• Korean Journal of Radiology
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• 제2권3호
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• pp.138-144
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• 2001

Objective: Bronchogenic carcinoma can mimic or be masked by pulmonary tuberculosis (TB), and the aim of this study was to describe the radiologic findings and clinical significance of bronchogenic carcinoma and pulmonary TB which coexist in the same lobe. Materials and Methods: The findings of 51 patients (48 males and three females, aged 48-79 years) in whom pulmonary TB and bronchogenic carcinoma coexisted in the same lobe were analyzed. The morphologic characteristics of a tumor, such as its diameter and margin, the presence of calcification or cavitation, and mediastinal lymphadenopathy, as seen at CT, were retrospectively assessed, and the clinical stage of the lung cancer was also determined. Using the serial chest radiographs available for 21 patients, the possible causes of delay in the diagnosis of lung cancer were analyzed. Results: Lung cancers with coexisting pulmonary TB were located predominantly in the upper lobes (82.4%). The mean diameter of the mass was 5.3 cm, and most tumors (n=42, 82.4%) had a lobulated border. Calcification within the tumor was seen in 20 patients (39.2%), and cavitation in five (9.8%). Forty-two (82.4%) had mediastinal lymphadenopathy, and more than half the tumors (60.8%) were at an advanced stage [IIIB (n=11) or IV (n=20)]. The average delay in diagnosing lung cancer was 11.7 (range, 1-24) months, and the causes of this were failure to observe new nodules masked by coexisting stable TB lesions (n=8), misinterpretation of new lesions as aggravation of TB (n=5), misinterpretation of lung cancer as tuberculoma at initial radiography (n=4), masking of the nodule by an active TB lesion (n=3), and subtleness of the lesion (n=1). Conclusion: Most cancers concurrent with TB are large, lobulated masses with mediastinal lymphadenopathy, indicating that the morphologic characteristics of lung cancer with coexisting pulmonary TB are similar to those of lung cancer without TB. The diagnosis of lung cancer is delayed mainly because of masking by a tuberculous lesion, and this suggests that in patients in whom a predominant or growing nodule is present and who show little improvement of symptoms despite antituberculous or other medical therapy, coexisting cancer should be suspected.

• Korean Journal of Radiology
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• 제20권4호
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• pp.671-682
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• 2019

Objective: To investigate whether computed tomography (CT) and fluorine-18-labeled fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) may be applied to distinguish thymic epithelial tumors (TETs) from benign cysts in the anterior mediastinum. Materials and Methods: We included 262 consecutive patients with pathologically proven TETs and benign cysts 5 cm or smaller who underwent preoperative CT scans. In addition to conventional morphological and ancillary CT findings, the relationship between the lesion and the adjacent mediastinal pleura was evaluated qualitatively and quantitatively. Mean lesion attenuation was measured on CT images. The maximum standardized uptake value (SUVmax) was obtained with FDG-PET scans in 40 patients. CT predictors for TETs were identified with multivariate logistic regression analysis. For validation, we assessed the diagnostic accuracy and inter-observer agreement between four radiologists in a size-matched set of 24 cysts and 24 TETs using a receiver operating characteristic curve before and after being informed of the study findings. Results: The multivariate analysis showed that post-contrast attenuation of 60 Hounsfield unit or higher (odds ratio [OR], 12.734; 95% confidence interval [CI], 2.506-64.705; p = 0.002) and the presence of protrusion from the mediastinal pleura (OR, 9.855; 95% CI, 1.749-55.535; p = 0.009) were the strongest CT predictors for TETs. SUVmax was significantly higher in TETs than in cysts (5.3 ± 2.4 vs. 1.1 ± 0.3; p < 0.001). After being informed of the study findings, the readers' area under the curve improved from 0.872-0.955 to 0.949-0.999 (p = 0.066-0.149). Inter-observer kappa values for protrusion were 0.630-0.941. Conclusion: Post-contrast CT attenuation, protrusion from the mediastinal pleura, and SUVmax were useful imaging features for distinguishing TETs from cysts in the anterior mediastinum.

• Journal of Chest Surgery
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• 제25권9호
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• pp.962-967
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• 1992

Eight patients with proven clinical stage Ill lung carcinoma of which six were epidermoid cell carcinoma and two were small cell carcinoma underwent concomitant radiation therapy and chemotherapy before surgical resection from March 1990 to February 1992 at the thoracic surgical department, Yongdong Severance Hospital, Yonsei University College Medicine The therapy consisted of more than one cycle of chemotherapy every 4 weeks and concomitant irradiation. Three to four weeks after chemotherapy and radiation therapy, the patient were reevaluated for thoracotomy and pulmonary resection. Two patients were found to have unresectable lesions and, radiosotopes were implanted to the remaining tumors. Three patients had complete pneumonectomies and two patients had pericardial penumonectomyo. Only one patient had complete pneumonectomy & concomitant resection of ribs attached to tumors with reconstruction of chest wall with Marlex mesh. Complete sterilization of lung tumor and mediastinal nodes proven histologically was achieved in 2 patients, without operative mortality. The median survival of all patients was eight months, but the median survival of survivors which lung tumor were completely resected completely and whose pathologic reports showed stage I or 0, was about 18 months to now. The overall result indicates some benefit from this preoperative chemotherapy and radiation therapeutic regimen in patients with advanced unresectable lung cancer.

• Journal of Chest Surgery
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• 제13권2호
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• pp.149-153
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• 1980

Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.

• Journal of Chest Surgery
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• 제18권4호
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• pp.792-799
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• 1985

Primary neoplasms of the trachea are rare, but are a very serious critical life-threatening disease. Nearly all the lesions of the trachea are presented as obstructive lesions. Bronchoscopic examination including chest C-T, tomogram and air tracheogram are essential for the further definition of these lesions. The need for removal of tracheal tumors whether complete or incomplete, is clear enough regardless of the histology of the tumor. We have experienced 9 cases from Jan. 1965 to June, 1985. One patient with tracheal hamartoma was cured with complete resection through rigid bronchoscopy and another patient with fibrous histiocytoma was treated with re-excision and laser evaporation through superior mediastinotomy due to recurrence, 1 year later. The remaining patients were treated with mass excision or segmental resection and end-to-end anastomosis through collar incision and superior mediastinal sternotomy. The remaining two patients were operated with and segmental resection and end-to-end anastomosis of trachea using partial cardiopulmonary bypass. The histologic diagnosis were adenoid cystic Ca[5], fibrous histiocytoma[1], mucoepidermoid Ca[1]. hamartoma[1], anaplastic Ca.[1]. Three patients were treated post-operatively with radiation; with adenoid cystic Ca.[2] and anaplastic Ca.[1]. Their post-operative courses were uneventful during the follow-up from 2 months to 7 years.

• Tuberculosis and Respiratory Diseases
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• 제66권6호
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• pp.482-485
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• 2009

종격동은 다양한 기관들이 밀집되어 있는 구조라서 종양 등 질병이 발생하더라도 위치상 심장이나 대혈관의 음영과 중첩되어 보이기 때문에 단순 흉부 X-선 촬영상 정상 소견으로 오인할 수 있다. 종격동 종양의 경우 주위조직의 침범 여부나 주위 림프절 크기 이외에도 환자의 연령, 종양의 크기 및 위치, 환자의 증세 유무가 중요한 고려사항이다. 저자들은 흉부 불쾌감이 지속되어 내원한 56세 여자 환자에게서 단순 흉부 X-선 사진의 면밀한 관찰을 통해 기관 분지부의 종격동 종양을 발견한 증례를 통해, 다시 한번 단순 흉부 X-선 촬영의 진단적인 중요성을 임상의들에게 환기시키고자 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4263-4266
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• 2012

Colorectal cancer has become a major disease threatening human health. To establish animal models that exhibit the characteristics of human colorectal cancer will not only help to study the mechanisms underlying the genesis and development effectively, but also provide ideal carriers for the screening of medicines and examining their therapeutic effects. In this study, we established a stable, colon cancer nude mouse model highly expressing green fluorescent protein (GFP) for spontaneous metastasis after surgical orthotopic implantation (SOI). GFP-labeled colon cancer models for metastasis after SOI were successfully established in all of 15 nude mice and there were no surgery-related complications or deaths. In week 3, primary tumors expressing GFP were observed in all model animals under fluoroscopy and two metastatic tumors were monitored by fluorescent imaging at the same time. The tumor volumes progressively increased with time. Seven out of 15 tumor transplanted mice died and the major causes of death were intestinal obstruction and cachexia resulting from malignant tumor growth. Eight model animals survived at the end of the experiment, 6 of which had metastases (6 cases to mesenteric lymph nodes, 4 hepatic, 2 pancreatic and 1 mediastinal lymph node). Our results indicate that our GFP-labeled colon cancer orthotopic transplantation model is useful with a high success rate; the transplanted tumors exhibit similar biological properties to human colorectal cancer, and can be used for real-time, in vivo, non-invasive and dynamic observation and analysis of the growth and metastasis of tumor cells.

• 대한세포병리학회지
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• 제1권1호
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• pp.36-42
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• 1990

The fluoroscopy-guided fine needle aspiration biopsy has been gaining widespread acceptance as a rapid and effective method to make a pre-operative diagnosis of mediastinal tumors including thymoma, malignant lymphoma, and metastatic carcinoma. Although thymoma is a most common tumor of the superior mediastinum, most cytopathologists are not experted in cytologic diagnosis of this tumor because of limited experience. In order to define the diagnostic cytologic features of thymoma, we have retrospectively reviewed imprinting smears and corresponding tissue sections from four cases of this tumor. All cases revealed an apparent biphasic pattern of epithelial cell clusters and lymphocytes with occasional branching capillary fronds extending from three dimensional epithelial cell clusters. Epithelial cell clusters predominated in one case and lymphocytes in two cases. Mixed epithelial cell and lymphocyte type represented in one of four cases. In the lymphocyte predominant type, the presence of epithelial cell clusters and small mature lymphocytes are helpful features to differentiate from a malignant lymphoma.

• Journal of Chest Surgery
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• 제35권1호
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• pp.82-85
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• 2002

종격동에 발생하는 해면상 혈관종(cavernous hemangioma)은 매우 드문 양성종양이다. 환자는 3년 8개월 된 여아로서 내원 2개월 전 폐렴으로 입원하여 우연히 종격동 종양을 발견하였다. 단순 흉부 촬영상 좌측 전폐야에 걸쳐있는 비정상적인 음영이 있었으며 추가검사 후 수술적 절제를 시행하였다. 절제된 종괴는 약 15 $\times$ 10 cm크기의 해면상 혈관종으로 진단되었으며 수술 후 8일째 퇴원하여 이상소견 없이 외래 관찰중이다. 전 종격동에서 발생하여 좌측 전폐를 압박하고 있는 거대 해면상 혈관종을 수술 치험 하였기에 이를 보고하는바이다.

• Journal of Chest Surgery
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• 제27권6호
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• pp.502-505
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• 1994

Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen,hence the descriptive term dumbbell.Recently we had an occasion to remove a dumbbell neurilemmoma in a 62 years old woman using an approach designed to allow wide posterolateral thoracotomy and concomitant laminectomy for a single stage removal of the entire tumor. The mass in the posterior mediastinum was discovered on routine chest roentgenography. CT scan demonstrated a dumbbell shaped soft tissue mass density compressing spinal canal but preserving spinal cord. There were no neurologic signs. A standard posterolateral thoracotomy incision was made to remove tumor mass and then T5 unilateral laminectomy has done by Neurosurgeon. 7 x 7 cm sized extrapleural neurilemmoma was round, cystic, soft mass which covered parietal pleural with invaded regional vertebrae. There was no postoperative neurological complication.