6.Early Detection of the Acute Exacerbation of Interstitial Pneumonia after the Surgical Resection of Lung Cancer by Planned Chest Computed Tomography.
Kunihiro OYAMA ; Masato KANZAKI ; Mitsuko KONDO ; Hideyuki MAEDA ; Kei SAKAMOTO ; Tamami ISAKA ; Jun TAMAOKI ; Takamasa ONUKI
The Korean Journal of Thoracic and Cardiovascular Surgery 2017;50(3):177-183
BACKGROUND: To improve postoperative outcomes associated with interstitial pneumonia (IP) in patients with lung cancer, the management of the postoperative a cute exacerbation of IP (PAEIP) was investigated. METHODS: Patients with primary lung cancer were considered to be at risk for PAEIP (possible PAEIP) based on a preoperative evaluation. The early phase of this study was from January 2001 to December 2008, and the late phase was from January 2009 to December 2014. In the early phase, chest computed tomography (CT) was performed for patients for whom PAEIP was suspected based on their symptoms, whereas in the late phase, chest CT was routinely performed within a few days postoperatively. The numbers of possible PAEIP cases, actual PAEIP cases, and deaths within 90 days due to PAEIP were compared between both phases. RESULTS: In the early and late phases, surgery was performed in 712 and 617 patients, 31 and 72 possible PAEIP cases were observed, nine and 12 actual PAEIP cases occurred, and the mean interval from the detection of PAEIP to starting treatment was 7.3±2.3 and 5.0±1.8 days, respectively. Five patients died in the early phase, and one patient died in the late phase. Significantly fewer PAEIP-related deaths were observed in the late phase (p<0.05). CONCLUSION: Identifying patients at risk for PAEIP by routine postoperative CT examinations led to the early diagnosis and treatment of PAEIP, resulting in the reduction of PAEIP-related mortality.
Early Diagnosis
;
Humans
;
Lung Diseases, Interstitial*
;
Lung Neoplasms*
;
Lung*
;
Mortality
;
Thorax*
;
Tomography, X-Ray Computed
7.Reported Lung Adenocarcinoma with Idiopathic Pulmonary Fibrosis after Open Lung Biopsy.
Chang Woo CHOI ; Hwa Kyun SHIN ; Keun HER ; Jae Wook LEE ; Yong Soon WON ; Eun Seok KOH
The Korean Journal of Thoracic and Cardiovascular Surgery 2004;37(12):1032-1035
The specific diagnosis in diffuse interstitial lung disease may be obtained through open lung biopsy. Diffuse interstitial lung disease is often associated with lung cancer. We report one case of lung adenocarcinoma with idiopathic pulmonary fibrosis in whom previous open lung biopsy had been performed. We need general concepts about sites of open lung biopsy in these patients. Therefore, we report this case and document other references.
Adenocarcinoma*
;
Biopsy*
;
Diagnosis
;
Humans
;
Idiopathic Pulmonary Fibrosis*
;
Lung Diseases, Interstitial
;
Lung Neoplasms
;
Lung*
9.The Role of Open Lung Biopsy in Diagnosis and Treatment of Diffuse Interstitial Lung Disease in High-resolution Computed Tomography Era.
Gye Su KIM ; Jae Chul LEE ; Seung Joon LEE ; Chul Gyu YOO ; Young Whan KIM ; Sung Koo HAN ; Kyung Up MIN ; Jung Gi IM ; You Young KIM ; Young Soo SHIM
Tuberculosis and Respiratory Diseases 1996;43(5):746-754
Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share common clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCT) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide information on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treatment plan in patients who have undergone high-resoluticm CT. Method: Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results: High-resolution CT suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confirmed to be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution CT was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lung biopsy in only 2 cases. Conclusion: The above findings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.
Biopsy*
;
Diagnosis*
;
Diagnosis, Differential
;
Humans
;
Lung Diseases, Interstitial*
;
Lung*
;
Retrospective Studies
10.The Role of Open Lung Biopsy in Diagnosis and Treatment of Diffuse Interstitial Lung Disease in High-resolution Computed Tomography Era.
Gye Su KIM ; Jae Chul LEE ; Seung Joon LEE ; Chul Gyu YOO ; Young Whan KIM ; Sung Koo HAN ; Kyung Up MIN ; Jung Gi IM ; You Young KIM ; Young Soo SHIM
Tuberculosis and Respiratory Diseases 1996;43(5):746-754
Objective: Diffuse interstitial lung disease (DILD) is a group of diverse diseases that share common clinical, radiologic, and pulomonary function features. Open lung biopsy (OLB) has been regarded as gold standard in differential diagnosis of DILD. However open lung biopsy is a invasive diagnostic tool not free of its own risk or complications. These days, high-resolution computed tomography (HRCT) has become an important diagnostic tool in DILD through its precise image analysis. In many instances, HRCT could provide specific diagnosis or, at least, provide information on the disease activity of DILD. The authors re-evaluate the role of open lung biopsy in this "HRCT era" by investigating the additional diagnostic gain and impacts on the treatment plan in patients who have undergone high-resoluticm CT. Method: Diagnoses obtained by high-resolution CT and open lung biopsy were compared and changes of treatment plans were evaluated retrospectively in 30 patients who had undergone open lung biopsy for the purpose of diagnosis of diffuse interstitial lung disease from March 1988 to June 1994. Results: High-resolution CT suggeted specific diagnoses in 22 out of 28 patients (78.6%) and the diagnoses were confirmed to be correct by open lung biopy in 20 of those 22 cases (91%). Open lung biopsy could not give specific diagnosis in 5 out of 30 cases (16.7%). In 5 out of 6 cases (83.3%) in whom high reolution CT was not able to suggest specific diagnosis, open lung biopsy gave specific diagnoses. Treatment plan was altered by the result of open lung biopsy in only 2 cases. Conclusion: The above findings suggest that in "HRCT era", when HRCT could suggest specific diagnosis, the need for open lung biopsy should be re-evaluated.
Biopsy*
;
Diagnosis*
;
Diagnosis, Differential
;
Humans
;
Lung Diseases, Interstitial*
;
Lung*
;
Retrospective Studies