• Title/Summary/Keyword: pulmonary metastasis

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Video-Assisted Thoracic Surgery Lobectomy

  • Kim, Hong Kwan
    • Journal of Chest Surgery
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    • v.54 no.4
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    • pp.239-245
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    • 2021
  • Video-assisted thoracoscopic surgery (VATS) has been established as the surgical approach of choice for lobectomy in patients with early-stage non-small cell lung cancer (NSCLC). Patients with clinical stage I NSCLC with no lymph node metastasis are considered candidates for VATS lobectomy. To rule out the presence of metastasis to lymph nodes or distant organs, patients should undergo meticulous clinical staging. Assessing patients' functional status is required to ensure that there are no medical contraindications, such as impaired pulmonary function or cardiac comorbidities. Although various combinations of the number, size, and location of ports are available, finding the best method of port placement for each surgeon is fundamental to maximize the efficiency of the surgical procedure. When conducting VATS lobectomy, it is always necessary to comply with the following oncological principles: (1) the vessels and bronchus of the target lobe should be individually divided, (2) systematic lymph node dissection is mandatory, and (3) touching the lymph node itself and rupturing the capsule of the lymph node should be minimized. Most surgeons conduct the procedure in the following sequence: (1) dissection along the hilar structure, (2) fissure division, (3) perivascular and peribronchial dissection, (4) individual division of the vessels and bronchus, (5) specimen retrieval, and (6) mediastinal lymph node dissection. Surgeons should obtain experience in enhancing the exposure of the dissection target and facilitating dissection. This review article provides the basic principles of the surgical techniques and practical maneuvers for performing VATS lobectomy easily, safely, and efficiently.

Are There Any Additional Benefits to Performing Positron Emission Tomography/Computed Tomography Scans and Brain Magnetic Resonance Imaging on Patients with Ground-Glass Nodules Prior to Surgery?

  • Song, Jae-Uk;Song, Junwhi;Lee, Kyung Jong;Kim, Hojoong;Kwon, O Jung;Choi, Joon Young;Kim, Jhingook;Han, Joungho;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.4
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    • pp.368-376
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    • 2017
  • Background: A ground-glass nodule (GGN) represents early-stage lung adenocarcinoma. However, there is still no consensus for preoperative staging of GGNs. Therefore, we evaluated the need for the routine use of positron emission tomography/computed tomography (PET)/computed tomography (CT) scans and brain magnetic resonance imaging (MRI) during staging. Methods: A retrospective analysis was undertaken in 72 patients with 74 GGNs of less than 3 cm in diameter, which were confirmed via surgery as malignancy, at the Samsung Medical Center between May 2010 and December 2011. Results: The median age of the patients was 59 years. The median GGN diameter was 18 mm. Pure and part-solid GGNs were identified in 35 (47.3%) and 39 (52.7%) cases, respectively. No mediastinal or distant metastasis was observed in these patients. In preoperative staging, all of the 74 GGNs were categorized as stage IA via chest CT scans. Additional PET/CT scans and brain MRIs classified 71 GGNs as stage IA, one as stage IIIA, and two as stage IV. However, surgery and additional diagnostic work-ups for abnormal findings from PET/CT scans classified 70 GGNs as stage IA, three as stage IB, and one as stage IIA. The chest CT scans did not differ from the combined modality of PET/CT scans and brain MRIs for the determination of the overall stage (94.6% vs. 90.5%; kappa value, 0.712). Conclusion: PET/CT scans in combination with brain MRIs have no additional benefit for the staging of patients with GGN lung adenocarcinoma before surgery.

Involvement of FoxM1 in Non-Small Cell Lung Cancer Recurrence

  • Xu, Nuo;Wu, Sheng-Di;Wang, Hao;Wang, Qun;Bai, Chun-Xue
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4739-4743
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    • 2012
  • Background: Predictive biomarkers for lung cancer recurrence after curative tumor resection remain unclear. This study set out to assess the role of FoxM1 in the recurrence of non-small cell lung cancer. Methods: Immunohistochemistry for FoxM1 expression was performed on paraffin-embedded tumor tissues from 165 NSCLC patients. Association of FoxM1 expression with clinicopathological parameters and disease free survival were evaluated. Results: Our results indicated FoxM1 expression to be significantly associated with poorer tissue differentiation (P =0.03), higher TNM stage (P <0.01), lymph node metastasis (P <0.01), advanced tumor stage (P <0.01), and poorer disease free survival (P <0.01). Multivariable analysis showed that FoxM1 expression increased the hazard of recurrence (hazard ratio= 1.96, 95% CI, 1.04-3.17, P <0.05), indicating that FoxM1 is an independent and significant predictor of lung cancer recurrence. Conclusion: Therefore, FoxM1 is an independent risk factor for recurrence of NSCLC. Elevated FoxM1 expression could be used as an indicator of poor disease free survival.

Study on Antitumor and Immunomodulatory Effects of Cambodian Phellinus linteus (캄보디안 상황버섯의 항암 및 면역조절작용에 대한 연구)

  • Lee Hyo Jeong;Park Jung Min;Song Gyu Yong;Kang Kyung Sun;Kim Sung Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.332-337
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    • 2002
  • Phellinus Iinteus from Cambodia was confirmed to have a homologous DNA sequencec to Phellinus Iinteus. Antitumor and immunomodulatory activities were evaluated with aquous extract of Cambodian Phellinus Iinteus(CPL). CPL didn't show any significant cytotoxicity on HT1080, Sarcoma 180 and B16BL6, whereas it inhibited the relaxation of DNA topoisomerase I from the concentration of 250ug/ml. In the pulmonary colonization assay it inhibited pulmonary metastasis by B16BL6 in C57BL6 mice to 36%, 36.9% and 55.5% at various doses of 2 mg, 20 mg and 50 mg. From FACS analysis with splenocytes pretreated with CPL, it significantly increased lymphoblast and induced production of IL-2. These results indicate Cambodian Phellinus Iinteus has antitumor and immunomodulatory activities still suggesting more study on its mechanism and effective compound in detail.

Primary Hemangiopericytoma of the Lung -1 Case Report - (폐에 발생한 원발성 혈관주위세포종 -1례 보고-)

  • 최광민;김건일;신호승;박희철;홍기우
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.315-318
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    • 1998
  • Primary hemangioperiycytoma is quite rare tumor of the lung and arising from pericyte in external layer of capillaries. Most cases are developed in 4th and 5th decade, are asymptomatic, and have malignant otential. On chest radiography, primary pulmonary hemangiopericytoma shows lobulated, well demarcated, homogeneous soft tissue density. Microscopically, it consisits of numerous vascular spaces of variable size and shape separated by aggregates of tightly packed oval to spindle-shaped cells. Treatment of choice is surgical excision. We report a case of primary pulmonary hemangiopericytoma in a 16-year-old man who had well demarcated homogeneous mass in the superior segment of left lower lobe, but had no symptom. He had undergone left lower lobectomy. He has been followed up for 8 months but has no sign of relapse or metastasis yet.

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Suppressive Effects of Young Radish Cultivated with Sulfur on Growth and Metastasis of B16-F10 Melanoma Cells

  • Kim Soo-Jin;Kim Byung-Sam;Kyung Tae-Wook;Lee Sang-Chul;Rho Chi-Woong;Choi Kyung-Rak;Hwang Hae-Jun;Choi Hye-Seon
    • Archives of Pharmacal Research
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    • v.29 no.3
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    • pp.235-240
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    • 2006
  • The oral administration of extracts of young radishes cultivated with sulfur after intravenous tumor cell injection achieved a marked reduction of pulmonary colonization in mice. Treatment of the mice with extracts of young radish cultivated with sulfur did not show any increase in the number of CD8+ or NK T cells in the spleen, indicating no influence on host immunity. Sulforaphane, which could be a candidate for an active compound from young radishes cultivated with sulfur, inhibited cell growth of B16-F10 melanoma cells. In addition, extracts of the young radish cultivated with sulfur-fed group showed enhanced quinine reductase (QR) activities in the liver and lung and a slight increase of glutathione S-transferase (GST) activity in the liver. These results suggested that the administration of extracts of young radishes cultivated with sulfur suppressed pulmonary tumorigenesis, possibly due to increased activity of detoxification enzymes in the liver and lung, and partly due to cell cytotoxicity.

Fine Needle Aspiration Cytology of Metastatic Synovial Sarcoma to the Lung - A Case Report - (폐에 전이된 활막육종의 세침흡인 세포학적 소견 - 1 예 보고 -)

  • Kang, Dong-Wook;Min, Sung-Kyi;Kang, Gil-Hyeun;Kang, Dae-Yung
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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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.

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Primary Pulmonary Carcinoma Ex-pleomorphic Adenoma of the Salivary Gland Type (일차성 폐의 침샘형 악성 다형선종)

  • Park, Sang-Jun;Cho, Sung-Woo;Lee, Hee-Sung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.217-220
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    • 2010
  • Pleomorphic adenoma is also called a mixed tumor and it most commonly occurs in the salivary gland. This neoplasm has a low grade malignant potential, but it may also show aggressive clinical behavior like recurrence or metastasis. We report here on a case of a tumor that was confirmed to be primary pulmonary carcinoma ex-pleomorphic adenoma by the pathologic examination after complete resection, and it had the characteristics of malignant neoplasms, such as multiple metastases.

Pulmonary carcinoid tumor presented with recurrent pneumonia in adolescence (반복되는 폐렴으로 내원한 청소년기 폐 칼시노이드 종양)

  • Park, Eun Sil;Park, Ji Suk;Seo, Ji-Hyeon;Lim, Jae Young;Lee, Joung Hee;Ko, Gyung Hyuck
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.805-809
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    • 2006
  • The incidence of endobronchial tumor in the pediatric period is very rare and the symptoms are very close to those of respiratory tract infection. Diagnosis can be delayed because of low clinical suspicion and the many ways in which these tumors can present. We report the first case, in Korea, of a pulmonary carcinoid tumor that presented with recurrent pneumonia at the same location in adolescence. Treatment is surgical and geared towards complete resection while sparing healthy lung parenchyma. Long-term and careful follow up is recommended to detect local and distant metastasis.

Liver abscess and septic complications associated with advanced gastric cancer (간농양에 의한 패혈성 합병증과 동반된 진행성 위암)

  • Youn, Gun Jung;Choi, Young;Kim, Min Jae;Lee, Jae Sin;Ko, Ui Won;Joo, Yeon Ho
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.38-41
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    • 2015
  • Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.