• Title/Summary/Keyword: Subcarinal mass

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A Case of Lung Cancer associated with von Recklinghausen's Disease (Von Recklinghausen 병에 동반된 폐암 1예)

  • Han, Yo-Seb;Kang, Hong-Mo;Han, Min-Soo;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.604-608
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    • 1998
  • Von Recklinghausen's disease is an autosomal dominant hereditary disease associated with characteristic cafe-au-lait spots of skin and multiple neurofibromatosis. It is complicated by malignancies, which in most cases is neurofibrosarcoma. The development of lung cancer in von Recklinghausen's disease is rare. A 61-year-old male was admitted for cough and sputum for 20 days. He had multiple cafe-au-lait spots and subcutaneous neurofibromas in whole body area and Lisch nodules in both iris and he had been diagnosed von Recklinghausen's disease 35 years ago. Chest radiography showed emphysematous bullae in both upper lung field and mass in right upper lung field. Chest CT scan revealed subcarinal lymph node enlargement. Bronchoscopic biopsy was done in mass in superior segment of right lower lobe and the results showed squamous cell carcinoma. The presence of von Recklinghausen's disease and lung cancer are noteworthy.

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Cicatricial Fibromatosis Diagnosis after Suspected Local Recurrence at the Bronchial Stump Following Lobectomy for Lung Cancer

  • Hwang, Wan Jin;Lee, Yeiwon;Jung, Soo Young;Yeh, Daewook;Park, Soon Hyo;Yoon, Yoo Sang
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.134-137
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    • 2016
  • A mass excision surrounding the bronchial stump was performed to exclude malignancy in a 42-year-old man who had undergone a right lower lobectomy for lung cancer. The mass was identified as a cicatricial fibroma. Cicatricial fibromatosis, which is desmoid fibromatosis that arises in a surgical scar, is a well-known clinical condition. It consists of histologically benign neoplasms. Their occurrence after thoracic surgery is extremely rare. Biopsy or excision of suspicious lesions is very important for diagnosis. R0 resection remains the principal outcome for intrathoracic desmoid fibromatosis. We report that a cicatricial fibromatosis in the subcarinal space was removed after suspicion of local recurrence at the bronchial stump follwing lobectomy for lung cancer.

Resection of Intrapericardial Schwannoma Co-Existing with Thymic Follicular Hyperplasia through Sternotomy without Cardiopulmonary Bypass

  • Chung, Jae Ho;Jung, Jae Seung;Lee, Sung Ho;Kim, Kwang Taik;Lee, Kanghoon;Lee, Seung Hun
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.298-301
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    • 2014
  • A 35-year-old man was admitted to Korea University Anam Hospital for evaluation of intermittent chest pain. Computed tomography of the chest showed enlargement of a previously identified anterior mediastinal mass and also a well-defined, circumscribed mass in the subcarinal area, surrounded by the roof of the left atrium, right pulmonary artery, and the carina. Complete resection of the intrapericardial tumor was performed through median sternotomy without cardiopulmonary bypass. Pathologic examination identified the tumor as schwannoma, of an ancient type, diffusely positive for the S-100 antigen. Unlike other reported cases, grossly, the tumor did not seem to be involved with any nerve.

Magnetic Resonance Imaging in Thoracic Disease (흉부질환의 자기공명영상)

  • Song, Koun-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.345-352
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    • 1993
  • The role of magnetic resonance(MR) imaging in the evaluation of thoracic disease has been limited Nontheless, MR has inherent properties of better contrast resolution than CT allowing tissue-specific diagnosis. MR has capability of direct imaging in sagittal, coronal, and oblique planes which provide better anatomic information than axial images of CT such as lesions in the pulmonary apex, aorticopulmonary window, peridiaphragmatic region, and subcarinal region. MR is sensitive to blood flow making it an ideal imaging modality for the evaluation of cardiovascular system of the thorax without the need for intravenous contrast media. Technical developments and better control of motion artifacts have resulted in improved image quality, and clinical applications of MR imaging in thoracic diseases have been expanded. Although MR imaging is considered as a problem-solving tool in patients with equivocal CT findings, MR should be used as the primary imaging modality in the following situations: 1) Evaluation of the cardiovascular abnormalities of the thorax 2) Evaluation of the superior sulcus tumors 3) Evaluation of the chest wall invasion or mediastinal invasion by tumor 4) Evaluation of the posterior mediastinal mass, especially neurogenic tumor 5) Differentiation of fibrosis and residual or recurrent tumor, especially in lymphoma 6) Evaluation of brachial plexopathy With technical developments and fast scan capabilities, clinical indications for MR imaging in thorax will increase in the area of pulmonary parenchymal and pulmonary vascular imaging.

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Surgical Treatment of Adenoid Cystic Carcinoma by Left Tracheal Sleeve Pneumonectomy (좌측 수상 전폐 적출술에 의한 선양 낭포암 치험 1례)

  • 김동원
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.413-417
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    • 1994
  • Adenoid cystic carcinoma usually grows in the trachea or near its bifurcation and causes obstruction of the air way. We recently experienced a 33 year-old male patient who had adenoid cystic carcinoma in the left main bronchus with the chief complaint of productive cough. On the bronchoscopy, the mass obstructed the left main bronchus completely and had nodularity and increased vascularity.The trachea was shifted to the left side and the lower lobe of the left lung was atelectatic on chest X-ray and computed axial tomogram.He underwent left tracheal sleeve pneumonectomy and lymph node dissection through bilateral thoracotomy. At first,we attempted left tracheal sleeve pneumonectomy through the left thoracotomy,however, it was very difficult to perform carinoplastic procedure after sleeve resection of 2.5cm of distal trachea and 1cm of proximal right main bronchus including whole left lung because of poor operative field and difficulty in the anastomosis of the right main bronchus to the distal end of the trachea without tension.Therefore after radical resection of the left lung we made right thoracotomy,through which we could anastomosed the distal trachea and right main bronchus with 4-0 PDS interrupted suture after mobilization of the right hilum without difficulty. The tumor was confirmed to be adenoid cystic carcinoma with metastasis to subcarinal lymph node histopathologically. Postoperative course was uneventful but he needed two bronchoscopic procedure to clear distal airway of the retained bronchial secretion. He was discharged at 14 days after operation with complete recovery.

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CT findings of the Mediastinal tumors (종격동 종양의 전산화단층촬영 소견)

  • Chung, Ho-Son;Lee, Sang-Jin;Son, Mi-Young;Kwon, Hyuk-Po;Hwang, Mi-Soo;Kim, Son-Yang;Chang, Jae-Chun;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.79-90
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    • 1989
  • Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors ana lysed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymona(9 cases), and teratoma(6 cases), lymphoma(6 cases), bronchogenic cyst(4 cases), neurogenic tumor (4 cases), pericardial cyst(1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma(3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor(2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.

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A Case of Poorly Differentiated Squamous Cell Lung Cancer with Hyperamylasemia (아밀라제 상승이 동반된 저분화 편평상피세포폐암 1예)

  • Chung, Hyun Soo;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.674-678
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    • 2005
  • A 78-year-old man was admitted to our hospital as a result of dyspepsia with a 2-month duration. Upon admission, the laboratory data showed a marked elevation in amylase activity in both the serum and urine. The pancreas and salivary glands were considered unlikely to have any clinical involvement in the hyperamylasemia. The chest PA revealed a right side pleural effusion, and the chest CT showed a heterogeneous enhancing mass on the subcarinal area. The patient was diagnosed bronchoscopically with a poorly differentiated squamous cell carcinoma. The amylase isoenzyme patterns indicated the salivary types, but lung cancer was strongly suspected to be the source. In most cases, lung cancers with hyperamylasemia have been diagnosed as adenocarcinomas. A squamous cell carcinoma is quite rare. We report an interesting case of squamous cell lung cancer with hyperamylasemia.