• Title/Summary/Keyword: Empyema, pleural

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Imaging Features of Various Benign and Malignant Tumors and Tumorlike Conditions of the Pleura: A Pictorial Review (흉막의 여러 가지 양성 및 악성 종양 혹은 종양 같은 질환들의 영상 소견: 임상 화보)

  • June Young Bae;Yookyung Kim;Hyun Ji Kang;Hyeyoung Kwon;Sung Shine Shim
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1109-1120
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    • 2020
  • Pleural masses may be caused by various conditions, including benign and malignant neoplasms and non-neoplastic tumorlike conditions. Primary pleural neoplasms include solitary fibrous tumor, malignant mesothelioma, and primary pleural non-Hodgkin's lymphoma. Metastatic disease is the most common neoplasm of the pleura and may uncommonly occur in patients with hematologic malignancy, including lymphoma, leukemia, and multiple myeloma. Pleural effusion is usually associated with pleural malignancy. Rarely, pleural malignancy may arise from chronic empyema, and the most common cell type is non-Hodgkin's lymphoma (pyothorax-associated lymphoma). Non-neoplastic pleural masses may be observed in several benign conditions, including tuberculosis, pleural plaques caused by asbestos exposure, and pleural loose body. Herein, we present a review of benign and malignant pleural neoplasms and tumorlike conditions with illustrations of their computed tomographic images.

Pleural Mesothelioma -Report of 4 Cases- (흉막중피 세포종 -4례 보고-)

  • 김종환
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.49-54
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    • 1969
  • Four cases of pleural mesothelioma were treated surgically. The tumors from all cases were microscopicaly malignant, although only in one case the tumor was found to be diffuse in growth. The diagnosis made before operation were exudative pleurisy, empyema or lung cancer with no tumor cells found in examination of pleural fluid, sputum or the specimen of pleuraI biopsy. In two cases only the tumors were resected, and in other two cases pneumonectomy and pleuropneumonectomy were performed. Irradiations added in two cases postoperatively were found not to be beneficial. Postoperative recurrence of tumor growth were found in three cases within two months after surgery, and in one case no evidence of recurrence was noted four and a half months after resection of the tumor.

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A Case of Empyema Caused by Streptococcus Constellatus (Streptococcus Constellatus에 의한 농흉 1예)

  • Ryu, Yong Suc;Lee, Jae Hyung;Lee, Byung Hoon;Kim, Sang Hoon;Yang, Dong Jin;Ryu, Sang Ryol;Yu, Yun Hwa;Cheong, Mi Youn;Chae, Jeong Don
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.463-466
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    • 2009
  • Streptococcus constellatus (S. constellatus) is a commensal microorganism belonging to the "Streptococcus milleri" group, but may cause infections in different locations in immunocompromised patients. The infection of S. constellatus has high mortality and morbidity due to its tendency to cause abscesses in infected patients, which require immediate surgical drainage for effective treatment. We report on a 72-year-old woman with end stage renal disease, who suffered from dyspnea and general weakness that had developed over 7 days. Chest CT showed loculated pleural effusion. S. constellatus was cultured from exudative pleural effusions and confirmed by an analysis of 16S rRNA sequence. The patient was treated with drainage of pleural effusion and piperacillin/tazobactam for 5 weeks.

Clinical Study on Closed Thoracotomy (폐쇄식 흉관삽관술에 관한 임상적 고찰)

  • 이종수
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.822-834
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    • 1985
  • Reexpansion of the lung is the most desirable method of filling the pleural space whether it`s contents may be, and closed thoracotomy connected to a water-seal drainage remains the basic therapeutic modality in the treatment of the problems of the pleural space. We usually used rubber mushroom tubes, size No. from 16 to 34 Fr., and performed closed thoracotomy after preliminary thoracentesis to determine the exact depending position. Author reviewed 576 cases of closed thoracotomy which were performed in the Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, since Jan., 1980 to June, 1984. The results were as follows: 1. The age distribution was 10 days to 76 years old and mean age of the patients was 36.6 year, and the most prevalent age group was twenties, and sex predisposition was male dominant, 86.9%. 2. The most common etiologic disease group was pneumothorax and the most common etiologic disease was traumatic hemothorax. 3. Sites of tubing were predominantly at posterior axillary line, 7th intercostal space and midclavicular line, 2nd intercostal space even though frequent presence of free pleural space. The two sides, right and left difference of occurrence rate was more frequent at right side, 51.2%. 4. Usually the durations of tubing was less than 10 days, 52.6%, and the number of tubes used to the same patient concomitantly was one, 73.9%, and the time of tubing to the same patient was 1st, 83.6%. 5. The common symptom and sign were dyspnea, 50.0%, chest pain, 30.7%, cough, 10.7%, fever, 6.5%. Especially, fever and cough was the most common symptom and sign in pyogenic empyema, 59.3%. 6. The common etiologic lesions of pneumothorax were blebs and bullae, 73.3%, and of pyogenic empyema was pneumonia, 69.0%. 7. The complication rate of closed thoracotomy was 26.0%. Among these complications, infection was 44.7%, and intercostal neuralgia was 25.3%. 8. 70.9% of all patients recovered with only closed thoracotomy and the rest of patient needed additional some necessary managements such as open thoracotomy [Blebectomy, Resection, Pleurodesis, Decortication, Bleeding control], open drainage, thoracoplasty and so on to have successful results.

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Genome sequence of Bifidobacterium dentium strain ATCC 15424 originally isolated from pleural fluid of an empyema patient (농흉 환자의 흉막액에서 분리된 Bifidobacterium dentium strain ATCC 15424의 유전체 염기서열 해독)

  • Moon, Ji-Hoi;Kim, Suegene;Yang, Seok Bin;Jang, Eun-Young;Shin, Seung-Yun;Lee, Jin-Yong;Lee, Jae-Hyung
    • Korean Journal of Microbiology
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    • v.55 no.3
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    • pp.280-282
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    • 2019
  • We present here a draft genome sequence of Bifidobacterium dentium strain ATCC 15424, originally isolated from pleural fluid of an empyema patient. The genome is 2,625,535 bp in length and has a GC content of 58.5%. The genome includes 2,154 protein-coding genes, 4 rRNAs, and 55 tRNAs. Unlike other B. dentium strains isolated from human dental caries, ATCC 15424 carries 247 strain-specific genes, including prophage remnants and type III/IV secretion system proteins, N-acetylmuramoyl-L-alanine amidase, and PRTRC system protein E. The sequence information will contribute to understanding of the natural variation of B. dentium as well as the genome diversity within the bacterial species.

The Clinical Study for Empyema: 176 Cases (농흉의 임상적 고찰[176예])

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.475-485
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    • 1980
  • For the past 5 year 6 months from January 1975 to June 1980, 176 patients with empyema have been treated in Chonnam University Hospital. They were 134 males and 42 females ranging from ] 8 days to 69 years of age. [mean age: 26.1 years] The duration of illness prior to treatment was relatively shorter in pediatric group than in adult group, that is, the duration of less than 1 month was 89.5% in pediatric group and 38.0% in adult group. In bacteria study there were Staphylococcus 26.1%, Streptococcus 17.6%, E. coil 10.8%, Pseudomonas 10.8%, Diplococcus pneumoniae 5.7% and Candidia. And 4 children and 3 adults had infections of two species of bacteria. The underlying pathologic lesions were pyogenic pneumonia 34.7%, tuberculosis 29.5%, paragonimiasis 15.3%, trauma 9.7% and postoperative state. The over-all mortality rate was 1.7% [3 patients]. The causes of death were sepsis In 1 child and sepsis secondary to esophageal fistula in 2 adults. Adequate drainage and obliteration of the pleural space seems to be the most important aspect of treatment and can frequently be achieved by initial tube drainage in acute empyema, especially in the pediatric group. The chronic thick walled or loculated cavities required open window therapy, decortication, resection therapy and sterilization. Modified Eloesser`s operation and 0.3-0.5% potadine irrigation brought good result in the patients who had general weakness, marked pulmonary parenchymal destruction due to pyothorax, and pyothorax with severe bronchopleural fistula.

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A Case of Pasteurella Multocida Pleural Empyema (Pasteurella Multocida 농흉 1예)

  • Lee, Dong-Yeub;Baek, Seung-Min;Seo, Hyang-Eun;Sohn, Kyung-Rak;Song, Do-Yong;Chung, Byung-Chun;Lee, Byung-Ki;Kim, Won-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.1
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    • pp.111-116
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    • 2000
  • Pasteurella multocida, a Gram-negative coccobacillus, is part of the normal oral flora of many types of animals, including domestic dogs and cats. It is the etiologic agent of a variety of infectious diseases, such as hemorrhagic septicemia in cattle or fowl cholera in chicken. Although this is a primary pathogen in the animal world, infection due to Pasteurella multocida in man has been described with increasing frequency recently. The majority of individuals with Pasteurella multocida pulmonary infection possess some underlying pulmonary diseases, most commonly bronchiectasis or COPD. With a review of literature, We report a young man who developed the empyema caused by Pasteurella multocida.

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The effect of Percutaneous pig-tail catheter drainage in the management of lung abscess and empyema (폐 농양및 농흉 치료에서 Pig-tail 도관 배액술의 효과)

  • Kim, Yeon Sao;Kim, Seong Min;Kim, Jin Ho;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee;Choi, Yo Won;Jean, Seok Chol;Kim, Young Tae
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.571-578
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    • 1996
  • Background : Long abscess is an accumulation of pus within a destroyed portion of the lung. Antibiotic therapy and postural drainge has proven to be an effective method of treatment for the majority of patients with pyogenic lung abscess. When medical therapy fails, thoracotomy and pulmonary resection are the current therapies. empyema is pus in the pleural space, and this term is deserved for effusions on which the Gram stain of the pleural fluid is positive. Initially, such collection may be drained via chest tribe. Recently, in patients who are judged to be unsuitable for surgery are in poor condition, percutaneous drainage using pig-tail catheter has been performed. We report out experience with 10 cases of lung abscess and 23 cases of empyema who were treated by percutaneous pit-tail catheter drainage. Subjects and Methods : Our study included 10 patients with lung abscess and 23 patients with empyema who were treated by percutaneous pig-tail catheter drainage, from January, 1990, to May, 1996, at Hanyang University then a pig-tail catheter was inserted into the abscess or the site of empyema under fluoroscopic and ultrasonograpic guidance. Following aspiration, the catheter was sutured into the skin, and connected to the suction tip. Catheter drainage was discontinued when the abscess of empyema was resolved in radiologically and clinically. Results : There were 2 cases of lung abscess caused by Staphylococcus aureus and Klebsiella pneumoniae and 14 cases of empyema caused by M. tuberculosis. The others were unknown. The duration of drainage was 1-2 weeks in 7 cases of lung abscess and 14 cases of empyema. In the 29 of 33 patients, percutaneous drainage were carried out successfully 20 of the 29 Gases rapidly improved. Conclusion : Percutaneous drainge is effective and relatively saute for management of lung abscess or empyema refractory to medical therapy or poor candidates for surgical treatment.

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A Case of Mediastinal Teratoma Associated with Elevated Tumor Marker in Chronic Empyema (악성 종양 표지자가 상승된 만성 흉수를 동반한 종격동 기형종 1예)

  • Um, Soo-Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Roh, Mee Sook;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo;Bang, Jung Heui
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.127-131
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    • 2009
  • Most mediastinal teratomas are histologically well-differentiated tumors and benign. The majority of patients with a mediastinal teratoma are asymptomatic and their tumors are usually discovered incidentally on chest radiography. On rare occasions this tumor will rupture spontaneously into the adjacent organs. A 72-year-old female patient was admitted for dyspnea and she had a multiloculated pleural effusion in the left lung field. Although repeated pleural biopsy and pleural fluid cytology did not prove the presence of malignancy, we assumed that this was a malignant effusion because it revealed consistently high levels of carcinoembryonic antigen and carbohydrate antigen 19-9, and the chest CT scan did not show typical fat or bone density in the mass. Secondary infection and an uncontrolled septic condition due to pleural empyema finally compelled the patient to undergo a surgical operation. Mature teratoma was the final diagnosis and she has done well without recurrence for 2 months.

Histologic Change of Free Muscle Graft in the Rabbit Pleural Space (토끼에서 늑막강내 자유근육이식의 조직학적 변화: 술후 공기누출방지를 위한 자유근육이식술의 예비실험)

  • 원용순
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.10-15
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    • 1989
  • Excision of bullous emphysema or decortication of chronic empyema commonly results in a prolonged air leakage. Prolonged air leakage requires prolonged intercostal drainage, delays recovery, and can be followed complications such as pneumothorax, atelectasis, incomplete expansion of remained lung, secondary infection. To minimize these complications free muscle grafts can be used like a patch to close the opening of visceral pleura and reinforce suture lines without undue tension. From a preliminary study using the latissimus dorsi muscle as a free muscle graft in the rabbit pleural space, viable muscle fibers that seems the result of the process of regeneration can be consistently identified around the degenerating muscle fibers. Voluminous connective tissues and numerous blood vessels are also observed in the peripheral zone. Further studies in that free muscle graft will be sutured with visceral pleura and lung parenchyme will hopefully provide additional information before clinical application.

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