here on a case of successful da Vinci robotic esophgagectomy.