• Journal of Chest Surgery
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• v.31 no.9
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• pp.907-910
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• 1998

Primary leiomyosarcoma is an extremely rare tumor. We exprienced a case of 46-year-old man with a mass located in the left upper lobe bronchus which was discovered on a chest CT. Cytology of the sputum and bronchoscopic biopses did not reveal any malignant cells. The patient underwent a left sleeve upper lobectomy. The tumor was growing from the left upper lobe bronchus and had partially destroyed the lung parenchyme. The pathologic feature of the tumor was composed of fascicular arrayed cellular spindle cells with blunt-ended nuclei revealed mild to moderate pleomorphism and frequent mitoses (15/10HPF). The immunohistochemical staining was revealed positive reaction for antibody to smooth muscle actin and desmin. We conclude that the tumor is leiomyosarcoma of the lung and then report with a review of the literatures.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.240-243
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• 2006

Pulmonary hamartoma is a common benign tumor of the lung, but endobronchial hamartoma is a rare tumor. Although bronchoscopic rcemoval or removal by bronchotomy or sleeve resection with preservation of the lung may be possible, when irreversible lung damage has occurred because of chronic obstruction and pneumonitis, pulmonary resection may be indicated. We herein report a case of endobronchial hamartoma which was treated by left upper lobectomy. A 42-year-old female with 3-week history of cough and left chest pain visited our hospital. Bronchoscopy showed total occlusion of the orifice of the left upper lobe bronchus by a lobulated endobronchial tumor and bronchoscopic biopsy was failed due to bleeding. A left upper lobectomy was performed because of severe consolidation of the left upper lobe by chronic obstruction. The patient was discharged on postoperative 14th day.

• Journal of Chest Surgery
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• v.8 no.2
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• pp.109-118
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• 1975

This is a report on four cases of the lobar emphysema due to proximal bronchial obstruction in the Department of Thoracic Surgery, Hanyang University Hospital, during the period of three and half years from 1972 to 1975. First case, a two years old male child was referred to our Department with the lobar emphysema of the lower lobe of the right lung with pneumonia. This emphysema was developed after aspiration of a piece of peanut. Bronchoscopy revealed that the bronchus of the right lower lobe was obstructed with the foreign body, however removal of the peanut through bronchoscope was not attempted because of corruption and softening of the peanut. The removal of the peanut by bronchotomy was performed after subsiding of acute phase of pulmonary infection. Postoperative course was uneventful and the emphysema was disappeared. Second case, a twenty months old female baby was referred to our Department with lobar emphysema of the lower lobe of the left lung. The emphysema was suddenly developed with coughing and dyspneic symptoms and the diagnosis was made roentgenologically. She gave a history of reccurrent infections of the respiratory tract after birth. Bronchoscopy showed an obstruction of the left main bronchus with the growing of fibrinous tissue on the bronchial mucosa. The protruded tissue in the left main bronchus taken out about O.8ml with biopsy forceps for histological examination. After this procedure, the emphysema of the left lung was disappeared. Histological finding was reported to be a chronic inflammatory granulation tissue. Third case, a two and half years old male child was referred to our Department with roentgenological lobar emphysema. Two weeks prior to admission he had an episode of sudden onset of coughing attack with dyspnea. Bronchoscopy revealed that the bronchus of the left lower lobe was obstructed with a mass which was strongly suspected of a neoplastic tissue. At operation, there was found a perforation of enlarged tuberculous lymph node in the bronchus of the left lower lobe and protrusion of granulation tissue into the bronchus. Ruptured orifice on themembranous wall of the left lower lobe bronchus was closed with interrupted suture after the" removal of a perforated tuberculous lymph node. Postoperative course was uneventful and antituberculous chemotherapy was given. Fourth case, a 47 years old man was admitted to our Department with the complaint of severe dyspnea of few months duration. Twenty years ago, he had a history of lung tuberculosis and was treated for many years. X-ray examination including tomography and bronchography revealed that the upper lobe of the right lung was destroyed with cavities, the lower lobe was completely shrunk, and the right middle lobe was strongly overdistended with narrowing bronchial trees. Differential bronchospirometry and lung scanning confirmed that the respiratory function of the affected lung was impaired almost totally. The value of the right lung was calculated on 6% of oxygen uptake, 1% of Minute volume, and 32% of vital capacity. The right pneumonectomy was performed under the careful consideration of anesthetic and surgical procedures. Postoperative course was uneventful and the respiratory function was improved nearly to the normal level.evel.

• Journal of Chest Surgery
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• v.35 no.4
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• pp.315-317
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• 2002

Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.698-706
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• 1990

Congenital Cystic Lung Disease is a spectrum of closed related anomalies that arise during an early stage of embryonic lung bud maturation-namely bronchogenic cyst, congenital lobar emphysema, pulmonary sequestration and congenital cystic adenomatoid malformation. And they show similar surgical strategies. So they are called as the term bronchopulmonary-foregut malformations, firstly proposed by Gerle[1968]. From Aug. 1979 to Aug 1989, 47 patients were operated upon on Dept. of Thoracic & Cardiovascular Surgery at the CUMC. There were 21 females and 26 males ranging in age from age of 21 day to age of 56 year [15 cases under 15 years old]. 30 patients had bronchogenic cysts - 23 of intrapulmonary type, 7 of mediastinal type in location. Affected lobes and locations were as follows: 11 in upper lobe, 3 in middle lobe, 11 in lower lobe and anterosuperior, middle, and posterior mediastinal type were 3, 2, 2 respectively. There were 9 pulmonary sequestrations[all intralobar type] with the distribution of 5 in right lower lobe and 4 in left lower lobe. And associated anomalies were presented with arterial supply originating from thoracic aorta[8 cases], abdominal aorta[1 case] and with venous drainage into azygos vein[1 case]. They all were operated upon lower lobectomy [8 case], pneumonectomy[1 case] in case of pulmonary hypoplasia Congenital lobar emphysema and congenital cystic adenomatoid malformation had 4 cases respectively. Their affected lobes were as follows: the former were 3 in upper lobes, 1 in middle lobe and the latter were 3 in upper lobe, 1 in lower lobe. They were treated with lobectomy and segmentectomy. Diagnosis was aided by chest X - ray, bronchography, aortography, DSA and CT scan, They all were confirmed by pathologic exams. There were no hospital death but few minor morbidities such as, atelectasis-pneumonia[2], wound infection[2], prolonged chest tube placement[2]. We experienced surgical treatments of 47 cases for 10 years and reported them with literature review.

• Tuberculosis and Respiratory Diseases
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• v.38 no.2
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• pp.116-118
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• 1991

Foreign body aspiration occurs uncommonly in adults. A review of recent reports reveals only a few case reports on this topic. We have experienced 8 cases of endobronchial foreign bodies in adults from June 1988 to February 1991 which were removed successfully with fiberoptic bronchoscope and biopsy forceps. Only one of them had the primary disorder predisposing aspiration. Foreign bodies were located in right lower lobe (3 cases), right intermediate (2 cases), left lower lobe (2 cases) and left upper lobe bronchus (1 cases). Removal of endobronchial foreign boides in adult would be accomplished by fiberoptic bronchoscopy successfully.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.358-366
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• 1987

A case of malignant fibrous histiocytoma [MFH] of left pulmonary artery was reported in the 27 year-old male. He was admitted because of hemoptysis for several times. Chest x-ray revealed nodular lesions in left hilar area and left upper lobe. A left thoracotomy was performed followed left upper lobectomy. The main tumor was originated from the pulmonary arterial bifurcation and proximal portion of the left pulmonary artery. By light microscopy, there were many pleomorphic giant cells, which displayed the storiform pattern. And in those area, dilated or compressed vascular channels were involved by tumor cells, suggesting origin of This tumor. Pulmonary artery angiography and chest CT revealed this tumor was originated from pulmonary artery. It would be the first reported primary malignant fibrous histiocytoma of the pulmonary artery in our country. Postoperative prognosis was uneventful, but recently he was suffered from dyspnea, that was noticed by OVD follow-up for 1 month, probably the heart failure sign due to pulmonary arterial flow obstruction.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.64-71
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• 1991

Pulmonary aspergillosis is a rare disease, most commonly presenting pre-existing cavitary disease. In Department of thoracic and cardiovascular surgery, Chonbuk National University, 5 patients have been recognized as having this disorder from 1988 to 1990, June. Of the 5 patients, three were female and two were male. Age ranged from 30 to 53 years, the average age was 38.4 years. The most common presenting symptoms were blood-tinged sputum, hemoptysis, coughing, and chest pain Pulmonary tuberculosis occupied 8-% of underlying pulmonary disease. The locations of lesion were right upper lobe in 3 cases, left upper lobe in 1, and right lower lobe in l. All of these patients were treated by surgical resection. The operative procedures were as follows: lobectomy, 3 cases; segmentectomy, 1 case; lobectomy and segmentectomy, 1 case. There was no death in early and late postoperative period. Empyema and dead space developed in two cases, respectively. The postoperative empyema was treated with open thoracostomy and the dead space was carefully observed. During follow-up, there was no recurrence.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.741-746
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• 1996

Diffuse interstitial lung disease due to a wide variety of conditions are amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy site and reduced postoperative chest pain compared with the standard open lung biopsy Video assisted thoracoscopic lung biopsy was performed in twenty patients for diagnosis of diffuse in- terstitial lung disease during the period from January 1993 to June 1994. The ages of the patients ranged from 18 to 69 years(mean 48.5 years), and the patients consisted of 10 males and 10 females. In all twenty, thoracoscpic lung biopsy samples were obtained; 9 from left lower lobe, 7 from right lower lobe, 2 from right upper lobe, 1 from left upper lobe, and 1 from right middle lobe. All patients were correctly diagnosed. The two common diseases were usual in erstitial pneumonia(UIP)(8120) and mil- liary tuberculo si s(4120) . Mean duration of the chest drainage was 3.2 days. There was no complication.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.248-250
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• 2006

A 48-years-old woman was visited to our hospital because of incidental finding of intrapulmonary foreign body. Chest X-ray showed a 4cm sized foreign body in left upper lung field without adjacent fibrosis. Chest CT showed a sewing needle shaped foreign body of metallic density, located in the 113ft upper lobe. The foreign bodies including the needle were removed surgically using a wedge resection. The extracted needle was divided into three 4 cm pieces. Patient was discharged without other respiratory symptoms after surgery. We report a case of wedge resection in a patient with intrapulmonary needle in the left upper lobe, with review of literatures.