• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.28-33
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• 2014

We report a case of invasive pulmonary aspergillosis invading the mediastinum and the left atrium. A 70-year-old woman was hospitalized for dyspnea. She had been well controlled for her diabetes mellitus and hypertension. The chest X-ray disclosed mediastinal widening, and the computed tomography scan of the chest showed that there was a large mediastinal mass and this lesion extended into the left atrium and right bronchus. The cardiac echocardiography showed that a huge mediastinal cystic mass compressed in the right atrium and a hyperechoic polypoid lesion in the left. The pathology from the bronchoscopic biopsy observed abundant fungal hyphae which was stained with periodic acid-Schiff and Gomori's methenamine silver. Despite the treatment with antifungal agents, she died from cardiac tamponade after three months. Invasive pulmonary aspergillosis, which involves the mediastinum and the heart, is very rare in immunocompetent patients.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.807-811
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• 2002

Due to its less invasive nature and superior visual field, video-assisted thoracescopic excision of mediastinal mass is thought to be comparable to open thoracotomy. Material and Method : From January 1995 to August 2001, the medical records of 38 patients who underwent video-assisted thoracoscopic excision of mediastinal mass was retrospectively analyzed. The outcome of these patients were compared with 5 patients who converted to thoracotomy Result: Male to female ratio was 13(34.2%) : 25(65.8%), and mean age was 39.2$\pm$35.4 years. Regarding the pathology, there were 8 neurilemmomas(21.1%), 6 thymic cysts (15.8%), 5 teratomas(13.2%), 5 ganglioneuromas(13.2%), 4 bronchogenic cysts(10.5%), 3 pericardial cysts(7.9%), 3 thymomas(7.9%), and 2 lymphangiomas(5.3%). The mean operation time was 110.6$\pm$7.0 minutes, mean postoperative tube stay was 4.2$\pm$0.4 days, mean postoperative hospital stay was 5.2$\pm$0.4 days, and mean number of injection of analgesics was 1.9$\pm$0.4 times. Although the mean values for the above indices were less than those of the thoracotomy conversion cases, they were statistically insignificant. Postoperative complications of videoassisted thoracoscopic excision included chylothorax, prolonged air leakage, and unilateral phrenic nerve palsy, all of which recovered before patient discharge. There was, however, permanent unilateral ptosis in one patient. Conclusion : As video-assisted thoracoscopic excision of mediastinal mass is safe, less painful, conducive to earlier recovery and cosmetically more appealing, a more active application of this technique is recommeded.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.245-252
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• 1991

For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors and cysts, 50 patients with mediastinal tumors and cysts treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January, 1978 to Mach, 1990 were reviewed. The results of this cases analysis were as follows; 1. of all 50 mediastinal tumors and cysts, 27 patients were male and 23 patients were female. There was no sex preference. The age distribution was from 10 months to 84 years, and mean age was 37 years old, and no age preference. 2. Subjective symptoms were as follows : Dyspnea[54%], Chest pain[44%], Coughing [34%] Fever[16%] and General malaise[12%]. Objective signs were as follows: Decreased breathing sound[46%], Pleural effusion and hemothorax[32%], Palpable neck mass[24%] and SVC syndrome[14%]. But, there were no definitive symptoms in 5 cases[10%]. 3. The most frequently encountered tumors were teratodermoid tumors[26%] followed by lymphomas[22%], thymomas[12%] and benign cysts[8%] in decreasing order of frequency. 4. Based on the subdivision of the mediastinum, 44% of the tumors were in the anterior mediastinum, 24% in the middle mediastinum, 18% in the superior mediastinum and 14% in the posterior mediastinum. 5. The malignant tumors were 25 cases[50%]. 6. The successful removal was possible in all the benign mediastinal tumors and cysts. In malignant cases, the surgical removal had been 12 cases and inoperable cases were treated to radiation and chemotherapy. 7. Postoperative complications were bleeding, wound infection, pneumothorax and vocal cord paralysis. The recurrence was 3 cases. 8. The most frequent mediastinal tumor in the west is neurogenic tumor but is teratoma in Korea.

• Journal of Yeungnam Medical Science
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• v.34 no.2
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• pp.254-259
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• 2017

Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia- disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1419-1425
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• 1997

Primary mediastinal nonseminomatous germ cell tumor associated with Klinefelter's syndrome is a rare disorder. We experienced a case of recurred primary mediastinal nonseminomatous germ cell tumor developed in a 24-year-old patient with Klinefelter's syndrome. The patient had been treated with surgery and combination chemotherapy under the diagnosis of primary mediastinal nonseminomatous germ cell tumor before. A round mass was found on the right lower lung field in the chest X-ray during follow up. The patient was diagnosed as recurred primary nonseminomatous genu cell tumor and Klinefelter's syndrome through tumor markers, peripheral blood karyotyping, and other tests including hormonal assay and was treated with combination chemotherapy and surgery again. When the patient is diagnosed as primary mediastinal nonseminomatous germ cell tumor, Klinefelter's syndrome and hematologic malignancies should be considered to be associated diseases and vice versa.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.849-854
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• 1985

We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.

• Journal of Chest Surgery
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• v.37 no.5
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• pp.460-463
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• 2004

Hemangiomas of mediastinum are rare lesions comprising less than 0.5% of all mediastinal masses. Posterior mediastinal hemangiomas are less common than anterior mediastinal. A 21 year old female was refered to our hospital because of abnormal mediastinal shadow in simple chest X-ray. Chest CT scan and T-spine MRI revealed a posterior mediastinal dumbbell-shaped mass with extradural extension. Surgical excision was performed and pathologic diagnosis was confirmed as 3${\times}$4${\times}$2 cm sized capillary hemangioma.

• Journal of Chest Surgery
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• v.40 no.5 s.274
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• pp.380-383
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• 2007

A 42-years-old man was referred to our department due to his hemoptysis. Chest CT showed a cavitary lung lesion in the apical segment of the RUL and an anterior mediastinal mass. The patient underwent wedge resection for the cavitary lesion and complete resection for the mediastinal mass. The pathologic finding was Paragonimus Westermani infestation in both the lung and thymus. The abdomen CT taken postoperatively showed an inflammatory mass involving the transverse colon and a small nodular lesion around the descending colon, which strongly suggested paragonimiasis. Postoperatively, the patient took Praziquantel for 2 days and he was discharged without any complications. There was no evidence of recurrence for the last 2 years.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.847-850
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• 2000

Isolated bronchogenic cysts of the diaphragm are rare abnormalities. They are usually asymptomatic unless secondarily infected or large enough to cause compression of vital structures. The patient was a 31-year-old man and had no symptoms except mild postprandial epigastric discomfort. The chest X-ray and chest C-T examination revealed a mediastinal mass at the left cardio-vertebro-phrenic angle. We performed the operation under the impression of solid mass at mediastinum. We revealed that the mass was bronchogenic cyst in diaphragm. Therefore we report this case with review of literatures.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.45-47
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• 2012

Osteochondroma is a common bone tumor but a rare tumor in the rib. It is often asymptomatic and observed incidentally. This is a case report of a 49-year-old woman with an osteochondroma mimicking a mediastinal mass in hereditary multiple exostoses. The chest X-ray and computed tomography (CT) scans revealed the bony density feature of the mass. Surgical excision confirmed that the lesion was an osteochondroma.