Pulmonary bronchogenic cyst in adults is rare and the typical appearance is a sharply circumscribed, round or oval nodule or mass, usually in the medial third of the lungs. Bronchial polyps are rare histopathologically distinct nonneoplastic endobronchial lesions and are classified as multiple papillomas, solitary papillomas, and inflammatory polyps. We herein report a patient with polypoid endobronchial lung cyst. A 68-yr-old woman presented with a discomfort and pain in the right upper chest of four weeks' duration. Chest radiography revealed a cystic lesion in the right upper lung. Computed tomography revealed a 4x5 cm sized large cyst. Neither enlarged mediastinal lymph nodes nor extrabronchial involvements were observed. Flexible bronchoscopy revealed a peduncular polyp about 2 cm in length originating from the anterior segment of right upper lung. After bronchoscopic removal of polyp, cystic lesion of the right upper lung disappeared.
Aged ; Bronchogenic Cyst/*diagnosis/*surgery ; Bronchoscopy/*methods ; Female ; Humans ; Lung Diseases/*diagnosis/*surgery ; Research Support, Non-U.S. Gov't ; Treatment Outcome

Dyspnea ; diagnosis ; etiology ; Fatigue ; diagnosis ; etiology ; Lung Diseases ; surgery ; Pneumonectomy ; adverse effects ; Thoracic Surgery, Video-Assisted ; adverse effects ; Treatment Outcome

Dirofilariasis is a rare disease in humans. We report here a case of a 48-year-old male who was diagnosed with pulmonary dirofilariasis in Korea. On chest radiographs, a coin lesion of 1 cm in diameter was shown. Although it looked like a benign inflammatory nodule, malignancy could not be excluded. So, the nodule was resected by video-assisted thoracic surgery. Pathologically, chronic granulomatous inflammation composed of coagulation necrosis with rim of fibrous tissues and granulations was seen. In the center of the necrotic nodules, a degenerating parasitic organism was found. The parasite had prominent internal cuticular ridges and thick cuticle, a well-developed muscle layer, an intestinal tube, and uterine tubules. The parasite was diagnosed as an immature female worm of Dirofilaria immitis. This is the second reported case of human pulmonary dirofilariasis in Korea.
Animals ; Diagnosis, Differential ; Dirofilaria immitis/*isolation & purification ; Dirofilariasis/*diagnosis/parasitology/surgery ; Humans ; Lung/pathology ; Lung Diseases, Parasitic/*diagnosis/parasitology/surgery ; Male ; Middle Aged ; Republic of Korea ; Treatment Outcome

OBJECTIVETo summarize the experience of diagnosis and surgical treatment for pulmonary and pleural aspergillosis.

METHODSThe clinical data of cases with pulmonary and pleural aspergillosis were analyzed retrospectively between September 1972 and June 2003. There were 53 cases with pulmonary aspergillosis and 3 cases with pleural aspergillosis. Aspergillus was found preoperatively in 8 patients by sputum culture (5 cases) or needle biopsy of the lung (2 cases) or fibro-bronchoscopic biopsy (1 case). All patients were treated with surgical procedures following X-ray film or CT scan.

RESULTSOf 53 cases with pulmonary aspergillosis, 42 lobectomies, 3 segment-Pneumonectomies, and 8 wedge resections were performed. Of three cases with pleural aspergillosis following eliminating their diseased foci in residual pleural space, two underwent thoracoplasty, one underwent postoperative closed chest drainage for one and an half month with fluconazole injected into residual pleural space repeatedly for 1 month (200 mg/100 ml, 1 time per 2 or 3 days). No operative death and major postoperative complications occurred. None of the patients had recurrent symptoms at follow-up.

CONCLUSIONWe recommend aggressive surgical resection for pulmonary and pleural aspergillosis, and the surgical result is excellent.

Adult ; Aged ; Aspergillosis ; diagnosis ; surgery ; Female ; Humans ; Lung Diseases, Fungal ; diagnosis ; surgery ; Male ; Middle Aged ; Pleurisy ; diagnosis ; surgery ; Pneumonectomy ; methods ; Retrospective Studies ; Thoracoplasty ; Treatment Outcome

BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) has become the latest minimally invasive diagnostic and therapeutic technique due to its characteristics, e.g., non-invasion, accuracy, real-time positioning. In this study, we investigated the application of ENB biopsy combined with Massage staining in the diagnosis and treatment of peripheral pulmonary lesions (PPL). METHODS: The clinical data of 15 PPL patients undergoing ENB biopsy plus Massage staining between August 2017 and January 2018 were retrospectively reviewed. Among them, there were 12 male and 3 female, and the mean age was (51.3±2.1) years old. RESULTS: The diameter of PPLs ranged from 6 mm to 36 mm (mean: 14.0 mm). The successful biopsy rate was 66.7%. All patients successfully underwent Massage staining. The distance between the centers of staining and lesion was (1.0±0.4) cm, and the diameter of staining was (2.8±0.6) cm. The mean operation time was (26.7±5.3 ) min, and the mean blood loss during surgery was (3.3±1.5) mL. There was no pneumothorax, hemothorax and pulmonary vascular injury during the procedure. CONCLUSIONS The ENB biopsy plus Massage staining technique caused very few complications, and provided high precision, which warrants further application.
Bronchoscopy ; methods ; Electromagnetic Fields ; Female ; Humans ; Lung Diseases ; diagnosis ; surgery ; Lung Neoplasms ; diagnosis ; surgery ; Male ; Middle Aged ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Staining and Labeling ; methods

Pulmonary alveolar microlithiasis (PAM) is a rare chronic disease with paucity of symptoms in contrast to the imaging findings. We present a case of a 24-year-old Malay man having an incidental abnormal pre-employment chest radiograph of dense micronodular opacities giving the classical "sandstorm" appearance. High-resolution computed tomography of the lungs showed microcalcifications with subpleural cystic changes. Open lung biopsy showed calcospherites within the alveolar spaces. The radiological and histopathological findings were characteristic of PAM.
Biopsy ; Calcinosis/*diagnosis/surgery ; Chronic Disease ; Genetic Diseases, Inborn/*diagnosis/surgery ; Humans ; *Incidental Findings ; Lung Diseases/*diagnosis/surgery ; Male ; Pulmonary Alveoli/pathology/radiography ; Thoracic Surgery, Video-Assisted/methods ; Tomography, X-Ray Computed/*methods ; Young Adult

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

OBJECTIVETo assess the clinical feature, diagnosis and treatment of primary pulmonary cryptococcosis.

METHODSFrom 1996 to 2004, 11 patients with primary pulmonary cryptococcosis were surgical treated and confirmed by histologic study. At the same period, 2715 patients with pulmonary abnormalities received surgery. Their clinical data were retrospectively reviewed.

RESULTSSixty-four percent (7/11) of the patients were symptomatic at the time of diagnosis. All 11 cases were misdiagnosed as lung cancer or inflammatory or tuberculosis by X-ray and CT scan before surgery. Three cases received fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) scan and their primary pulmonary lesions showed FDG avid. All 11 patients were treated by antibiotics and antituberculosis therapy but no responses appeared. Primary pulmonary cryptococcosis was diagnosed by ultrasound-guided fine needle aspiration biopsy in only 2 cases, but antifungal therapy was not effective. All 11 patients underwent thoracotomy and their pulmonary cryptococcosis were resected. Only 1 patient with multiple nodules received antifungal therapy postoperatively. No recurrence was found in any patients.

CONCLUSIONSPrimary pulmonary cryptococcosis is non-specific and can be confused with lung cancer, tuberculosis, etc. The pulmonary abnormalities should be resected unless the diagnosis is established. Antifungal therapy is not necessary in patients whose abnormality has been resected thoroughly.

Adult ; Aged ; Biopsy, Needle ; Cryptococcosis ; diagnosis ; surgery ; Female ; Humans ; Lung Diseases, Fungal ; diagnosis ; surgery ; Male ; Middle Aged ; Positron-Emission Tomography ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

Hepatocellular carcinoma (HCC) is well known malignancy with poor prognosis, even after resection of the primary tumor. Sorafenib is the first-line treatment in advanced HCC, but the disease control rate of sorafenib is only 43%. Pulmonary metastasectomy in patients with pulmonary metastasis from HCC has been reported to increase long-term survival compared with systemic chemotherapy. Video-assisted thoracic surgery is considered a reliable approach to the diagnosis and treatment of pulmonary diseases with low complication rate. Pulmonary metastasectomy is not universally accepted because of frequent local recurrence, an uncontrollable primary tumor, and frequent multiple pulmonary metastases in HCC, but outcome of pulmonary metastasectomy and adjuvant sorafenib therapy has not been studied. We experienced a patient who had advanced HCC with pulmonary oligometastasis and received surgical resection of the metastatic pulmonary nodule and sorafenib chemotherapy. In advanced HCC with pulmonary oligometastasis, surgical resection of pulmonary metastasis and sorafenib chemotherapy should be considered.
Carcinoma, Hepatocellular* ; Diagnosis ; Drug Therapy ; Humans ; Lung Diseases ; Metastasectomy ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Thoracic Surgery, Video-Assisted

Patients undergoing thoracic surgery show various lesions such as chronic obstructive lung diseases, pleural adhesion, pneumonia, acute respiratory distress syndrome, atelectasis, pleural effusion, pulmonary edema, and pneumothorax throughout preoperative, operative, and recovery periods. Therefore, lung ultrasonography has potential for perioperative use in thoracic surgery. Benefits of lung ultrasonography over conventional chest X-ray are convincing. First, ultrasonography has higher sensitivity than X-ray in various lesions. Second, it can be performed at bed side to obtain diagnosis immediately. Third, it does not expose patients to radiologic hazard. If anesthesiologists can obtain necessary skills and perform lung ultrasonography as a routine evaluation process for patients, territory of anesthesia would become broader and patients would obtain more benefit.
Anesthesia ; Diagnosis ; Humans ; Lung Diseases, Obstructive ; Lung* ; Pleural Effusion ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Respiratory Distress Syndrome, Adult ; Thoracic Surgery* ; Thorax ; Ultrasonography*