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Malignant Mesothelioma Presenting as Large Neck Mass.

Bae Young LEE ; Hyeon Sook KIM ; Kyung Sup SONG ; Song Mee CHO ; Kang Hoon LEE ; Jung Eun CHOI ; Sang Haak LEE ; Hwa Sik MOON ; Ji Young KANG ; Hyun Hee KANG ; Ki Ouk MIN

Tuberculosis and Respiratory Diseases.2009;67(4):369-373. doi:10.4046/trd.2009.67.4.369

Malignant mesothelioma is the most common primary malignant tumor involving pleura, but its diagnosis is difficult to determine by pathology in addition to the fact that it is rare. We present an unusual case of malignant mesothelioma, which initially presented as large neck mass contrary to the more common presentation of a rind like growth along the pleura demonstrated on imaging and by pathologic findings.
Mesothelioma ; Neck ; Pleura

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A Case of Bronchiolitis Interstitial Pneumonitis.

Su Young CHI ; Kyoung Ho RYU ; Dae Hun LIM ; Hong Joon SHIN ; Hee Jung BAN ; In Jae OH ; Yong Soo KWON ; Kyu Sik KIM ; Sung Chul LIM ; Young Chul KIM ; Yoo Duk CHOI ; Sang Yun SONG ; Hyun Ju SEON

Tuberculosis and Respiratory Diseases.2009;67(4):364-368. doi:10.4046/trd.2009.67.4.364

Bronchiolitis interstitial pneumonitis (BIP), an unclassified and newly described interstitial pneumonia, has a combined feature of prominent bronchiolitis, interstitial inflammation, and fibrosis. It is distinct from bronchiolitis obliterans or bronchiolitis obliterans organizing pneumonia (BOOP). BIP has a better prognosis than common cases of interstitial pneumonia. However, BIP has a poorer prognosis than BOOP. BIP's response to corticosteroids is not as successful as BOOP's response to this treatment. We encountered the case of a 31-year-old woman with BIP with an initial presentation of dyspnea and a cough that had lasted for 3 months. The patient's chest CT scan demonstrated patchy ground glass opacities and multiple ill-defined centrilobular nodules in both lungs, suggesting military tuberculosis or nontuberculous mycobacterial infection. A video-assisted thoracoscopic lung biopsy resulted in the diagnosis of BIP. Clinical symptoms, pulmonary lesions, and pulmonary function tests were improved after oral glucocorticoid therapy.
Adrenal Cortex Hormones ; Adult ; Biopsy ; Bronchiolitis ; Bronchiolitis Obliterans ; Cough ; Cryptogenic Organizing Pneumonia ; Dyspnea ; Female ; Fibrosis ; Glass ; Humans ; Inflammation ; Lung ; Lung Diseases, Interstitial ; Military Personnel ; Prognosis ; Respiratory Function Tests ; Thorax ; Tuberculosis

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Two Cases of Pulmonary Involvement of Immunoglobulin G4 Related Autoimmune Disease.

Jung Wan YOO ; Jae Hyung ROH ; Chae Man LIM ; Sang Do LEE ; Woo Sung KIM ; Dong Soon KIM ; Jin Woo SONG

Tuberculosis and Respiratory Diseases.2009;67(4):359-363. doi:10.4046/trd.2009.67.4.359

Immunoglobulin G4 (IgG4) related autoimmune diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation of numerous IgG4-positive lymphoplasma cells of varying origin, and a positive response to steroid treatment. Autoimmune pancreatitis, sclerosing cholangitis, and retroperitoneal fibrosis are representative presentations of IgG4 related autoimmune disease. Herein, we describe 2 patients (40-years-old woman and 47-years-old man) diagnosed with pulmonary involvement of IgG4-related autoimmune disease. The patients were admitted for an evaluation of the lung mass or multiple lung nodules found on chest radiography. Surgical lung biopsies were performed and pathologic finding revealed lymphoplasmacytic sclerosing inflammation with numerous IgG4 positive cells. The patients had elevated serum total IgG and IgG4 levels. Treatment consisted of high dose methylpredinisolone (1 mg/kg/day) and demonstrated good responsiveness. However, one patient experienced 2 relapses while being tapered off of steroid treatment.
Autoimmune Diseases ; Biopsy ; Cholangitis, Sclerosing ; Female ; Humans ; Immunoglobulin G ; Immunoglobulins ; Inflammation ; Lung ; Pancreatitis ; Recurrence ; Retroperitoneal Fibrosis ; Thorax

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A Case of Oral Tuberculosis Confirmed by Histopathology.

Jinwoo LEE ; Young Sik PARK ; Hyo Jeong LIM ; Min Sun KWAK ; Woo Hyun LIM ; Jae Joon YIM ; Seok Chul YANG ; Chul Gyu YOO ; Young Whan KIM ; Sung Koo HAN ; Young Soo SHIM ; Sang Min LEE

Tuberculosis and Respiratory Diseases.2009;67(4):356-358. doi:10.4046/trd.2009.67.4.356

Although tuberculosis is a chronic infectious disease that can occur in any section of the body, oral tuberculosis is rare. Here, we report a case of oral tuberculosis in which the patient sought treatment for a painful oral lesion. A histopathologic examination revealed the characteristics of tuberculosis and pulmonary lesions were detected on subsequent examination. The patient was treated with antituberculosis therapy, and his symptoms improved. This case emphasizes the importance of including oral tuberculosis as part of the differential diagnosis for mucosal lesions.
Communicable Diseases ; Diagnosis, Differential ; Humans ; Mouth ; Tuberculosis ; Tuberculosis, Oral

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A Case of Pulmonary Thromboembolism with JAK2 Mutation.

Jin Jin KIM ; Soon Seog KWON ; Hyun Jeong LEE ; Hea Yon LEE ; Myung Hee JEONG ; Yong Hyun KIM

Tuberculosis and Respiratory Diseases.2009;67(4):351-355. doi:10.4046/trd.2009.67.4.351

The incidence of pulmonary thromboembolism increases with age. The risk factors of pulmonary thromboembolism include surgery, malignancy, obesity, lupus anticoagulants, and vascular conditions such as deep vein thrombosis. Thromboembolism in younger patients or in unusual locations, the possibility of primary thrombophilic conditions should be considered. Primary thrombophilic states include myeloproliferative disorders (MPD). JAK2 V617F mutation is found commonly in patients diagnosed with MPD, in 90~95% of polycythemia vera (PV) and in 50~60% of essential thrombocytosis (ET) patients. Sometimes the JAK2 V617F mutation is found in cases without MPD. The relationship between JAK2 V617F mutation and thrombosis has not been defined. Recently, clinical evidence suggests that this mutation may be variably associated with thrombosis. We present one case of pulmonary thromboembolism in a young patient, who was positive for the JAK2 V617F mutation and did not have MPD.
Anticoagulants ; Humans ; Incidence ; Myeloproliferative Disorders ; Obesity ; Polycythemia Vera ; Pulmonary Embolism ; Risk Factors ; Thrombocytosis ; Thromboembolism ; Thrombosis ; Venous Thrombosis

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Erdheim-Chester Disease with Hepatitis, Glomerulonephritis, Aplastic Anemia and Lung Involvement.

Ji Won PARK ; Chae Uk CHUNG ; Ji Young SHIN ; Sun Young JUNG ; Su Jin YOO ; Jeong Eun LEE ; Sung Soo JUNG ; Ju Ock KIM ; Sun Young KIM ; Hee Sun PARK

Tuberculosis and Respiratory Diseases.2009;67(4):345-350. doi:10.4046/trd.2009.67.4.345

Erdheim-Chester disease (ECD) is a proliferative non-Langerhans cell histiocytosis of multiple organs. This is a rare disease of unknown etiology with a high mortality. We present the case report of a 26-year-old man diagnosed with ECD. He was referred to our hospital with elevated levels of aminotransferases. Although the diagnosis was uncertain, the patient was lost to follow up at that time. One year later, the patient returned to the hospital with generalized edema. Although a specific bone lesion was not found, the patient was experiencing the following: glomerulonephritis, aplastic anemia, hepatitis, and lung involvement. A lung biopsy was performed: the immunohistochemical stain were positive for CD68 and negative for S-100 protein and CD1a. We diagnosed as the patient as havinf ECD. Approximately 50% of ECD cases present with extraskeletal involvement. ECD should be considered as part of the differential diagnosis when multiple organs are involved.
Adult ; Anemia, Aplastic ; Biopsy ; Diagnosis, Differential ; Edema ; Erdheim-Chester Disease ; Glomerulonephritis ; Hepatitis ; Histiocytosis ; Humans ; Lost to Follow-Up ; Lung ; Rare Diseases ; S100 Proteins ; Transaminases

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Lesion Mimicking Lung Tumor.

Hoon KO ; Yongseon CHO ; Yang Deok LEE ; Min Soo HAN ; Dong Wook KANG

Tuberculosis and Respiratory Diseases.2004;57(2):197-200. doi:10.4046/trd.2004.57.2.197

A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, 3.5x2 cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.
Actinomycosis ; Aged ; Basophils ; Biopsy ; Biopsy, Fine-Needle ; Bronchoscopy ; Diagnosis ; Female ; Humans ; Hyalin ; Lung* ; Lymph Nodes ; Microscopy ; Sulfur ; Thorax ; Tomography, X-Ray Computed ; Uterine Prolapse

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A Case of Acute Respiratory Distress Syndrome Induced by Injection of Silicone Fluid for Colpoplasty.

Chang Wook JUNG ; Ik Soo JEON ; Jae Young JANG ; Jee Eun PARK ; Chun Young SONG ; Sung Hun KIM ; Kyung Woo KANG

Tuberculosis and Respiratory Diseases.2004;57(2):193-196. doi:10.4046/trd.2004.57.2.193

Acute respiratory distress syndrome after silicone fluid injection is uncommon. Reasons that organic silicone is inactive in the human body and has low surface tension and is not affected by physical factors such as time or temperature make this material to be widely used as a medical product. However, lately some of its side effects have been noted and also cause respiratory problems in rare occasions. The mechanism is not clear but silicone injection cause one to cough, produce hemoptysis, fever, pleuritic chest pain, and dyspnea, and may even lead to acute respiratory failure. In other countries, these side effects were reported from 1970s and several cases started to appear in Korea from 1990s. We report a 58 years-old female who recovered from acute respiratory distress syndrome after injection of silicone fluid into vaginal wall by a conservative therapy.
Chest Pain ; Cough ; Dyspnea ; Female ; Fever ; Hemoptysis ; Human Body ; Humans ; Korea ; Middle Aged ; Respiratory Distress Syndrome, Adult* ; Respiratory Insufficiency ; Silicones* ; Surface Tension

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A Case of Isolated Pulmonary Takayasu's Arteritis Combined with Pulmonary Thromboembolism and Hyperthyroidism.

Jae Sun UHM ; Jung Hyun KWON ; Tae Woo KIM ; Jeong Seon JI ; Jin Woo KIM ; Seung Joon KIM ; Sook Young LEE ; Young Kyoon KIM ; Sung Hak PARK

Tuberculosis and Respiratory Diseases.2004;57(2):188-192. doi:10.4046/trd.2004.57.2.188

Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.
Aorta ; Cerebral Infarction ; Chest Pain ; Constriction, Pathologic ; Dizziness ; Dyspnea ; Hypertension ; Hyperthyroidism* ; Pulmonary Artery ; Pulmonary Embolism* ; Takayasu Arteritis*

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Recurrent Secondary Pneumothorax Caused by Bronchiolitis Obliterans Due to Chronic Graft Versus Host Disease in a Patient with Chronic Myelogenous Leukemia after Allogenic Bone Marrow Transplantation.

Chul Min AHN ; Sang Yun HWANG ; Min Kwang BYUN ; Jin Hyoung LEE ; Wou Young CHUNG ; Jin Wook MOON ; Moo Suk PARK ; Yoo Hong MIN ; Se Kyu KIM ; Joon CHANG ; Sung Kyu KIM ; Haeryoung KIM ; Hoguen KIM ; Young Sam KIM

Tuberculosis and Respiratory Diseases.2004;57(2):183-187. doi:10.4046/trd.2004.57.2.183

Bronchiolitis obliterans (BO) is a nonspecific inflammatory injury affecting primarily the small airways. Its inflammatory process is characterized by fibrotic obliteration of the lumen of bronchioles. BO can be idiopathic or associated with connective tissue disease, inhaled toxins, infections, drugs, and chronic graft-versus-host-disease (GVHD). Pulmonary complications occur in 40~60% of patients who undergo allogeneic bone marrow transplantation (BMT), causing 10~40% of transplant-related deaths. BO is a characteristic pulmonary complication which occurs usually within a few years after BMT. Documented complications of BO include air-leak syndromes such as pneumomediastinum, subcutaneous emphysema and pneumothorax. We report a case of a 30-year-old male patient with BO due to chronic GVHD after allogenic BMT who presented with recurrent bilateral pneumothoraces.
Adult ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchioles ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Connective Tissue Diseases ; Graft vs Host Disease* ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Male ; Mediastinal Emphysema ; Pneumothorax* ; Subcutaneous Emphysema ; Transplants*

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