• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.203-209
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• 2008

Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months ($6{\sim}24$ months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months ($6{\sim}36$ months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Brostrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.

• Journal of Chest Surgery
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• v.25 no.7
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• pp.711-715
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• 1992

Massive hemoptysis is defined as pulmonary hemorrhage of more than 600ml to 800ml within 24hours. Among the many causes, the most common include pulmonary tuberculosis, abscess, bronchiectasis, cystic fibrosis bronchial carcinoma. Most acute episodes of hemoptysis last less than 24 hours and gradually subside. However, when the hem-optysis is massive, it carries a mortality rate of 50% to 100%. It is generally agreed that surgery is the treatment of choice for patients with massive hemoptysis. We had the one case of 39 year-old male with recurrent massive hemoptysis. In the past history, he had pulmonary tuberculosis 20 years ago but no chest trauma, Previous chest CT showed well defined cavitary lesion with calcification on RUL Under the bronchoscope finding, we indentified active bleeding from right upper lobe bronchus without end-obronchial lesion. Therefore, emergency thoracotomy was done with impression of hem-optysis due to pulmonary tuberculosis. But operative findings were as follows ; the 4th fractured rib was impacted into the lung parenchyme with severe adhesion and middle lobe was not inflated. So, Upper and middle lobectomy were performed. He was diagnosed finally by operative and pathological findings as massive hemoptysis due to impaction of fractured rib into the lung parenchyme and discharged without complication.

• Tuberculosis and Respiratory Diseases
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• v.53 no.3
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• pp.319-324
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• 2002

Many disorders and abnormalities are accompanied by cavitary lesoin of the lung and one of the most common causes of cavitary lung disease are primary and metastatic lung neoplasms. but cavitary formation of primary lung cancer is not frequent and cavitary or cystic pulmonary metastases of this is also rare. We report a case of cavitary pulmonry metastases of primary lung cancer proven by bronchoscopic biopsy and chest CT. The patients was 60 year-old heavy smoker who had no known underlying lung diseases 7 years ago and complained chronic cough. The chest CT showed primary lung cancer in right low lobe with multiple cavitary or cystic metastases in both lungs and multiple lymphatic metastases.

• Tuberculosis and Respiratory Diseases
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• v.76 no.2
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• pp.88-92
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• 2014

We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.79-83
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• 2011

Pulmonary sequestration is a rare anomaly, in which a local area of a lung is supplied separately by an anomalous artery that arises from the aorta or one of its branches. Infection, mainly bacterial, is a major complication of sequestration. We report the case of a 17-year-old male patient, who presented with cough and fever. The contrast-enhanced chest computer tomomgraphy (CT) scans revealed an aberrant artery that originated from the descending thoracic aorta. He underwent a left-lower lobectomy. Macroscopically, the abnormal segment presented as multiple heterogenous cystic and solid lesions, and the cysts were filled with mucoid and pus-like material. Histology showed that the pulmonary parenchyma had been replaced by caseating epitheloid granulomas. The mycobacterial culture of his sputum was positive. On the basis of these results, the diagnosis of tuberculosis was established. The patient was treated with anti-tuberculous medication for 6 months, and 1 year later, his clinical status remained excellent.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.129-135
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• 1999

We describe unusual manifestations of congenital cystic adenomatoid malformation (C.C.A.M.) of the lung, such as movable fungal ball-like intracystic blood clots and hemoptysis, which were detected in previously healthy 23 years-old woman. We identified blood clots only after left upper lobectomy and could not distinguish from fungal ball with radiographic methods. CCAM of the lung, rare and lethal form of congenital pulmonary cystic disease, was initially introduced by Ch, in and Tang in 1949. The histogenesis of this lesion is characterized by polypoid glandular tissue proliferation and overgrowth of mesenchymal elements due to cessation of bronchiolar maturation which occurred in after 16weeks intrauterine period. In 80-95% of reported cases, the lesion was confined to a single lobe and there was no lobe and right and left lung predilection The clinical presentation may be widely variable, ranging from intrauterine fetal death to late discovery in childhood with recurrent pulmonary infection. But there,s no reports which were misdiagnosed with intracystic fungal ball. The treatment choice is lobectomy of affected lobe. There,s a few case reports with rhabdomyosarcoma, bronchiolar cell carcinoma and myxosarcoma arising in CCAM patients. Therefore, early resection is recommended even if asymtomatic cases. We experienced a rare case of CCAM of the lung in 23 years old female, and there were intracystic fungal ball-like movable blood clots in lower portion of left lung. After left upper lobectomy was performed, now she is discharged and followed up without any complications.

• Tuberculosis and Respiratory Diseases
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• v.51 no.6
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• pp.597-602
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• 2001

A 47-years-old woman presented with a 2-month history of a dry mouth and dry cough. The patient had been taking medication for Sj$\ddot{o}$gren's syndrome for approximately 7 years. The chest radiography showed multiple cystic lesions and a hazy density in both lower lung fields. The HRCT showed a diffuse ground glass like appearance and multiple variable sized cystic lesions in both lung fields. After medication, the symptoms were aggravated. Bronchoscopy was preformed with a transbronchial lung biopsy. The biopsies showed an infiltration of lymphocytes, neutrophils, monocytes and histiocytes through the interstitial space of the alveola and a widening of the alveolar septa. However, the histological findings of the cysts were not obtained. Sj$\ddot{o}$gren's syndrome is a slowly progressive inflammatory autoimmune disease, which is characterized by lymphocyte mediated destruction of the exocrine glands, with pulmonary involvement in approximately 19-65%, High-resolution CT is a sensitive technique for assessing the pulmonary involvement in patients with Sj$\ddot{o}$gren's syndrome. Although a lung biopsy is not always necessary for establishing a diagnosis of an interstitial lung disease in Sj$\ddot{o}$gren's syndrome. A lung biopsy may reveal a wide spectrum of changes ranging from a mild inflammatory response to end stage fibrosis with honeycombing. Because of the predominantly peribronchiolar inflammatory infiltration and inspissated secretions the cysts were suspected to have been formed by the ball-valve phenomen. However, no definite evidence was obtained.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.463-468
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• 2015

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.

• Tuberculosis and Respiratory Diseases
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• v.69 no.4
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• pp.284-287
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• 2010

We report the case of a 68-year-old man with a stromal tumor of uncertain malignant potential (STUMP), which had metastasized to the lung. The patient complained of an enlarged mass in the anterior chest. Chest computed tomography (CT) showed a sternal abscess with multiple nodules in both lungs. A thoracoscopic lung biopsy of the nodules and incision/drainage of the sternal mass were performed simultaneously. CT of the pelvis revealed an enlarged prostate with irregular cystic lesions in the pelvis. Prostate biopsy was done and demonstrated hypercellular stroma with minimal cytological atypia, a distinct pattern of STUMP. The sternal abscess proved to be tuberculosis and the lung lesion was consistent with STUMP, which had spread from the prostate. However, to our knowledge, the tuberculous abscess might not be assoicated with STUMP in the lung. The patient refused surgical prostatectomy and was discharged with anti-tuberculosis medication. On one-year follow up, the patient had no evidence of disease progression.

• Parasites, Hosts and Diseases
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• v.55 no.4
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• pp.429-431
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• 2017

Hydatid cyst is usually located in the liver and lungs, rare cases showing localization in other organs or tissues. In the unusual location, echinococcosis is an excluding diagnosis that is established only after microscopic evaluation. Our first case occurred in a 67-year-old female previously diagnosed with pulmonary tuberculosis and hospitalized with persistent pain in the hip joint. The clinical diagnosis was tuberculosis of the joint, but the presence of the specific acellular membrane indicated a hydatid cyst of the synovial membrane, without bone involvement. Fewer than 25 cases of joint hydatidosis have been reported in literature to date. In the second case, the intramural hydatid cyst was incidentally discovered at autopsy, in the left heart ventricle of a 52-year-old male hospitalized for a fatal brain hemorrhage, as a result of rupture of an anterior communicating artery aneurysm. The conclusion of our paper is that echinococcosis should be taken into account for the differential diagnosis of cystic lesions, independently from their location.