• Journal of Chest Surgery
• /
• v.15 no.2
• /
• pp.174-182
• /
• 1982

On the right lower lobe, scar carcinoma was presented in the Korean male, 56 years old, in February, 1982. His tumor is moderate differentiated adenocarcinoma. Scar carcinoma, a rare form of adenocarcinoma, is usually discovered on autopsy and rarely on surgical resected specimen and these tumors are found in areas of lung scarring. Most of the tumors are adenocarcinoma and found in the upper lobes and related to infarcts, tuberculous scars. No relationship between smoking and scar cancers were reported. The scar cancers are becoming more common. An apparent increase in scar cancer in the periphery of the lung was reported in America. Scar cancer does not present special clinical symptoms and signs, except manifestations of surrounded tissue compressed by large tumors in far advanced stage. These tumors progress slowly and metastasize late but characteristic signs on scar area of the lung can be discovered from the early stage on X-ray examination [solitary peripheral nodule and scar]. So careful study on chest x-ray film was acquired and if necessary, conservative resection of the lesion is indicated because the long term prognosis is not at all bad.

• Pediatric Infection and Vaccine
• /
• v.24 no.3
• /
• pp.178-182
• /
• 2017

Paragonimiasis was one of the most common causes of cavitary lung lesions until the 1960s, but now it has become a very rare disease in Korea. A 16-year-old boy presented with hemoptysis and several days of cough. His plain chest radiograph showed nodular opacity with a cavity in the left upper lung region. Although his symptoms disappeared after taking antituberculous drugs, his plain chest radiograph and computed tomography images after completion of therapy showed a new nodule with a cavity in the left lung field. Through video-assisted thoracoscopic wedge resection, Paragonimus eggs were found in the lung tissues.

• Journal of Chest Surgery
• /
• v.54 no.5
• /
• pp.338-341
• /
• 2021

As diagnoses of small ground glass nodule (GGN)-type lung adenocarcinoma are increasing due to the increasing frequency of computed tomography (CT) screening, surgical treatment for GGN-type lung adenocarcinoma has rapidly become more common. However, the appropriate surgical extent for these lesions remains unclear; therefore, several retrospective studies have been published and prospectively randomized controlled trials are being undertaken. This article takes a closer look at each clinical study. Convincing evidence must be published on 2 issues for sublobar resection to be accepted as a standard surgical option for GGN lung adenocarcinoma. In the absence of such evidence, it is better to perform lobar resection as long as the patient has sufficient lung function. The first issue is the definition of a sufficient resection margin, and the second is whether lymph node metastasis is conclusively ruled out before surgery. An additional issue is the need for an accurate calculation of the total size and solid size on CT. Given the results of clinical studies so far, wedge resection or segmentectomy shows a good prognosis for GGNs with a total size of 2 cm or less. Therefore, sublobar resection will play a key role even in patients who can tolerate lobectomy.

• The Korean Journal of Nuclear Medicine
• /
• v.35 no.6
• /
• pp.398-400
• /
• 2001

The authors report a case of unsuspected myocardial ischemia detected during CoDe FDG PET (coincidence detection fluorodeoxyglucose positron emission tomogram) which was performed for the evaluation of a solitary pulmonary nodule. Camera-based FDG PET without attenuation correction often reveals false defect in the inferior wall of the left ventricle in normals due to excessive attenuation. However, this asymptomatic patient had increased uptake in the inferior wall suggesting ischemic myocardium. The scan finding was confirmed by Tl-201 myocardial SPECT and coronary angiogram. The patient then underwent successful PTCA of mild RCA and right ventricular branch followed by right upper lobectomy for small cell lung cancer.

• Journal of Chest Surgery
• /
• v.54 no.5
• /
• pp.412-415
• /
• 2021

Primary intrapulmonary thymomas (PITs) are defined as thymomas arising in intrapulmonary locations, without an associated mediastinal component. They are rare lesions, the diagnosis of which can be very difficult. We present a case of PIT in an asymptomatic 74-year-old woman in whom pulmonary nodules were found on pulmonary angiography performed for an episode of pulmonary embolism. She underwent wedge resection and the pathology report revealed a PIT. We also summarize this patient's clinicopathological features and discuss the diagnosis, pathogenesis, and treatment of PIT.

• Tuberculosis and Respiratory Diseases
• /
• v.57 no.2
• /
• pp.118-124
• /
• 2004

Lung cancer is the leading cause of cancer death for men and women in the industrialized world. It is desirable to detect disease at a stage when it is not causing symptoms and when control or cure is possible. If the screening test detects patients with the disease at an early stage, they can be examined to confirm the diagnosis and intervention can alter the natural history of the disease. The results of screening programs designed to detect early lung cancer using either conventional chest radiograph or sputum cytology are disappointing for a diagnostic screening test. Because of advances in helical CT imaging techniques, screening for lung cancer has been suggested as a possible method of improving outcome. Findings in recent publications suggest that substantial dose reduction is possible in chest CT. The advantages of low-dose CT are more sensitive than chest radiograph for detecting small pulmonary nodules that may be lung cancers, shorter scanning time than conventional chest CT scan without intravenous contrast injection, cheaper cost than standard CT, low radiation dose. However, the true clinical significance of the small tumors found by screening is still unknown, and their effect on mortality awaits future investigation. Furthermore, in addition to detecting an increased number of lung cancers, low-dose CT found at least one indeterminate nodule in many of all screened patients. The majority should be benign but evaluation of all these indeterminate nodules is not a trivial problem in routine practice. In conclusion, lung cancer screening with low-dose CT is a complex subject. The true effectiveness of lung cancer screening (a reduction in mortality from lung cancer) with low-dose CT can be determined through well-designed randomized control trials with enrolment of appropriate subjects.

• Journal of Chest Surgery
• /
• v.22 no.3
• /
• pp.425-435
• /
• 1989

The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

• Journal of Chest Surgery
• /
• v.47 no.5
• /
• pp.458-464
• /
• 2014

Background: The effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery. Methods: We retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup. Results: Of the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion. Conclusion: Our study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.

• Tuberculosis and Respiratory Diseases
• /
• v.55 no.6
• /
• pp.636-642
• /
• 2003

Primary lung lymphoma is an uncommon tumor, which constitutes 0.5% of primary lung cancer, and 3% of extranodal lymphoma. The most frequent radiologic presentation of pulmonary parenchymal lymphoma is single mass or nodule. But we have experienced a case which was radiologically presented as patchy lung infiltration at first, and then progressive multiple reticulonodular infiltrations in lung. A 48-year-old woman was admitted to the hospital because of fever and cough. Chest PA obtained on admission revealed multiple patchy infiltration. Eventually, open lung biopsy was performed and the specimen disclosed extranodal NK/T cell lymphoma, and in bone marrow aspiration, hemophagocytosis was present. We report a case of primary extranodal NK/T cell lung lymphoma presented as patchy lung infiltrations, which was treated with chemotherapy.

• Journal of Chest Surgery
• /
• v.35 no.8
• /
• pp.611-615
• /
• 2002

Pneumoconiosis is fibrogenic disease, caused by inhalation of mineral dust. It is defined as the accumulation of dust in the lung and tissue reaction to its presence and the dust is considered to be an aerosal of solid and inanimate particles. It is among the most common and the most important occupational lung disease, especially in developing countries. It is required three prerequisites for making a clinical diagnosis of pneumoconiosis: 1) a full clinical and occupational history together with the result of physical examination; 2) previous X-ray for comparison; and 3) a clear understanding of the time scale involved in the progression of the diseases. Most pneumoconiosises are slow to evolve and changes in the appearances take many months -usually years- to occur. Pneumoconiosis is represented on a plain X-ray of the chest as multiple small round opacities, usually smaller than 1cm diameter. In 58 years old female patient, pneumoconiosis is manifested as $5{\times}4{\times}3$cm sized solitary pulmonary nodule without any occupational history and past history of exposure of dust. so we treated this case with right upper lobectomy. Therefore we report this case with a brief review of literatures.