For Stereotactic Radiosurgery of lung tumor, 4 dimensional CT was done during for free breathing of the patient. The movement of the treated target was measured in the CT images, and appropriate breathing cycle was selected for treatment. For patient A, the movement of the treatment target was 10.1 mm during full breathing cycle, and 5.4 mm for treated breathing cycle, 30~70%. For patient B, the movement was 13 mm, and 3.5 mm for full breathing cycle and treated breathing cycle, respectively.
Four-Dimensional Computed Tomography* ; Humans ; Lung Neoplasms* ; Lung* ; Radiosurgery* ; Respiration

We present herein an unusual case of multilocular thymic cyst, with prominent lymphoid follicular hyperplasia, in a 64-year-old man. It was incidentally founded as a mediastinal mass on chest radiography, during a routine health check-up. Computed tomography revealed a cystic lesion, which contains thick septa involving the thymus. The resected mass, 8x4 cm in diameter, involved the thymus and there is no adhesion or invasion into the adjacent tissue. The cut surface showed cystic spaces with thick white-tan firm wall, which cysts contained gelatinous material. Microscopically, the lesion was characterized by multiple cysts, lined by flattened cuboidal epithelium that was separated by thick walls, having a dense lymphoid tissue with lymphoid follicles. The patient was discharged without any complication and is well without evidence of recurrence for sixteen months.
Epithelium ; Gelatin ; Humans ; Hyperplasia ; Lymphoid Tissue ; Mediastinal Cyst ; Mediastinal Diseases ; Middle Aged ; Recurrence ; Thorax ; Thymus Gland

PURPOSE: There is evidence supporting the concept of tumor progression from pulmonary adenocarcinoma in situ (formerly bronchioloalveolar carcinoma, BAC) to adenocarcinoma with varying degrees of invasion. The aim of this study was to investigate the role of transforming growth factor beta1 (TGFbeta1) in tumor invasiveness in lung adenocarcinoma, and to determine the potential relationships between its expression and immunophenotypes of cell adhesion molecules. MATERIALS AND METHODS: Tumor samples from adenocarcinoma in situ (n=13), minimally invasive adenocarcinoma (formerly BAC with < or =5 mm invasion, n=2), and lepidic predominant invasive adenocarcinoma (formerly mixed adenocarcinoma showing non-mucinous BAC features with >5 mm invasion, n=25) were examined for the expression of TGFbeta1, E-cadherin, N-cadherin, and H-cadherin proteins using immunohistochemistry. RESULTS: Of a total of 40 cases, 25 (63%) were positive for TGFbeta1. The frequency of immunoreactivity in patients with adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant invasive adenocarcinoma was 23% (3/13), 50% (1/2), and 84% (21/25), respectively (p=0.001). TGFbeta1 correlated with T classification (p=0.006) and stage (p=0.001). Loss of E-cadherin expression was more frequently observed in invasive adenocarcinomas than in adenocarcinomas in situ (p=0.034). E-cadherin expression inversely correlated with T classification (p=0.009). TGFbeta1 expression showed a statistically significant correlation with H-cadherin expression (p=0.040), but not with E-cadherin expression (p=0.752). CONCLUSION: These results suggest that TGFbeta1 and E-cadherin may play an important role in invasive progression of lung adenocarcinoma through regulating epithelial-to-mesenchymal transition.
Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Cadherins ; Cell Adhesion ; Humans ; Lung ; Lung Neoplasms ; Proteins ; Transforming Growth Factor beta1 ; Transforming Growth Factors

PURPOSE: Cyclins, and their associated cyclin dependent kinases, regulate progression of the cell cycle through the G1 phase and into the S-phase during the DNA replication process. Cyclin E regulation is an important event in cell proliferation. Despite its importance, abnormalities of these genes and their protein products have yet to be found in lits asoociation with lung cancer. MATERIALS AND METHODS: The relationships between expression of cyclin A, cyclin B1, cyclin D1, cyclin D3, and cyclin E and clinicopathologic factors were investigated in 103 cases with non-small cell carcinomas, using immunohistochemical analysis. RESULTS: The positive immunoreactivity was observed in 51 cases (50%) for cyclin A, 33 cases (32%) for cyclin B1, 83 cases (81%) for cyclin D1, 19 cases (18%) for cyclin D3, and 11 cases (11%) for cyclin E. Expression of cyclin E was significant for lymph node metastasis (p=0.004, Chi-square test). There was no relationship between cyclin A, B1, D1, and E and histological typing, tumor size, lymph node metastasis, or pathological tumor, node and metastasis staging. CONCLUSION: These findings suggest that the expression of cyclin E played a role, to some degree, in the lymph node metastasis.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Cycle ; Cell Proliferation ; Cyclin A ; Cyclin B1 ; Cyclin D1 ; Cyclin D3 ; Cyclin E ; Cyclin-Dependent Kinases ; Cyclins ; DNA Replication ; G1 Phase ; Lung ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: Given the emerging evidence for differential responses to new targeted therapies and the identification of molecular differences between specific subtypes of non-small cell lung carcinoma (NSCLC), there is an increased need for greater accuracy in subtyping NSCLC. In a substantial proportion of cases, standard morphology cannot specifically subtype the tumor, resulting in a final diagnosis of NSCLC-not otherwise specified. In this study, we added newly proposed markers (napsin A, desmocollin-3) to conventional markers (p63, thyroid transcription factor-1 [TTF-1], cytokeratin 5/6 [CK5/6], high molecular weight cytokeratin [HMWCK], cytokeratin 7 [CK7]) and evaluated for the minimal panel of immunohistochemical markers required for subtyping poorly differentiated (PD) NSCLC. MATERIALS AND METHODS: Resection specimens of 110 adenocarcinomas (ADCs) and 171 squamous cell carcinomas (SCCs) were collected and tissue microarrays were constructed to simulate small biopsy conditions. All specimens were stained with TTF-1, napsin A, CK7, p63, CK5/6, HMWCK, desmocollin-3 and mucicarmine. RESULTS: For 32 PD ADC, a combination of TTF-1 and napsin A increased sensitivity (81%). With regard to the 29 PD SCC, a combination of desmocollin-3 and p63 did not substantially increase diagnostic performance. Logistic regression analysis identified napsin A, p63 and TTF-1 as the optimal panel to separate PD ADC and PD SCC. Mucin stains for PD NSCLC increased accuracy rate (88%) for diagnosis of PD ADC. CONCLUSION: We recommend a minimal panel of immunohistochemical and histochemical markers to include TTF-1, p63, napsin A and one of mucin stains for tumor subtyping of PD NSCLC in a small biopsy sample.
Adenocarcinoma ; Biopsy ; Carcinoma, Squamous Cell ; Coloring Agents ; Immunohistochemistry ; Keratin-7 ; Keratins ; Logistic Models ; Lung ; Lung Neoplasms ; Molecular Weight ; Mucins ; Thyroid Gland

Non-small cell lung carcinoma (NSCLC) from histological and biological perspectives is a complex neoplasm. The sequential preneoplastic changes have been defined for centrally arising squamous cell carcinomas (SCCs) of the lung, and they are less documented for peripherally arising adenocarcinomas. The main morphologic forms of preneoplastic lesions recognized in the lung are squamous dysplasias for SCC, and atypical adenomatous hyperplasia for adenocarcinoma. Several studies have provided information regarding the molecular characterization of lung preneoplastic changes, especially for SCC. These molecular changes have been detected in the histologically normal and abnormal respiratory epithelium of smokers and patients with lung cancer, phenomenon known as field of cancerization. Our improved understanding of the changes and origins of the field of cancerization can be applied clinically to improve early detection of lung cancer. In the last decade, significant progress has been made in the characterization of molecular abnormalities in NSCLC tumors that are being used as molecular targets and predictive biomarkers for patients' selection for targeted therapy. As our understanding of the biology of the molecular pathogenesis of lung cancer evolves, there is an opportunity to use this knowledge for the development of novel chemoprevention strategies using those molecularly targeted agents used to treat advanced lung cancer, a concept coined as reverse migration. The rapid development of technologies for large-scale molecular analysis, includeing microarrays and next-generation sequencing will facilitate high-throughput molecular analysis of lung cancer preneoplastic lesions and the field of cancerization.
Adenocarcinoma ; Biomarkers ; Biology ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Chemoprevention ; Humans ; Hyperplasia ; Lung ; Lung Neoplasms ; Numismatics ; Precancerous Conditions ; Receptor, Epidermal Growth Factor ; Respiratory Mucosa

Immunotherapy was long considered as an attractive modality in the treatment of lung cancer. However, clinical successes were hampered by the inability to achieve potent activation of the antitumor immune system and effectively overcome the immune suppressive environment associated with lung cancer. Recent advances in cancer immunotherapy demonstrate that these limitations can be surmounted. In this review, we discuss the recent advances in immunotherapy of lung cancer and their potential implication for management of this disease.
Immune System ; Immunomodulation ; Immunotherapy ; Lung ; Lung Neoplasms ; Translational Medical Research ; Vaccines

PURPOSE : Weight loss and malnutrition in patients undergoing radiation therapy for lung cancer are common problems. We evaluated the effect of nutritional support with administering oral high calorie, high protein liquid, Mediwell ProteinTM. MATERIALS AND METHODS : From Feb. 2007 to Aug. 2008, 21 patients with lung cancer received nutritional supplement for 4 weeks with Mediwell StandardTM (n=10) or higher protein liquid, Mediwell ProteinTM (n=11). Their nutritional statues were evaluated just before radiation therapy and after 4 weeks. RESULTS : Nutritional support with oral high calorie, high protein liquid, Mediwell ProteinTM, showed improvement of the nutritional status during radiation therapy for lung cancer, even though it was not statistically significant. CONCLUSION : Nutritional support with oral high calorie, high protein liquid was effective for maintaining the nutritional status of patients with lung cancer during radiation therapy
Humans ; Lung ; Lung Neoplasms ; Malnutrition ; Nutritional Status ; Nutritional Support ; Weight Loss

PURPOSE : Lung cancer is the leading cause of cancer death in the world, including Korea. The aim of this study was to investigate the clinical features of the lung cancer patients who were seen in a University hospital between 1994 to 1998. MATERIALS AND METHODS : We performed a retrospective review of lung cancer clinical information at Kosin University Gospel Hospital from 1994 to 1998. We analyzed the age, gender, pathologic types, treatment methods and survival. RESULTS : Among 1,547 patients, 1,232 patients (79.6%) were male. The age distribution ranged from 20 to 84 years, and the mean age was 60.2 years old. Squamous cell carcinoma was the most common type of lung cancer (39.7%), followed by adenocarcinoma (23.1%), and small cell carcinoma (16.4%). However, there was an increasing incidence of adenocarcinoma every year. The stages at the diagnosis were I : 6.6%, II : 6%, III : 45.6% and IV : 41.8%. For the small cell carcinoma, 44.6% of the patients were in a limited stage and 55.4% were in an extensive stage. The initial treatments included chemotherapy (46.5%), surgery (15.1%) and radiotherapy (5.1%), but 32.2% of the patients received supportive care only. For the cases receiving surgery, the 5 year survival rate for the stage I patients was 66%, that for the stage II patients was 43.2% and that for the stage III patients was 11.8%. The median survival time (MST) for patients who underwent surgery plus adjuvant chemotherapy was 3.22 year, but the MST of the surgery-treated only patients was 1.51 years. So, adjuvant chemotherapy prolonged survival (p=0.000). On the subgroup analysis, young age and female lung cancer patients who did not receive adjuvant chemotherapy showed poor survival. CONCLUSION : Squamous cell carcinoma was the most common type of lung cancer. The active treatments were important for the patients' prognosis. For the patients receiving surgery, adjuvant chemotherapy had a role in improving survival and especially for young age and female lung cancer patients
Adenocarcinoma ; Age Distribution ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chemotherapy, Adjuvant ; Female ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Male ; Prognosis ; Retrospective Studies ; Survival Rate

PURPOSE : Since the year 2000, lung cancer has been the leading cause of cancer death in South Korea and also in many other parts of the world. MATERIALS AND METHODS : We developed a multidisciplinary (MD) care system for lung cancer patients in 1996. Here, we report the results obtained in the process of development of MD team (MDT). RESULTS : The MDT was launched with including medical doctors, chest surgeons, radiation oncologists, radiologists, nuclear medicine specialists and physician assistants. To facilitate co-operation between the MDT members, a specialized out-patient clinic was located within a sector of the hospital. A common ward was allocated for lung cancer patients regardless of the department of the attending physician. Shared electronic medical record forms that were specialized for lung cancer were developed. The MDT operates weekly lung cancer conferences and multidisciplinary out-patient clinics. To make diagnostic or therapeutic decisions early on, the electronic medical records of the patients were previewed or consulted by the specialists before they meet the individual patients. CONCLUSION : Despite every effort, we still need to shorten the waiting time from presentation to the first treatment and we need to improve the patients' satisfaction. We also have a mission to develop our own regulations and guidelines for our lung cancer MD care system. Clinical trials and basic research should also be encouraged along with improving the quality of life of the team members
Congresses as Topic ; Electronic Health Records ; Humans ; Lung ; Lung Neoplasms ; Missions and Missionaries ; Nuclear Medicine ; Outpatients ; Physician Assistants ; Quality of Life ; Republic of Korea ; Social Control, Formal ; Specialization ; Thorax