• Journal of Chest Surgery
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• v.18 no.2
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• pp.341-344
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• 1985

Carcinosarcoma is an unusual and rarest neoplasm in man, consisting of carcinomatous parenchyme and sarcomatous stroma. Two clinical types of carcinosarcoma were present. One type of tumor was centrally located [endobronchial type], infrequent metastasis, and better prognosis than parenchymal type. The other type was peripherally located [parenchymal type], frequent metastasis, and poor prognosis. The histogenesis of carcinosarcoma is many hypothesis, but controversial; 1] sarcomatous degeneration of stroma, 2] intermingling of simultaneously arising carcinoma & sarcoma, 3] multiple primary tumor, 4] blastomatous changes in hamartoma, 5] stromal reaction to squamous cell carcinoma, 6] true & collision carcinosarcoma. In this case, 52 year-old male patient was hospitalized due to intermittent hemoptysis & known pulmonary lesions. Since 1968, chest PA showed round haziness within cyst & multiple cyst on RUL & RLL. Radical pneumonectomy was performed and histopathology showed carcinosarcoma, surrounded by bronchial epithelium. The patient maintain general well-being without clinical evidence of recurrence till now.

• Tuberculosis and Respiratory Diseases
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• v.42 no.4
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• pp.605-609
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• 1995

Primary leiomyosarcoma of the lung is very uncommon, and fewer than 50 cases now have been reported. Primary leiomyosarcoma of the lung resembles bronchogenic carcinoma in its clinical presentation and radiologic appearance. However, the former has some differences; younger onset than bronchogenic carcinoma, polypoid endobronchial growth, few positive cytologic examination of sputum and unusual lymph node metastasis. We experienced a case of primary leiomyosarcoma of the lung.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.138-145
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• 1983

The value of exfoliative sputum cytology in diagnosis of lung cancer has been accepted with bronchoscopic technique and results has been much improved by foreign investigators, but there was not presented accurate reports for sputum cytologic evaluation in Korea. We tried to find indicators of cytologic tests result in our hospital. During the period between May, 1980 and August, 1982, 400 patients, tested at Department of Thoracic and Cardiovascular Surgery of Kosin Medical College, had diagnostic bronchofiberscopic examination, and the cytologic study of sputum and bronchial secretions were performed. The sputum or bronchial secretion during bronchofiberscopic examination were obtained with various methods and the name of specimen were labeled as I, ASPIRATION SPUTUM, which was collected initially endobronchial sputum as introducing of scope, II, WASHING SPUTUM, which was collected washing bronchial secretion, III, BRUSHING SPUTUM, which was washing solution of brushing instrument and endobronchial sputum after brushing of lesions, IV, POST-SCOPIC SPUTUM, which was expectorated sputum as soon as removing of scopic instrument, V, ALL SPUTUM CYTOLOGY & CELL BLOCK, which was collected all specimen of above procedures. The diagnostic results of bronchofiberscopic examination was disclosed 174 cases [43.5%] of proved lung cancer, 47 cases [11.8%] of suspected lung cancer in grossly, and 179 cases [44.8%] of others finding except cancer. Patient with bronchofiberscopically grossly evidence of lung cancer which were not confirmed histologically or cytologically were excluded from this cytologic study. Histologic and cytologic correlation in proven lung cancer, 174 cases was revealed that number of cytologic positive patients were 45 cases [38.7%] among the 117 cases of proved squamous cell carcinoma, 12 cases [38.7%] among hislogically unknown cancer 34 cases and 6 cases [33.3%] among small cell undifferentiated carcinoma 18 Gases. Total cytologic positive result was presented as 67 cases [38.3%]. The other type of lung cancer, histologically, could not comparison because of small cases. The sequence of positive cytologic result in I-V specimen were disclosed as II, WASHING SPUTUM 57.6%, and V, ALL SPUTUM & CELL BLOCK 41.4%. The I, III & IV result were 28.6%, 22.2% and 26.1% respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9865-9869
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• 2014

Background: Transthoracic fine needle aspiration (FNA) is one of several methods for establishing tissue diagnosis of lung lesions. Other tissue or cell sources for diagnosis include sputum, endobronchial biopsy, washing and brushing, endobronchial FNA, transthoracic core needle biopsy, biopsy from thoracoscopy or thoracotomy. The purpose of this study was to compare the sensitivity and specificity of FNA and other diagnostic tests in diagnosing lung lesions. Materials and Methods: The population included all patients undergoing FNA for lung lesions at Meir Medical Center from 2006 through 2010. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology, patient records and files from the Department of Oncology. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for each test. Results: FNA was carried out in 245 patients. Malignant tumors were diagnosed in 190 cases (78%). They included adenocarcinoma (43%), squamous cell carcinoma (15%), non-small cell carcinoma, not otherwise specified (19%), neurondocrine tumors (7%), metastases (9%) and lymphoma (3%). The specificity of FNA for lung neoplasms was 100%; sensitivity and diagnostic accuracy were 87%. Conclusions: FNA is the most sensitive procedure for establishing tissue diagnoses of lung cancer. Combination with core needle biopsy increases the sensitivity. Factors related to the lesion (nature, degenerative changes, location) and to performance of all stages of test affect the ability to establish a diagnosis.

• Journal of Chest Surgery
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• v.18 no.3
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• pp.497-505
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• 1985

Bronchoplastic techniques represent the ideal surgical therapy for benign endobronchial tumors as well as tumors of low-grade malignant potential, such as bronchial adenomas, and for repair of traumatic airway injuries and benign strictures. This approach is also applicable to a select group of patients with carcinoma of the lung, with long-term survival being comparable to that achieved by standard pneumonectomy. Five bronchoplastic procedures were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 7 months periods from Dec. 1984 to Jun. 1985. Of the 5 patients, 3 patients were male and 2 patients were female and ages ranged from 8 years to 55 years old. The final diagnoses of 5 patients were as followed; traumatic bronchostenosis, endobronchial tuberculoma, carcinoid tumor, tuberculous bronchostenosis and traumatic bronchial fracture. Operative procedures of 5 patients were as followed; resection and end-to-end anastomosis of right main bronchus, left lower lobectomy and wedge resection of bronchus, left upper sleeve lobectomy, right middle and lower sleeve lobectomy and resection and end-to-end anastomosis of left main bronchus. And 2 lungs and 3 lobes could be preserved by these bronchoplastic procedures. There was no post-operative complication or mortality and all patients are being followed up without specific problem.

• Tuberculosis and Respiratory Diseases
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• v.61 no.2
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• pp.157-161
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• 2006

A 70-year-old man was referred to the department of pulmonology due to blood tinged sputum and an abnormal chest X-ray. The chest X-ray and CT scans revealed a lobulated contour mass-like lesion in the left upper lung field. The bronchoscopic examination showed a whitish and polypoid mass occluding the left upper lobe bronchus. A biopsy specimen from the lesion revealed many aspergillus hyphae. Intravenous and oral itraconozole were administered over a 4 weeks period. Several months later, the size of the mass on chest X-ray increased and a percutaneous lung biopsy revealed a sarcomatoid carcinoma. We reported a case of lung cancer that was obscured by an endobronchial aspergilloma with a review of the relevant literature.

• Tuberculosis and Respiratory Diseases
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• v.67 no.6
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• pp.545-550
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• 2009

Background: Endobronchial ultrasonogram (EBUS) has increased the diagnostic yield of a bronchoscopic biopsy of peripheral pulmonary lesions (PPL). This study evaluated the diagnostic yield of EBUS-guided transbronchial biopsy (TBB) and the visibility of EBUS PPL. Methods: Between August 2007 and November 2008, 50 patients (32 men and 18 women, median age, 61.1${\pm}$10 yrs; range, 16 to 80 yrs) whose PPL lesions could not be detected with flexible bronchoscopy were enrolled in this study. Among the 50 patients, 40 cases were malignant lesions (adenocarcinoma 25, squamous cell carcinoma 10, small cell carcinoma 5) and 10 cases were benign lesions (tuberculoma 7, fungal ball 1, other inflammation 2). Results: The mean diameter of the target lesion was 35.4${\pm}$4.3 mm. Of the 50 patients examined, the overall diagnostic yield by EBUS-TBLB was 46.0% (23/50). The visualization yield of EBUS was 66.0% (33/50). A definitive diagnosis of PPL localized by EBUS was established using EBUS-TBLB in 69.6% (23/33) of cases. The diagnostic yields from washing cytology and brushing cytology from a bronchus identified by EBUS were 27.0% and 45.4% respectively. The diagnostic yields reached 78.7% when the three tests (washing cytology, brushing cytology and EBUS-TBLB) were combined. The visualization yield of EBUS in lesions <20 mm was significantly lower than that in lesions ${\geq}$20 mm (p=0.04). The presence of a bronchus leading to a lesion (open bronchus sign) on the chest CT scan was associated with a high visualization yield on EBUS (p=0.001). There were no significant complications associated with EBUS-TBLB. Conclusion: EBUS-TBLB is a safe and effective method for diagnosing PPL. The lesion size and open bronchus signs are significant factors for predicting the visualization of EBUS.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.389-396
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• 1994

Background : The two most important purposes of fiberoptic bronchoscopy in lung cancer patients are obtaining tissue diagnosis and staging. The direct sign of lung cancer on FOB includes visible tumor, with smooth or nodular surface, with or without necrosis and infiltration. Variant cell types of lung cancer have their characteristic biological behaviors respectively. For example, squamous cell carcinoma grows slowly, invades locally and has easy necrosis resulting in cavitation, whereas adenocarcinoma shows early metastasis, small cell carcinoma shows rapid growth and higher early metastasis rate. Based on this, it could be hypothesized that each cell type may have characteristic bronchoscopic finding. Method : To answer this question, we reviewed 106 cases which were diagnosed as primary lung cancer and had bronchoscopically visible specific cancerous lesions. Results : The results were as follows. 1) Squamous cell carcinoma accounted for 66 cases(62.2%), adenocarcinoma 15 cases(14.2%), large cell carcinoma 3 cases(2.8%). 2) The endobronchial tumor lesion was arbitrarily classified into 5 types according to gross characteristics. Type A, multilobulating mass with necrosis, accounted for 24.5%, type B, multilobulating mass without necrosis, 25.5%, type C, round beefy mass, 9.4%, type D, infiltration with mucosal irregularity, 6.6%, and type E, infiltration without mucosal irregularity, 34%. 3) The analysis of correlation between endobronchial tumor pattern and specific cell type revealed that squamous cell carcinoma had relation with the morphologic type B and small cell carcinoma had relation with the morphologic type E, but adenocarcinoma had no preponderance in morphologic type. The gross appearance had influence on the diagnostic yields of biopsies and the diagnostic yields of lobulating mass types(type A, B) were higher than those of other types. Conclusion : From the above observations, it could be concluded that squamous cell carcinoma and small cell carcinoma have relations with specific types of bronchoscopic morphology, but not the case in adenocarcinoma.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.772-777
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• 1995

Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.407-416
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• 1992

Background: Endobronchial tuberculosis is an important complication of pulmonary tuberculosis. It is highly infetious, difficult to diagnose mimicking bronchogenic carcinoma or bronchial asthma and it can leave bronchial stenosis with parenchymal collapse or bronchiectasis as complications. Early diagnosis, adequate treatment and follow-up are crucial in the management of endobronchial tuberculosis. The most important diagnostic tool in its diagnosis is bronchoscopic examination. Authors have tried to elucidate changes in sequential bronchoscopic findings in these patients to help diagnose and manage these patients. Method: We have analysed the sequential bronchoscopic findings and clinical features of 83 endobronchial tuberculosis patients admitted in Seoul National University Hospital from August 1987 to December 1990. Results: We can observe the following results: 1) In the actively caseating type, improvement of the bronchial stenosis was observed in 29 patients (76.3%) up to 5 months of treatment. Caseation disappeared in 31 patients (81.6%) during the same period. 2) In the stenotic without fibrosis type, improvement of the stenosis was observed in 8 patients (66.4%) during the same period. 3) In the tumorous type, improvement of the stenosis was observed in 12 patients (92.3%) during the same period. Conclusion: We can conclude that improvement of the endobronchial lesions may occur up to about 5 months after adequate treatment of endobronchial tuberculosis.