• Title/Summary/Keyword: mediastinal lymphadenopathy

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A Case of Malignant T Cell Lymphoma of Chest Wall (흉벽에 발생한 악성 T 세포 임파종 1예)

  • Hwang, Eai-Suk;Kim, Hyung-Jung;Lee, Jong-Hwa;Ahn, Chul-Min;Kim, Sung-Kyu;Lee, Won-Young;Kim, Sang-Jin;Choi, Youn-Jung;Jung, Woo-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.192-196
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    • 1993
  • Malignant T cell lymphoma is a morphologically and immunologically distinct subtype of non-Hodgkin's lymphoma. One of the most striking clinical findings is relatively high incidence in males in their twenties or thirties with cervical, supraclavicular and axillary lymphadenopathy (50%), mediastinal mass (50%) or less commonly with extranodal disease. More than 90% of patients present with stage III or IV disease and approximately 60% of patients develop bone marrow infiltration. Clinical trials are needed to optimize therapeutic strategies, since these tumors have a poor prognosis and need to be treated aggressively. A 17-year-old male was admitted to the hospital because of chest pain. Chest PA and CT scan revealed massive pleural effusion and soft tissue masses with destructive change of right third and eighth ribs Histologic diagnosis of pleura and chest wall mass revealed high grade, pleomorphic T cell type, malignant lymphoma.

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Sequential CT Findings in Two Cases of Immunoglobulin G4-Related Lung Disease: Focused on Disease Progression (Immunoglobulin G4 관련 폐 질환의 질병 경과에 따른 순차적 CT 소견: 증례 보고)

  • Lee, Dong-Kyu;Ham, Soo-Youn
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.276-281
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    • 2018
  • Immunoglobulin G4 (IgG4)-related lung disease has been actively studied over the past few years. Radiologic findings of IgG4-related lung disease vary among patients, but there are no long-term follow up studies regarding variations in imaging features over the course of disease progression. In two cases with relatively long-term follow up, diverse early and late computed tomography (CT) findings of IgG4-related lung disease are reviewed in this report. In contrast to nodular or diffuse ground-glass opacity, which was predominantly noted in CT scans at earlier stages of disease, honeycombing and traction bronchiectasis were regarded as late radiologic manifestations. Solid nodules might be visible in both early and late stages; however, development of new solid nodules and enlargement of preexisting nodules could occur during disease progression. Interlobular septal thickening and mediastinal/hilar lymphadenopathy were persistent, even in later stages of the disease. These findings might be useful in making an accurate and timely diagnosis of IgG4-related lung disease.

Immunoglobulin G4-Related Disease in the Thorax: Imaging Findings and Differential Diagnosis (흉부에서 발생한 IgG4 연관 질환: 영상 소견 및 감별진단)

  • Yookyung Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.826-837
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    • 2021
  • Immunoglobulin G4-related disease (IgG4-RD) is a chronic inflammatory condition involving multiple organs, including the salivary or lacrimal glands, orbit, pancreas, bile duct, liver, kidney, retroperitoneum, aorta, lung, and lymph nodes. It is histologically characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, storiform fibrosis, and obliterative phlebitis. In the thoracic involvement of IgG4-RD, mediastinal lymphadenopathy and perilymphangitic interstitial thickening of the lung are the most common findings. Peribronchovascular and septal thickening and paravertebral band-like soft tissue are characteristic findings of IgG4-RD. Other findings include pulmonary nodules or masses, ground-glass opacity, alveolar interstitial thickening, pleural effusion or thickening, mass in the chest wall or mediastinum, and arteritis involving the aorta and coronary artery. Radiologic differential diagnosis of various malignancies, infections, and inflammatory conditions is needed. In this review, we describe the imaging findings of IgG4-RD and the radiologic differential diagnoses in the thorax.

A Case of Peripheral T-cell Lymphoma with Diffuse Bilateral Pulmonary Infiltration and Whole Body Rash (양측 미만성 폐침윤과 전신 홍반을 동반한 말초 T세포 림프종)

  • Lee, Seung Hyeun;Ha, Eun Sil;Kim, Jung Ha;Jung, Jin Yong;Lee, Kyung Joo;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.566-570
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    • 2005
  • Primary pulmonary non-Hodgkin's lymphoma (NHL) account for 0.4% of all types of lymphoma. Most cases are of the mucosa-associated lymphoid tissue (MALT) type, low grade B-cell lymphoma, but cases of the T-cell type are rare. The radiological findings frequently show hilar or mediastinal lymphadenopathy, but lung parenchymal involvement is uncommon. Here, a case of a patient, who presented with fever, generalized erythema, diffuse pulmonary infiltration and pleural effusion, diagnosed as a peripheral T-cell lymphoma, is reported.

Effect of Chlorhexidine Mouthrinse on Prevention of Microbial Contamination during EBUS-TBNA: A Study Protocol for a Randomized Controlled Trial

  • Kim, Na Young;Park, Jae Hyeon;Park, Jimyung;Kwak, Nakwon;Choi, Sun Mi;Park, Young Sik;Lee, Chang-Hoon;Cho, Jaeyoung
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.291-298
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    • 2021
  • Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard diagnostic method for mediastinal and hilar lymphadenopathy. Although rare, fatal infectious complications can occur following EBUS-TBNA. However, to date, there is a lack of effective preventive strategies to reduce these complications. We started a trial to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Methods: This study is a single-center, parallel-group, assessor-blinded randomized controlled trial (RCT). We will enroll 112 adult participants undergoing EBUS-TBNA using a convex probe, and randomly assign them to two groups at a 1:1 ratio. The intervention group will gargle for 1 minute with 100 mL of 0.12% chlorhexidine gluconate before EBUS-TBNA, while the control group will have no mouthrinse before the procedure. Immediately after completion of EBUS-TBNA on all targeted lesions with an aspiration needle, a needle wash sample will be taken by instilling 5 mL of sterile saline into the used needle. The primary outcome is colony forming unit (CFU) counts in aerobic cultures of the needle wash samples. Secondary outcomes are CFU counts in anaerobic cultures, fever within 24 hours after EBUS-TBNA, and infectious complications within 4 weeks after EBUS-TBNA. Conclusion: This trial was designed as the first RCT to investigate the effect of chlorhexidine mouthrinse on the prevention of microbial contamination during EBUS-TBNA. Results from this trial can provide clinical evidence for a simple, safe, and cost-effective strategy to prevent infectious complications following EBUS-TBNA (ClinicalTrials.gov ID: NCT04718922, registered on 22 January 2021).

Clinical and Radiological Characteristics of Non-Tuberculous Bronchial Anthracofibrosis (비결핵성 기관지탄분섬유증의 임상적 특징과 방사선학적 특징)

  • Jang, See Jin;Lee, Sook Young;Kim, Suk Chan;Lee, So Young;Cho, Hyun Sun;Park, Ki Hoon;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Kim, Young Kyoon;Park, Hyun Jin
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.139-144
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    • 2007
  • Background: Bronchial anthracofibrosis, which is defined as bronchial narrowing with black pigmentation of the overlying bronchial mucosa, is frequently associated with tuberculosis. The aim of this study was to examine the relationship between bronchial anthrocofibrosis and to identify the clinical and radiological characteristics of non-tuberculous bronchial anthracofibrosis. Methods: All patients who showed bronchial anthracofibrosis in more than one segment on a bronchoscopic examination from January 2003 to July 2006 at Kangnam St. Mary's hospital were enrolled in this study. The underlying diseases, baseline clinical characteristics, characteristic findings on a computed tomogram (CT) of the chest, pathologic findings of the bronchial mucosa, and the clinical response to steroid therapy were analyzed retrospectively. Results: A total 54 patients (19 males, 35 females) were enrolled with a mean age of 75 years. The most common presenting symptoms were cough, sputum and dyspnea. The predominant X-ray findings were peribronchial soft tissue attenuation with or without calcification, mediastinal lymphadenopathy with or without calcification and atelectasis. Fourteen non-tuberculous anthracofibrosis patients were treated with steroid. Nine patients were improved clinically, and 6 patients were improved radiologically. Conclusion: Bronchial anthracofibrosis is frequently associated with various pulmonary diseases not only tuberculosis but also COPD pneumonia etc.