No abstract available.
Calcium* ; Coronary Vessels*

Endobronchial tuberculosis is the tuberculous affection of bronchial wall during the process of sloughing ofparenchymal necrotic material through airway. When the lesion results in complete obstruction, it resembles thefeatures of central type endobroanchial tumor. On the other hand, in the cases of incomplete obstruciton veryminimal parenchymal change, not corresponding with clinical symptoms, delays the correct diagnosis. This is the summary of 35 cases of endobronchial tuberculosis, diagnosed by bronchofiberscopy and biopsy of the lesion from1982 to 1984 June in Yonsei University Medical Center. 1. 35 patients included 9 children and 26 dults. Allchildren were less than 5 years old. In adults women accupied the majority and especially prevalent in 3rd decade.2. The findings of plain chest showed lobar collapse and/or overinflation 8 (88.9%) in children group, but lovarcollapse 13 (50%), minimal pulmonary tbc 9 (34.5%) and moderately advanced pulmonary tbc4(15.5%) in adults graoup.3. In 20 patients the bronchial lesion itself was evaluated by bronchotomogram or bronchogram. The incidence ofright and left affection was same, the each side included 10 patients. But the most frequent affected site was left main bronchus (10). In right side 6 patients showed main lesion only on lobar and/or segmental bronchi. 4.The lesion site of bronchus showed complete obstruction in 12, among which symmetric V-shape obstruction in 8,abrupt amputation in 2 and nodular protruding mass in 2. In remaining 8 incomplete obstruction 2 showed diffuseirregular nodularity 3 smooth long concentric narrowing and 3 concentric focal narrowing. 5. Proximal to thelesion, gradual and symmetric narrowing of bronchial lumen in fairly long distance was noted in 5, whichcorrespond with typcial bronchoscopic findings. The other 2 showed the extension of tuberculous lesion to the ipsilateral wall of distal trachea. 6. Distal to the lesion 12 patients showed patency of bronchial lumen, of which 6 with radiographically complete obstruction of endobronchial lesion. This maintenance of luminal patencydistal to the obstructing lesion seems to be a characteristics of endobronchial tuberculosis.
Academic Medical Centers ; Adult ; Amputation ; Biopsy ; Bronchi ; Child ; Diagnosis ; Female ; Hand ; Humans ; Incidence ; Phenobarbital ; Thorax ; Trachea ; Tuberculosis

Until recently, soliatry coin lesions of pulmonary disease hs been a conspicious problem in radiologic diagnosis, It is now well informed that CT has offered high resolution with its objective CT numbers to porvide additional information in terms of anatomic changes. Here by the aid of CT, the author gas reviewed retrospectively patients with various shape of round masses thus illustrating the advantage of it over conventional X-ray in diagnosis. 1. Total 53 patients, including 34 males and 19 females, aging between 19 to 76years old with nodule or mass of any size ranging 1 to 13cm in diameter were observed. 2. On palin chest X-raythey were indentified where 50 patients has single round nodule or mass, only one had two masses which were ecchinococcal cysts, and the rest two had invisible lesions only detected by CT. 3. With philips tomoscan 310, CTscan was taken with 12mm thick slice during quiet respiration. Using the ROI cursor the average CT number of thecentral area was calculated 1.0cm in side the outer border of the mass. 4. As a consequence of their pathologic features, they were itemized to 4 group as 36 solid, 9 cystic, 4 consolidative and 4 cavitary lesions. 5. Correctdiagnosis of 3 cystic lesions, 4 diffuse calcification, 1 A-V malformation were available by CT densitometry. 6.By the aid of better resolution and additional cross-sectional orientation of CT, 3 extrapulmonary lesions, 3segmental consolidations, 2 bronchocele, and 2 solitary metastasis, were helpful in diagnosis. 7. Also helpful indetermining the extent of intrathoracic extent of bronchogenic carcinoma for the same reason but given clues werenot more than the ordinary. 8. However, the limitation of the CT densitometry led to miss diagnosis of 3 examplesof cystic vs. solid lesions, and CT density of noncalcified granuloma together with bronchogenic carcinoma, didnot have a clear cut separation in between.
Aging ; Carcinoma, Bronchogenic ; Densitometry ; Diagnosis ; Female ; Granuloma ; Humans ; Lung Diseases ; Male ; Neoplasm Metastasis ; Numismatics ; Pipemidic Acid ; Radiography, Thoracic ; Respiration ; Retrospective Studies ; Thorax

PURPOSE: In Korea, Lung cancer is the Second most common prevailing malignancy among male population next to stomach cancer. Although CT scan and MRI is widely used in the staging of lung cancer, plain chest x-ray still plays an important role in screening and diagnosis. Our intention was to review the confusing radiographic features which result in delayed diagnosis of lung cancer. MATERIALS AND METHODS: Of the 160 patients with lung cancer evaluated by us, 62 patients(39%) with delayed diagnosis had average diagnostic duration of 5.1 months compared with 2.1 months for those without delay. We reviewed the plain chest x-ray findings of those 62 patients. RESULTS: The diagnosis of lung cancer was delayed more than half of the cases under the impression of intrathoracic tuberculosis. Upon reviewing the roentgenologic findings in patients with diagnostic delay, central type appeared as a small hilar or mediastinal mass with or without obstructive pneumonia. Peripheral type appeared as an ill-defined pulmonary nodule, a nodule hidden by overlapping structures, or as a lung cancer associated with pulmonary tuberculosis. Some cases were misinterpreted as extranodal spread of malignancy. CONCLUSION: To solve above mentioned problems, we recommend proper understanding of natural history of lung cancer, incorporation of high kVp technique in chest radiographs, routine acquisition of lateral chest radiograph to increase diagnostic accuracy, and appropriate use of CT scan in cases of difficult diagnosis.
Delayed Diagnosis* ; Diagnosis ; Humans ; Intention ; Korea ; Lung Neoplasms* ; Lung* ; Magnetic Resonance Imaging ; Male ; Mass Screening ; Natural History ; Pneumonia ; Radiography, Thoracic ; Stomach Neoplasms ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: We performed this study to evaluate the incidence of thoracic inlet pathologies. We also evaluated the extension of the thoracic inlet lesions to neck and/or mediastinum to determine anatomic connections between neck and mediastinum. MATERIALS AND METHODS: we evaluated chest radiographs and CT scans of the 41 patients with various pathologies involving this region. RESULTS: Thyroid lesions and malignant lymphomas were the most common pathologic lesions in this region (54%). Thoracic inlet lesions extending from mediastinum included various pathologies including thymic lesion (n=8) in the anterior mediastinum, neurogenic tumor(n=2) in the posterior mediastinum and malignant lymphoma(n=5) in the multiple compartment. Thoracic inlet lesions extending from the neck(n=9) were mostly thyroid lesions(n=8) arising in the visceral space of the neck. Thoracic inlet lesions(n=11) involving both neck and mediastinum were thyroid lesions, abscesses, thymic lesion, malignant lymphomas and cavernous hemangiomas. Thyroid lesions and cavernous hemangiomas showed remarkable enhancement on post contrast enhanced CT. Teratoma contained fat density and Two cases of abscesses contained air density. CONCLUSION: Thyroid lesions and malignant lymphomas were the most common pathologies in the thoracic inlet. There was anatomic connection between neck and mediastinum through the thoracic inlet. CT was valuale in evaluation of the location, extension, and density of the mass for the differential diaguonis of the thoracic inlet lesions.
Abscess ; Bays* ; Hemangioma, Cavernous ; Humans ; Incidence ; Lymphoma ; Mediastinum ; Neck ; Pathology ; Radiography, Thoracic ; Teratoma ; Thyroid Gland ; Tomography, X-Ray Computed

In 6 cases of invasive thymoma proved histologically from 1981 to 1984 in Yonsei University Medical Center,the CT findings and pattern were analysed. The results were as follows 1. Of 6 case, 4 were males and 2 werefemales. All cases were between 40-64 years and the average was 51 year old. 2. Of 6 cases, 2 female patients wereassociated with myasthenia gravis. 3. By the histological examination, 2 were confirmed as mixed cell type, 2spindle cell type, 1 lymphocytic type and 1 epithelial cell type. 4. CT findings of invasive thymoma were 1) Adiscrete but lobulated and irregular marginated soft tissue mass in the superoanterior mediastinum replacing thenormal mediastinal fat tissue. 2) Usually irregular low density areas within the mass suggesting central necrosisor calcification in 1 of 6 cases was noted. 3) Local invasiveness of the mass shown as obliteration of the normalfat planes surrounding great vessels, irregular thickenings or nodular shadows of the pleura, diagphragm andpericardium and irregular and ragged tumor-lung interfaces if the tumor invaded to these structures. 4) Frequentextention of tumor to middle and post. mediastinum along pericardium or mediastinal pleura with resultantextrinsic indentation and/or invasion of the hilar region. 5) Extensive tumor infiltration to middle and post.mediastinum in 1 case, indistinguishable from lymphoma. 6) Low attenuation numbered area of brain in another 1case, but not confirmed histologically.
Brain ; Epithelial Cells ; Female ; Humans ; Lymphoma ; Male ; Mediastinum ; Myasthenia Gravis ; Pericardium ; Pleura ; Thymoma

Bronchogenic cyst is relatively uncommon disease in clinical practice, 15 cases of bronchogenic cyst wereobtained and X-ray findings were analized retrospectively. The results are as follows: 1. 5 patients were symptomfree (30%) and common symptoms and signs were hemoptysis, dyspnea, chest pain in order of frequency. 2. 9 patientswere female and 6 patients were male. The most common age group was 21 years old to 30 years old(40%) and the nexcomon age group was 31 years old to 40 years old (20%) 3. 9 cases of intrapulmonary bronchogenic cyst and 6 casesof mediastinal bronchogenic cyst were obtained. 4. The average size of bronchogenic cyst was about 8x7x6cm. 5. Thecommon location of intrapulmonary bronchogenic cyst was lower lobe (56%) and common x-ray findings was thin walledcyst with air fluid level(78%). 6. Bronchography was performed in 3 cases of intrapulmonary bronchogenic cyst andonly one case demonstrated comunication with bronchus. 7. All 6 cases of mediastinal bronchogenic cyst showed wellmarginated soft tissue mass density. 3 cases were performed CT scanning and average precontrast Hounsfield numberwas 51 unit. No case showed contrast enhancement.
Bronchi ; Bronchogenic Cyst ; Bronchography ; Chest Pain ; Dyspnea ; Female ; Hemoptysis ; Humans ; Male ; Retrospective Studies ; Tomography, X-Ray Computed

Pulmonary aspergilloma may usually demonstrate the classic "air-crescent sign" in the conventional radiograph. However, this lesion is often seen as a pulmonary nodule or is obscured by the surrounding scarred and fibrotic lung tissue, which may limit the value of the conventional techniques and hinder the diagnosis. We retrospectively analysed the plan film findings of 44 lesions of 40 patients and CT findings of 29 lesions of 26 patients with pulmonary aspergilloma with special emphasis upon the atypical manifestation. The cases with classic "air-meniscus sign" in conventional radiograph accounted for 50%, while 30%, presented with a pulmonary nodule and 20% were unrecognized forms due to surrounding parenchymal lesion. CT findings of 28 aspergillomas were analyzed according to the shape of the intracavitary space(space between the cavity wall and the fungal ball) and the fungal ball itself. The intracavity space showed "air-meniscus sign" (62%), filling cavity (28%), peripheral air bubble (3%) and high density due to hemorrhage (3%), in descending order of frequency, The shape of the fungal ball itself showed homogeneous low density mass (62%) and spongeform or irregular air bubble contained mass (34%), CT was more accurate than conventional radiograph in the diagnosis and evaluation of number and location of atspergilloma, particularly in the case of atypical presentaion and was useful to assess the associated disease and to predict postoperative outcome.
Cicatrix ; Diagnosis ; Hemorrhage ; Humans ; Lung ; Retrospective Studies

Chest CT scans of 70 patents with malignant lymphoma were reviewed to evaluate the thoacic manifestation of malignant lymphoma. Sixteen patients had Hodgkin's disease and 54 patients had non-Hodgkin's lymphoma. The thoracic involvement of malignant lymphoma was observed i 47 patients (67.1%) and 11 of these patients had Hodgkin's disease, and 36 had non-Hodgkin's lympoma. The most common finding was mediastinal lymphadenopathy and the most frequently involved sites were anterior mediastinal and paratracheal lymph nodes. Pulmonary parenchymal involvement was seen in 11 patients (15.7%), and CT scan showed thickening of bronchovascular bundle, parenchymal consolidation and nodules. Pleural effusion was seen in 18 patients (25.7%), however, without any evidence of parietal pleural thickening in all cases. Involvement of chest wall and breast was seen in two patient(2.9%). The data obtained through the current study showed no differences from those of previous reports, except the fact that there was no CT evidence of pleural thickening in patients who had pleural effusion.
Breast ; Hodgkin Disease ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Pleural Effusion ; Rabeprazole ; Thoracic Wall ; Tomography, X-Ray Computed

Constrictive pericarditis is caused by fibrosis of the pericardium leading to decrease in ventricular compliance. The diagnosis is often delayed due to nonspecific signs and symptoms. The authors experienced eight cases of constrictive pericarditis detected on chest CT scan while being treated for considerable length of time under the clinical impressions of intrathoracic tumor, tuberculous pleural effusion, liver cirrhosis, etc. Constrictive hemodynamics of these patients were confirmed by echocardiogram and cardiac catheterization. Among them five cases were due to tuberculosis. In four cases with pathologically proven tuberculous granuloma, the pericardium was markedly thickened and intensely enhanced. Associated pericardial effusion (n=3), and mediastinal lymphadenitis (n=3) were present, but pericardial calcifications were not seen. On the other hand, the fibrosis group (n=3) displayed mild pericardial thickening. All the three patients showed pericardial calcifications, mild or absent enhancement of pericardium, but no mediastinal lymphadenitis. The cardiovascular changes such as inferior or superior vena caval distension, left ventricular deformity, interventricular septum angulation, and biatrial enlargements were more severe than those in patients with active granuloma. In patients with constrictive pericarditis with nonspecific signs and symptoms, CT scan is very helpful in making the diagnosis and can give informations about the evolution of the disease.
Cardiac Catheterization ; Cardiac Catheters ; Compliance ; Congenital Abnormalities ; Diagnosis* ; Fibrosis ; Granuloma ; Hand ; Hemodynamics ; Humans ; Liver Cirrhosis ; Lymphadenitis ; Pericardial Effusion ; Pericarditis, Constrictive* ; Pericardium ; Pleural Effusion ; Tomography, X-Ray Computed ; Tuberculosis