• Title/Summary/Keyword: Pulmonary nodule

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The Usefulness of F-18 FDG PET to Discriminate between Malignant and benign Nodule in Idiopathic Pulmonary Fibrosis (특발성 폐섬유증에서 발견된 폐결절의 악성여부 감별에서 F-18 FDG PET의 유용성)

  • Kim, Bom-Sahn;Kang, Won-Jun;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.163-168
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    • 2006
  • Purpose: Incidence of lung canter in patients with idiopathic pulmonary fibrosis (IPF) is known to be higher than that in general population. However, it is difficult to discriminate pulmonary nodule in patients with IPF, because underlying IPF can be expressed as lung nodules. We evaluated the diagnostic performance of FDG PET in discriminating lung nodule in patients with IPF. Methods: We retrospectively reviewed 28 lung nodules in 16 subjects (age; $67.53{\pm}9.53$, M:F=14:2). Two patients had previous history of malignant cancer (small cell lung cancer and subglottic cancer). The diagnostic criteria on chest CT were size, morphology and serial changes of size. FDG PET was visually interpreted, and maximal SUV was calculated for quantitative analysis. Results: from 28 nodules, 18 nodules were interpreted as benign nodules, 10 nodules as malignant nodules by histopahthology or follow-up chest CT. The sensitivity and specificity of FDG PET were 100% and 94.4%, while those of CT were 70.0% and 44.4%, respectively. Malignant nodule was higher maxSUV than that of benign lung nodules ($7.68{\pm}3.96\;vs.\;1.22{\pm}0.65$, p<0.001). Inflammatory lesion in underlying IPF was significantly lower maxSUV than that of malignant nodules ($1.80{\pm}0.43$, p<0.001). The size of malignant and benign nodule were $23.95{\pm}10.15mm\;and\;10.83{\pm}5.23mm$ (p<0.01). Conclusion: FDG PET showed superior diagnostic performance to chest CT in differentiating lung nodules in patients with underlying IPF. FDG PET could be used to evaluate suspicious malignant lung nodule detected by chest in patients with IPF.

3D mechanical model based pulmonary nodule segmentation in CT images (CT영상용 3차원 역학 모델 기반 폐 결절 분할 방법)

  • Yoon, Ji-Seok;Choi, Tae-Sun
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.8 no.4
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    • pp.319-326
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    • 2015
  • In this paper, a 3D mechanical model based on pulmonary nodule segmentation method is proposed. The proposed method has three main parts. First, an initial 3D mechanical model is generated. The model is made up of many triangle elements resulting in forming whole shape of the model as sphere. Second, points of the model are deformed, and finally internal and external energies according to each deformation are calculated. The internal energy is determined by the model shape, and the external energy is determined by intensity. After the model is deformed, the process of searching the minimum energy generated by the deformation is executed repetitively. If the model energy converges, the nodule is segmented by using the proposed model. The proposed method greatly improves the result compared with conventional methods.

Two Cases of Pulmonary Hyalinizing Granuloma - 2 cases report - (폐장의 초자화 육아종 - 치험 2예 -)

  • Oh, Sang-Gi;Choi, Yong-Sun;Ryu, Sang-Woo;Yun, Chi-Hyeong;Kim, Sang-Hyung;Song, Sang-Yun
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.663-666
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    • 2008
  • Pulmonary hyalinizing granuloma (PHG) is a rare disease that usually presents with multiple bilateral pulmonary nodules and characteristic histological findings, with hyaliuized collagen lamellae. Because of the absence of characteristic radiologic and clinical features, PHG is usually diagnosed after surgical resection or biopsy. We performed thoracoscopic wedge resection for a pulmonary nodule located in the right lower lobe that proved to be PHG histo-pathologically. We report two cases along with a review of the literature.

DOUBLE PULMONARY BLASTOMAS - A CASE REPORT - (다발성폐아세포종 -수술치험 1례 -)

  • 김태식;조원민;류영진;김욱진;최영호;김학제;이주한;김한겸
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.248-252
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    • 1996
  • Pulmonary blastoma is rare malignant neoplasm usually situated peripherally in lung and composed of epithelial and mesenchymal components that resemble the lung at about 3 months gestation. Fortysix year-old man had no symptoms and signs, but solitary pulmonary nodule was found accidentally in a routine simple chest X-ray occupying right upper lung field. Preoperative chest CT-guided aspiration cytology revealed adenocarcinoma. We had done right upper lobectomy with Iymph node dissecton therapeutically. Final postoperative pathology reported this tumor as double pulmonary blastomas(well differentiated fetal adenocarcinoma). We report a case of pulmonary blastoma with review of literature.

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Accumulation of Ga-67 in Metastatic Pulmonary Nodules from a Moderately Differentiated Adenocarcinoma of the Rectum (직장의 중등도 분화성 선암으로부터 전이된 폐결절에서의 Ga-67 섭취)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.2
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    • pp.140-142
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    • 2002
  • A 67-year-old woman who had undergone anterior resection for a moderately differentiated adenocarcinoma of the rectum and wedge resection for liver metastasis presented with hematogenous lung metastasis. Metastatic pulmonary nodules in both lung fields were shown on plain chest radiograph and CT. Ga-67 SPECT images revealed accumulation of radioactivity corresponding to the pulmonary nodules. The authors present an unusual case of accumulation of Ga-67 in metastatic pulmonary nodules in a patient with a moderately differentiated adenocarcinoma of the rectum.

A Case of Synchronous Lung Adenocarcinoma and Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) Type

  • Jung, Chi Young;Kwon, Kun Young
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.1
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    • pp.61-66
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    • 2012
  • Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (extranodal MZL) is a distinct subgroup of non-Hodgkin's lymphoma. Pulmonary extranodal MZL is a rare entity and accounts for less than 0.5% of primary pulmonary malignancies. Only a few cases of simultaneous occurrence of lung cancer and pulmonary extranodal MZL have been reported. A 60-year-old woman was referred to our hospital with a pulmonary nodule. She was diagnosed with lung adenocarcinoma by percutaneous needle biopsy. The protrusions into the left main bronchus were found by accident while performing bronchoscopy during lung cancer evaluation. The bronchial lesions were diagnosed as extranodal MZL. Although the patient underwent surgical resection for the lung adenocarcinoma, the pulmonary extranodal MZL was left untreated; it was monitored during follow-up visits. To our knowledge, this is the first report of synchronous lung adenocarcinoma and primary extranodal MZL of the main bronchus.

Pulmonary Malakoplakia Associated with Peripheral Cysts in an Immunocompetent Patient: A Case Report

  • Correa, Liana Ferreira;Silva, Thiago Krieger Bento da;Camarg, Spencer Marcantonio;Furian, Bianca Canela
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.422-424
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    • 2022
  • Pulmonary malakoplakia is a rare lung lesion more frequently found in immunocompromised patients than in immunocompetent individuals. In this study, we report the challenging case of a young immunocompetent patient with an irregular pulmonary nodule with peripheral cysts who, after undergoing surgery, was diagnosed with malakoplakia. Due to the rarity of the disease and the similarity of this condition to malignant neoplasms, cytopathological or histopathological examinations are necessary for the correct diagnosis. A description of pulmonary malakoplakia with peripheral cysts has not been previously published in the literature.

Evaluation of the Solitary Pulmonary Nodule by Spiral Computed Topography with Contrast Enhancement (고립성 폐결절의 감별에 있어서 나선형 흉부 전산화 단층촬영시 조영증강의 의의)

  • Song, Kwang Seon;Shin, Kye Chul;Yong, Suk Joong;Ryu, Jeong Seon;Kang, Sin Goo;Kim, Chong Ju;Sung, Ki Joon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.519-526
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    • 1996
  • Background : Clinical and Radiographic studies to differentiate benign from malignant pulmonary nodules have previously focused on clinical status and the morphologic and the computed tomographic attenuation characteristics of the lung nodules. Distinctive differences in the vascularity and pathophysiology of malignant versus benign pulmonary nodules were identified. We evaluated the diagnostic method for differentiating malignant from benign solitary pulmonary nodule by contrast enhancement on the spiral CT. Method : Sixteen patients with solitary pulmonary nodule were examined(Tuberculoma 8, primary lung cancer 8). Serial thin section on the spiral CT was performed before and after(45second, 2min, 5min) the onset of the injection of 100mL of nonionic contrast material(2mL/sec). Results : There was no difference in size of nodule and pre-contrast CT number (Hounsfield unit) between benign and malignant nodules. At forty-five second after the onset of the injection, malignant neoplasms($19.6{\pm}7.9$ HU) enhanced significantly more than tuberculomas($4.9{\pm}9.4$ HU, p=0.008). At 2minute and 5 minute after, malignant neoplasms($34.0{\pm}19.2$HU, $34.0{\pm}15.4$HU) enhanced significantly more than tuberculomas ($6.7{\pm}9.7$HU, p=0.007 and $7.7{\pm}11.5$HU, p=0.011). On cut-off value 20HU(contrast enhancement) 2minute after the injection of contrast media, sensitivity was 87% and specificity was 87%. No correlation between the contrast enhancement and size of the nodules was observed. Conclusion : Studies with the use of an intravenously administered noniodinated contrast medium in examining the enhancement properties of lung nodules was performed. The contrast enhancement was useful in differential diagnosis of solitary pulmonary nodules.

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Incidence of Malignancy and Its Predictive Factors in Intrapulmonary Nodules Associated with cT1-2N0M0 Non Small Cell Lung Cancer (임상적 병기 T1-2N0M0인 비소세포폐암에 동반된 폐결절의 악성여부 및 그 예측인자)

  • Yoon, Ho Il;Yim, Jae-Jun;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.151-158
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    • 2004
  • Background : When a non small cell lung caner patient at the $_cT_{1-2}N_0M_0$ stage is diagnosed with intrapulmonary nodule(s), the treatment plan and prognosis of the patient largely depend on whether the nodule is benign or malignant. In most cases, however, it is hard to conduct a biopsy on such a nodule, due to its small size. Furthermore, the predictive factors that may imply benignancy or malignancy of the nodules remain unknown. As such, the purpose of our study was to validate the incidence of malignant nodules in such cases, and find if there are any predictive factors. Methods : Chest computed tomography(CT) scans and the medical records of 444 patients, who had undergone non small cell lung cancer surgery, between July, 2001 and September, 2003, at Seoul National University Hospital, were retrospectively reviewed. Among $_cT_{1-2}N_0M_0$ non small cell lung cancer patients, with intrapulmonary nodule(s), only those cases where a CT scan or a biopsy of the nodules had been conducted, and had been followed up at intervals of more than 6 months were included. However, patients who had received chemotherapy or radiation therapy, pre- or post-operatively, or with calcified nodules, were excluded. Results : Our study group consisted of 39 patients, divided into two groups. The first group, 33 patients, had benign nodules, and the second group, 6 patients, had malignant nodules. The two groups were compared with regard to gender, age, cell type, pathologic stage, shape, size, location and number of nodules and presence of calcification around the nodules. There was no statistically significant difference between the two groups. Conclusion : The intrapulmonary nodules in non small cell lung cancer patients at the $_cT_{1-2}N_0M_0$ stage were mostly benign. Therefore, surgical treatment for such patients can be considered. Moreover, without predictive factors, pathological confirmation of the diagnosed nodules should be sought in all patients.

Fine Needle Aspiration Cytology of Pulmonary Hamartoma (폐과오종의 세침흡인 세포학적 소견)

  • Lee, Tae-Jin;Lee, Jin-Sook;Gong, Gyung-Yub;Khang, Shin-Kwang;Ro, Jae-Y.
    • The Korean Journal of Cytopathology
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    • v.11 no.1
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    • pp.19-24
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    • 2000
  • Pulmonary hamartomas are uncommon benign tumors, usually discovered radiologically as a solitary coin lesion in asymptomatic individual. The approach to the patient with a peripheral lung nodule has changed with the increasing acceptance of fine needle aspiration cytology(FNAC) as a rapid, safe, inexpensive, and highly accurate diagnostic tool. However, a few reports describing the FNAC findings of pulmonary hamarioma have appeared in the cytologic literature and the experience of FNAC is limited. We reviewed all 9 cases of pulmonary hamartoma with histologic confirmation after FNAC seen at Asan Medical Center since 1995 to evaluate cytologic findings and to determine the value of FNAC in identifying that lesion. Originally, seven of nine patients were diagnosed as pulmonary hamartoma, while two patients were diagnosed as inflammatory lesion and adenocarcinoma of each. On review, eight of nine patients were considered as diagnostic of pulmonary hamartoma. The diagnostic findings in FNAC of pulmonary hamartoma were the presence of fibrillary myxoid tissue with spindle cells as well as hyaline cartilage.

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