• Tuberculosis and Respiratory Diseases
• /
• v.62 no.6
• /
• pp.486-491
• /
• 2007

Background: This study examined the relationship between the pleural adenosine deaminase (ADA) level and the patterns of pleural enhancement in patients with a tuberculous pleural effusion (TPE) shown on a CT scan. Methods: The charts and CT findings of 44 patients with TPE from February 2002 to October 2006 were reviesed retrospectively. A diagnosis of TPE was made by the pleural ADA level with a follow-up (24/44), sputum smear or culture of sputum (16/44), pleural fluid culture (3/44) or pleural biopsy (1/44). The patients were divided into two groups according to the ADA level(Group I [n=12]: 40-70, Group II [n=32]: >70 U/L). The presence or absence, maximal thickness and patterns of pleural enhancement were analyzed. The pattern of pleural enhancement was classified into diffuse or focal, smooth or irregular and interrupted or continuous. The difference in CT findings between groups I and group II were analyzed using an unpaired T test, Chi-square test and Z test. Results: All 44 patients showed diffuse pleural enhancement on the CT scans. The maximal pleural thickness of groups I and II was $1.83{\pm}1.03mm$ (1-4 mm) and $3.63{\pm}1.78mm$ (1-8 mm), respectively (p =0.0002). Pleural thickening ${\geq}5mm$ was only demonstrated in 31.3% of patients in group II (10/32). Diffuse interrupted pleural thickening was noted in 91.7% (11/12) of patients in group I and 62.5% (20/32) in group II, respectively. Diffuse continuous pleural thickening was observed in 8.3% (1/12) of patients in group I and 37.5% (12/32) in group II, respectively (p=0.0748). Conclusion: Pleural thickening ${\geq}5mm$ on the contrast enhanced CT is rare in patients with lymphocyte-dominant TPE in whom the pleural ADA level is between 40-70 U/L.

• Tuberculosis and Respiratory Diseases
• /
• v.76 no.1
• /
• pp.42-45
• /
• 2014

An immunoglobulin G4 (IgG4)-related disease is a recently emerging entity, and a few cases of IgG4-related disease in lung and pleura have been reported. Herein, we report the case of a 74-year-old man with IgG4-related disease of lung and pleura, clinically suspicious of malignant mesothelioma. Chest computed tomography showed diffuse nodular pleural thickening, and microscopic finding disclosed diffuse thickening of visceral pleura with infiltrations of many lymphoplasma cells with increased number of IgG4-positive plasma cells and a few multinucleated giant cells. It is important for pathologists and clinicians to recognize this rare entity and its histologic finding, because it can be confused with malignant tumors on the radiologic examination although it can be treated with steroid therapy.

• Journal of Chest Surgery
• /
• v.24 no.6
• /
• pp.595-604
• /
• 1991

Pleural mesothelioma is usually divided into two forms of localized and diffuse type. Localized pleural fibrous mesothelioma is uncommon mesodermal neoplasm, which may occurs in both sexes and at the age of 50 years. This type of mesothelioma is usually asymptomatic and detected on routine chest X-ray and made fibrous tissue and shows of collagen fibers microscopically. Most localized fibrous mesothelioma arises from the visceral pleura and is well encapsulated and pedunculated mass. CT findings included well delineated, often lobulated, non-calcified soft tissue masses in close relation to a pleural space, associated pleural thickening, and absence of chest wall invasion and a peripheral or fissure location. Three cases of localized pleural fibrous mesothelioma diagnosed by resectional surgery were reported with the review of literature.

• Safety and Health at Work
• /
• v.5 no.4
• /
• pp.234-237
• /
• 2014

Background: Inhalation of asbestos fibers can lead to adverse health effects on the lungs. This study describes lung function profiles among individuals with nonmalignant asbestos-related disorders (ARDs). Methods: The study population was from the Workers' Compensation (Dust Diseases) Board of New South Wales, Sydney, Australia. Lung function measurements were conducted in males with asbestosis (n = 26), diffuse pleural thickening (DPT; n = 129), asbestosis and DPT (n = 14), pleural plaques only (n = 160) and also apparently healthy individuals with a history of asbestos exposure (n = 248). Standardized spirometric and single-breath diffusing capacity for carbon monoxide ($DL_{CO}$) measurements were used. Results: Mean age [standard deviation (SD)] was 66.7 (10.3) years for all participants. Current and ex-smokers among all participants comprised about 9.0% and 54.8%, respectively. Median pack-years (SD) of smoking for ex- and current-smokers were 22.7 (19.9). Overall 222 participants (38.6%) and 139 participants (24.2%) had forced expiratory volume in 1 second ($FEV_1$) and forced vital capacity (FVC) measurements < 80% predicted, and 217 participants (37.7%) had $FEV_1/FVC$ results < 70%. A total of 249 individuals (43.8%) had DLCO values < 80% predicted and only 75 (13.2%) had DLCO/VA results < 80% predicted. A total of 147 participants (25.6%) had peak expiratory flow (PEF) measurements < 80% predicted. The presence of ARDs lowered the lung function measurements compared to those of healthy individuals exposed to asbestos. Conclusion: Lung function measurement differs in individuals with different ARDs. Monitoring of lung function among asbestos-exposed populations is a simple means of facilitating earlier interventions.

• Journal of the Optical Society of Korea
• /
• v.20 no.5
• /
• pp.607-613
• /
• 2016

The pleura is known as an end target organ of exposure to toxic environmental materials such as fine particulate matter and asbestos. Moreover, long-term exposure to hazardous materials can eventually lead to fatal lung disease such as diffuse pleural fibrosis or mesothelioma. Chest computed tomography (CT) and ultrasound are gold standard imaging modalities for detection of advanced pleural disease. However, a diagnostic tool for early detection of pleural reaction has not been developed yet due to difficulties in imaging ultra-fine structure of the pleura. Optical coherence tomography (OCT), which provides cross-sectional images of micro tissue structures at a resolution of 2-10 μm, can image the mesothelium with a thickness of ~100 μm and therefore enables investigation of the early pleural reaction. In this study, we induced the early pleural reaction according to a time sequence after pleurodesis using talc, which has been widely used in the clinical field. The pleural reaction in talc grouped according to the time sequence (1st, 2nd, 4th weeks) showed a significant thickening (average thickness: 45 ± 7.5 μm, 80 ± 10.7 μm, 90 ± 12.5 μm), while the pleural reaction in sham and normal groups showed pleural change from normal to minimal thickening (average thickness: 16 ± 5.5 μm, 17 ± 4.5 μm, 15 ± 6.5 μm, and 12 ± 7.5 μm, 13 ± 2.5 μm, 12 ± 3.5 μm). The measurement of pleural reaction by pathologic examinations was well-matched with the measurement by OCT images. This is the first study for measuring the thickness of pleural reactions using a biophotonic modality such as OCT. Our results showed that OCT can be useful for evaluating the early pleural reaction.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.786-791
• /
• 1996

Systemic sclerosis is a multisystemic disease of unknown origin charicterized by degenerative fibrotic and inflammatory changes in the skin, vessels, joints, muscles, and visceral organs. Involvement of the lung in systemic sclerosis is common, but pleural effusion is rare. Although vasculitis commonly accompanies many connective tissue disorders, it has been rarely reported in systemic sclerosis. A 43-year-old woman, with a 10-year history of Raynaud's phenomenon, was admitted due to right chest pain. Her hands showed diffuse thickening and swelling of skin. Chest X-ray showed pleural effusions and esophageal manometry showed hypotonic peristalsis and low lower esophageal sphincter tone compatible with scleroderma esophagus. Antinuclear antibodies were present (titer>1 : 160) with a speckled pattern. She was positive for rheumatoid factor, anti scl-70 and RNP antibodies, but negative for anti-Ro, La, and Sm antibodies. Histology of the pleura revealed the presence of leukocytoclastic vasculiti. After adminisrration of prednisolone 30 mg/day, her chest symptom was improved. We report a case of systemic sclerosis with pleural effusions due to leukocytoclastic vasculitis with review of the literatures.

• Korean Journal of Radiology
• /
• v.1 no.2
• /
• pp.73-78
• /
• 2000

Objective: To describe the HRCT findings of cytomegalovirus (CMV) pneumonia in non-AIDS immunocompromised patients Materials and Methods: This retrospective study involved the ten all non-AIDS immunocompromised patients with biopsy-proven CMV pneumonia and without other pulmonary infection encountered at our Medical Center between January 1997 and May 1999. HRCT scans were retrospectively analysed by two chest radiologists and decisions regarding the findings were reached by consensus. Results: The most frequent CT pattern was ground-glass opacity, seen in all patients, with bilateral patchy (n = 8) and diffuse (n = 2) distribution. Other findings included poorly-defined small nodules (n = 9) and consolidation (n = 7). There was no zonal predominance. The small nodules, bilateral in eight cases and unilateral in one, were all located in the centrilobular region. Consolidation (n = 7), with patchy distribution, was bilateral in five of seven patients (71%). Pleural effusion and bilateral areas of thickened interlobular septa were seen in six patients (60%). Conclusion: CMV pneumonia in non-AIDS immunocompromised patients appears on HRCT scans as bilateral mixed areas of ground-glass opacity, poorly-defined centrilobular small nodules, and consolidation. Interlobular septal thickening and pleural effusion are frequently associated.

• Korean Journal of Veterinary Research
• /
• v.62 no.2
• /
• pp.17.1-17.5
• /
• 2022

A 12-year-old castrated male Persian cat presented with abdominal distension and anorexia. The radiography revealed ascites, pleural effusion, and a cranioventral mediastinal mass. Ultrasonography showed a well-defined mass lesion within a thickened ileal segment with a transmural loss of layering and multiple hyperechoic nodules arising from the peritoneum. Computed tomography showed peritoneal thickening with contrast enhancement, a bulky heterogeneous ileal mass, and mesenteric involvement with diffuse nodules. An alimentary lymphoma was confirmed by fine needle aspiration of the small intestinal mass. This report describes the imaging features of lymphoma with peritoneal lymphomatosis in a cat.

• Journal of Korean Neurosurgical Society
• /
• v.48 no.2
• /
• pp.181-184
• /
• 2010

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions.

• Journal of Chest Surgery
• /
• v.29 no.6
• /
• pp.664-668
• /
• 1996

Malignant mesothelioma has been considered a uniformly fatal disease associated with a median survival of 4 to 18 months. However, a multimodality approach toward therapy may Increase the length of palliation when a maximal resection of tumor is achieved. Recently we have experienced a 49 years-old male patient who had d ffuse malignant mesothelioma. The patient has complained of blood-tinged sputum and right chest pain for several months. Chest x-rays and CT scans showed compact haziness in the right entire thorax with massive bloody elusion, diffuse pleural thickening and collapsed underlying lung. We performed extrapleural pneumonectomy, and postoperative chemotherapy with cisplatin and mltomycin (Memorial Sloan-fettering Cancer Center method) was done. We are observing him for months now and there is no evidence of local recurrence.