• Journal of Chest Surgery
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• 제30권7호
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• pp.708-712
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• 1997

경상대학교 의과대학 흉부외과학 교실에서는 1988년 4월부터 19%년 3월까지 47명의 원발성 종격동 종양 및 낭종 환자에 대하여 수술적 치험을 하였다. 환자들의 연령분포는 5세에서 67세로 평균연령은 36.4세였곡 남녀의 성비는 1:1.5였다. 임상증상은 홉통이(27.7%) 가장 많았고, 안검하수(14,9%), 전신쇠약(12.8%), 기침 (10.6%) 복시(10.6%) 등의 순이먼으며 증상이 없는 경우도 8례(17.0%) 있었다 종양의 위치는 전상부 종격동 이 63.8%로 가장 많았고· 술후 병리조직학적 진 단상으로는 흉선종(32.9%)이 가장 많았으며 낭종(21.3%), 신경 절 종잉(17.0%) 배아세포종(12.8%), 간엽종양(6.4%) 순의 빈도를 보였다. 수술시 양성종양 41례와, 악성종양 6 례중 3례는 완전절제가 가능하였으나 나머지 3례는 부분절제만이 가능했고 술후 6례 모두에서 화학요법 또 는 방사선요법을 시행하였다. 술후 합병증으로는 Homor 증후군, 유미흉, 상대정맥 파열, 그리고 횡격막 신경 마비 등이 각각 1례씩 발생하였으며 술후 사망례는 없었다.

• Journal of Chest Surgery
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• 제32권10호
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• pp.910-915
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• 1999

Background: Positron emission tomography(PEFT) using fluorine-18 deoxyglucose(FDG), showing increased FDG uptake and retention in malignant cells, has been proven to be useful in differentiating malignant from benign tissues. We indertook the prospective study to compare the accuracy of the whole-body FDG PET with that of the conventional chest computed tomography(CT) for nodal staging of non-small-cell lung cancers(NSCLC). Material and Method: FDG PET and contrast enhanced CT were performed in 36 patients with potentially resectable NSCLC. Each Imaging study was evaluated independently, and nodal stations were localized according to the AJCC regional lymph nodes mapping system. Extensive lymph node dissection(1101 nodes) of ipsi- and contralateral mediastinal nodal stations was performed at thoracotomy and/or mediastinoscopy. Image findings were compared with the histopathologic staging results and were analyzed with the McNema test(p) and Kappa value(k). Result: The sensitivity, specificity, positive predictive value, and negative predictive value of CT for ipsilateral mediastinal nodal staging were 38%, 68%, 25%, 79%, and 61%, and those of PET were 88%, 71%, 47%, 95%, and 75%(p>0.05, K=0.29). When analyzed by individual nodal group(superior, aortopulmonary window, and inferior), the sensitivity, specificity, positive predictive value, and negative predictive value of CT were 27%, 82%, 22%, 85%, and 73%, and those of PET were 60%, 87%, 92%, and 82%(p<0.05, k=0.27). Conclusion: FDG PET in addition to CT appears to be superior to CT alone for mediastinal staging of non-small cell lung cancers.

• Journal of Chest Surgery
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• 제47권1호
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• pp.13-19
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• 2014

Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis. Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival. Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multi-station N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate. Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

• Journal of Chest Surgery
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• 제35권11호
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• pp.807-811
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• 2002

종격동 종양의 경우 그 분포가 다양하나 양성질환이 더 많고, 흉강경 수술시 시야가 좋으며, 수술에 필요한 공간을 쉽게 확보할 수 있다는 점에서 비디오 흉강경 절제술이 기존의 개흉술에 못지 않은 수술방법 이라고 생각되어 본원에서 양성 종격동 종양으로 진단 받은 환자들을 대상으로 비디오 흉강경을 이용한 종격동 종양 절제술을 시행하고 고찰하였다. 대상 및 방법 : 1995년 1월부터 2001년 8월까지 근무력증을 제외한 양성 종격동 종양 43례의 환자에서 비디오 흉강경술을 시도하여 이중 개흉술로 전환된 5례를 제외한 38례를 분석하였다. 결과 : 성별은 남자가 13명(34.2%), 여자가 25명(65.8%)이었으며, 평균 연령은 39.2$\pm$35.4세였다 진단은 신경초종(neurilemmoma) 8.11(21.1%), 흉선 낭종(thyrnic cyst) 6례(15.8%), 기형종(teratoma) 5례(13.2%), 신경절신경종(ganglioneuroma) 5례(13.2%), 기관지원성 낭종(bronchogenic cyst) 4례(10.5%), 심막 낭종(pericardial cyst) 3례(7.9%), 흉선종(thymoma) 3례(7.9%), 림프관종(Iymphangioma) 2례(5.3%) 등이었다. 평균 수술 시간은 110.6$\pm$7.0분, 평균 흉관 거치기간은 4.2 $\pm$0.4일, 수술후 평균 재원기간은 5.2$\pm$0.4일, 평균 술후 진통제 근주 횟수는 1.9 $\pm$ 0.4회이었으며, 이상의 측정치들은 개흉술로 전환된 5례와 비교하여 평균값이 적었으나, 통계적으로 유의하지는 않았다. 수술후 합병증으로는 유미흉, 장기간 공기유출 및 일측성 횡격막 마비가 각 1례가 있었으나 퇴원시 소실된 일과성이었으며, 편측안검하수 1례가 있었다. 결론 : 비디오 흉강경을 이용한 종격동 종양 절제술은 안전하게 시행될 수 있으며, 수술 후 통증경감과 빠른 회복 및 미용상의 장점이 있어 계속 발전되고 적극적으로 시도되어야 한다고 사료된다.

• 대한세포병리학회지
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• 제14권1호
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• pp.12-16
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• 2003

Ganglioneuroma is a well-differentiated, benign tumor of the sympathetic nervous system. These tumors belong to a family of neoplasm that exhibit a wide range of differentiation, with neuroblastoma at one end and ganglioneuroma at the other. Because it share morphologic features with other both benign and malignant neural tumors, accurate preoperative diagnosis is often difficult. Nonetheless, it is critical for proper management. Fine needle aspiration cytology (FNAC) in the diagnosis of the ganglioneuroma has been a little documented. We describe a case of mediastinal ganglioneuroma in a 33-month-old girl. The diagnosis was suggested on FNAC and was confirmed by histopathologic examination later.

• Journal of Chest Surgery
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• 제35권12호
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• pp.906-908
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• 2002

전신쇄약을 주소로 내원한 60세 남자환자가 흉부 방사선 사진상 좌폐하엽에서 폐종양이 발견되었다. 좌폐하엽절제술과 종격동 임파선 절제를 시행후 병리조직검사상 폐의 대세포 신경내분비암으로 진단되었다. 폐의 대세포 신경내분비암은 드문 질환으로 저자들은 이를 치험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제27권11호
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• pp.938-941
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• 1994

Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen, then have symptoms of back pain,lower extremity tingling sensation. CT scan or MRI demonstrated a Dumbbell-shaped mass density compressing spinal canal, enlargement of the foramen, erosion of bone, and intervertebral widening. We report the analysis of the 18 cases of neurogenic tumors on posterior mediastinum and Dumbbell type tumors are 3 cases among the 18 cases. The neurilemmomas were 12 cases[67%], the ganglioneuroma were 5 cases[28%], and neuroblastoma was one case[5%]. The successful removal was done in all cases, a standard thoracotomy and laminectomy was done in Dumbbell type tumors.There was no postoperative neurological complications.

• Journal of Chest Surgery
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• 제32권8호
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• pp.768-771
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• 1999

본 증례는 45세 남자환자로서 흉부X-선상 우측폐야에 종괴모양이 발견되어 내원하였다. 입원당시 우측제7 흉신경부위의 피부분절에 감각둔감이 있었고, 컴퓨터 단층촬영 및 자기공명영상에서 우측 후종격동에 2개의 종양이 각각 제6 및 제7번 흉추 신경공을 통하여 척주관내로 확장되는 모양이었다. 자기공명영상에서 척수 침범소견은 없었다. 우측개흉술후 제7번 늑골두와 신경공주위의 척추경을 절제\ulcorner 후 종양을 제거하였다. 종양은 신경초종양으로 확진되었으며 수술후 환자는 별다른 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제47권5호
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• pp.487-490
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• 2014

Cellular schwannoma is an uncommon variant of schwannomas that can occur in a peripheral nerve. Although cellular schwannomas typically do not differ in prognosis from regular schwannomas, they are known to cause local recurrence when not completely resected. Here, we report the case of a patient with cellular schwannoma of the posterior mediastinum, which recurred after 13 years.

• Journal of Chest Surgery
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• 제33권10호
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• pp.851-854
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• 2000

Tuberculomas of the lung are rare in children and one of the more common lesions presenting a solitary pulmonary nodule roetgenorgraphically. We are reporting of a 3-year-old child with a tuberculoma in left upper lobe. The patient was initially diagnosed as the benign mediastinal tumor but in the end as tuberculoma in left uper lobe. Wedge resection including the mass was done. The tumor had brown smooth external surfaces on sectioning including the mass was done. The tumor had brown smooth external surfaces on sectioning show pale gray and soft cut surface was shown. In light electromicroscopy chronic granulomas with multinucleated giant cells and central caseous necrosis were observed which are the characteristics of tuberculoma. The postopeative course was smooth and uneventful and patient has been well for 4 months postoperatively.