• Title/Summary/Keyword: Solitary pulmonary nodule

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Prediction Models for Solitary Pulmonary Nodules Based on Curvelet Textural Features and Clinical Parameters

  • Wang, Jing-Jing;Wu, Hai-Feng;Sun, Tao;Li, Xia;Wang, Wei;Tao, Li-Xin;Huo, Da;Lv, Ping-Xin;He, Wen;Guo, Xiu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6019-6023
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    • 2013
  • Lung cancer, one of the leading causes of cancer-related deaths, usually appears as solitary pulmonary nodules (SPNs) which are hard to diagnose using the naked eye. In this paper, curvelet-based textural features and clinical parameters are used with three prediction models [a multilevel model, a least absolute shrinkage and selection operator (LASSO) regression method, and a support vector machine (SVM)] to improve the diagnosis of benign and malignant SPNs. Dimensionality reduction of the original curvelet-based textural features was achieved using principal component analysis. In addition, non-conditional logistical regression was used to find clinical predictors among demographic parameters and morphological features. The results showed that, combined with 11 clinical predictors, the accuracy rates using 12 principal components were higher than those using the original curvelet-based textural features. To evaluate the models, 10-fold cross validation and back substitution were applied. The results obtained, respectively, were 0.8549 and 0.9221 for the LASSO method, 0.9443 and 0.9831 for SVM, and 0.8722 and 0.9722 for the multilevel model. All in all, it was found that using curvelet-based textural features after dimensionality reduction and using clinical predictors, the highest accuracy rate was achieved with SVM. The method may be used as an auxiliary tool to differentiate between benign and malignant SPNs in CT images.

Three cases of Pulmonary Epithelioid Hemangioendothelioma (폐 유상피 혈관내피종 3예)

  • Lee, Seung-Hyun;Seo, Chang-Gyun;Park, Sun-Hyo;Kim, Kyung-Chan;Kim, Min-Soo;Han, Seung-Beom;Kwon, Kun-Young;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.1
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    • pp.56-65
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    • 2002
  • A pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor with a vascular origin. A PEH can arise in many organ systems, such as the lung, liver, bone and soft tissues. It is a borderline malignancy but the clinical course is usually benign. In this report, we describe three cases of PEH. Case 1, a 61-year-old man, had nonspecific chest discomfort and the chest X-ray showed a solitary lung nodule. This nodule was diagnosed by an open lung biopsy. The pathologic findings including abundant necrosis, mitosis and hyperchromatic and pleomorphic nuclei, indicated a malignancy. The electron microscopic study showed Weibel-Palade bodies and the immunohistochemical stain for CD31 showed a positive reaction in the tumor cells, and linear staining along the vascular lumina. Case 2, a 34-year-old man, was admitted for an evaluation of multiple small nodules, incidentally detected a screening chest X-ray. The nodules were diagnosed by a immunohistochemical stain for the factor VIII-related antigen. Case 3, a 34-year-old woman, complained of left pleuritic chest pain. A simple chest film and the chest CT scan revealed multiple bilateral nodules and a left pleural effusion. An immunohistochemical stain for the factor VIII-related antigen was used to diagnose the nodules. Forth-one months after the diagnosis, she died of pulmonary insufficiency.

The Clinical Study on the Characteristics of Pulmonary Lesions Which Should Be Differentiated from Pulmonary Tuberculosis in Lung Resection Cases (폐절제 예에서 결핵과 구별해야 할 질환의 특성에 관한 임상적 고찰)

  • 정황규;정성운;박서완
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1232-1240
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    • 1996
  • From January 1990 through June 1995, we operated on 121 patients who were suspected for pulmonary tuberculosis without definite final diagnosis. After operation the final pathologic diagnoses were as follows: 68 pulmonary tuberculosis in which 29 were tuberculoma, 23 lung cancer, 16 bronchiectasis, 6 aspergilloma, 2 lung abscess, 2 benign cyst and 4 others. In 121 cases, 81 were male and 40 were female and the peak age incidence was 4th decade in tuberculosis (39.7%) and 6th and 7th decade in lung cancer (69.6%). The diagnoses in 44 cases presented roentgenographically as pulmonary nodules were pulmonary tuberculosis(29 cases) and lung cancer(15 cases). Tuberculous nodules tended to be smaller in size with calcification and satellite lesions compared to carcinomas. Indications for operation were solitary nodules 44 cases (36.4%); destroyed lobe 31(25.6%); hemoptysis 25 (20.7%); cavitary lesion 11(9.1 %); bronchostenosis 3 (2.5%); destroyed lung 5(4.1 %) and destroyed lung with empyema 2(1.7%). We conclude that preoperatively suspected pulmonary tuberculosis should be distinguished from various pulmonary lesions such as carcinoma, bronchiectasis, aspergilloma, lung abscess and benign cyst. For the possibility of carcinoma, pulmonary nodules of size greater than 3cm, non-calcified, non satellite lesion, newly developed nodule even under the anti-tuberculous medication, negative PPD skin test with elevated CEA level are recommended for an early resectional surgery and follow-up and delayed surgery is recommended in cases such as pulmonary nodules less than 3 cm in size with calcification, satellite lesion, positive PPD skin reaction and elevated ESR, CRP, ALP levels.

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CT-Guided Percutaneous Transthoracic Needle Biopsy Using the Additional Laser Guidance System by a Pulmonologist with 2 Years of Experience in CT-Guided Percutaneous Transthoracic Needle Biopsy

  • Jeon, Min-Cheol;Kim, Ju Ock;Jung, Sung Soo;Park, Hee Sun;Lee, Jeong Eun;Moon, Jae Young;Chung, Chae Uk;Kang, Da Hyun;Park, Dong Il
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.330-338
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    • 2018
  • Background: We developed an additional laser guidance system to improve the efficacy and safety of conventional computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB), and we conducted this study to evaluate the efficacy and safety of our system. Methods: We retrospectively analyzed the medical records of 244 patients who underwent CT-guided PTNB using our additional laser guidance system from July 1, 2015, to January 20, 2016. Results: There were nine false-negative results among the 238 total cases. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of our system for diagnosing malignancy were 94.4% (152/161), 100% (77/77), 100% (152/152), 89.5% (77/86), and 96.2% (229/238), respectively. The results of univariate analysis showed that the risk factors for a false-negative result were male sex (p=0.029), a final diagnosis of malignancy (p=0.033), a lesion in the lower lobe (p=0.035), shorter distance from the skin to the target lesion (p=0.003), and shorter distance from the pleura to the target lesion (p=0.006). The overall complication rate was 30.5% (74/243). Pneumothorax, hemoptysis, and hemothorax occurred in 21.8% (53/243), 9.1% (22/243), and 1.6% (4/243) of cases, respectively. Conclusion: The additional laser guidance system might be a highly economical and efficient method to improve the diagnostic efficacy and safety of conventional CT-guided PTNB even if performed by inexperienced pulmonologists.

Fine Needle Aspiration Cytology of the Sclerosing Hemangioma of the Lung - A Report of Five Cases - (폐의 경화성 혈관종의 세침흡인 세포학적 소견 - 5예 보고 -)

  • Kim, Ji-Young;Lee, Yong-Hee;Lee, Kwang-Gil
    • The Korean Journal of Cytopathology
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    • v.9 no.2
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    • pp.193-199
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    • 1998
  • Sclerosing hemangioma is a rare, benign neoplasm of the lung, usually presented as a solitary pulmonary nodule in an otherwise asymptomatic middle-aged woman. Cytologically it shows papillary, sheet, and cyst-like arrangements representing three main histologic patterns of papillary, solid, and angiomatous ones, respectively. Herein, we report the fine needle aspiration cytology of 5 cases of sclerosing hemangioma of the lung. The most characteristic finding is cyst-like spaces Intimately related to the papillary or solid cell nests. The tumor cells are relatively monotonous round to oval, small to medium in size. They have small amount of eosinophilic cytoplasm. The nuclei are uniform, round and have small but conspicuous nucleoli. The tumor cells in one of the presenting cases are large with abundant cytoplasm and show moderate nuclear pleomorphism. The nuclear chromatin, however, is fine and even without exception, even in the case showing nuclear pleomorphism. Major differential diagnoses based on the cytologic findings are well-differentiated papillary adenocarcinoma, bronchioloalveolar carcinoma, and carcinoid tumor.

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Lung and Airway Segmentation using Morphology Information and Spline Interpolation in Lung CT Image (흉부 CT 영상의 형태학적 정보 및 Spline 보간법을 이용한 폐 및 기관지 분할 알고리즘)

  • Cho, Joon-Ho;Kim, Jung-Chul
    • Journal of Broadcast Engineering
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    • v.18 no.5
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    • pp.702-712
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    • 2013
  • In this paper, we proposed an algorithm that extracts the airway and lung without loss of information in spite of the pulmonary vessel and nodules of the chest wall in the chest CT images. We use a mask image in order to improve the performance and to save processing time of airway and lung segmentation. In the second step, by converting left and right lungs to binary image using the morphological information, we have removed the solitary pulmonary nodule to identify the value of the threshold lung and the chest wall. The last step is to connect the outer shell of the lung with cubic Spline interpolation by adding the perfect pixel and computing the distance of the removed part. Experimental results using Matlab verified that the proposed method could overcome the drawbacks of the conventional methods.

A Case of Intrapulmonary Lymph Nodes Presenting Multiple Nodules (다발성 폐결절로 나타난 폐내림프절 1예)

  • Lee, Sook-Young;Jo, Keon-Hyon;Kim, Kan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.879-883
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    • 1999
  • The lymphoid system of the lung represents a complex network of lymphoid tissue and lymphatic vessels. Lymph nodes are normally located in the hila, adjacent to the lobar bronchi and within the lung to the level of the fourth-order bronchi. Clinically apparent intrapulmonary lymph nodes are rare. Although of intrapulmonary lymph node histogenesis is uncertain, They are probably hyperplastic lymphoid nodules related to inhalation of irritant dusts and attendant distortion of local lymphatic vessels. Intrapulmonary lymph nodes are detected as solitary or multiple pulmonary nodules. These nodules are difficult to differentiate from intrapulmonary metastasis by radiologic finding. We experienced a case of intrapulmonary lymph nodes presenting multiple nodules in a 46 years old man, which was confirmed by thoracoscopic biopsy.

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Disseminated Coccidioidomycosis Presenting with Miliary Nodules (속립성 폐결절로 발현된 파종성 콕시디오이데스 진균증)

  • Kim, Jung Ha;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hae Chul;Park, Dae Won;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shon, Jang Uk;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.1
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    • pp.97-101
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    • 2006
  • Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.

Obstructive Ventilatory Impairment as a Risk Factor of Lung Cancer (폐암의 위험인자로서의 폐쇄성 환기장애)

  • Kim, Yeon-Jae;Park, Jae-Yong;Chae, Sang-Cheol;Won, Jun-Hee;Kim, Jeong-Seok;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.746-753
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    • 1998
  • Background : Cigarette smoking is closely related to both lung cancer and chronic obstructive pulmonary disease. The incidence of lung cancer is higher in patients with obstructive ventilatory impairment than in patients without obstructive ventilatory impairment regardless of smoking. So, obstructive ventilatory impairment is suspected as an independent risk factor of lung cancer. Methods: For the evaluation of the role of obstructive ventilatory impairment as a risk factor of lung cancer, a total of 73 cases comprising 47 cases of malignant and 26 benign solitary pulmonary nodule were analyzed retrospectively. A comparative study of analysis of forced expiratory volume curves and frequencies of obstructive ventilatory impairment were made between cases with malignant and benign nodules. Results: In comparison of vital capacity and parameters derived from forced expiratory volume curve between two groups. VC, FVC and $FEV_1$ were not significantly different. whereas $FEV_1/FVC%$ and FEF 25-75% showed a significant decrease in the cases with malignant nodule. The frequency of obstructive ventilatory impairment determined by pulmonary function test was significantly higher in the cases with malignant nodule(23.4%) than in benign nodule(3.8%). When the risk for lung cancer was examined by the presence or absence of obstructive ventilatory impairment using the logistic regression analysis, the unadjusted relative risk for the lung cancer of obstructive ventilatory impairment was 17.17. When the effect of smoking and age were considered, the relative risk was to 8.13. Conclusion: These findings suggest that an obstructive ventilatory impairment is a risk factor of lung cancer.

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Inflammatory Endobronchial Myofibroblastic Tumor: A Case Report (기관지 내 염증성 근섬유모세포 종양: 증례 보고)

  • Soo Won Nam;Yeon Joo Jeong;Geewon Lee;Ji Won Lee;Jung Seop Eom;Jeong Su Cho;Won Young Park;So Min Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.219-224
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    • 2020
  • Inflammatory myofibroblastic tumor is a rare benign lesion that accounts for 0.04-1% of all lung tumors and usually appears as a solitary pulmonary nodule or mass. Here, we report the case of an endobronchial inflammatory myofibroblastic tumor in a 21-year-old man with a focus on the imaging findings and a review of previous literature.