• Title/Summary/Keyword: bronchoscopy

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A Case of Endobronchial Lipoma causing middle lobe syndrome (중엽증후군을 유발한 기관지 지방종 1예)

  • Kim, Hyun Jun;Wang, Jun Ho;In, Haing Hwan;Song, Ki Ho;Song, Jong Oh;Song, Kwang Seon;Yong, Suk Jung;Shin, Kye Chul;Hong, Soon Won
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.191-196
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    • 1997
  • Although lipomas are common benign tumors in humans, endobronchial lipomas are quitely rare. Up to date, about 60 cases have been reported in the English literature. But endobronchial lipomas causing middle lobe syndrome were only 4 cases. These benign slow-growing tumors generally occur in the proximal portion of the lobar or segmental bronchi and originate from fatty tissue that is normally present in the bronchial tree. Smoking or chronic inflammation may be important in the pathogenesis of these tumors. Bronchoscopy is the definite diagnostic tool but, in general, open thoracotomy is required for diagnosis and treatment. Here, we present a case of endobronchial lipoma, with a review of the literature.

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Analysis of ICU Treatment on Resection of Giant Tumors in the Mediastinum of the Thoracic Cavity

  • Kang, Nai-Min;Xiao, Ning;Sun, Xiao-Jun;Han, Yi;Luo, Bao-Jian;Liu, Zhi-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3843-3846
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    • 2013
  • Objective: The purpose of this study was to assess prognosis after resection of giant tumors (including lobectomy or pneumonectomy) in the mediastinum. Materials and Methods: Patients with resection of a giant tumor in the mediastinum of the thoracic cavity received ICU treatment including dynamic monitoring of vital signs, arterial blood pressure and CVP detection, determination of hemorrhage, pulmonary function and blood gas assay, treatment of relevant complications, examination and treatment with fiber optic bronchoscopy, transfusion and hemostasis as well as postoperative removal of ventilators by invasive and non-invasive sequential mechanical ventilation technologies. Results: Six patients were rehabilitated successfully after ICU treatment with controlled postoperative errhysis and pulmonary infection by examination and treatment with fiber optic bronchoscopy without second application of ventilators and tubes after sequential mechanical ventilation technology. One patient died from multiple organ failure under ICU treatment due to postoperative active hemorrhage after second operative hemostasis. Conclusions: During peri-operative period of resection of giant tumor (including lobectomy or pneumonectomy) in mediastinum ofthe thoracic cavity, the ICU plays an important role in dynamic monitoring of vital signs, treatment of postoperative stress state, postoperative hemostasis and successful removal of ventilators after sequential mechanical ventilation.

A Case of Endobronchial Tuberculosis with Repeated Expectoration of Nodular Tissues (반복적인 결절조직 배출 후 호전된 기관지 결핵 1예)

  • Kim, Soo Woong;Lee, Byoung Hoon;Ahn, Youngsoo;Kim, Nam In;Eom, Woo Youn;Woo, Jeong Joo;Kim, Sang-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.204-208
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    • 2005
  • Herein, we report a case of tumorous endobronchial tuberculosis with successful recovery of atelectasis without any significant bronchial stricture, after repeated expectorations of nodular tissues. A 24-year-old male patient was presented with persistent cough. The patient was diagnosed to be suffering from tuberculous lymphadenitis on right axillar and mediastinum of lung, and was subsequently treated with antituberculosis agents. After two months, clinical deteriorations and atelectasis were observed on right upper lobe of lung. Multiple endobronchial tumorous lesions, which obstructed the right main bronchus, were revealed on bronchoscopy, and based on the endobronchial biopsy findings we confirmed that the patient was suffering from endobronchial tuberculosis. We decided to administer antituberculosis agents without any additional procedure. After few weeks, the patient spontaneously expectorated nodular tissues with vigorous coughing. Later on, the symptoms and atelectasis disappeared and the patient was completely recovered. This case shows that in patients suffering from tumorous endobronchial tuberculosis, endobronchial mass can be expectorated spontaneously without sequelae of significant bronchial stenosis.

Usefulness of Photodynamic Therapy in the Management of Early Central Lung Cancer: A Report of Three Cases

  • Lee, Jong Hoo;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Han, Joungho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.338-344
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    • 2009
  • In photodynamic therapy, a chemical photosensitizer is activated by light of a specific wavelength., Photodynamic therapy has been combined with bronchoscopy in patients who are ineligible for surgical resection in order to treat patients with early central lung cancer. Here, we describe 3 patients with early central lung cancer who were treated effectively using photodynamic therapy. Our experience shows that this approach is a useful modality in the therapy of these types of tumors.

A Case of Occult Foreign Body Lodged in Bronchus for a Long Period and Removal by Flexible Bronchoscopy (굴곡성 기관지 내시경에 의한 장기간 체류한 기관지이물의 제거 1예)

  • Jo, Kyoung-Geun;Baek, Man-Sun;Kim, Mi-Suk;Hur, Jean-Man;Jeon, Jong-Il;Park, Kang-Seo;Jung, Kyung-Tae;Choi, Duck-Yeii;Na, Moon-Jun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1166-1171
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    • 1997
  • Aspiration of foreign bodies into tracheobronchial tree is more common in children than in adults. Foreign bodies in airway commonly occur by accident, and in most cases they get removed without delay. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Although foreign body aspiration is frequently suspected in children with acute or recurrent pulmonary symptoms, it is rarely considered in adults, unless a clear history of an aspiration event can be obtained. We have experienced and studied a case of occult aspiration of a shrimp which had been lodged for a long period.

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A Case of Hodgkin's Disease as Endobronchial Presentation (기관지내 종양으로 발견된 호지킨병 1예)

  • Lee, Hyo-Jin;Cheon, Du-Su;Yun, Sang-Myung;Park, Sam-Seok;Ryu, Ki-Chan;Lee, Min-Ki;Lee, Chang-Hun;Park, Soon-Kew
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.614-618
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    • 1998
  • Although mediastinal involvement by Hodgkin's disease is frequent, the initial presentation of the lymphoma by an endobronchial lesion is rare. A 23-year-old man was admitted with progressive dyspnea. Initial chest roentgenogram showed atelectasis of right middle and lower lobe. Fiberoptic bronchoscopy showed a polypoid mass obstructing the right mainstem bronchus. The mass lesion was histologically confirmed as Hodgkin's disease, nodular sclerosis type. He received systemic chemotherapy and improved rapidly.

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Diagnosis and Treatment of Bronchial Foreign Body by Ventilating Bronchoscopy (환기형 기관지경술을 이용한 기도내 이물의 진단과 치료)

  • Kim, Beom-Gyu;Kang, Jin-Wook;Kim, Young-Jae;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.8 no.2
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    • pp.36-42
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    • 2002
  • Aspirated and ingested foreign bodies continue to present challenges to otolaryngologists. The major discussions were the accurate diagnosis and speedy, safe removal of foreign body. Many diagnostic tools have been tried and removal of foreign bodies has been facilitated by technical improvements with rod lens telescope, video endoscope, flexible fiberoendoscope and safer anesthesia. In spite of these advances, more than 3000 children's death occur per year in the world because of foreign bodies and untold number of parients survive with variable sequelae. In these study, 59 consecutive cases of children and adults with tracheobronchial foreign bodies were reviewed from 1992 to 2001. We studied the history, symptoms, ausculatory radiologic, bronchoscopic finding and post operative complications. 71% (42 cases in 59 cases) of patients had foreign body aspiration history or choking crisis. In 64% (38cases) cough was observed. 81% (48cases) had abnormal finding in chest auscultation and 78% in chest X-ray. Computed tomography was done in 12 cases, all were founded foreign body shadow. Main site of foreign body was right main bronchus (41%, 24cases) and most frequent foreign body was peanut (36% , 21cases) . 4 experienced ICU(intensive care unit) care. 2 cases were failed to remove foreign. In these cases 1 cases was improved by steroid therapy and physical therapy and the other was treated with thoracotomy. We concluded the morbidity and motality were much correlated with speedy decision making and experienced skill of operator.

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Reverse V-Shape Kinking of the Left Lower Lobar Bronchus after a Left Upper Lobectomy and Its Surgical Correction

  • Kim, Min-Seok;Hwang, Yoohwa;Kim, Hye-Seon;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.483-486
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    • 2014
  • A 76-year-old male underwent a left upper lobectomy with wedge resection of the superior segment of the left lower lobe using video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer of the left upper lobe. He presented with shortness of breath, fever, and leukocytosis. Chest radiography showed atelectasis at the remaining left lower lobe. Bronchoscopy revealed narrowing of the left lower bronchus with purulent secretion, and computed tomography showed downward kinking of the left lower lobar bronchus. He underwent exploratory VATS, and intraoperative findings showed an inferiorly kinked left lower lobar bronchus with upward displacement of the left lower lobe. After adhesiolysis, the kinked bronchus was straightened, and bronchopexy was performed to the pericardium to prevent the recurrence of bronchial kinking. Also, the inferior pulmonary ligament was reattached to prevent upward displacement. Postoperative follow-up bronchoscopy revealed no evidence of residual bronchial obstruction, and chest radiography showed no atelectasis thereafter.

Changes in Diagnostic Methods for Pulmonary Tuberculosis between 2005 and 2013

  • Ahn, Bin;Kim, Joohae;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.227-231
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    • 2015
  • Background: Diagnostic methods for pulmonary tuberculosis (TB) have recently advanced. The aim of this study was to evaluate the changes in TB diagnostic tests that prompted the initiation of anti-TB treatment over time in South Korea, an industrialized country with an intermediate TB burden. Methods: Patients diagnosed with pulmonary TB in the first halves of 2005 and 2013 at a tertiary referral hospital were included. Diagnostic methods that prompted the initiation of anti-TB treatment were compared between the 2 groups of patients. Results: A greater proportion of patients were diagnosed with pulmonary TB using bronchoscopy in 2013 than in 2005 (26.7% vs. 6.6%, respectively; p<0.001), while the proportion of patients clinically diagnosed with pulmonary TB was lower in 2013 than in 2005 (24.7% vs. 49.0%, respectively; p<0.001). Additionally, more patients started anti-TB treatment based on positive polymerase chain reaction (PCR) results for Mycobacterium tuberculosis DNA in 2013 than in 2005 (47.3% vs. 7.9%, respectively; p<0.001). Conclusion: The initiation of treatment for pulmonary TB in South Korea has become more frequently based on PCR and the use of bronchoscopic specimens.

Invasive Pulmonary Aspergillosis after Influenza A Infection in an Immunocompetent Patient

  • Kwon, Oh Kyung;Lee, Myung Goo;Kim, Hyo Sun;Park, Min Sun;Kwak, Kyoung Min;Park, So Young
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.6
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    • pp.260-263
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    • 2013
  • Invasive aspergillosis has emerged as a major cause of life-threatening infections in immunocompromised patients. Recently, patients with chronic obstructive pulmonary disease, who have been receiving corticosteroids for a long period, and immunocompetent patients in the intensive care unit have been identified as nontraditional hosts at risk for invasive aspergillosis. Here, we report a case of invasive pulmonary aspergillosis after influenza in an immunocompetent patient. The patient's symptoms were nonspecific, and the patient was unresponsive to treatments for pulmonary bacterial infection. Bronchoscopy revealed mucosa hyperemia, and wide, raised and cream-colored plaques throughout the trachea and both the main bronchi. Histologic examination revealed aspergillosis. The patient recovered quickly when treated systemically with voriconazole, although the reported mortality rates for aspergillosis are extremely high. This study showed that invasive aspergillosis should be considered in immunocompetent patients who are unresponsive to antibiotic treatments; further, early extensive use of all available diagnostic tools, especially bronchoscopy, is mandatory.