• 대한핵의학회지
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• 제36권2호
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• pp.140-142
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• 2002

A 67-year-old woman who had undergone anterior resection for a moderately differentiated adenocarcinoma of the rectum and wedge resection for liver metastasis presented with hematogenous lung metastasis. Metastatic pulmonary nodules in both lung fields were shown on plain chest radiograph and CT. Ga-67 SPECT images revealed accumulation of radioactivity corresponding to the pulmonary nodules. The authors present an unusual case of accumulation of Ga-67 in metastatic pulmonary nodules in a patient with a moderately differentiated adenocarcinoma of the rectum.

• Journal of Chest Surgery
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• 제15권2호
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• pp.148-154
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• 1982

The experience with operative treatment for peripheral situated solitary circumscribed lesions of the lung at the Department of Thorac. & Cardiovasc. Surg., Korea University Hospital during 8 years from March 1974, through April, 1982 was reviewed. Our criteria for Solitary pulmonary nodule were 1. Round or Ovoid shape 2. Surrounded by normal lung Parenchyme 3. Well circumscribed peripheral location 4. No other visible pulmonary diseases on chest X-ray except minimal atelectasis or pneumonitis 5. Largest diameter less than 8 cm Of the 55 patients reviewed, there were 69% of malignancy and 31% of benign pulmonary diseases. In malignancy 38 patients, there were 18 patients with squamous cell carcinoma, 8 patients with undifferentiated large cell carcinoma, 2 patients with undifferentiated small cell carcinoma, 10 patients with adenocarcinoma and patient with metastatic carcinoma. In benign pulmonary nodule 17 patients, here were 5 patients with tuberculoma, 5 patients with aspergilloma, 2 patients with A-V fistula, 1 patient with pulmonary blastoma, 1 patient with paragonimiasis, and 1 patient with lung abscess. Overall male to female occurrence ratio was 39:16, and most prevalent age incidence was 7th decades. Most frequent size distribution was 4-6 cm in diameter. All of benign diseases were cured by resection and 66% of malignancy performed operation and has 75% resectability.

• Journal of Chest Surgery
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• 제28권5호
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• pp.495-498
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• 1995

Pulmonary arteriovenous fistula can be either congenital or acquired. The vast majority are congenital, and about 60% have been associated with hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease . Secondary or acquired pulmonary arteriovenous fistula occurs with trauma, schistosomiasis, long-standing hepatic cirrhosis, metastatic carcinoma, and actinomycosis. Pulmonary hemorrhage secondary to acquired pulmonary arteriovenous fistula is a rare event associated with mortality. We have experienced 64 year-old female patient with the hemoptysis secondary to acquired pulmonary arteriovenous fistula due to the infection of pulmonary parasite. The chest PA and CT scan was showed calcified nodule to the distal portion of lateral segmental bronchus of RML. The bronchial angiogram was demonstrated slightly hypertrophied bronchial artery supplying RML bronchus and the presence of hypervascularization around the calcified nodule, rapid A-V shunting is noted by fluoroscopy. The patient was successfully treated by the right middle lobectomy.

• 대한세포병리학회지
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• 제4권2호
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• pp.171-175
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• 1993

Synovial sarcoma us a rare malignant neoplasm of the soft tissue arising in the lower extremity, inguinal area, and upper arm. The majority occurs in patients between the age of 15 and 40 years. The histologic diagnosis is based on the classical biphasic type with the distinct epithelial and spindle cell components. We have recently encountered a case of metastatic synovial sarcoma of the lung diagnosed by fine needle aspiration cytology. A 34-year-old man was admitted because of a palpable mass on the antero-lateral side of the right tibia for 3 years. On admission, a well demarcated metastatic pulmonary nodule, measuring 5 cm in diameter, was also identified in the simple chest X-ray. Resection of the lower leg mass revealed typical histologic features of biphasic synovial sarcoma. Aspiration cytology of the pulmonary nodule revealed numerous clusters of spindle cells admixed with groups of epithelial cells. The epithelial cells had moderate-sized, round to oval shaped, and hyperchromatic nuclei. The cytoplasm was clear, but not distinctive. Interspersed tell elements were fibroblast-like spindle cells having elongated hyperchromatic nuclei.

• Journal of Chest Surgery
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• 제48권6호
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• pp.447-451
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• 2015

This report describes the case of a 57-year-old man with an anterior mediastinal tumor. Four years previously, he underwent laparoscopic anterior resection for sigmoid colon cancer. Thirty months after that procedure, bilateral pulmonary metastasectomy was performed. Twelve months later, follow-up computed tomography revealed a 1-cm pulmonary nodule on the upper lobe of the right lung and a solid mass on the anterior mediastinum, and the patient was also observed to have an elevated serum carcinoembryonic antigen (CEA) level. Repeated pulmonary nodule resection and total thymectomy were performed. Immunohistochemical staining of the anterior mediastinal tumor revealed adenocarcinoma, and his serum CEA level returned to normal after the operation. These findings strongly suggested metastatic thymic adenocarcinoma from a colorectal cancer.

• Journal of Chest Surgery
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• 제56권1호
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• pp.1-5
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• 2023

Background: The number of patients with incidentally identified pulmonary nodules is increasing. This study attempted to confirm the usefulness and safety of video-assisted thoracic surgery (VATS) core needle biopsy of pulmonary nodules. Methods: Data from 18 patients diagnosed with pulmonary nodules who underwent VATS core need biopsy were retrospectively reviewed. Results: Of the 18 patients, 15 had malignancies (primary lung cancer, n=14; metastatic lung cancer, n=1), and 3 had benign nodules. Mortality and pleural metastasis did not occur during the follow-up period. Conclusion: In patients with solitary pulmonary nodules that require tissue confirmation, computed tomography-guided percutaneous cutting needle biopsy or diagnostic pulmonary resection sometimes may not be feasible choices due to the location of the solitary pulmonary nodule or the patient's impaired pulmonary function, VATS core needle biopsy may be performed in these patients as an alternative method.

• Journal of Chest Surgery
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• 제35권9호
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• pp.692-696
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• 2002

폐동맥에서 발생하는 육종은 드문 질환으로서 예후도 좋지 않다고 알려져 있다. 임상적인 의심이 조기치료에 가장 중요하다. 환자의 증상은 대부분 폐동맥색전증과 유사하며, 우심부전으로 인한 증상이 진행하기 때문에 수술적 치료가 거의 모든 예에서 필요하다 보조적 항암치료나 방사선 치료에 대해서는 아직까지 논란의 여지가 있으나, 보조적 치료를 시행하였을 경우 생존률을 높일 수 있다는 보고가 많다. 본 증례에서는 42세 남자환자가 흉통을 주소로 내원하였으며 컴퓨터 단층촬영과 혈관조영술에서 우폐동맥의 종괴를 발견하였다. 수술 소견에서 우폐동맥뿐만이 아니라 좌폐동맥 내막에도 종양의 침범이 확인되어 완전절제는 불가능하였다. 환자가 항암치료를 거부하여 술후 방사선 치료를 시행하였으며 술후 6개월까지 잔존하는 종괴의 크기는 커지지 않았다. 술후 15개월에 시행한 컴퓨터 단층촬영에서 잔존하던 종괴의 크기가 커졌으며, 좌폐에도 전이로 의심되는 병변이 발견되어 항암치료를 시행하였으나 술후 24개월에는 늑골에 골전이가 발견되었다. 환자는 다시 항암치료를 받을 예정이다.

• Tuberculosis and Respiratory Diseases
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• 제64권2호
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• pp.133-137
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• 2008

폐흡충증은 폐흡충(Paragonimus westermani)의 중간 숙주인 민물 게, 민물 가재 등의 섭취를 통해 인체에 감염되는 기생충 질환으로, 기흉, 흉수, 낭성 종괴 등 다양한 임상 양상을 보인다. 고립 폐 결절로 형태로 발현하는 경우에는, 폐결핵 및 폐암 등과의 구분이 중요하다. 양전자 방출 단층촬영 검사가 감별 진단에 도움이 되지만, 폐결핵 및 폐 히스토플라스마종 등의 진균 감염에서의 위양성이 보고된 바 있다. 저자들은 48세 남자로 단순흉부촬영상 우연히 발견된 고립 폐 결절에 대한 평가 위해 내원한 환자에게서, 흉부 CT 및 FDG-PET에서 좌폐상엽의 폐문주위에 FDG 섭취가 증가된 고립 폐 결절 양상을 보여 폐암으로 의심하였으나, 폐엽 절제술을 시행 후 폐흡충증으로 진단하여 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제22권3호
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• pp.425-435
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• 1989

The solitary pulmonary nodule is considered as a round or ovoid lesion with sharp, circumscribed borders, surrounded by normal appearing lung parenchyme on all sides, and found on a simple chest X-ray without any particular symptoms or signs. There is a wide spectrum of pathologic conditions in the solitary pulmonary nodules prove to be malignant tumors, either primary or metastatic. Most Benign granulomas and other benign conditions can also be seen as solitary nodules. The resection of solitary malignant nodules results in a surprisingly high 5-year survival rate. On the contrary, most benign nodules do not need to be resected and a period of prolonged observation and nonsurgical management is usually indicated. Therefore, the best approach to the controversial management of solitary pulmonary nodules depends on finding factors affecting the probability of malignancy. In this article, clinical records and chest roentgenographies of 60 patients operated on over the past 8 years at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital were reviewed. There were 15 malignant nodules and 45 benign nodules and the prevalence of malignancy was 25%. The most common pathologic entity was tuberculoma [21 cases]. The mean age was 55.5*9.6 years in the malignant group, 45.8>12.5 years in the benign group and there was a significant statistical difference between the two groups [P < 0.05]. The malignant ratio in each age group increased with advancing age. The average smoking amount was 35.6*12.9 cigarettes per day in malignant smokers, 20.9* 12.0 cigarettes per day in benign smokers, and there was a significant statistical difference between the two groups [p< 0.05]. The malignant ratio also increased with the increasing smoking amount. Comparing the appearance of the nodule on chest films, 6 calcifications and 7 cavitations were found only in benign nodules, not in malignant nodules. Therefore, calcification and cavitation can be considered as preferential findings for benignity. Previous cancer history was also a significant factor deciding the prognosis of the nodule [p< 0.05]. The average diameter on chest X-ray was 3.07*0.82 cm in malignant nodules, 3.25*1.04 cm in benign nodules and there was no significant statistical difference between the two groups [p< 0.05]. The author used Bayes theorem to develop a simple method for combining individual clinical or radiological factors of patients with solitary nodules into an overall estimate of the probability that the nodule is malignant. In conclusion, patient age, smoking amount, appearance of nodule on chest film such as calcification and cavitation, and previous cancer history were found to be strongly associated with malignancy, but size of nodule was not associated with malignancy. Since these prognostic factors have been found retrospectively, prospective controlled studies are needed to determine whether these factors have really prognostic significance.

• Radiation Oncology Journal
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• 제32권3호
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• pp.116-124
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• 2014

Purpose: To investigate the frequency and clinical significance of detected incidental lung nodules found on computed tomography (CT) simulation images for hepatocellular carcinoma (HCC) using computer-aided diagnosis (CAD) and a physician review. Materials and Methods: Sixty-seven treatment-$na{\ddot{i}}ve$ HCC patients treated with transcatheter arterial chemoembolization and radiotherapy (RT) were included for the study. Portal phase of simulation CT images was used for CAD analysis and a physician review for lung nodule detection. For automated nodule detection, a commercially available CAD system was used. To assess the performance of lung nodule detection for lung metastasis, the sensitivity, negative predictive value (NPV), and positive predictive value (PPV) were calculated. Results: Forty-six patients had incidental nodules detected by CAD with a total of 109 nodules. Only 20 (18.3%) nodules were considered to be significant nodules by a physician review. The number of significant nodules detected by both of CAD or a physician review was 24 in 9 patients. Lung metastases developed in 11 of 46 patients who had any type of nodule. The sensitivities were 58.3% and 100% based on patient number and on the number of nodules, respectively. The NPVs were 91.4% and 100%, respectively. And the PPVs were 77.8% and 91.7%, respectively. Conclusion: Incidental detection of metastatic nodules was not an uncommon event. From our study, CAD could be applied to CT simulation images allowing for an increase in detection of metastatic nodules.