• Journal of Chest Surgery
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• v.25 no.8
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• pp.806-811
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• 1992

The primary neuroendocrine carcinomas[NEC] of the lung are relatively rare. There are classified histologically into the following groups. 1] bronchial carcinoid, 2] well differentiated neuroendocrine carcinoma[WDNC], 3] intermediate cell neuroendocrine carci-noma[ICNC], 4] small cell neuroendocrie carcinoma[SCNC]. The NE cells can be found throughout the mucosa of the bronchial tree by the electron microscopy. By the immunocytochemistry, Neuron-specific enolase[NSE], serotonin, born-csin, and calcitonin are found in normal solitary NE cells and neuroepithelial bodies. The immunohistochemistry has the advantage that it can be applied on routine pathology specimens. The NSE was localized in all of the NE granule bearing tumors but also present in 57 per cent of the non NE carcinomas. Together the combination of chromogranin A, bombesin and NSE should provide an exellent signature for tumor cells expressing NE features, such as carcinoids and other NE carcinomas. We have experienced two cases of primary pulmonary NEC in 59 and 29 years old men. The former was admitted due to exertional dyspnea and left chest pain, the latter, newly developed mass on chest X-ray. They were treated by Lt pneumonectomy with LN dissection and RLL resection with LN dissection The postoperative diagnoses were could be confirmed by NSE study as NEC which were SCNEC and INEC in subgroups. The postoperative courses were uneventful.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.437-440
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• 1997

A case of inflammatory pseudotumor of the entire lung In a 61-ycar-old man is prcscntcd. The respiratory symptoms developed 2 months ago and progressed rapidly and the diagnosis of chronic pneumonia with ateletectasis of the entire lung, destroyed lung by tuberculosis and sepsis hAd to be ruled out The operative finding was different from our expectation. This case suggests that the Inflammatory pseudotumor can manifest as a whole lung-involving ass. Inflammatory pseudotumor is a nonneoplastic reactive pulmonary mass lesion that resembles tumor but shows little or no growth. Thc inflammatory pseudotufor usually present as a solitary round lung mass but in this casts progressed rapidly and destroyed the whole lung, which is rare. The patient was discharged with no problem and with outpatient followup.

• Journal of Chest Surgery
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• v.14 no.3
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• pp.274-279
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• 1981

We performed three replacement operations of great venous obstruction with Dacron prosthesis from July, 1980 to Nov. 1980. Summary of 3 cases as belows: 1) Inferior vena cava obstruction . 43 years old male was admitted because of abdominal distension and marked superficial collateral circulation on chest and abdomen. Inferior vena cavogram showed complete obstruction of I. V .C. just below hepatic vein. Bypass operation was done between Rt atrium '||'&'||' I. V.C. (just above renal vein) with Woven Dacron prosthesis (22mm in Diameter) under ex tracorporeal ci rculation. 2) Superior vena cava obstruction . 21 years old male was admitted because of facial edema and irritative cough. Well circumscribed lobulated mass was located at ant. superior mediastinum and extended to Rt. thorax in chest P-A view. Woven Dacron prosthesis (10mm in Diameter) was replaced at involved S.V.C. segment after Rt. upper '||'&'||' middle lobectomy with tumor resection. 3) Common iliac vein obstruction (Lt) . 64 years old female was admitted because of generalized edema and tenderness of Lt. lower extremity. Venography of Lt leg showed complete obstruction of common iliac vein. Woven Dacron prosthesis (10mm in Diameter) was replaced at obstruction site.eplaced at obstruction site.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.109-115
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• 1988

With the decreasing incidence of new cases and the highly effective results with antituberculous drug therapy, there is a marked decline in the need for surgery which was formerly such an important part in the successful program of management of this disease. During the period of two years and a half from Jun. 1984 to Dec. 1986, this study represents an analysis of 163 cases of several surgical management for eventual control of pulmonary tuberculosis at National Kon-ju tuberculosis Hospital. 1. Mode of surgical treatment was: Resection; 123 cases [Pneumonectomy: 83, lobectomy: 35, lobectomy plus segmentectomy; 4 segmentectomy: 1], thoracoplasty: 20 and others: 20. 2. Age distribution ranged 16and 68 with average of 34 years. Male and female ratio was 1.2: 1. 3. Surgical indications were: totally destroyed lung; 64, Destroyed lobe of segment; 13, cavity positive sputum; 10, cavity c negative Sputum; 6, Bronchostenosis c atelectasis; 2, empyema c or s BPF; 46, Aspergilloma; 8, Questions of Associated tumor; 4 and other 5. 4. Incidence of Complications was 10.4% and the mortality was 5.5 percent. The cause of mortality were analyzed. The main causes of death were respiratory insufficiency; 4, fulminant hepatitis; 1, hemorrhage; 1 and unknown; 1 in pneumonectomy, and asphyxia; 1 in lobectomy and sepsis; 1 in other procedure. 5. Conversion rare of positive sputum to negative state related to resectional surgery was 91.5%. In pneumonectomy, drug resistant group preoperatively showed 88.1% conversion rate postoperatively and drug sensitive group showed that 100% conversion rate. In lobectomy, both drug resistant and sensitive groups showed that 100% conversion rate postoperatively.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.69-72
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• 1998

Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4$\times$5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.792-799
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• 1985

Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

• 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.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.364-373
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• 1994

Alpha 1-Proteinase inhibitor[PI] was known as a major protective enzyme against to excessive hydrolytic and proteolytic reaction. So, it was suggested that Alpha 1-PI may implicated in growth of bronchogenic cancer. This study was undertaken to investigate the role of Alpha 1-PI in local invasion of bronchogenic cancer. Three groups of patients were studied; Preliminary research group of 15 bronchogenic cancer patients, Main research group of 13 bronchogenic cancer patients and Normal control group of 10 nephrectomy donor. Serum Alpha 1-PI level was observed in each group of patients during pre-and postoperative days. Pre-operative serum Alpha 1-PI level in preliminary research group [329.2$\pm$14.21mg/dl]and main research group[406.2$\pm$39.30mg/dl] were higher than in normal control group[236.2$\pm$19.55mg/dl] significantly[p<0.005]. Serial Alpha 1-PI level in each group during pre-and postoperative days shows peaked at 3rd. postoperative day in preliminary and main research group, thereafter decreased gradually. Immunohistochemical study for Alpha 1-antitrypsin[A1AT] was carried out by ABC[avidin-biotin peroxidase complex] method using Alpha-1 antitrypsin DAKOR to tumor tissues of 13 lung cancer patients in main research group. 6 cases[46.2%, squamous cell ca.;5, adenocarcinoma;1] of above 13 cases show positive immunoreactivity for A1AT. In conclusion, alpha 1-PI and elastase are disclosed that have defined actions for lung cancer growing or spreading.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.964-967
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• 2001

Giant thymic Hyperplasia is a rare lesion in children. We report a case of giant thymic hyperplasia in the right anterior mediastinum in a 2 year-old male patient. Presenting symptom was frequent cough and sputum, plain chest X-ray and computed tomography showed huge mass in the right anterior mediastinum. The tumor resection was done through a median sternotomy for the prevention of progression to atelectasis caused by mass effect and tissue diagnosis. An open biopsy specimen showed normal thymic architecture. The patient recovered without any problem and is doing well untill now. We report this rare case of giant thymic hyperplasia with review of the literature.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.851-854
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• 1999

Hemangioma in the esophagus is an uncommon tumor. There have only been about 30 cases reported in the world literatures. It occurs predominantly in men and although majority are asymptomatic, may cause bleeding and dysphagia. Hemangioma in the esophagus was diagnosed with a barium swallowed esophagography and endoscopy. The main treatment modes recommended are surgery and endoscopic resection. We experienced one case of cav ernous hemangioma occurring at the distal esophagus. The patient was a forty-six year old male with dysphagia and indigestion. Barium esophagogram showed a filling defect at the distal portion. Esophagoscopy showed a bluish polypoid mass. Surgical resection was per formed and the pathologic diagnosis was confirmed as cavernous hemangioma. Postoperative course was uneventful and the patient had been followed up without any problems.