• 대한세포병리학회지
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• 제8권2호
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• pp.109-114
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• 1997

Transbronchial fine needle aspiration(TBNA) is one of the cytologic methods in diagnosing lung cancers. TBNA can be used in cases of hilar, mediastinal or lung masses adjacent to the bronchi. We analyzed and compaired the findings of 27 cases of TBNA and bronchial washing and brushing(BW/BB) in lung cancers confirmed by either biopsy or surgical resection between Jun, 1996 and May, 1997 in Asan Medical Center. They were 18 cases of non-small cell carcinomas(eight squamous cell carcinomas, nine adenocarcinomas, and one large cell undifferentiated carcinoma), eight cases of small cell carcinomas, and one case of metastatic hepatocellular carcinoma. The sensitivity of TBNA was 37%(10/27) and false negative was 63%(17/27). Although the sensitivity of BW/BB w3s 56%(15/27), it was not different statistically from that of TBNA(Chi square, p=0.38). Overall sensitivity of TBNA and BW/BB in this series was 70%(19/27). Forty-seven percent of false negative TBNA(8/17) were positive in BW/BB. The findings suggest that the addition of TBNA to the standard BW/BB increases diagnostic yield in cytologic diagnosis of lung cancer.

• Tuberculosis and Respiratory Diseases
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• 제41권6호
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• pp.644-650
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• 1994

어머니가 Stage 2 폐유육종증으로 진단 받고 치료된 후 4년만에 친 딸에서 X선상 폐문종대와 전방 포도막염이 발생하여, 기관지 폐생검 및 종격동경으로 실시한 종격동 임파선 생검으로 유육종증으로 진단된 가족형 유육종증이 우리나라에서는 처음 발견되어 문헌 고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제49권5호
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• pp.639-643
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• 2000

A 33-year-old woman was presented with dyspnea and chest discomfort after indigesting approximately 500ml of oil paint brush washing fluid. Hypoxic symptoms and radiographic infiltrates rapidly progressed. The patient was intubated and received mechanical ventilation. Bronchoalveolar lavage and transbronchial lung biopsies were performed. The CT scan of the lung showed bilateral extensive pneumonitis with necrosis and the lung tissue pathologic findings showed diffuse alveolar damage with extensive necrosis and numerous lipid-laden macrophages. After intensive medical care with mechanical ventilation, her symptoms and radiological findings improved.

• Tuberculosis and Respiratory Diseases
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• 제56권4호
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• pp.374-380
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• 2004

목 적 : 폐암의 진단에 있어서 진단율이 낮은 기관지주위나 점막하 병변에서 TBNA의 진단율을 조직 생검과 비교하여 TBNA의 임상적인 유용성에 대해 조사하였다. 방 법 : 연세대학교 의과대학 세브란스병원에서 1994년 1월부터 2002년 12월까지 5,582예의 굴곡성 기관지내시경검사를 시행하였으며, 기관지주위나 점막하 병변을 보여 TBNA와 조직생검을 시행한 환자 중 폐암이 확진되었던 120예를 대상으로 후향적으로 조사하였다. 결 과 : 기관지주위나 점막하 병변을 가진 폐암에서 TBNA의 진단율은 75.8%로 생검(52.5%)에 비해 진단율이 높았으며(p=0.001), 생검 단독에 비해 TBNA와 생검을 병용하는 경우 진단율이 유의하게 높았다(88.3%, p=0.0001). 폐암의 세포형이나 내시경적 형태에 따른 TBNA의 진단율은 유의한 차이가 없었으나, 소세포암에서 좀 더 높았다. 결 론 : 기관지주위나 점막하 병변을 가진 폐암의 진단에 있어서 TBNA는 생검보다 진단율이 높았고 생검과 같이 시행함으로써 폐암의 진단율을 향상시킬 수 있었다.

• Journal of Chest Surgery
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• 제30권12호
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• pp.1232-1236
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• 1997

미만성 간질성 폐질환의 진단은 임상소견, 기관지폐포 세척액 검사, 경기관지 생검 그리고 폐생검등이 이용되고 있다. 확진을 위해서는 폐생검을 하여야 하며 흉강경을 이용한 폐생검이 흉강내를 자세히 관찰하여 적절한 위치을 선정할 수 있고 개흉적 폐생검보다 수술후 통증이 적음으로 해서 합병증이나 입원기간을 단 축하는 장점이 있다 중앙대학교 의과대학 흉부외과 교실에서는 1994년 4월부터 1996년 12월까지 미만성 간질성 폐질환 환자 22 명에서 흉강경을 이용한 폐생검을 실시하여 다음과 같은 결과를 얻었다. 1. 남녀비는 14:8로 남자에서 많았고 평균연령은 54.6세, 연령분포는 60대가 7례로 가장 많았다. 2. 생검부위는 좌우폐비가 6:20로 우측에서 많았으며, 부위별로는 우하엽이 13례, 우상엽이 4례, 우중엽이 3 례, 좌상엽이 3례 좌하엽이 3례로서 우하엽이 많았으며 한부위에서만 시행한 환자가 \ulcorner례, 2군데서 시행한 환자가 4례 있었다. 3. 수술전후 폐기능검사는 WC, FEVI, FEV1/PVC에서 의미있는 변화는 없었다. 4. 생검결과 통상성 간질성 폐렴이 8례로 가장 많았고 그 다음 속립성 결핵에 의한 것이 4례, 전이성 암성 폐질환이 3례, 박리성 간질성 폐렴, 기질화된 폐렴을 동반한 폐쇄성 기관지염이 각각 2례, 기타 유육종증, 범세기관지염, 기관지 확장증이 각각 1례씩 있었다. 결론적으로 미만성 간질성 폐질환 환자에서 확진을 위한 흉강경을 이용한 폐생검은 폐기능이 나쁜데도 불구 하고 안전하고 유용하게 사용할 수 있다.

• Tuberculosis and Respiratory Diseases
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• 제48권6호
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• pp.980-985
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• 2000

호흡곤란과 마른 기침을 주소로 내원한 52세 여자 환자가 미만성 간질성 폐음영의 급속한 악화소견을 보이며 급성호흡부전으로 진행하여 입원 11일째 사망하였다. 입원 초기에 임상적 진단용 내리는데 어려움이 있었으나 기관지경을 통한 경기관지 폐생검상 선암의 림프관성 폐전이를 확진할 수 있었다. 저자들은 암을 아직 진단받지 않은 상태의 환자에서도 미만성 간질성 폐음영이 진행하는 경우 림프관성 폐암종을 감별진단으로 고려하여야 하며 경기관지 폐생검이 진단에 유용할 수 있을 것으로 생각한다.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.256-259
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• 1995

The diffuse nodular lung lesion has a diagnostic problem and should be made differential diagnosis. A chest X-ray of 62-year-old male patient with dyspnea showed small-sized scattered multinodular lesion on entire lung field. Bronchoalveolar lavage and transbronchial needle aspiration showed the non-specific findings, so open lung biopsy was done and revealed bronchioloalveolar cell carcinoma.

• Tuberculosis and Respiratory Diseases
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• 제42권6호
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• pp.951-954
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• 1995

Diagnostic procedures in pregnant wowen is limited and is usually delayed, especially so if she is on mechanical ventilation. A 28-year-old pregnant woman with severe dyspnea was referred to our hospital under the impression of miliary tuberculosis. The respiratory failure was so severe that patient had to be managed with mechanical ventilator under clinical impression of overwhelming pneumonia or pulmonary tuberculosis. But the patient's conditions deteriorated. Bronchoscopy and blind transbronchial lung biopsy performed to determine the nature of the etiology, and to our surprise, revealed squamous cell carcinoma of the lung.

• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.262-273
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• 1990

In order to assess the method which is more sensitive one to detect the early change of lung tissue by the inhaled dust, we have performed the various medical examinations such as chest radiography, pulmonary function test, high resolution chest CT, brnchoalveolar lavage and lung biopsy used bronchoscope and ultrathin bronchoscopy examination to 48 persons. The control group were 8 persons who did not exposed to dust, 40 cases of the experimental group have professionally exposed to the mineral dust. The results were as follows 1. The total number of cells in bronchoalveolar lavage was significantly increased in all of the pneumoconiosis group classified by chest and high resolution chest CT. 2. The composition rate of macrophage to the total number of cells in bronchoalveolar lavage fluid was significantly decreased in all of the pneumoconiosis group compared with the control group. 3. The composition rate of neutophils and lymphocytes to the total number of cells in bronchoalveolar lavage fluid was significantly increased in all of the pneumoconiosis group compared with the control group. 4. The forced expiratory volume in one second ($FEV_{1-0}$), maximal mid-expiratory flow (MMF), and maximal voluntary ventilation (MVV) were significantly increased only in the group of the progressed pneumoconiosis relatively. 5. We observed submucosal edema, anthracotic pigmentation and granuloma formation in transbronchial lung biopsy of the suspected pneumoconiosis (category 0/1) case which is thought to the early change of coal workers' pneumoconiosis.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.182-186
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• 2012

Miliary brain metastasis from the lung is uncommon and has a poor therapeutic response. We report a case of pulmonary adenocarcinoma combined with multiple brain cystic lesions that were initially misdiagnosed as neurocysticercosis. A 53-year-old male who never smoked was admitted to our hospital with complaints of agitation and cognitive impairment. Brain magnetic resonance imaging showed innumerable, small nodular lesions with a central, low signal intensity in whole brain parenchyma. His symptoms were not improved by the empirical praziquantel medication for disseminated neurocysticercosis. After a transbronchial biopsy from the right middle lobe, we could diagnose the primary lung adenocarcinoma with a single nucleotide polymorphism in the epidermal growth factor receptor exon 20 at codon 787 (Q787Q). His neurologic symptoms and imaging findings have been gradually improving with a first-line Gefitinib treatment for five months. We recommend a more active diagnostic approach including biopsy in case of atypical imaging findings.