• Tuberculosis and Respiratory Diseases
• /
• v.38 no.2
• /
• pp.128-134
• /
• 1991

This report is an analysis of 60 cases of primary mediastinal tumors and cysts which were experienced in chonbuk National University Hospital, Wonkwang University Hospital and Chonju Presbyterian Medical Center from january 1985 to October 1990. The result was summarized like this; 1) Age distribution was various from ages of 5 to 75 years. There were 26 males and 34 females, sex ratio of patients was 1: 1.3 (M:F). 2) The most common chief compliant was dyspnea (21 cases, 35%) and followed by chest pain, coughing and chest discomfort. 17 patients (28%) were asymptomatic. 3) The most common primary mediastinal tumor was thymoma, which comprise 28% (17 cases) of all our cases and followed by neruogenic tumor (14 cases, 23%) and germ cell tumor (11 cases, 18%). 4) The incidence of malignancy of all case was 22%; 2 cases were asymptomatic and the most common malignancy was malignant lympoma (5 cases, 38.5%). 5) The anterior mediastinum was the most common tumor location and followed by posterior and middle mediastinum. Anterior mediastinal tumors mainly consisted of thymomas and germ cell tumors and posterioc mediastinal tumors mainly did neurogenic tumors. 6) Of 60 cases, 21 cases were confirmed histopathologically by percutaneous transthoracic needle lung biopsy. 7) Of 60 cases, 40 cases were received radical tumor resection.

• Journal of Chest Surgery
• /
• v.9 no.2
• /
• pp.315-322
• /
• 1976

This report is a analysis of 72 cases of mediastinal tumors which are originated in mediastinum or probably metastasized from other organs, and classified on the basis of histopathological types. And all are experienced in the Depart. Thoracic and cardiovascular Surgery, National Medical Center from 1959 to April 1976. Among these cases, 58 cases were confirmed by histopathologically, and remained 14 cases were considered as mediastinal tumor by clinically and roentgenologically. In this series, dermoid cyst and teratoma was most frequent tumor among histopathologically confirmed cases(27.6%), and thymoma 20.7%, neurogenic tumors 17.2%, carcinoma 19%, lymphoid tumor 8.6% and others was 5.9%. The cases of not verified histopathologically were 14 cases. The main clinical symptoms were dyspnea on exertion or orthopnea (62.55%), productive or irritative cough (59.77%), decreased breathing sound (43. 09%). S.V.C syndromes was seen in 25.02%, and there were no definitive symptom in 4.2% of all cases. The main treatment method was surgical removal and irradiation therapy.

• Journal of Chest Surgery
• /
• v.19 no.3
• /
• pp.453-456
• /
• 1986

Primary intrathoracic liposarcomas are extremely rare tumors. 50 cases of mediastinal liposarcoma till 1977 have been recorded in the world literature, and 2 cases of pleural origin were reported in 1967. We report two cases, one is mediastinal origin and the other is pleural origin.

• Journal of Chest Surgery
• /
• v.25 no.7
• /
• pp.719-722
• /
• 1992

Two cases of benign mediastinal tumor were treated by complete resection under the video-thoracoscopic guidance. The procedure has been performed on the 2 patients, allowing definite treatment and was less invasive than standard surgical treatment. The 2 patients have been benefited by decreased postoperative pain, reduced scarring of the skin and rapid recovery. Two patients had benign mediastinal tumors; teratodermoid on anterior mediastinum and neurilemmoma on posterior mediastinum. There were no operative death and complication, median hospital stay was four days.

• Journal of Chest Surgery
• /
• v.26 no.9
• /
• pp.705-709
• /
• 1993

The mediastinoscopy was a well known useful diagnostic tool for detection of certain mediastinal tumors ,mediastinal lymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A total of 33 cases of mediastinoscopies were reviewed, which were experienced at Chon Buk National University Hospital from August,1980 to October 1991. Mediastinoscopy was performed through anterior or parasternal approach in 18 cases, cervical approach in 14 cases and both in 1 case. In 12 cases which were used for preoperative stagig of lung cancer, 10 cases[83.3%] had the positive biopsy results at mediastinal nodes. In 11 cases for diagnosis of lymph nodes and masses with unknown lung lesion, small cell carcinoma revealed in 3 cases,squamous cell carcinoma in 2 , adenocarcinoma in 1 case and the others were had the negative biopsy results. In 10 cases for diagnosis of mediastinal tumors, lymphoma revealed in 2 cases, malignant thymoma in 2, sarcoidosis in 2, tuberculous granuloma in 1, mesothelioma in 1, metastatic cancer with unknown origin in 1 case. Thoracotomy was performed in 3 cases of lung cancers, 2 patients with negative biopsy results in preoperative staging and 1 patient with subcarinal lymph node involvement only. Bleeding complications during mediastinoscopy were developed in 2 cases, managed by anterior mini-thoracotomy.

• Journal of Chest Surgery
• /
• v.36 no.9
• /
• pp.707-710
• /
• 2003

Chordomas are slowly growing and rare malignant tumors arising from the remnants of the notochord. Furthermore, intrathoracic chordomas presenting as a posterior mediastinal tumor account for only 1∼2％ of all reported chordomas. Incomplete resection of these tumors can lead to local recurrence, distant metastasis and result in a poor outcome, but complete remission can be expected with complete resection and adjuvant radiotherapy. We report a case of thoracic chordoma presenting as a posterior mediastinal tumor which was successfully treated with complete resection and adjuvant radiotherapy without recurrence and distant metastasis for 2 years.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.1
• /
• pp.117-122
• /
• 1999

Primary germ cell tumors of the mediastinum are rare, accounting 1-5 % among all germ cell tumors and 10% of all neoplasms in this area. Approximately 85 % of these tumors occur in men with a mean age 29 years. 'These tumors are mainly found in the anterior mediastinum and appear grossly as large lobulated masses. They are frequently invasive at the time of diagnosis and almost 90% of patients are symptomatic. Primary nonseminomatous germ cell tumor arising in the posterior mediastinum is very rare. We report a case of 37-year old male arising from the posterior mediastinum. Serum tumors markers including alpha-fetoprotein and $\beta$-hCG which are usually elevated in germ cell tumor were not elevated. He was found to have a primary mediastinal embryonal carcinoma with pulmonary metastasis at open exploration. He was treated with debulking surgery and cisplatin-based chemotherapy, died of sepsis after 15 months postoperatively.

• Journal of Chest Surgery
• /
• v.29 no.7
• /
• pp.763-768
• /
• 1996

This report is an analysis of 43 cases of primary mediastinal tumors and cysts which were treated in the Department of Thoracic and Cardiovascular Surgery, Tae Jeon Eul li General Hospital from January, 1986 to April, 1995. There were 19 males and 24 females, and their ages ranged from 4 years to 68 years, with mean age of 31.3 years. The most common symptoms were dyspnea 48.8%, chest disconyort 39.5%, cough )4.9%, and chest pain 23.3%, and the most frequently encountered location of tumor was anterior mediastinum followed by posterior, and middle mediastinum. From the pathologic viewpoint, teratoma was the most frequent type followed by neurogenic tumors, cysts, thymoma, and Iymphoma. The most useful diagnostic method was plain X-ray examination of the chest, and final diagnosis could usually be made only after an operation. All of benign tumors were completely removed and malignant tumors were treated with chemotherapy and radiotherapy after operation There were 7 (16.3 %) cases of postoperative complications, and there was no postoperative mortality.

• Journal of Chest Surgery
• /
• v.43 no.5
• /
• pp.506-512
• /
• 2010

Background: This study was designed to evaluate the FDG uptake ratio of mediastinal node and primary tumors using integrated PET/CT imaging combined with Glut-1 expression of the primary tumor in order to predict the N2 status more accurately in NSCLC patients. Material and Method: Patients who underwent integrated PET/CT scanning with a detectable mSUV for both primary tumors and mediastinal lymph nodes were eligible for this study. The FDG uptake ratio between the mediastinal node and the primary tumor was calculated. Result: The average mSUV of primary tumors and mediastinal nodes were, respectively, $7.4{\pm}2.2$ and $4.2{\pm}2.2$ in N2-positive patients and $7.6{\pm}3.7$ and $2.8{\pm}6.9$ in N2-negative patients. The mean FDG uptake ratio of mediastinal node to primary tumor were $0.58{\pm}0.23$ for malignant N2 lymph nodes and $0.45{\pm}0.20$ for benign lymph nodes (p<0.05). Models which combined Glut-1 expression with an FDG ratio have better diagnostic power than models that use the FDG uptake ratio alone. Conclusion: In some patients with a previous history of pulmonary tuberculosis or other inflammatory lung diseases, an FDG uptake ratio combined with Glut-1 expression may be useful in diagnosing mediastinal node metastasis more exactly.

• Journal of Chest Surgery
• /
• v.23 no.1
• /
• pp.81-89
• /
• 1990

A total of 178 patients with primary lung cancer who had undergone complete resection of the tumor in combination with complete mediastinal lymphadenectomy were reviewed at the Department of Thoracic and Cardiovascular Surgery of Yonsei Medical Center from January 1980 through July 1989. Materials; 1. There were 45 men and 33 women ranging of age from 25 to 78 years with a mean age of 55.4 years. 2. Histological types were squamous carcinoma in 115 cases [64.6%] adenocarcinoma in 42 cases [23.6 %], bronchioloalveolar carcinoma in 9 cases [5.1%], large cell carcinoma in 8 cases [4.5 %] and small cell carcinoma in 4 cases [2.2%] Results were summarized as follows: 1. The size of primary tumor was not directly proportional to the frequency of mediastinal lymph node metastasis. [P =0.0567] 2. The histologic types of the primary tumor did not related to the incidence of mediastinal lymph node metastasis. [P >0.19] 3. The chance of mediastinal lymph node metastasis in the case with lung cancer located in right middle lobe[31.8%, N=22] and left lower lobe [31.4%, N=32] were the highest and the lowest was the one located in right lower lobe, while over all incidence of mediastinal lymph node metastasis in this series was 25.4 % [N=55]. 4. The rate of mediastinal lymph node metastasis without evidence of regional and hilar lymph node metastasis was 13%. [N=23] The chance of mediastinal lymph node involvement without N1 lymph node metastasis was 16.3 % [N=17] in both upper lobes and 8.2 % [N=6] in both lower lobes. It was statistically significant that the tumors in the upper lobes had greater chance of the mediastinal lymph node metastasis without N1 than the tumors in the lower lobes. 5. In this series majority of the patients with lung cancer the mediastinal lymph node metastasis from the tumor in each pulmonary lobes usually occurs via ipsilateral tracheobronchial and paratracheal lymphatic pathway. Especially the lung cancer located in lower lobes can metastasize to subcarinal, paraesophageal and inferior pulmonary ligamental lymph node through the lymphatic pathway of inferior pulmonary ligament. It can be speculated that in some cases of this series otherwise mediastinal lymph node metastasis can also occur with direct invasion to the parietal pleura and to the mediastinal lymph node via direct subpleural lymphatic pathway .