• Title/Summary/Keyword: Thoracic lymph

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Giant Lymph Node Hyperplasia (Castleman's Disease) as a Rare Cause of Back Pain

  • Kim, Kyoung-Han;Kim, Sang-Dae;Kim, Se-Hoon;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.43 no.3
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    • pp.169-171
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    • 2008
  • Giant lymph node hyperplasia (Castleman's disease) is a nonneoplastic lymphoproliferative disorder of unknown etiology that usually occurs in the chest. Its morphological recognition is based on a composition of various histological features. The mass is often asymptomatic, but it can cause nonspecific thoracic symptoms, such as regional pain. This disease can be found wherever lymph nodes are present, but two-thirds of these tumors are found in the chest, along the tracheobronchial tree in the mediastinum or lung hilus. However, we experienced an unusual case of Castleman's disease as a cause of back pain that was localized in the posterior mediastinum bordering the chest wall.

Clinical Characteristics of False-Positive Lymph Node on Chest CT or PET-CT Confirmed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Lung Cancer

  • Lee, Jongmin;Kim, Young Kyoon;Seo, Ye Young;Choi, Eun Kyoung;Lee, Dong Soo;Kim, Yeon Sil;Hong, Sook Hee;Kang, Jin Hyoung;Lee, Kyo Young;Park, Jae Kil;Sung, Sook Whan;Kim, Hyun Bin;Park, Mi Sun;Yim, Hyeon Woo;Kim, Seung Joon
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.339-346
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    • 2018
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and $^{18}F$-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT. Methods: Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study. Results: Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ${\geq}65$, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT. Conclusion: These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.

Accuracy of Preoperative Computed Tomography in Comparison with Histopathologic Findings in Staging of Lung Cancer (폐암의 병기결정시 임파절의 조직학적 소견과 전산화단층활영의 정확도에 관한 고찰)

  • 박기진;김대영
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.52-58
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    • 1996
  • Sixty six patients who were operated as lung cancer during the period from Mar. 1991 to Sep. 1993 at the department of Thoracic and cardiovascular surgery, were reviewed retrospectively and the accuracy of regional lymph node in preoperative CT were compared with histopathologlc report obtained from operation. The age ranged from 30 to 72 years old (mean age : 56.5), and 51 patients were male and 15 patients were female. The author analysed the true positive, true negative, false positive and false negative and sensitivity, specificity, positive predictive index, negative predictive index and accuracy of each nodes. The result is that there were differences between seven nodal groups in specificity, sensitivity, positive predictive Index, negative predictive index and accuracy. The range of each nodal group is from 81.7 to 98.3% The nodes of the most poor accuracy are aortopulmonary area and hilar area.

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The lateral intercostal artery perforator as an alternative donor vessel for free vascularized lymph node transplantation

  • Kwak, Min-Seok Daniel;Machens, Hans-Guenther
    • Archives of Plastic Surgery
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    • v.45 no.3
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    • pp.275-279
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    • 2018
  • Chronic lymphedema is caused by an impairment of the lymphatic system due to primary or secondary causes. Vascularized lymph node transplantation (VLNT) is currently the most promising and frequently used technique besides lymphaticovenous anastomosis. However, the vessel anatomy in the lateral thoracic region is sometimes quite variable. Based on our experiences with vascular anatomical inconstancy in the lateral thoracic region, we planned a lateral intercostal artery perforator flap for VLNT in a female patient with chronic stage II lymphedema of both legs after cervical cancer treatment. After surgery, the patient reported significant improvement in limb volume and the accompanying symptoms. The limb circumference was reduced by an average of 19.2% at 6 months postoperatively. Despite having a short pedicle and small vessel caliber, the lateral intercostal artery perforator flap can safely be used for VLNT in lymphedema patients with anatomical variants.

Lung Cancer Associated with Sarcoidosis - A case report -

  • Kim, Jae-Jun;Park, Jae-Kil;Wang, Young-Pil;Choi, Soo-Hwan;Jo, Keon-Hyon
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.301-303
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    • 2011
  • Sarcoidosis is a somewhat common pulmonary disease, but the concurrence of lung cancer and sarcoidosis in the same patient is very rare. Because sarcoidosis usually presents as mediastinal lymphadenopathies, this concurrence in a lung cancer patient detected radiologically is apt to be misunderstood to be mediastinal metastases, and it is thus considered to be an unresectable disease. We report a case of lung cancer associated with sarcoidosis that developed in a 65-year-old woman who underwent surgery. Radiological studies revealed a $1.9{\times}1.7$ cm mass in the left upper lobe with multiple enlarged bilateral mediastinal lymph nodes (2R, 3a, 4R, 4L, 5, 6, 7, 8R). Pathologic findings showed that the mass was a well-differentiated adenocarcinoma and all of the enlarged mediastinal lymph nodes were granulomas without cancer metastasis. We report this case with a review of the literature.

Mediastinal Tuberculous Abscess - Report of two cases - (종격동 결핵성 농양: 2례 보고)

  • 표현인
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.830-835
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    • 1991
  • Tuberculosis is a chronic disease caused by Mycobacterium tuberculosis, which usually affects the lung but may cause lesions in any organ or tissue of the human body. Mediastinal lymph node involvement is common feature of intrathoracic tuberculosis in children. Sometimes the lymph node may be enlarged and it causes compressive symptoms. Recently we experienced two cases of tuberculous abscess at middle mediastinum. The abscess seemed to be originated from the mediastinal lymphadenitis, and caused the symptoms. Operation was performed by median sternotomy and by posterolateral thoracotomy incision respectively for the purpose of relieving symptoms and diagnosing the mediastinal mass. The symptoms were relieved completely and postoperative course was uneventful.

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Real-Time Fluorescence Imaging in Thoracic Surgery

  • Das, Priyanka;Santos, Sheena;Park, G. Kate;I, Hoseok;Choi, Hak Soo
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.205-220
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    • 2019
  • Near-infrared (NIR) fluorescence imaging provides a safe and cost-efficient method for immediate data acquisition and visualization of tissues, with technical advantages including minimal autofluorescence, reduced photon absorption, and low scattering in tissue. In this review, we introduce recent advances in NIR fluorescence imaging systems for thoracic surgery that improve the identification of vital tissues and facilitate the resection of tumorous tissues. When coupled with appropriate NIR fluorophores, NIR fluorescence imaging may transform current intraoperative thoracic surgery methods by enhancing the precision of surgical procedures and augmenting postoperative outcomes through improvements in diagnostic accuracy and reductions in the remission rate.

Development of Castleman Disease in the Paravertebral Space Mimicking a Neurogenic Tumor

  • Kwak, Yu Jin;Park, Samina;Kang, Chang Hyun;Kim, Young Tae;Park, In Kyu
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.51-54
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    • 2019
  • Castleman disease is a relatively rare disease, characterized by well-circumscribed benign lymph-node hyperplasia. The disease may develop anywhere in the lymphatic system, but is most commonly reported as unicentric Castleman disease in the mediastinum along the tracheobronchial tree. It is usually asymptomatic and detected on plain chest radiography as an incidental finding. We report an incidentally detected case of Castleman disease in the paravertebral space that was preoperatively diagnosed as a neurogenic tumor and treated by complete surgical resection.