Solitary nodule is a term, which express a circle or oval shape with maximum diameter < 3cm, in centre or peripheral area of the lung. Solitary nodule was diagnosed by lung tomography, thoracic CT scan and percutaneous biopsy puncture. The treatment: If patients can not be treated by operation: need to monitor and take percutaneous biopsy puncture. If patients can be treated by operation, their disease is reliable benign, need to monitor and take thoracoscopy, take operation with contraindication of endoscopy. If their disease is acute with mediastinal tumors: mediastinal endoscopy but lack of instrument, thoracoscopy should be recommended. Thoracoscopy or open-thoracic surgery denpend on individuals and pathoanatomy’s results
Coin Lesion, Pulmonary ; diagnosis ; Therapeutics ; therapy

The receiver operating characteristic (ROC) curve, which is defined as a plot of test sensitivity as the y coordinate versus its 1-specificity or false positive rate (FPR) as the x coordinate, is an effective method of evaluating the performance of diagnostic tests. The purpose of this article is to provide a nonmathematical introduction to ROC analysis. Important concepts involved in the correct use and interpretation of this analysis, such as smooth and empirical ROC curves, parametric and nonparametric methods, the area under the ROC curve and its 95% confidence interval, the sensitivity at a particular FPR, and the use of a partial area under the ROC curve are discussed. Various considerations concerning the collection of data in radiological ROC studies are briefly discussed. An introduction to the software frequently used for performing ROC analyses is also presented.
Area Under Curve ; Coin Lesion, Pulmonary/radiography ; Human ; *ROC Curve ; Radiography/*statistics & numerical data ; Software ; Statistics, Nonparametric

OBJECTIVE: To evaluate how changes in lung volume affect volumetric measurements of lung nodules using a multi-detector row CT. MATERIALS AND METHODS: Ten subjects with asthma or chronic bronchitis who had one or more lung nodules were included. For each subject, two sets of CT images were obtained at inspiration and at expiration. A total of 33 nodules (23 nodules > or = 3 mm) were identified and their volume measured using a semiautomatic volume measurement program. Differences between nodule volume on inspiration and expiration were compared using the paired t-test. Percent differences, between on inspiration and expiration, in nodule attenuation, total lung volume, whole lung attenuation, and regional lung attenuation, were computed and compared with percent difference in nodule volume determined by linear correlation analysis. RESULTS: The difference in nodule volume observed between inspiration and expiration was significant (p < 0.01); the mean percent difference in lung nodule volume was 23.1% for all nodules and for nodules > or = 3 mm. The volume of nodules was measured to be larger on expiration CT than on inspiration CT (28 out of 33 nodules; 19 out of 23 nodules > or = 3 mm). A statistically significant correlation was found between the percent difference of lung nodule volume and lung volume or regional lung attenuation (p < 0.05) for nodules > or = 3 mm. CONCLUSION: Volumetric measurements of pulmonary nodules were significantly affected by changes in lung volume. The variability in this respiration-related measurement should be considered to determine whether growth has occurred in a lung nodule.
Tomography, X-Ray Computed/*methods ; Middle Aged ; Male ; Humans ; Female ; Coin Lesion, Pulmonary/pathology/*radiography ; Bronchitis/radiography ; Asthma/radiography ; Adult

We present three cases of malignant solitary fibrous tumors of the pleura (SFTP) that produced recurrent hypoglycemia. Removal of the tumors produced normoglycemia. The tumors were well circumscribed and lobulated, and consisted of firm masses weighing 1,150 g to 1,450 g with the greatest diameter of 15 to 20 cm. The tumors were composed of spindle cells in fascicles or in a haphazard arrangement and were highly cellular and mitotically active (3-8 mitoses/10 high-power fields), showing histologically malignant features. Ultrastructurally, fibroblastic features of the tumor cells were present. Insulin-like growth factors (IGF) have been implicated in the presentation of hypoglycemia. The serum insulin and C-peptide levels were not elevated. Serum IGF-I levels were also low with values of 97.4, 157.1 and 51.9 ng/mL (ref. 125-317 ng/mL), respectively. However, tumor cells were strongly positive for IGF-I receptor on immunohistochemical analysis. It is tempting to speculate that IGF-I contributes to the hypoglycemia, even though the circulating levels were low.
Aged ; Blood Glucose ; Coin Lesion, Pulmonary/chemistry/*complications/pathology ; Female ; Human ; Hypoglycemia/*etiology ; Immunohistochemistry ; Male ; Middle Age ; Pleural Neoplasms/chemistry/*complications/pathology ; Receptor, IGF Type 1/*analysis ; Recurrence

BACKGROUND: Solitary pulmonary nodule (SPN) may show different pre- sentation in tuberculosis (TB)-endemic countries. The aim of this study was to identify clinical and radiological predictors favoring benign or malignant SPN in TB-endemic region. METHODS: Two hundred one SPNs in 201 consecutive Korean patients were included (< 3 cm in diameter, all confirmed by pathology or bacteriology, 93 benign and 108 malignant diseases). For clinical parameters, age, sex, smoking status and amount, and past history of pulmonary tuberculosis and diabetes mellitus were investigated retrospectively. For radiological parameters, size, location, margin characteristics, presence of calcification, pleural tag, surrounding satellite nodule, cavitation, internal low attenuation, open bronchus sign, surrounding ground-glass opacity, enhancement pattern of the SPNs and mediastinal lymph node (LN) enlargement were analyzed on chest CT scans. RESULTS: Patients with a older age (60.7+/-9.6 vs 56.2+/-13.1, p=0.008) and more than 40-pack years smoking (27.8% vs 14.0%, p=0.017) were more frequently related with malignant than benign SPN. On chest CT scans, spiculated margin, contrast enhancement more than 20 Hounsfield unit and presence of pleural tag and mediastinal LN enlargement were more frequently observed in malignant than benign SPNs. In contrast to previous studies, satellite lesions (21.5% vs 1.9%, p < 0.001) and cavitation (20.4% vs 5.6%, p=0.001) were more frequently seen in benign than malignant SPN. Positive predictive values of benignity were 90.9% and 76.0%, respectively, when satellite lesions and cavitation were found in cases of SPN. CONCLUSION: Satellite lesions and cavitation on chest CT scan could be useful predictors for benign SPN in TB-endemic areas.
Adult ; Age Factors ; Carcinoma/pathology/radiography ; Coin Lesion, Pulmonary/*pathology/*radiography ; Female ; Human ; Korea ; Lung Neoplasms/pathology/radiography ; Male ; Middle Age ; Multivariate Analysis ; Predictive Value of Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary/*pathology/*radiography

No abstract available.
Solitary Pulmonary Nodule*

No abstract available.
Myocardial Ischemia* ; Solitary Pulmonary Nodule*

PURPOSE: To evaluate the usefulness of contrast-enhanced dynamic MR imaging for differentiation of benign andmalignant solitary pulmonary nodules (SPNs). MATERIALS AND METHODS: Twenty-three patients with histologically orradiologically provened SPNs smaller than 40mm (14 benign, 9 malignant) underwent MR examination using the breathhold fast multiplanar spoiled gradient echo (FMPSPGR) technique. Pre-enhancement MR examination wasfollowed by serial scans obtained at one-minute intervals, beginning one-minute after the onset of bolus injectionof paramagnetic contrast agent for a total of five scans. Signal intensities of SPNs were measured from pre- andpost-contrast enhanced MR images and peak percentage increase in signal intensity (p%SI) was calculated. Meanpercentage increase in signal intensity (m%SI) was also calculated and the time-m%SI curve was plotted. The enhancement patterns of SPNs were classified as homogeneous, peripheral rim-like, inhomogeneous, or no (orminimal) enhancement. We compared differences in p%SI, the pattern of the time-m%SI curve, and the pattern ofenhancement between benign and malignant SPNs. RESULTS: On dynamic MR images, alignant SPNs (n=9) showed asignificantly higher p%SI than benign SPNs (n=14) (malignant: mean 120.6, range 81.8-171.6; benign: mean 29.5,range 3.7-78.9) (p < 0.0001). With 80 p%SI as the threshold for malignancy-positive, both sensitivity andspecificity were 100%. The m%SI of malignant SPNs rapidly increased at one minute after enhancement and decreasedgradually thereafter, whereas that of benign SPNs increased more slowly to form a plateau. Eighty-nine percent(8/9) of malignant SPNs showed homogeneous enhancement. In contrast, among benign SPNs, peripheral rim-likeenhancement and no (or minimal) enhancement occurred in the same proportion of cases: 50% (7/14). CONCLUSION:The superb demonstration of different enhancement characteristics obtained using dynamic contrast-enhanced MRimaging is useful to discriminate malignant from benign SPNs.
Humans ; Magnetic Resonance Imaging ; Solitary Pulmonary Nodule*

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary

The majority of the radiologically detected solitary pulmonary nodules are benign, although relatively infrequent malignant nodules always make problems. Regarding the high prevalence rate of pulmonary tuberculosis in this country, it could be assumed that a large number of the benign pulmonary nodules are tuberculomas. There have been various attempts with CT in the evaluation of solitary pulmonary nodules. Most of them were focused on the nodule itself, however. We evaluated not only the character of the nodules bus also the parenchymal changes around the nodules to find evidences of associated pulmonary tuberculosis by using highresolution CT. We analyzed 35 benign solitary pulmonary nodules which are less than 4cm in size. Three or 5 high-resolution CT images were obtained in additon to the conventional CT images. Most of the nodules were located at the periphery of lung. Most of the nodules were proved to betuberculomas or presumed to be tuberculomas (n=32). The mean diameter of the nodules was 22mm. Most of the nodules were well-marginated. We observed a lobulated margin in 16 tuberculomas and a finely spiculated margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one margin in 6 tuberculomas. Typical patterns of benign calcification were observed in 12 tuberculomas and one hamartoma. the findings of parenchymal tuberculosis such as interlobular septal thickening, small centrilobular micronodules, and lobular overinflation were identified in 12, 6 and 12 cases of tuberculomas respectively. The changes of juxtanodular lung parenchyma as well as the character of nodule itself were well demonstrated on high-resolution CT. which is valuabel I the evaluation of the equivocal solitary pulomnary nodules. Evidences of pulmonary tuberculosis around the nodule would be the secondary sign of benignancy.
Hamartoma ; Lung ; Prevalence ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis ; Tuberculosis, Pulmonary