• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.428-431
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• 2015

Epithelial-myoepithelial carcinoma (EMC) of lung is a minor subset of salivary type carcinoma of lung of known low grade malignancy. Histologically, two-cell components forming duct-like structure with inner epithelial cell layer and outer myoepithelial cell layer are characteristics of EMC. In salivary gland, dedifferentiation of conventional low grade malignancy has been reported and is thought to be related with poor prognosis. However, precise histomorphology and prognostic factors of pulmonary EMC have not been clarified due to its rarity. Herein, we reported a rare case of EMC presented as endobronchial mass in a 53-year old woman, which showed predominant solid lobular growth pattern and lymph node metastases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.594-600
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• 2019

With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.1
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• pp.24-30
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• 2017

Gorham-Stout disease is a rare disorder characterized by lymphovascular proliferation and destruction of osseous matrix. The etiology of this condition remains poorly understood. Chylothorax as a consequence of lymphatic leakage in thoracic cage may cause a severe life-threatening complication, accompanying respiratory difficulty. Currently, there is no standard management for this extremely rare condition. Here we describe a patient affected by Gorham-Stout disease successfully managed by the combined treatment of mTOR inhibitor and beta-blocker. A previously healthy 11-year-old female developed dyspnea and chest pain with a massive pleural effusion. The ligation of right thoracic duct and bilateral pleurodesis temporarily decreased her pleural effusion, which was aggravated repetitively and required frequent admission and tube thoracotomies. Along with bilateral pleural adhesiolysis with thoracotomy, the combined treatment of oral beta-blocker and mTOR inhibitor was commenced. After 1 month of oral medication, her pleural effusion was not increased and she was free of respiratory difficulty on room air without chest tubes. Over eleven months of treatment, no serious adverse reaction was noted and her condition has been stable with no further admission required.

• Tuberculosis and Respiratory Diseases
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• v.62 no.2
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• pp.119-124
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• 2007

Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.

• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.1035-1037
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• 2009

Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.718-722
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• 1999

Thymoma is the most common tumor in the compartment of anterior mediastinum. The malignant thymoma is classified into invasive thymoma(category I) and thymic carcinoma(category II). Recently, well-differentiated thymic carcinoma is a proposed category 1.5 used to describe a subset of thymic epithelial tumors, allowing for the existence of intermediate form based on the clinical features and the histological characteristics. Thymic cyst is a congenital or a acquired disorder. Congenital thymic cyst may develop due to failure of the thymopharyngeal duct to obliterate and acquired thymic cyst develops from inflammation(multilocular thymic cyst), or neoplasm(cystic thymoma). Cystic degeneration in thymoma is a relatively frequent but focal event. In rare cases, the process proceeds to the extent that most or all of the lesion becomes cystic. Until now, well-differentiated thymic carcinoma with extensive cystic degeneration has not been reported in our country. We experienced a case of 14 year-old female patient showing extensive cystic degeneration in well-differentiated thymic carcinoma. And so we report it with review of the articles related.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.31-37
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• 2008

Background and Objectives: In most cases of benign neck cysts, surgical excision has been considered as treatment of choice. However, sometimes complete excision is very difficult, and recurrences has been occured due to insufficient surgery frequently. In this point of view, non-surgical treatment has been attempted with sclerosing agents such as picibanil(OK-432). In this study, we evaluated the efficacy of picibanil sclerotherapy for benign neck cysts. Materials and methods: We retrospectively reviewed 53 patients(27 males, 26 females) who had undergone sclerotherapy with picibanil for benign neck cysts such as ranula, lymphangioma, thyroglossal duct cyst and branchial cyst. Information was gathered with respected to age, sex, number of injections, side effect and outcome of treatment. All patients were treated with intralesional aspiration of cystic contents and injection of picibanil, and followed on neck ultrasonography or neck CT. Results: 53 patients received sonoguided sclerotherapy using picibanil(OK-432). 31 patients(41.3%) showed total shrinkage, near total shrinkage(more than 90% of volume) in 7 patients(9.3%), marked shrinkage(more than 70%) in 5 patients(6.6%) and partial shrinkage(less than 70%) in 17 patients. 15 patients(20%) reaveled no response and 8 patients showed recurrences with repeated sclerotherapy. The side effects of therapy were observed by symptoms such as fever, localized pain and odynophagia. However, these complications disappeared after several days in all cases. Conclusions: We recognized that picibanil(OK-432) sclerotherapy for benign neck cyst is a safe and effective procedures as a primary treatment before considering surgery.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.458-461
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• 2009

A pseudochylothorax, a chyliform pleural effusion, is a rare disease of pleural effusion that contains cholesterol crystals or high lipid content that is not the result of a disrupted thoracic duct. Most of the cases were found in patients with long-standing pleural effusion due to chronic inflammatory disease, such as old tuberculous pleurisy or chronic rheumatoid pleurisy. We experienced a case of pseudochylothorax in a 74-year-old man, who was being treated for pulmonary tuberculosis and pleurisy 10 years ago. The diagnosis was confirmed on pathological study of the pleural effusion, which contained cholesterol crystals having a diagnostic rhomboid appearance.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.131-136
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• 2008

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

• The Journal of Internal Korean Medicine
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• v.19 no.2
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• pp.438-450
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• 1998

Pleural effusion means the inflammation of pleura which has a majority of respiratory disease. The main clinical manifestation is pleural effusional pain, dyspnea, cough, fever, etc. and at present the Tuberculous pleural effusion has the most frequency in which exists exudate in our country. And during studying oriental medical treatment about Tuberculous exudative pleural effusional patient, we found the clinical case about The Combination therapy of Chinese traditional and Western medicine at journal of traditional Chinese Medicine and considered it would be help in oriental medical treatment, so we adjust and report now. This study was performed by analyzing the six papers reported centering around the clinical case of The Combination therapy of Chinese traditional and Western medicine in journal of traditional Chinese Medicine published between 1990-1996. As these papers have no mistakes on diagnosis because it obtained pleurocentesis, tuberculin test positive reaction on choicing clinical case, definite results on X-ray, ultrasound as well as clinical basis, so it considers an apt conclusion. The results were as follows: 1. Western medical treatment uses chemical remedy same with pulmonary tuberculosis, and in case of tubercular pleuritis, it needs thoracic duct pyorrhea, and according to simple exudation also operates therapheutic pleural paracentesis. 2. In case of hydrothorax absorption about tuberculous pleural effusion, prescription of purge the heat accumulated in the lung and eliminate the retention of fluid with powerful purgatives shows considerable effects. 3. The latter period treatment of tuberculous pleural effusion needs Supplement qi and active the collaterals, Nourishing yin and clearing heat in addition to Supporting healthy energy to eliminate evils. 4. In case of curing tuberculous pleural effusion, The Combination therapy of Chinese traditional and Western medicine shows more considerable effect than single western medical treatment in absorption of hydrothorax. 5. In case of curing tuberculous pleural effusion, The Combination therapy of Chinese traditional and Western medicine shows more considerable effect than single western medical treatment in prevention of disease reappearance. 6. In case of curing tuberculous pleural effusion, The Combination therapy of Chinese traditional and Western medicine shows more considerable effect than single western medical treatment in vitality recovery at the latter period of disease.