• Journal of Chest Surgery
• /
• v.40 no.2 s.271
• /
• pp.151-154
• /
• 2007

A 34-year old man was admitted our hospital because he wished to evaluate the pulmonary mass that was incidentally detected on healthy examination. Bronchoscopy and chest CT showed endobronchial and peribronchial mass of the left lower lobe of the lung. Open thoracotomy and left lower lobectomy of the lung was done. Pulmonary mass was confirmed as a pulmonary inflammatory myofibroblastic tumor with bronchus invasion pathologically. Pulmonary inflammatory myofibroblastic tumor with bronchus invasion is a vary rare. Herein we report a case of pulmonary inflammatory myofibroblastic tumor with bronchus invasion.

• Tuberculosis and Respiratory Diseases
• /
• v.74 no.4
• /
• pp.169-176
• /
• 2013

Background: Although the lung is a common site of metastasis, endobronchial metastases (EBM) from extrathoracic malignancies are rare. Previous studies were retrospective reviews of the cases from each single institute, and the last one was performed between 1992 and 2002. We evaluated the characteristics of patients with EBM who had been diagnosed in recent 10 years in our hospital. Methods: We retrospectively reviewed 1,275 patients who had undergone diagnostic bronchoscopic procedures between 2001 and 2011. An EBM was defined as bronchoscopically notable lesion, which was histopathologically identical to the primary tumor. Results: A total of 18 cases of EBM were identified. The mean age was 53 years, and 12 cases of the 18 patients were female. The most common primary malignancies were colorectal cancer and breast cancer (4 cases each), followed by cervix cancer (3 cases) and renal cell carcinoma (2 cases). Cough was the most common symptom. The most common radiologic finding was atelectasis, which was identified in 27.7% of the cases. The median interval from the diagnosis of primary malignancy to the diagnosis of EBM was 14 months (range, 0-112 months). The median survival time from the diagnosis of EBM was 10 months (range, 1-39 months). Conclusion: EBM from extrathoracic malignancies were rare. Colorectal cancer and breast cancer were common as primary malignancies. Fiberoptic bronchoscopy should be performed in all patients, who are suspected of having EBM. If atypical clinical and pathological features are present, appropriate diagnostic studies should be undertaken.

• Microbiology and Biotechnology Letters
• /
• v.47 no.3
• /
• pp.441-448
• /
• 2019

This study was aimed at identifying the lower airway microbiota in patients with lung cancer (LC) using protected brush sampling. We enrolled 37 patients undergoing diagnostic bronchoscopy for suspected LC, 26 with LC and 11 with benign diseases. Protected brush specimens were obtained from the contralateral lung and the side of the tumor; these specimens were analyzed by 16S rRNA-based-next-generation sequencing. The results indicated that the biodiversity was not different between groups, and there were no significant differences between the proportion of microorganisms in the tumor and in the contralateral side of patients with LC. In patients with LC, there was a higher abundance of several microorganisms including Capnocytophaga, Haemophilus, Enterococcus, and Streptococcus; whereas, in individuals without LC, Bacteroides, Lactobacillus, or Methylobacterium were more abundant. Malignancy could be determined with an accuracy of 70% by isolating Enterococcus, Capnocytophaga, or Actinomyces. Microbispora indicated benignity with a sensitivity of 55%, specificity of 88%, and accuracy of 78%. Lower airway microbiota in patients with LC is fairly similar in both the tumor and contralateral sites. Endobronchial microbiota is different in patients with and without LC, and these differences may have a potential clinical value as diagnostic or prognostic biomarkers.

• Clinical Endoscopy
• /
• v.56 no.2
• /
• pp.239-244
• /
• 2023

Tuberculosis is an adverse event in patients with Crohn's disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn's disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

• Korean Journal of Bronchoesophagology
• /
• v.13 no.2
• /
• pp.61-64
• /
• 2007

Treatment choice for primary pulmonary sarcoma is complete surgical resection. A 69 year old man developed dyspnea due to left lung atelectasis. There was endobronchial tumor completely obstructing the left main bronchus. The tumor was resected completely by main bronchial resection via a left thoracotomy incision, and diagnosed as leiomyosarcoma. Bronchoscopy and computed tomography in 6 months after operation, there was no evidence of recurrence.

• Journal of Chest Surgery
• /
• v.28 no.8
• /
• pp.772-777
• /
• 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
• /
• v.57 no.2
• /
• pp.197-200
• /
• 2004

A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{\times}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.6
• /
• pp.331-335
• /
• 2012

Thymomas are one of the most common neoplasms of the mediastinum derived from thymic epithelium. It is common that invasive thymoma invades the lung, pericardium, and great vessels. Airway compression by mass effect also occurs, but direct polypoid tumor growth into the airway is extremely rare. Only 20 cases of invasive thymoma with endobronchial polypoid growth have previously been reported globally. However, there is no case report of invasive thymoma with endotracheal growth. Herein, we report a rare case of invasive thymoma with endotracheal polypoid growth in a 28-year-old woman.

• Tuberculosis and Respiratory Diseases
• /
• v.75 no.1
• /
• pp.36-39
• /
• 2013

Capillary hemangioma of the tracheobronchial tree is an extremely rare benign tumor in adults, especially those located in the bronchus. Characteristics and treatment of capillary hemangiomas of adult tracheobronchial trees have not been well known. We present a 61-year-old man with hemoptysis, which was caused by a small tiny nodule in the left lingular segmental bronchus. The nodule was removed by a forcep biopsy, via flexible bronchoscopy, and it was revealed to be capillary hemangioma. A small isolated endobronchial capillary hemangioma can be treated with excisional forcep biopsy, but a risk of massive bleeding should not be overlooked.

• Journal of Yeungnam Medical Science
• /
• v.34 no.2
• /
• pp.298-302
• /
• 2017

Glandular papilloma of the lung is one of three histologic types of solitary endobronchial papillomas. It is known as an uncommon benign neoplasm. No malignant glandular papillomas have been reported. Herein, the first case of granular papilloma with malignant transformation is reported. A 74-year-old man with huge right lung mass extended upper and lower lobe was admitted to the hospital complaining of progressive cough and dyspnea. An open lung biopsy was performed. Microscopically, the tumor showed papillary growth pattern with thick fibrovascular cores. The stroma of the fibrovascular cores shown the infiltration of lymphoplasmacytic cells and proliferation of capillaries. The epithelial cells surrounding the papillary fronds were cilliated columnar cells with focal cellar atypia, and frequent mitoses. Suspicious pleural invasion foci were identified. The Ki-67 labeling index was about 24.3% and p53 labeling index was about 31.7%. Glandular papilloma is known as a benign neoplasm, which is lack of atypia and mitosis. In present case, there were several indications of malignant transformation, such as cellular atypia, frequent mitosis, architectural distortion, and pleural invasion. Pathologists must be aware that glandular papilloma can have a changes of malignant transformation. Further studies about disease behavior and molecular characteristics are needed.