OBJECTIVE: To assess the feasibility and safety of CT-guided percutaneous transthoracic radiofrequency ablation (RFA) with saline infusion of pulmonary tissue in rabbits. MATERIALS AND METHODS: Twenty-eight New Zealand White rabbits were divided into two groups: an RFA group (n=10) and a saline-enhanced RFA (SRFA) group (n=18). In the RFA group, percutaneous RFA of the lung was performed under CT guidance and using a 17-gauge internally cooled electrode. In the SRFA group, 1.5 ml of 0.9% saline was infused slowly through a 21-gauge, polyteflon-coated Chiba needle prior to and during RFA. Lesion size and the healing process were studied in rabbits sacrificed at times from the day following treatment to three weeks after, and any complications were noted. RESULTS: In the SRFA group, the mean diameter (12.5+/-1.6 mm) of acute RF lesions was greater than that of RFA lesions (8.5+/-1.4 mm) (p < .05). The complications arising in 12 cases were pneumothorax (n=8), thermal injury to the chest wall (n=2), hemothorax (n=1), and lung abscess (n=1). Although procedure-related complications tended to occur more frequently in the SRFA group (55.6%) than in the RFA group (20%), the difference was not statistically significant (p = .11). CONCLUSION: Saline-enhanced RFA of pulmonary tissue in rabbits produces more extensive coagulation necrosis than conventional RFA procedures, without adding substantial risk of serious complications.
Animal ; *Catheter Ablation ; Lung/radiography/*surgery ; Lung Neoplasms/radiography/*surgery ; Male ; Rabbits ; Sodium Chloride ; Tomography, X-Ray Computed

OBJECTIVE: This study was designed to evaluate follow-up results in terms of patient prognosis for malignant pulmonary nodules depicted as pure ground-glass opacity (GGO) lesion observed at high-resolution CT (HRCT). MATERIALS AND METHODS: Surgical removal for malignant GGO nodules was accomplished in 58 patients (26 men, 32 women; mean age, 57 years; age range, 29-78 years). Patient prognoses were assessed by patient clinical status and the presence of changes in nodule size determined after a follow-up HRCT examination. Differences in patient prognoses were compared for nodule number, size, surgical method, change in size before surgical removal, and histopathological diagnosis by use of Fisher's exact test and Pearson's chi-squared test. RESULTS: Of the 58 patients, 40 patients (69%) were confirmed to have a bronchioloalveolar carcinoma (BAC) and 18 patients (31%) were confirmed to have an adenocarcinoma with a predominant BAC component. Irrespective of nodule size, number, treatment method, change in size before surgical removal and histopathological diagnosis, neither local recurrence nor a metastasis occurred in any of these patients as determined at a follow-up period of 24 months (range; 12-65 months). Of 14 patients with multiple GGO nodules, all of the nodules were resected without recurrence in six patients. In the remaining eight patients, the remaining nodules showed no change in size in seven cases and a decrease in size in one case as determined after a follow-up CT examination. CONCLUSION: Prognoses in patients with pure GGO malignant pulmonary nodules are excellent, and not significantly different in terms of nodule number, size, surgical method, presence of size change before surgical removal and histopathological diagnosis.
Adenocarcinoma/pathology/radiography/surgery ; Adenocarcinoma, Bronchiolo-Alveolar/pathology/radiography/surgery ; Adult ; Female ; Humans ; Lung Neoplasms/pathology/*radiography/surgery ; Male ; Middle Aged ; Multiple Pulmonary Nodules/pathology/*radiography/surgery ; Prognosis ; Solitary Pulmonary Nodule/pathology/*radiography/surgery ; *Tomography, X-Ray Computed ; Young Adult

Pleuropulmonary blastoma (PPB) is a rare malignant dysontogenetic neoplasm primarily affecting children and is characterized histologically by a variably mixed blastematous and sarcomatous patterns. We herein report a very exceptional adult case of PPB. A 21-yr-old male patient presented with a left chest pain of two weeks' duration. A computed tomography scan revealed a large, multicystic tumor occupying the left lower hemithorax, leading to the impression of a ruptured mediastinal cystic teratoma. A thoracotomy for resection of the tumor was performed. On histologic examination, the tumor consisted of cystic walls and associated solid lesions which showed undifferentiated blastemal tissues with focal fibrosarcomatous and rhabdoid features. Immunohistochemically the tumor cells only showed diffuse strong positivity for vimentin. The histologic findings corresponded to a type II PPB. The authors suggest that PPB, especially of type I or II, should be included in the radiologic differential diagnosis of mediastinal cystic neoplasms in a young adult.
Adult ; Diagnosis, Differential ; Human ; Immunohistochemistry ; Lung Neoplasms/*diagnosis/radiography/surgery ; Male ; Pulmonary Blastoma/*diagnosis/radiography/surgery ; Teratoma/*diagnosis/*radiography/surgery ; Tomography, X-Ray Computed ; Vimentin/biosynthesis

Thoracic paragangliomas comprise only 1-2% of all paragangliomas, including the adrenal pheochromocytomas, and these tumors are mostly found in the mediastinal compartments (1). To the best of our knowledge, there is only one case report in the pathology literature of endobronchial involvement by a primary pulmonary paraganglioma (2). We report here on the CT and bronchoscopic findings of a case of pathologically proven endobronchial paraganglioma in a 37-year-old woman. In our case, bronchoscopy and CT demonstrated an endobronchial hypervascular mass, which indicated the presence of carcinoid or hypervascular metastasis based on the known incidence of such tumors.
Adult ; Bronchial Neoplasms/*radiography/surgery ; Bronchoscopy ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/*radiography/surgery ; Paraganglioma/*radiography/surgery ; Tomography, X-Ray Computed

The occurrence of foreign body is uncommon in youths and adults. We report here a case of 16-year-old boy who inhaled a foreign body which was overlooked for 6 months. The patient suffered productive cough and received antibiotic treatment for 10 days. But the symptoms did not improve. Chest radiography and CT scan revealed a 1-cm-long needle-like foreign object in the right inferior lobar bronchus. Wedge resection of lung was finally performed because of severe hemorrhage caused by prior bronchoscopy.
Adolescent ; Bronchoscopy ; Foreign Bodies ; diagnostic imaging ; surgery ; Humans ; Lung ; diagnostic imaging ; surgery ; Male ; Radiography

The lung and stomach are very unusual sites for teratoma. The histologic findings of intrapulmonary and gastric teratomas are not different from those arising in usual sites, such as the ovary or testis. However, preoperative diagnosis is sometimes difficult to make partly because of unusual location. We report here two cases of teratoma, one intrapulmonary teratoma and the other gastric. The intrapulmonary teratoma in our study had an endobronchial tumor growth, which rules out mediastinal teratoma. Meanwhile gastric teratomas usually present as a submucosal tumor and most cases are reported in infancy and childhood. Gastric teratoma in this study occurred in a 27-year-old man. To the best of our knowledge, this case of intrapulmonary teratoma is the eighth and the gastric teratoma is the first to be reported in Korea.
Adult ; Case Report ; Gastrectomy ; Human ; Lung Neoplasms/surgery ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Stomach Neoplasms/surgery ; Stomach Neoplasms/radiography ; Stomach Neoplasms/pathology* ; Teratoma/surgery ; Teratoma/radiography ; Teratoma/pathology* ; Tomography, X-Ray Computed

Treatments for pure ground-glass nodules (GGNs) include limited resection; however, surgery is not always possible in patients with limited pulmonary functional reserve. In such patients, cryoablation may be a suitable alternative to treat a pure GGN. Here, we report our initial experience with cryoablation of a pure GGN that remained after repeated surgical resection in a patient with multiple GGNs. A 5-mm-sized pure GGN in the left lower lobe was cryoablated successfully without recurrence at the 6-month follow-up.
Cryosurgery/*methods ; Female ; Humans ; Lung Neoplasms/radiography/*surgery ; Middle Aged ; Multiple Pulmonary Nodules/radiography/*surgery ; Neoplasm Recurrence, Local/radiography ; Tomography, X-Ray Computed

A 56 year old female patient was found to have a lung mass in the right upper lobe lobe during evaluation for cough and sputum. The mass had grown slightly over the past 6 months when she was admitted for an operation. Preoperative studies revealed the benign nature of the tumor, and a thoracoscopic right upper lobectomy was performed. Postoperatively, the diagnosis was histologically proven to be pulmonary leiomyoma which is a rare type of benign lung tumor.
Case Report ; Female ; Human ; Leiomyoma/pathology/radiography/*surgery ; Lung Neoplasms/pathology/radiography/*surgery ; Middle Age ; Radiography, Thoracic ; Tomography, X-Ray Computed

Placental transmogrification is a very rare lung disease, where the alveoli resemble the chorionic villi of placenta, and this change is a characteristic finding. A 31-year-old female patient presented with cough and dyspnea that had begun 2 weeks prior to admission. Along with giant bulla found in the left upper lung field, subsegmental consolidation was also identified in the lingular segment on plain chest radiograph and CT scan. Wedge resection was performed to remove the bulla. Pathologic examination of the resected bulla revealed destruction of the normal structures and characteristic villous and papillary changes. These changes led to a diagnosis of placental transmogrification. We made an encounter of an unusual placental transmogrification which had different image findings from other reported transmogrification cases. Thus, we report an atypical placental transmogrification case where both consolidation and giant bulla coexist.
Adult ; Chorionic Villi/*pathology ; Diagnosis, Differential ; Female ; Humans ; Lung/*pathology/radiography/surgery ; Lung Diseases/pathology/*radiography/surgery ; Pneumonectomy ; Tomography, X-Ray Computed/*methods

Adult ; Castleman Disease ; complications ; diagnostic imaging ; pathology ; surgery ; Humans ; Lung Neoplasms ; etiology ; pathology ; Male ; Radiography