• Title/Summary/Keyword: Ground glass nodules

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Are There Any Additional Benefits to Performing Positron Emission Tomography/Computed Tomography Scans and Brain Magnetic Resonance Imaging on Patients with Ground-Glass Nodules Prior to Surgery?

  • Song, Jae-Uk;Song, Junwhi;Lee, Kyung Jong;Kim, Hojoong;Kwon, O Jung;Choi, Joon Young;Kim, Jhingook;Han, Joungho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.368-376
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    • 2017
  • Background: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. Methods: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. Results: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). Conclusion: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.

Adenocarcinoma of the Lung Progressing to Multiple Cystic Lesions in a 29-Year-Old Man (29세 남자에서 다발성 낭종성 병변으로 진행한 폐선암 1예)

  • Lee, Hyun-Seong;Jeon, Jae-Wan;Kim, Jae-Hee;Ju, Hyeong-Uk;Bae, Joong-Gi;Min, Young-Ju;Ahn, Jong-Joon;Seo, Kwang-Won;JeGal, Yang-Jin;Kwon, Woon-Jung;Cha, Hee-Jeong;Ra, Seung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.203-206
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    • 2012
  • Cystic lesions or progressive cystic changes in adenocarcinoma of the lung have rarely been reported. We report a case of lung adenocarcinoma that progressed from ground-glass opacities (GGOs) and consolidations or nodules to extensive cystic lesions during 12 months in a young adult patient. A 29-year-old male was initially diagnosed with primary lung adenocarcinoma by transbronchial lung biopsy of the right lower lobe and lung to lung metastasis in both lungs according to imaging findings. The initial chest computed tomography (CT) scans showed multifocal GGOs, consolidations, and nodules in both lungs. Despite treatment with palliative chemotherapy, the patient's follow-up CT scans showed multiple, cystic changes in both lungs and that the lesions had progressed more extensively. He died of hypoxic respiratory failure one year after his diagnosis.

Pulmonary Mineralization Secondary to Iatrogenic Hyperadrenocorticism in a Dog (개에서 발생한 의인성 부신피질기능항진증과 속발성 폐 석회화 진단 1례)

  • Park, Noh-Won;Chung, Wook-Hun;Han, Jae-Ik;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.233-236
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    • 2014
  • An 11-year-old, intact male Shih Tzu presented with obesity, thin hair coat, and abdominal distention. The patient had previously received corticosteroid therapy for dermatitis. Thoracic radiographs showed incidental findings of a generally diffuse bronchointerstitial pattern and markedly radiolucent pleural lines between the middle and caudal lung lobes, but clinical signs related to the thoracic radiographic findings were absent. Echogenicity of the hepatic parenchyma was increased and bilateral adrenal glands were not enlarged on ultrasonography. On computed tomography, the central regions of the lung lobes showed ground-glass attenuation, the peripheral regions of the lung lobes were relatively hypoattenuated compared with the central regions, and hyperattenuated nodules were distributed throughout the pulmonary parenchyma. Iatrogenic hyperadrenocorticism and secondary pulmonary mineralization was diagnosed on the basis of diagnostic imaging and adrenocorticotropic hormone stimulation test.

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.

A Study of Usefulness of Fine Needle Aspiration Cytology of the Thyroid Lesions (갑상선 병변의 세침흡인 세포검사의 유용성에 관한 연구)

  • Kwon, Kye-Hyun;Jin, So-Young;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.111-121
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    • 1996
  • Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and non-diagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12(1.7%) were suspicious, 71(10.1%) were malignancy, and 50(7.1%) were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinona, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was $4.12{\pm}1.81$ in material insufficiency and $5.63{\pm}1.79$ in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that FNAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 6.6%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.

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Surgical Treatment of the Pulmonary Nodular Lymphoid Hyperplasia - A case report - (폐에 발생한 결절성 림프구양 증식증 (Nodular Lymphoid Hyperplasia) 치험 - 1예 보고 -)

  • Yang, Hong-Seok;Park, In-Kyu;Shin, Dong-Hwan;Lee, Yoon-Hee;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.517-519
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    • 2007
  • Nodular Lymphoid hyperplasia of the lung has a very low incidence and both the nomenclature and this disease entity have changed since its appearance in the 1960s. It has recently been classified as lymphoid hyperplasia of the B cell associated lymphoid tissue. Ground glass opacity was incidentally diagnosed in the right lower lobe of the a 60 year old male and he underwent right lower lobe lobectomy. The opacified lesion in the chest CT was diagnosed as nodular lymphoid hyperplasia under microscopic examination.

A Case of Hypersensitivity Pneumonitis by Alternaria as a Suspected Etiology (Alternaria가 원인으로 추정되는 과민성 폐장염 1예)

  • Do, Yun Kyung;Kim, Yeon Jae;Kang, Hyun Jae;Yu, Kyung Sul;Yun, Hae Jin;Jun, Jae Hyun;Lee, Byung Ki;Song, Do Young
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.338-345
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    • 2003
  • A 65-year-old man was admitted due to low grade fever, dry coughing, and dyspnea on exertion. The chest radiograph and CT scan showed diffuse ground glass opacities and small nodules in the both lung fields resulting in a diagnosis of severe interstitial pneumonia. Conservative treatment with antibiotics and bronchodilators decreased the symptoms, but the dyspnea and cough reappeared when he returned home. An inspection of his house revealed the presence of fungi under the wallpaper. His symptoms disappeared completely after these were removed. His clinical course raised the suspicion of hypersensitivity pneumonitis and these fungi believed to be the cause of hypersensitivity pneumonitis. The histological findings of a lung specimen by video-assisted thorachoscopy were compatible with hypersensitivity pneumonitis. The fungi were identified as Alternaria.

Immunoglobulin G4-Related Disease in the Thorax: Imaging Findings and Differential Diagnosis (흉부에서 발생한 IgG4 연관 질환: 영상 소견 및 감별진단)

  • Yookyung Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.826-837
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    • 2021
  • Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

Immunoglobulin G4-Related Lung Disease with Waxing and Waning Pulmonary Infiltrates: A Case Report (호전과 악화를 반복하는 폐 병변을 가진 면역글로불린 G4 관련 폐 질환: 증례 보고)

  • John Baek;Jongmin Park;Byunggeon Park;Jae-Kwang Lim;Chun Geun Lim;An Na Seo
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1373-1377
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    • 2023
  • Immunoglobulin G4 (IgG4)-related lung disease can have various clinical courses. To our knowledge, reports of IgG4-related lung disease with waxing and waning pulmonary infiltrates only are very rare. A few lung nodules and ground glass opacities were incidentally found in a pre-operative evaluation in a 36-year-old female. The lung lesions showed waxing and waning in the follow-up chest CT. She underwent a surgical biopsy, and IgG4-related lung disease was confirmed.

Lung Imaging Reporting and Data System (Lung-RADS) in Radiology: Strengths, Weaknesses and Improvement (영상의학에서 폐영상 판독과 자료체계: 강점, 단점, 그리고 개선)

  • Gong Yong Jin
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.34-50
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    • 2023
  • In 2019, the American College of Radiology announced Lung CT Screening Reporting & Data System (Lung-RADS) 1.1 to reduce lung cancer false positivity compared to that of Lung-RADS 1.0 for effective national lung cancer screening, and in December 2022, announced the new Lung-RADS 1.1, Lung-RADS 2022 improvement. The Lung-RADS 2022 measures the nodule size to the first decimal place compared to that of the Lung-RADS 1.0, to category 2 until the juxtapleural nodule size is < 10 mm, increases the size criterion of the ground glass nodule to 30 mm in category 2, and changes categories 4B and 4X to extremely suspicious. The category was divided according to the airway nodules location and shape or wall thickness of atypical pulmonary cysts. Herein, to help radiologists understand the Lung-RADS 2022, this review will describe its advantages, disadvantages, and future improvements.