• Radiation Oncology Journal
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• v.35 no.2
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• pp.153-162
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• 2017

Purpose: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. Materials and Methods: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ${\pm}$ boost (WBRT ${\pm}$ boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy). Results: The WBRT ${\pm}$ boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ${\pm}$ boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) <27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ${\geq}42.3Gy$ compared to those receiving <42.3 Gy, although the difference was not significant (p = 0.347). Conclusions: Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.591-595
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• 1995

Recently, primary lung cancer has increased markedly in incidence and prevalence in Korea. From January 1986 to June 1993, 86 patients were operated and evaluated at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital. The results are as follows; 1. There were 79 males and 7 females with the peak incidence of 5th and 6th decades of life[75.6% . The age ranged from 13 to 76[mean 56.6$\pm$10.3 years. 2. Symptoms were cough[47.7% , sputum[25.6% , chest pain or dyspnea[18.6% , and hemoptysis or blood tinged sputum[20.9% in order. Symptoms were frequently encountered before hospitalization, but asymtomatic patients were 12.8% in this study. 3. Methods of diagnostic confirmatiom were bronchoscopic biopsy[55.8% , percutaneous needle aspiration[29.1% , suspicious sputum cytology[1.2% , and open biopsy[14.0% . 4. Histopathologically, squamous cell carcinoma[51.2% was the most frequent cell type and adenocarcinoma[26.7% , large cell carcinoma[8.1% , adenosquamous cell carcinoma[3.5% , and the others in order. And TNM stages were Stage I 40.5%, Stage II 15.5%, Stage IIIa 27.4%, and Stage IIIb 3.6%. 5. Methods of operation were pneumonectomy[25.6% , bilobectomy[5.8% , lobectomy[53.4% , segmentectomy[1.2% , and exploration[14.0% . The overall resectability was 86.0% 6. The operative mortality was 2.3% and postoperative complications developed in 7 cases[8.1% . 7. The postoperative follow-up reveals that the overall cumulative survival rates at 1 year, 2 year, 3 year, 4 year, 5 year were 76%, 62%, 43%, 36%, and 27%, respectively.

• Tuberculosis and Respiratory Diseases
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• v.75 no.2
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• pp.67-70
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• 2013

A 52-year-old man was referred to our clinic for an 11.3 mm nodule in the left lower lobe that was discovered on a chest computed tomography (CT) scan. Eleven small nodules were subsequently found in both lungs. Initially, we performed a transthoracic needle aspiration using CT scan guidance. The pathologic report showed a few clusters of atypical cells that were suspicious for malignancy. The positron emission tomography images revealed multiple lung nodules scattered throughout both lungs. The largest nodule (11.3 mm) in the left lower lobe did not have any discernible fludeoxyglucose uptake. For pathologic confirmation, we consulted a thoracic surgeon to perform the video-assisted thoracoscopic surgery. The final diagnosis was minute pulmonary meningothelial-like nodules (MPMNs). MPMNs are benign in nature, and only a few cases require treatment. However, when clinicians are suspicious of potential malignancy, a pathological correlation is essential, even if the final diagnosis is MPMNs.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.125-132
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• 1995

Cytodiagnosis of pleural and ascitic fluid is a commonly performed laboratory examination. Especially, positivity for malignant cells in effusion cytology is very effective and also presents the first sign of malignancy in unknown primary site of the tumor. We examined each 34 cases of pleural and ascitic fluid cytologic specimen diagnosed as metastatic tumor, which was selected among 964 pleural fluid cytology cases and 662 ascitic fluid cytology cases from September 1989 to June 1995. Among the pleural fluid cytology specimens examined, 34 specimens were positive in 27 patients. The lung was the most frequent primary site(44%), followed by the stomach (12%), lymphoreticular neoplasm(12%), pancreas(3%) and colon(3%). And the cases of unknown primary site with positive pleural biopsy alone were 24%. Among trio ascitic fluid cytology specimens examined, 34 specimens were positive in 29 patients. The most common primary neoplasms. were carcinomas of ovary(32%), stomach(22%), colon(6%), breast(3%), pancreas(3%), and lung(3%) and lymphoreticular neoplasms(3%) The metastatic tumor was predominantly adenocarcinoma type in both pleural(82%) and ascitic(91%) fluid. The study of metastatic adeno- carcinoma in effusion from lung, ovary, and stomach was undertaken to find distinctive features for the identification of the primary site. The smears of metastatic pulmonary adenocarcinoma had a tendency to show high grade pleomorphism and many large tight cell clusters, whereas that of the ovarian adenocarcinoma showed low grade pleomorphism with abundant intracytoplasmic vacuoles in relatively clear background. That of the stomach revealed the intermediate features.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.718-721
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• 2006

We describe the case of primary pulmonary paraganglioma in a 37-year-old woman who presented recurrent, severe cough. Computed tomography revealed a lobulated inhomogeneous enhanced mass with endobronchial protruding lesion suspected to be lung neoplasm, located in the upper lobe of the left lung. Bronchoscopic biopsy showed chronic inflammation with granulation tissue which was not in accord with the radiologic findings. Subsequently, a left lower sleeve lobectomy was peformed. Histological analysis of the resected tumor proved to be compatible with pulmonary paraganglioma. Primary pulmonary paragangliomas are very uncommon tumors. So we report this case with literature review.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.725-729
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• 1998

Endobronchial leiomyoma is extremely rare and accounts for less than 2% of benign tumors of the lower respiratory tract. Leiomyomas are predominantly found in the young and the middle aged : of the average age being 35 years for bronchial and lung parenchymal lesions and 40.6 years for tracheal lesions. The symptom depends on the location of the tumor, its size, and changes in the lung distal to the lesion. A 37-year-old woman was admitted to our hospital complaining of coughing. Bronchoscopy revealed complete obstruction of the right main bonchus at the carina by an oval-shaped, nonulcerative, smooth, and pinkish-tan tumor with a broad margin and extended to the left main bronchus. A biopsy was performed and showed a benign spindle cell tumor. A right pneumonectomy was performed because of chronic infection, and the lung could not expanded during aeration. The histological diagnosis of the resected specimen was leiomyoma. The postoperative course was uneventful.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.566-568
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• 2001

WDFA(Well-differentiated fetal adenocarcinoma) histologically resembles pulmonary blastoma. It is also thought to be a subtype of pulmonary blastoma, which has differentiated epithelial features resembling the fetal lung among its epithelial features and sarcomatous features. We recently encounted a patient who underwent surgery for WDFA. A 19-year-old man had a mass shadow in the upper lobe of the left lung. The tumor was diagnosed as pulmonary blastoma as a result of fine needle aspiration biopsy, and left upper lobe lobectomy was performed. No sarcomatous features was observed on postoperative histologic assessment, and the patient was diagnosed as having WDFA. This case is reported with a discussion of the literatures.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.289-292
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• 2003

Primary malignant melanoma occurring in the lung is very rare and only few cases have been reported in the literatures. We have experienced one case of primary malignant melanoma of the right middle lobe. The patient was a 65-year-old male who had cough with blood tinged sputum for one month. Chest computed tomography showed about 4.5$\times$3 cm sized mass at the right middle lobe encasing the bronchus. Percutaneous needle biopsy was performed and confirmed to malignant melanoma. Physical examination and additional clinical history showed that the mass had not metastasized to other possible primary sites. The patient underwent thoracotomy with right middle lobe lobectomy. Histologically, the tumor showed sheets of tumor cells that have nuclear atypia and melanin pigment Postoperative course was uneventful and the patient has been followed up for 24 months with no recurrence.

• Tuberculosis and Respiratory Diseases
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• v.60 no.6
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• pp.673-677
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• 2006

Most malignant mesenchymal tumors of the lung are metastases of a primary tumor from elsewhere in the body. A primary pulmonary synovial sarcoma is a very rare neoplasm that accounts for approximately 10% of soft tissue sarcomas and makes up only 0.5% of all primary lung malignancies. We report a case of a primary pulmonary synovial sarcoma in a 60-year old woman. In this case, a lung metastasis was excluded using 18F-FDG PET /CT imaging.

• Journal of Chest Surgery
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• v.39 no.4 s.261
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• pp.335-339
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• 2006

Benign metastasizing leiomyoma (BML) is a rare entity, characterized by the occurrence of multiple smooth muscle nodules in the lung with histologically benign leiomyoma, Both the uterine and pulmonary tumors have been found to express estrogen and progesterone receptors, which suggest that the pulmonary lesions represented metastases from leiomyoma. We experienced a 41-year-old female patient with BML and report here with the literature review.