• Journal of Chest Surgery
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• v.34 no.6
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• pp.506-510
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• 2001

Langerhans\` Cell Histiocytosis(LCH) is a disease of unknown origin, characterized by abnormal proliferation of Langerhans\` cells. Previously, it has been called histiocytosis X, which included eosinophilic granuloma, Hand-Sch ller-Christian\`s disease, and Letterer-Siwe disease. Any organs or tissues such as skin, lymph nodes, bone and bone marrow can be involved. However, LCH of chest wall is rarely reported in our country. We experienced a 18 month old male child, who had osteolytic lesion involving the rib with axillary lymph node metastasis. The tumor was confirmed as LCH after surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5819-5823
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• 2014

Purpose: To investigate the expression of hypoxia-inducible factor prolyl hydroxylase 3 (HIFPH3) in non-small cell lung cancer (NSCLC) and explore the correlation of HIFPH3 expression with lymph node metastasis and microvessel density (MVD). Materials and Methods: A total of 73 cases of NSCLC specimens, 24 cases of para-cancerous tissues, and 20 normal pulmonary tissues were collected for HIFPH3 and CD31 immunohistochmical (IHC) study. Microvessel density (MVD) of the NSCLC tissues was also determined based on the expression of CD31. Results: The expression of HIFPH3 in carcinoma tissue was statistically higher than para-cancerous and normal pulmonary tissues (${\chi}^2=48.806$, p<0.05). Compared withthe negative lymph node metastasis group, the lymph node metastasis group showed significantly higher HIFPH3 expression (${\chi}^2=6.300$, p<0.05). The strong HIFPH3+group displayed a significantly higher MVD than weak HIFPH3+ and HIFPH3- groups (p<0.05). No differences in positive HIFPH3 expression were noted regarding the tumor diameter, age, smoking status, gender of NSCLC patients, tumor size, histopathology, or differentiation. Conclusions: HIFPH3 expression in human NSCLC lesions is significantly higher than that in para-cancerous and normal lung tissues and is positively associated with lymph node metastasis and MVD.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.582-587
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• 1987

Castleman`s disease, giant lymph node hyperplasia, is a rare benign disease. The lesion usually consists of a single node, unassociated with any abnormality of the adjacent lymph nodes or other organs. In the first accounts of giant lymph node hyperplasia of Castleman, the lesion was described as solitary and localized to the mediastinum, which is still the most frequent site of involvement. The disease occurs in all age groups and there is no particular sex preference. It is symptomless and is usually detected on chest films as an incidental finding. On a single involvement, it does not recur after excision, whether total or partial, and the main indication of operation is to rule out more serious tumors. Recently multicentric form appears to be a variant of classic giant lymph node hyperplasia and is associated with significant morbidity and mortality. Histologically, two distinct types have been reported; hyaline-vascular and plasma cell. The hyaline-vascular type of lesion is much more common than the plasma cell type. We report two cases of the hyaline-vascular type of Castleman`s disease.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1081-1084
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• 1998

Background: Esophageal surgery in esophageal cancer has low curative resection rate and its resut has not improved even after the extended lymphnode dissection. To evaluate the effectiveness of cervical lymph node dissection, we compare the node of cervical lymph node metastasis in patients esophageal cancer. Materials and methods: We studied a series of 32 patients who underwent operation for thoracic esophageal carcinoma at our institution. The 25 patient who underwent curative surgery were divided into two groups. Both groups A and B underwent transthoracic esophagectomies with mediastinal and abdominal lymphadenectomies only, but group B also underwent bilateral lower neck node dissection. Results: The rate of operative complications did not differ significantly between two groups. No operative and hospital mortalities were noted in either group. However, the mean anesthetic time was significantly longer in group B(mean: 90 minutes). Neck node metastasis was revealed in 27% of group B. Conclusions: Therfore, neck node dissection is meaningful for surgical treatment of the thoracic esophageal carcinoma. The longterm survival rate should be compared later.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.68-73
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• 2008

Background: The presence of infiltrated mediastinal lymph nodes is a crucial factor for the prognosis of lung cancer. The aim of our study is to investigate the pattern of metastatic non-small cell lung cancer that spreads to the mediastinal lymph nodes, in relation to the primary tumor site, in patients who underwent major lung resection with complete mediastinal lymph node dissection. Material and Method: We retrospectively. studies 293 consecutive patients [mean age $63.0{\pm}8.3$ years (range $37{\sim}88$) and 220 males (75.1%)] who underwent major lung resection due to non-small cell lung cancer from January 1998 to December 2005. The primary tumor and lymph node status was classified according to the international TNM staging system reported by Mountain. The histologic type of the tumors was determined according to the WHO classification. Fisher's exact test was used; otherwise the chi-square test of independence was employed. A p-value < 0.05 was considered significant. Result: Lobectomy was carried out in 180 patients, bilobectomy in 50, sleeve lobectomy in 10 and pnemonectomy in 53. The pathologic report revealed 124 adenocarcinomas, 138 squamous-cell tumors, 14 adenosquamous tumors, 1 carcinoid tumor, 8 large cell carcinomas, 1 carcinosarcoma, 2 mucoepidermoid carcinomas and 5 undifferentiated tumors. The TNM stage was IA in 51 patients, IB in 98, IIB in 41, IIIA in 71, IIIB in 61 and IV in 6. 25.9 % of the 79 patients had N2 tumor. Most common infiltrated mediastinal lymph node was level No.4 in the right upper lobe, level No. 4 and 5 in the left upper lobe and level No. 7 in the other lobes, but no statistically significant difference was observed. Thirty-six patients (12.3%) presented with skip metastasis to the mediastinum. Conclusion: Mediastinal lymph node dissection is necessary for accurately determining the pTNM stage. It seems that there is no definite way that non-small cell lung cancer spreads to the lymphatics, in relation to the location of the primary cancer. Further, skip metastasis to the mediastinal lymph nodes was present in 12.3% of our patients.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.180-187
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• 2011

Background: In mediastinal lymph node sampling in non-small cell lung cancer (NSCLC) it is important to determine the appropriate treatment as well as to predict an outcome. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a recently developed, accurate, safe technique in patients with NSCLC for sampling mediastinal lymph nodes. We sought to determine the usefulness of EBUS-TBNA in mediastinal staging with NSCLC considered to be operable. Methods: We retrospectively reviewed the records of 142 patients who underwent EBUS-TBNA for mediastinal staging in the Asan Medical Center, Korea from July 2008 to July 2010. If patients were in an operable state, they underwent subsequent surgical staging. Diagnoses based on biopsy results were compared with those based on surgical results. Results: We performed EBUS-TBNA in 184 mediastinal lymph nodes in 142 NSCLC patients. Almost all of the EBUS-TBNA samples were from the lower paratracheal (112, 60.9%) and subcarinal (57, 31.0%) lymph nodes. In 142 patients, 51 patients (35.9%) were confirmed with malignant invasion of the mediastinal lymph node by EBUS-TBNA and 91 (64.1%) patients were not confirmed. Among the 91 patients, 64 patients (70.3%) underwent surgical staging. 3 patients (4.7%) who were misdiagnosed by the EBUS-TBNA were confirmed by surgery. After Diagnostic sensitivity of EBUS-TBNA, the prediction of mediastinal metastatsis was 94.4% and specificity was 100%. The procedures were performed safely and no serious complications were observed. Conclusion: We demonstrated the high diagnostic value of EBUS-TBNA for mediastinal staging.

• Proceedings of the KOR-BRONCHOESO Conference
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• 2010.03a
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• pp.43-43
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• 2010

• Journal of Chest Surgery
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• v.44 no.1
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• pp.39-43
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• 2011

Background: Pulmonary sclerosing hemangioma is a rare thoracic tumor, and pathophysiology or clinical course of this tumor is not yet fully described. Furthermore, there is no consensus on the standard operative procedure for this tumor. Material and Methods: Medical records of thirty-two patients, who underwent surgical resection of pulmonary sclerosing hemangioma from 1996 to 2007, were retrospectively reviewed. Results: Nineteen patients underwent lobectomy and thirteen patients underwent limited resection. Video-assisted thoracoscopic surgery was performed in 9 patients in the latter group. Lymph node dissection was done in 21 patients, and one patient was found to have lymph node metastasis of the tumor. There was no postoperative complication, no early death and no tumor-related late mortality. The mean follow-up duration was 39.3 months (2 months~129 months), and all patients were free of local recurrence and distant metastasis during this period. There was no significant difference in patient's characteristics between the two groups, except that the mean hospital stay was shorter in limited resection group than in lobectomy group (p=0.0031). Conclusion: Pulmonary sclerosing hemangioma usually requires surgical resection for both diagnosis and treatment. Limited resection can decrease hospital stay with a surgical outcome comparable to lobectomy, and may be preferred to lobectomy if sufficient resection margin can be achieved.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.109-114
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• 2010

Background: The aim of this study was to compare a novel mannose receptor-binding agent(Technetium-99m human serum albumin, $^{99m}Tc$-MSA) with $^{99m}Tc$-phytate for sentinel node mapping in patients with esophageal cancer. Material and Method: Twenty patients with clinical stage T1N0m0 or T2N0M0 esophageal cancer that were candidates for esophagectomy were enrolled. Endoscopic injection of $^{99m}Tc$-MSA or $^{99m}Tc$-phytate was administered at the peri-tumor region before surgery in 10 patients. The radioactive lymph nodes were identified with a handheld gamma probe after lymph node dissection. Results: The patient's age and the sex ratio of both groups were similar. The clinical stage, tumor location, and operative technique did not differ. The total number of dissected lymph nodes did not differ ($28.5{\pm}9.12$ in MSA group, $32.2{\pm}11.24$ in phytate group, p=0.430). The sentinel node was identified in all cases in both groups. The number of sentinel nodes per patient was $2.7{\pm}1.57$ in the MSA group, which was significantly greater than the $1.7{\pm}0.88$ in the phytate group (p=0.036). Five out of 20 patients whose sentinel nodes could be identified had metastases; however, neither group had any false-negative results for sentinel node identification. Conclusion: Sentinel nodes were detected more frequently with MSA than with phytate.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.373-376
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• 2013

A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.