• Title/Summary/Keyword: Solitary Pulmonary Nodule

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Incidental detection of myocardial ischemia during F-18 FDG CoDe PET for the evaluation of a solitary pulmonary nodule

  • Park, Chan-H.;Park, Kwang-J.;Lee, Myoung-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.6
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    • pp.398-400
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    • 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.

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Small Solitary Ground-Glass Nodule on CT as an Initial Manifestation of Coronavirus Disease 2019 (COVID-19) Pneumonia

  • Tianyi Xia;Jiawei Li;Jiao Gao;Xunhua Xu
    • Korean Journal of Radiology
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    • v.21 no.5
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    • pp.545-549
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    • 2020
  • The 2019 novel coronavirus (2019-nCoV) outbreak in Wuhan, Hubei Province, China in 2019 led to large numbers of people being infected and developing atypical pneumonia (coronavirus disease 2019, COVID-19). Typical imaging manifestations of patients infected with 2019-nCoV has been reported, but we encountered an atypical radiological manifestation on baseline computed tomography (CT) images in three patients from Wuhan, China infected with the 2019-nCoV. Surprisingly, the only similar CT finding was a solitary sub-centimeter ground-glass nodule adjacent to bronchovascular bundles, which could be easily overlooked. In addition, the follow-up images in these patients showed how COVID-19 pneumonia evolved from these small nodules. The radiologic manifestation of the three cases will expand contemporary understanding of COVID-19.

Primary Adenoid Cystic Carcinoma of Salivary Gland with Metastatic to the Lung (악하선 종괴를 동반한 고립성 폐결절)

  • Cho, Hai-Jeong;Kim, Jin-Hee;Kim, Ju-Ock;Song, Kju-Sang;Nam, Boo-Hyun;Lim, Seung-Pyung;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.579-583
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    • 1994
  • A 22-year old female visited CNUH due to palpable neck mass. Cytologic examination of a fine needle aspiration was performed and the result was Pap class II. Routine chest x-ray shows solitary pulmonary nodule. For rule-out malignancy, FNA at neck mass was repeated and pathologic finding was dysplasia. She was admitted to MI department for evaluation of solitary pulmonary nodule and percutaneous needle aspiration was done. Pathologic diagnosis was adenoid cystic carcinoma. Thereafter, the lesions were treated by excisional biopsy of submandibular gland mass with left supraomohyoid neck dissection and wedge resection of right lower lobe at ENT department and thoracic and cardiovascular surgery department, respectively. Final diagnosis was adenoid cystic carcinoma arising in submandibular gland with solitary lung metastasis. According to TMN staging system, surgical staging is stage IV of T2N0M1. Clinical follow-up to postoperative 13 months in this case showed that she is alive and well without evidence of recurrence.

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Diagnostic Efficacy of FDG-PET Imaging in Solitary Pulmonary Nodule (고립성폐결절의 진단시 FDG-PET의 임상적 유용성에 관한 연구)

  • Cheon, Eun Mee;Kim, Byung-Tae;Kwon, O. Jung;Kim, Hojoong;Chung, Man Pyo;Rhee, Chong H.;Han, Yong Chol;Lee, Kyung Soo;Shim, Young Mog;Kim, Jhingook;Han, Jungho
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.882-893
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    • 1996
  • Background : Over one-third of solitary pulmonary nodules are malignant, but most malignant SPNs are in the early stages at diagnosis and can be cured by surgical removal. Therefore, early diagnosis of malignant SPN is essential for the lifesaving of the patient. The incidence of pulmonary tuberculosis in Korea is somewhat higher than those of other countries and a large number of SPNs are found to be tuberculoma. Most primary physicians tend to regard newly detected solitary pulmonary nodule as tuberculoma with only noninvasive imaging such as CT and they prefer clinical observation if the findings suggest benignancy without further invasive procedures. Many kinds of noninvasive procedures for confirmatory diagnosis have been introduced to differentiate malignant SPNs from benign ones, but none of them has been satisfactory. FOG-PET is a unique tool for imaging and quantifying the status of glucose metabolism. On the basis that glucose metabolism is increased in the malignant transfomled cells compared with normal cells, FDG-PET is considered to be the satisfactory noninvasive procedure which can differentiate malignant SPNs from benign SPNs. So we performed FOG-PET in patients with solitary pulmonary nodule and evaluated the diagnostic accuracy in the diagnosis of malignant SPNs. Method : 34 patients with a solitary pulmonary nodule less than 6 cm of irs diameter who visited Samsung Medical Center from Semptember, 1994 to Semptember, 1995 were evaluated prospectively. Simple chest roentgenography, chest computer tomography, FOG-PET scan were performed for all patients. The results of FOG-PET were evaluated comparing with the results of final diagnosis confirmed by sputum study, PCNA, fiberoptic bronchoscopy, or thoracotomy. Results : (I) There was no significant difference in nodule size between malignant (3.1 1.5cm) and benign nodule(2.81.0cm)(p>0.05). (2) Peal SUV(standardized uptake value) of malignant nodules (6.93.7) was significantly higher than peak SUV of benign nodules(2.71.7) and time-activity curves showed continuous increase in malignant nodules. (3) Three false negative cases were found among eighteen malignant nodule by the FDG-PET imaging study and all three cases were nonmucinous bronchioloalveolar carcinoma less than 2 em diameter. (4) FOG-PET imaging resulted in 83% sensitivity, 100% specificity, 100% positive predictive value and 84% negative predictive value. Conclusion: FOG-PET imaging is a new noninvasive diagnostic method of solitary pulmonary nodule thai has a high accuracy of differential diagnosis between malignant and benign nodule. FDG-PET imaging could be used for the differential diagnosis of SPN which is not properly diagnosed with conventional methods before thoracotomy. Considering the high accuracy of FDG-PET imaging, this procedure may play an important role in making the dicision to perform thoracotomy in diffcult cases.

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Primary Malignant Lymphoma of Lung -A Case Report- (원발성 폐 림프종 치험 1례)

  • 민경석
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.878-881
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    • 1994
  • Primary malignant lymphomas of the lung are rare and known often to be localized, solitary pulmonary lesions, in chest radiograph. Because they are highly treatable contrast to the other primary lung cancer, the distinction is important. A 35-year old man who was admitted for a solitary pulmonary nodule in the right middle lobe. Percutaneous needle aspiration disclosed diffuse, small cell lymphoma. Bone marrow biopsy showed no evidence of neoplastic lymphoid cell infiltration. There were a walnut sized mass involving right middle lobe with a small satellite nodule at 2cm distal to the right upper lobe bronchial orifice. The histopathology of the bilobectomized specimen showed diffuse, small cell, malignant, non-Hodgkin`s lymphoma. Immunologic subtype was defined as B-cell type.

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Clinical Application of $^{18}F-FDG$ PET in Non-Small Cell Lung Cancer (비소세포성 폐암에서의 $^{18}F-FDG$ PET의 임상 이용)

  • Choi, Joon-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.17-28
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    • 2008
  • This review focuses on the clinical use of $^{18}F-FDG$ PET to evaluate solitary pulmonary nodule (SPN) and non-small cell lung cancer (NSCLC). When SPN or mass without calcification is found on chest X-ray or CT, $^{18}F-FDG$ PET is an effective modality to differentiate benign from malignant lesions. For initial staging of NSCLC, $^{18}F-FDG$ PET is useful, and proved to be cost-effective in several countries. $^{18}F-FDG$ is useful for detecting recurrence, restaging and evaluating residual tumor after curative therapy in NSCLC. For therapy response assessment, $^{18}F-FDG$ PET may be effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in NSCLC. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations. PET/CT is better for evaluating NSCLC than conventional PET.

Primary Pulmonary Amyloidosis with Mediastinal Lymphadenopathy

  • Kim, Dohun;Lee, Yong-Moon;Kim, Si-Wook;Kim, Jong-Won;Hong, Jong-Myeon
    • Journal of Chest Surgery
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    • v.49 no.3
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    • pp.218-220
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    • 2016
  • We report a case of inadvertent hoarseness after surgery for primary pulmonary amyloidosis. A 55-year-old male was transferred to our facility due to a lung mass. Chest computed tomography revealed a solitary pulmonary nodule. Positron emission tomography-computed tomography showed fluorodeoxyglucose uptake in the main mass and in the mediastinal lymph nodes. To confirm the pathology of the mass, wedge resection and thorough lymph node dissection were performed via video-assisted thoracic surgery (VATS). No complications except for hoarseness were observed; hoarseness developed soon after surgery and lasted for 3 months. The main mass was diagnosed as amyloidosis, but this was not found in the lymph nodes. In conclusion, VATS wedge resection for peripheral amyloidosis is a feasible and safe procedure. However, mediastinal lymph node dissection is not recommended unless there is evidence of a clear benefit.

A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule That Showed No Growth Over 4 Years (4년간 크기가 일정한 고립성 폐결절이 선암으로 진단된 1예)

  • Yoon, Byeong Kab;Kim, Eun Ju;Kim, Deok In;Lee, Kum Ho;Ryu, Jeong Seon;Kwak, Seung Min;Lee, Hong Lyeol;Cho, Jae Hwa;Kim, Lucia;Lee, Kyeong Hee;Kim, Jeong Taek
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.326-329
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    • 2005
  • A case of 51-year-old woman with a malignant solitary pulmonary nodule (SPN) that exhibited no growth over a period of 4 years is reported. Surgical wedge resection revealed an adenocarcinoma upon intra-operative frozen examination. The operation was completed with a right upper lobectomy and complete lymphadenectomy. The authors recommend an early surgical procedure for any SPNs due to risk factors for developing lung cancer.

Primary Intrapulmonary Thymoma Appearing as a Solitary Pulmonary Nodule: The "Master of Disguise" of Lung Tumors?: Case Report

  • Krassas, Athanasios;Diamantis, Ioannis;Karampinis, Ioannis;Vgenopoulou, Stefani;Misthos, Panagiotis
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.412-415
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    • 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.

A Case of Endobronchial Aspergilloma Presented by Solitary Pulmonary Nodule (고립성 폐 결절 형태로 나타난 기관지 내 국균종 1예)

  • Lee Ki-Man;Kim Sung-Jin;Hong Jong-Myeon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.648-651
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    • 2006
  • A 53 year-old woman visited to our hospital due to increased hemoptysis for 4 days. The chest X-ray showed solitary pulmonary nodule on right upper lobe and computed tomography of chest demonstrated mass on posterior segmental bronchus of right upper lobe. Bronchoscopic examination revealed that this segmental bronchus was completely obstructed by a yellow and brownish mud like mass, which was identified as an aspergilloma by pathologic examination. Patient had undergone bilobectomy because of persistent hemoptysis. Tracheobronchial apergillosis in an immunocompetent person is very rare disease. then, we report this case with review of the Korean literature.