• 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.35 no.6
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• pp.491-494
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• 2002

Inflammatory myofibroblastic tumor was widely known as inflammatory pseudotumor, commonly developed as a solid mass in lung. The endobronchial inflammatory myofibroblastic tumor is a very rare case where only a few cases have been reported. We report a 13-year-old girl who had coughing for 5 months. The simple chest X-ray and computued tomography of the chest revealed a mass which obstructed the right lower lobe bronchus and pneumonic consolidation. The fiberoptic bronchoscopic finding was mostly gelatinous, gray-yellowish mass that obstructed the airway of right lower lobe bronchus nearly, and was considered as a chondroid hamartoma pathologically. Right lower lobectomy of lung was performed. The mass was confirmed as a endobronchial inflammatory myofibroblastic tumor The patient was discharged without complication and with outpatient followup.

• Tuberculosis and Respiratory Diseases
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• v.70 no.5
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• pp.423-427
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• 2011

Epithelioid sarcomas are rare soft tissue sarcomas with a high tumor grade and high local recurrence and metastasis rates. Although the lung is the most common site of metastasis, endobronchial metastasis hasn't been reported yet. We now report a case of epithelioid sarcoma with endobronchial metastasis. A 28-year-old man had recurrent pneumothorax and underwent wedge resection. He presented at our hospital with hemoptysis, dyspnea, and chest pain. Chest computed tomography revealed left pneumothorax, multiple lung nodules and endobronchial lesions at the right lower basal lobe. Bronchoscopy showed a hemorrhagic mass obstructing the bronchus of the right lower basal lobe. Magnetic resonance imaging revealed multiple nodular lesions in the left thigh muscles. The bronchoscopic biopsy of the endobronchial lesion and the muscle biopsy of the thigh showed the same feature epithelioid sarcoma. This is the first case report of an epithelioid sarcoma with endobronchial metastasis that was diagnosed by bronchoscopic biopsy.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.828-837
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• 2006

Background: Tissue hypoxia is characteristic of many human malignant neoplasm, and hypoxia inducible factor-1(HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increasing $O_2$ delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-$1{\alpha}$ has been reported in many human malignancies, but in non-small cell lung carcinoma the influence of HIF-$1{\alpha}$ on tumor biology, including neovascularization, is not still defined. In present study the relationship of HIF-$1{\alpha}$ expression on angiogenetic factors, relationship between the tumor proliferation and HIF-$1{\alpha}$ expression, interaction of HIF-$1{\alpha}$ expression and p53, and relationship between HIF-$1{\alpha}$ expression and clinico-pathological prognostic parameters were investigated. Material and Method: Archival tissue blocks recruited in this study were retrieved from fifty-nine patients with primary non-small cell lung carcinoma, who underwent pneumonectomy or lobectomy from 1997 to 1999. HIF-$1{\alpha}$, VEGF(vascular endothelial growth factor), and p53 protein expression and Ki-67 labeling index in tumor tissues were evaluated, using a standard avidin-biotin-peroxidase complex(ABC) immunohistochemistry. Relationship between the HIF-$1{\alpha}$ expression and VEGF, p53 overexpression and correlation between the HIF-$1{\alpha}$ expresseion and Ki-67 index were analyzed. Clinico-pathologic prognostic parameters were also analyzed. Result: HIF-$1{\alpha}$ expression in cancer cells was found in 24 of 59 cases of non-small cell lung carcinoma(40.7%). High HIF-$1{\alpha}$ expression was significantly associated with several pathological parameters, such as pathological TMN stage(p=0.004), pT stage(p=0.020), pN stage (p=0.029), and lymphovascular invasion(p=0.019). High HIF-$1{\alpha}$ expression was also significantly associated with VEGF immunoreactivity(p<0.001), and aberrant p53 expression(p=0.040). but was marginally associated with Ki-67 labeling index(p=0.092). The overall 5-year survival rate was 42.3%. The survival curve of patients with a high HIF-$1{\alpha}$ expression was worse than that of patients with low-expression(p=0.002). High HIF-$1{\alpha}$ expression was independent unfavorable factors with a marginal significance in multivariate analysis performed by Cox regression. Conclusion: It is suggested that high HIF-$1{\alpha}$ expression may be associated with intratumoral neovascularization possibly through HIF-VEGF pathway, and high HIF-$1{\alpha}$ expression could be associated with lymph node metastasis and post operative poor prognosis in patients with non-small cell lung carcinoma.

• Journal of radiological science and technology
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• v.6 no.1
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• pp.91-102
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• 1983

The study was carried out on 468 cases among total 4,347 cancer cases which was confirmly diagnosed as malignant neoplasms at Yonsei Center Hospital, appended to Yonsei University, during 10 years from January 1, 1971 to December 31, 1980. The results of this study are as follows: 1. Total malignant neoplasm cases treated with radiation were 4,347, 1,685 of whom were males, and 2,662 females(male to female ratio was 1:1.58). 2. Lung cancer were 10.8% of total malignant neoplasm cases(468 cases), 391 cases for the male and 77 cases for the female. So, average the male to female ratio was 8:1 and cases of the male were much more. 3. The age distribution of lung cancer cases was from 27 to 82 years old. The highest age distribution was $50{\sim}59$ for males(37.9%) and $60{\sim}69$ for females(41.6%) ; 77.1% of total lung cancer cases were over 50 years old. 4. In regard to stages, the distribution of the third stage was highest(49.3%). That of the first stage was much higher during the last period(11.8%) than the first period(2.7%), and that of the fourth stage was much lower during the last period (7.8%) than the first period(21.1%). 5. In regard to pathological type, the distribution was 51.3% for squamous cell carcinoma, 29.3% for undifferentiated cell cercinoma, 12.2% for adenocarcinoma, and 7.2% for bronchoalveolar cell carcinoma in order of frequency. In regard to adenocarcinoma, the male to female ratio was 1:3.7 and cases of the female were much more. 6. In regard to tumor location, the distribution of tumor location in the right-left lobe was 59.1% in the right lobe, 33.6% in the left lobe, and 7.3% in the both lobes in order of frequency. And that of tumor location in the upper and lower lobes was all higher in the upper lobe ; especially, that of the right upper lobe was highest(31.2% of total cases). 7. For the main symptom, coughing was highest(64%), 50% for hemoptysis, and 41% for dyspnea.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.777-781
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• 2008

Benign metastasizing leiomyoma is a rare disease that histologically shows features of a benign tumor; however it can metastasize to the lung or other organs. We report here on a case of a 53-year-old Woman with benign metastasizing leiomyoma, and she was admitted to the hospital with symptoms of coughing for 2 months; she showed multiple diffuse nodular opacities of both lungs on a chest radiograph. She had undergone hysterectomy for leiomyoma of the uterus 13 years previously. Thoracoscopic lung biopsy was performed to rule out metastatic lung cancer. The pulmonary nodules appeared benign with a very low mitotic rate and they consisted of smooth muscle cells. The pathologic findings of the pulmonary nodules were consistent with benign metastasizing leiomyoma. The patient has been followed up closely without any specific therapy.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.659-663
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• 2002

The objective of this study was to assess the usefulness of bone scans in routine preoperative examinations of patients with newly diagnosed non-small cell lung carcinoma. Material and Method: We reviewed the medical records of 258 patients who were newly diagnosed with non-small cell lung cancer in our hospital between January 2000 and December 2000. More than half of the patients (132) were deemed to be inoperable due to their advanced stage based on the CT scans. The remaining 126 patients were considered potentially operable. For these patients, clinical evaluation including the presence of bone pain, serum alkaline phosphatase, and calcium levels was used as clinical predictors of bone metastasis. All patients received bone scans. Bone X-rays, MRI or bone biopsy were performed to confirm the presence of bone metastasis. The usefulness of the bone scan was evaluated by comparing its power of predicting bone metastasis to that of the clinical information. Result: In all patients, the positive and negative predictive values of bone scans for the bone metastasis were 44%, and 99%, respectively. Those of the clinical information were 38% , and 94%. However, in potentially operable patients, the negative predictive value of the clinical information was as high as 99%. Conclusion: If newly diagnosed non-small cell lung cancer patients are presented as potentially operable on the basis of CT scan with no clinical evidence of distant metastases, curative resection could be considered without performing routine bone scans because of the low probability of bone metastasis. However, if there are positive clinical findings, further evaluations, including bone scan should be followed as metastasis will be documented in more than 30% of patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.4025-4028
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• 2014

Background: Relationships between smoking and bladder neoplasms, one of the common malignancies, are well-known. Different smoking-related malignancies may occur together. In this study, we evaluated the stage and grade of bladder neoplasms in patients also featuring lung or larynx cancer. Materials and Methods: From January 2006 to February 2012, patients who underwent surgery for bladder neoplasms in our clinic were screened retrospectively. In the evaluation, 5 patients had larynx cancer and 20 patients have lung cancer in addition, all having been smoking for a long time. The bladder tumor stage and grade were investigated in these 25 cases. Results: Mean age of patients was 66.8 (49-78). In the evaulation, all of 5 patients who had larnyx cancer also had high grade urothelial cancer. One had T2 urothelial, and 3 T1 urothelial cancer. In the same way, all of the 20 patients with lung cancer also have high grade urothelial cancer, three T2, and 13 T1. Bladder cancer stage and grade were determined to be significantly increased in patients with concomitant bladder and lung or larynx cancer. Conclusions: In the patients who have smoking releated second malignancy, bladder cancer prognosis appears more aggressive. We now need a larger series and multi-center studies for understanding relevant pathophysiology.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.189-193
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• 1999

Mesenchymal cystic hamartoma of the lung is quite rare lesion which has an unknown prevalence, firstly described in 1986. It is characterized by multiple nodules and variable sized cysts in both lung field. The nodules of immature mesenchymal cells gradually enlarge and become cysts which are lined with normal or metaplastic respiratory epithelium and have the cambium layer of primitive mesenchymal cells. Main symptoms are hemoptysis, recurrent pneumothorax, and hemothorax. It is known to benign tumor, but has possibility of malignant degeneration. In gross findings in opertive field, multiple and variable-sized cystic lesions and nodules were observed. The cysts were lined with normal respiratory epithelium and had the cambium layer of primitive mesenchymal cell. Gross and microscopic findings were compatible with mesenchymal cystic hamartoma. We report a case of mesenchymal cystic hamartoma in a 27-year-old woman who had recurrent pneumothorax and hemoptysis.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3923-3926
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• 2015

Background: Lung cancer is a fatal malignancy with high mortality and short survival time. The aim of this study was to estimate survival rates of Iranian patients with lung cancer and its associate predictive factors. Materials and Methods: The study was conducted on 355 patients admitted to hospitals of West Azerbaijan in the year 2007. The patients were followed up by phone calls until the end of June 2014. The survival rate was estimated using the Kaplan-Meier method and log-rank test for comparison. The Cox's proportional hazard model was used to investigate the effect of various variables on patient survival time, including age, sex, Eastern Cooperative Oncology Group (ECOG) performance, smoking status, tumor type, tumor stage, treatment, metastasis, and blood hemoglobin concentration. Results: Of the 355 patients under study, 240 died and 115 were censored. The mean and median survival time of patients was 13 and 4.8 months, respectively. According to the results of Kaplan-Meier method, 1, 2, and 3 years survival rates were 39%, 18%, and 0.07%, respectively. Based on Cox regression analysis, the risk of death was associated with ECOG group V (1.83, 95% CI: 1 Conclusions: The survival time of the patients with lung cancer is very short. While early diagnosis may improve the life expectancy effective treatment is not available.