Clinical Analysis of Primary Mediastinal Tumors / 대한흉부외과학회지

We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%), and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed in 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's lymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.

Ruptured Aneurysm of Descending Thoracic Aorta due to Salmonella Arteritis: 1 case report / 대한흉부외과학회지

A very rare case of mycotic aneurysm in the descending thoracic aorta due to salmonellosis was treated in our hospital. The patient was a 62 year-old male who 48 days before the operation was admitted to the department of internal medicine complaining of fever, nausia, vomiting, and loose stool. He was treated for 35 days and discharged. Three days after discharge, however, the patient was readmitted to the hospital complaining of right upper quadrant abdominal pain. Fever developed on the third hospital day, and on the eighth hospital day, the patient complained of back pain and epigastric pain. A simple chest x-ray showed evidence of hemothorax in the left plueral space, and therefore, computed tomography of the chest was done. The patient was diagnosed as a ruptured mycotic aneurysm of the descending thoracic aorta, and was transferred to our Department of Thoracic and Cardiovascular Surgery. The aneurysm and infected tissues was widely debrided, and the site was then patched with a Dacron graft. Salmonella choleraesuis was identified in the blood and aneurysm cultures, and antibiotics were administered for 6 weeks according to the sensitivity of the organism. The patient experienced no complication thereafter and for the last three months since the operation, he has been leading a healthy and normal social life.