• 대한세포병리학회지
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• 제2권2호
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• pp.134-141
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• 1991

Localized or solitary fibrous tumor (SFT) of the pleura has been classified as a type of mesothelioma, arising from the submesothelial connective tissue cells. The preoperative diagnosis of the tumor at the cytologic or histologic level is very important for the proper handling of the lesion. This preoperative diagnosis is now possible by means of the advance in the transthoracic fine needle aspiration biopsy (FNA) techniques and in the very experience of the cytopathologists. We describe FNA cytologic feature of two cases of SFT arising from the pleura. Cytologic, histologic, immunohistochemical, and electron microscopic characteristics of pleural SFT are discussed. The tumor cells of SFT are spindle or oval in shape with a variable amount of cytoplasm. They are arranged in irregular trabeculae intimately associated with capillaries. A unique cytologic feature observed in this tumor is that thick, eosinophilic, amorphous collagen bundles are scattered between tumor cells.

• Journal of Chest Surgery
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• 제29권10호
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• pp.1133-1137
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• 1996

흉강경을 이용한 흉부수술의 경우 최근 들어 상당한 발전이 계속되면서 시술할 수 있는 분야가 크게 증가하였다. 중앙대학교 흉부외과에서는 1994년 9월부터 1995년 8월까지 비디오흉강경을 이용한 수술 67례의 임상결과를 보고하는 바이다. 1. 진단은 기흉 35례, 미만성 간질성 폐질환 9례, 농흉 7례, 폐암에 의한 삼출액 3례, 다한증 3례, 흉강내 이물질 2례, 중피종 1례, 속립성 폐결핵 1례, 기질화된 폐렴 1례였다 2. 수술은 기흉환자 35례중 흉막 유착이 심하여 개흉술로 전환한 2례를 제외한 33례 에서 비디오 흉강경 기포절제술을 시행하였다. 그외에 흉강경을 이용한 지혈 5례, 세척술 7례, 이물질 제거 2례, 악성 늑막 삼출시 활석분무 3례, 교감신경 절제 술을 3례 시행하였다. 흉강경적 생검은 12례 시행하였다. 3. 기흉환자중 재발성 기흉으로 18례 수술하였고 지속적 공기누출 12례, 단순흉부사진상 기포가 보인 례가 5례 있었다. 심한 유착을 보여 흉강경에서 전환한 개흉적 기포제거술 2례를 시행하였다. 4. 비디오흉강경적 생검을시행한 12례의 병리학적 소견은 특발성 폐섬유화증 9례, 속립성 결핵 1례, 중피종 1례 및 기질화된 폐염 1례였다. \ulcorner鈒\ulcorner폐섬유화증 9례중 7례는 박리성 간질성 폐염, 2례는 통상 성 간질성 폐염이었다. 5. 비디오흉강경 67례중에서 63례에서 특별한 합병증 없이 퇴원하였고 4례에서 합병증이 발생하였다. 2 례가 계속된 공기누출, 2례는 반대측의 무기폐가 발생하였다. 따라서 비디오홍강경 수술은 비교적 안전하고 합병증이 적으며 앞으로 흉부수술영역에서 사용범위가 확대될 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제58권2호
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• pp.179-184
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• 2005

폐의 유상피 혈관 내피종이 진단 당시 흉막과 간을 동시에 침범한 경우는 드물다. 저자 등은 폐에 결절이 있고 동측에 다량의 흉막 삼출액이 동반되어 있으면서 간에 다발성 결절을 보인 26세의 젊은 여자환자에서 개흉 폐생검으로 진단된 유상피 혈관내피종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한세포병리학회지
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• 제8권1호
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• pp.35-46
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• 1997

The authors reviewed 167 malignant effusions from 110 patients, of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm. Main factors analysed were the distribution of primary organs and the cytohistoiogic correlation of body cavity effusions. The 167 fluid specimens from 110 patients consisted of 90 cases(53.9%) of pleural, 68(40.7%) of peritoneal, and 9(5.4%) of pericardial origins. Histologically they consisted of 82 cases(74.5%) of adenocarcinoma, 8(7.3%) of malignant lymphoma, 6(5.5%) of squamous ceil carcinoma, and 3(2.7%) of small cell carcinoma. The most common site among the primary lesions was the stomach in 25 cases(22.7%) followed by the lung in 21(19.1%), ovary on 17(15.5%), and breast in 7(6.4%). As for the distribution of primary tumors in adenocarcinoma, the most common site was lung un 16 cases (48.5%) in pleural fluid and stomach in 22(48.9%) in peritoneal fluid. In pericardial effusions, all 5 cases were from the lung. As a whole, the cytologic findings of malignant effusion were fairly representative of histologic characteristics of primary lesions. Thus, when the primary lesion Is unknown, careful evaluation of effusion cytology is presumed to be a helpful tooi for tracing the primary tumor.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.739-742
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• 2013

Background: This study was to evaluate the survival of patients with pleural and intraperitoneal malignant mesothelioma and to investigate the efficacy of chemotherapy (CT) as well as radiotherapy (RTH) and surgery compared to best supportive care (BSC). Materials and Methods: Forty patients with malignant mesothelioma (38 with pleural and 2 with intraperitoneal) were enrolled. Twenty seven patients underwent (CT) chemotherapy of which 2 also received (RTH) and surgery was only for biopsy in 15/40. Combination chemotherapy included cisplatin-gemcitabine, cisplatin-navelbine and cisplatin (or carboplatin) with premetrexed. Thirteen patients received only best supportive care. Results: A total of 12 (30%) patients were male, and 28 (70%) female. Median age was 54.0 years and the male/female ratio was 1/2.33 (P=0.210). Residential exposure played a major role in two regions, Helwan and Shoubra, in 20% and 15%, respectively. Overall mean survival time was $13.9{\pm}2.29$ months. That for patients who had received best supportive care was $7.57{\pm}1.85$ months, for chemotherapy was $16.5{\pm}3.20$ months, and multimodality treatment regimen $27{\pm}21.0$ months (P=0.028). Kaplan-Meier survival did not significantly vary for sex, residence and the pathological types epithelial, mixed and sarcomatous. The median survival for performance status and treatment modalities was significant (P=0.001 and 0.028). Best supportive care using opioids with a mean dose of 147.1 mg (range 0-1680) of morphine sulphate produced good subjective response and reasonable quality of life but did not affect survival. Conclusions: We conclude that CT prolongs survival compared to BSC in patients with malignant mesothelioma. Moreover, using escalating doses of opioids provides good pain relief and subjective responses.

• 한국임상수의학회지
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• 제28권2호
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• pp.262-266
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• 2011

체중 2.2 kg 4년령 수컷 Maltese 개가 호흡곤란과 고체온증 평가를 위해 건국대학교 부속 동물병원에 내원하였다. 신체 검사에서 호흡곤란을 확인 하였으며, 오른쪽 흉강 청진상에서 희미한 심음을 확인하였다. 방사선 검사와 CT검사에서 오른쪽 중간엽의 경화와 흉수 및 복수를 확인하였다. 탐색적 개흉술을 통해 $360^{\circ}C$ 염전 된 오른쪽 중간엽을 확인하였으며 TA 장치를 이용 염전된 폐엽을 절제하였다. 복수 원인을 확인하기 위해 탐색적 개복술을 통한 소장생검을 실시하였으며, 조직 검사를 통해 림프관 확장증을 확인 하였다. 림프관 확장증 치료를 위해 prednisone과 저지방 사료를 사용하였으며, 임상증상의 개선을 확인하였다.

• Tuberculosis and Respiratory Diseases
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• 제62권2호
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• pp.119-124
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• 2007

Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.

• Tuberculosis and Respiratory Diseases
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• 제53권1호
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• pp.52-55
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• 2002

A extrapulmonary small cell carcinoma is a very rare disease, and a primary pleural manifestation is extremely rare. A diagnosis of a small cell carcinoma should be based on the cell morphology, histological pattern, and an immunohistochemical study. We recently experienced a case of small cell carcinoma (SCC) of the pleura in a 59-year-old man who had suffered from right pleuritic chest pain. A histopathological confirmation of SCC was made by a video-associated thoracoscopic lung biopsy. Systemic chemotherapy with etoposide and cisplatin was initiated.

• Journal of Korean Neurosurgical Society
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• 제48권2호
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• pp.181-184
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• 2010

A case of idiopathic hypertrophic cranial pachymeningitis (IHCP) misdiagnosed as an acute subdural hematoma is reported. A 37-year-old male patient presented with headache following head trauma 2 weeks earlier. Computerized tomography showed a diffuse high-density lesion along the left tentorium and falx cerebri. Initial chest X-rays revealed a small mass in the right upper lobe with right lower pleural thickening, which suggested lung cancer, such as an adenoma or mediastinal metastasis. During conservative treatment under the diagnosis of a subdural hematoma, left cranial nerve palsies were developed (3rd and 6th), followed by scleritis and uveitis involving both eyes. Magnetic resonance imaging (MRI) revealed an unusual tentorium-falx enhancement on gadolinium-enhanced T1-weighted images. Non-specific chronic inflammation of the pachymeninges was noticed on histopathologic examination following an open biopsy. Systemic steroid treatment was initiated, resulting in dramatic improvement of symptoms. A follow-up brain MRI showed total resolution of the lesion 2 months after steroid treatment. IHCP should be included in the differential diagnosis of subtentorial-enhancing lesions.

• Journal of Chest Surgery
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• 제47권3호
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• pp.320-324
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• 2014

A 37-year-old woman was referred to our institution for further management of a mass lesion located in the thoracic cavity. The mass had grown by more than 10 cm over the course of a year and was initially considered to be a scar from previous pulmonary tuberculosis at another hospital. The patient had complained of left-sided flank pain for a year and experienced dyspnea for one month. Chest radiography and chest computed tomography revealed an irregular-shaped mass in the left mid to lower pleural cavity. The mass was widely excised through left thoracotomy. Pathologic examination of the biopsy specimen revealed a malignant spindle cell tumor, which consisted of components of osteosarcoma, pleomorphic sarcoma, and leiomyosarcoma. The patient underwent adjuvant chemotherapy and has been doing well without any evidence of recurrence for 14 months.