Cystic Neck Mass in an Adult: Unusual Manifestation of a Mediastinal Mature Teratoma

Anterior mediastinal teratomas are congenital tumors containing derivatives of all three germ layers. They usually grow slowly and are often detected incidentally by imaging studies. We describe the case of a 38-year-old man with an anterior mediastinal teratoma extending to the anterior neck, which resulted in a cystic neck mass.

An esophageal duplication cyst that presented with sudden-onset dysphagia / 대한내과학회지

Esophageal duplication is a rare congenital disorder. Although infrequent, complications such as infection, bleeding, and perforation have been reported. Surgical resection is the standard treatment for esophageal duplication cysts. We report the case of a 45-year-old female with an esophageal duplication cyst that presented with dysphagia, with a review of the literature.

Tracheobronchial Stenosis due to Malrotation of the Heart: A case report / 대한흉부외과학회지

We experienced tracheobronchial stenosis caused by malrotation of the heart in a 3-year-old girl. Malrotation of the heart is induced by the decreased right lung volume, which was the result of right lung hypoplasia and herniation of the left thoracic cavity. We corrected the right lung volume and location of the heart to treat tracheobronchial stenosis.

Analysis of Risk and Benefit of Open Lung Biopsy in Severe Immunocompromised Patients with Pulmonary Complications / 대한흉부외과학회지

BACKGROUND: Pulmonary complications in immunocompromised patients are often fatal. Empirical treatment is usually applied based on the clinical and radiological findings because of the risk of the aggressive diagnostic procedures such as open lung biopsy. However, recent advancements in operative procedures and perioperative management has decreased the procedure-related risks. We have prospectively analyzed the risks and benefits of the early application of open lung biopsy in such patients. MATERIAL AND METHOD: Forty-two consecutive immunocompromised patients with critical pulmonary complications were included from June, 1996 to December, 1999. The definition of the immunocompromised is as those with chemotherapy and/or other modality for hematologic disorders, with usage of immunosuppressive drug after transplantation, with usage of steroid for more than 1 month, and with primary immunodeficiency disorders. The indication of open lung biopsy was those with no significant improvement after a week of aggressive application of empirical treatment or with rapidly aggressive process. The underlying disease included hematologic disorder(31 patients), post-transplantation(3 patients), chemotherapy for solid tumor(2 patients), and others(6 patients). Operations were done through thoracotomy(conventional or mini-) or VATS. RESULT: One patient died on the first postoperative day and seven patients died in the hospital after the operation but none was related to the operation. Preoperative usage of steroid and preoperative mechanical ventilator-dependency was significantly related to the in-hospital mortality but the other factors such as thrombocytopenia and neutropenia had no relation to the in-hospital mortality. There was no major or minor surgical complication except for prolonged air leak(1 patient). Postoperative diagnosis included infectious diseases (26 diagnoses; fungal, 20; pyogenic bacteria, 3; mycobacteria, 2; viral, 1), inflammatory disorders(6 diagnoses), malignancy(2 diagnoses), and nonspecifically-defined disorders(13 diagnoses). In 35 patients(81.4%) treatment plans were changed after open lung biopsy and 30 patients(69.8%) improved after change of treatment. CONCLUSION: Open lung biopsy in immunocompromised patients with pulmonary complications can be done with acceptable risk and significant benefit. For accurate diagnosis, adequate treatment, and better prognosis, the early application of open lung biopsy should be considered when the empirical treatment does not improve the patient's condition.

The Toxicity of Cisplatin Administered by Isolated Lung Perfusion in Dogs / 대한암학회지

PURPOSE: This research was designed to evaluate the chronic effect of isolated lung perfusion (ILP) with cisplatin on dogs. MATERIALS AND METHODS: Fifteen dogs were divided into three groups. Group I was in ILP without cisplatin, group II with 2.5 mg/kg and group III with 5.0 mg/kg of cisplatin for 30 minutes respectively. Serial blood samples were taken before and after ILP for quantitative analysis of serum lactate dehydrogenase (LDH) and blood urea nitrogen/creatinine (BUN/Cr). The specimens from the lung were obtained 2 weeks after ILP. RESULTS: There were no statistic significant differences in LDH concentration according to the time interval among the groups. The LDH concentration peaked at 1 week after ILP and declined thereafter to the pre-ILP concentration. The concentration of BUN/Cr was in normal range. Histologic examination showed no pathologic change. No significant histopathologic differences were found in the pulmonary parenchyme and vasculature among the groups. All of the dogs survived without complication 2 weeks after ILP. CONCLUSION: In ILP with cisplatin of 5.0 mg/kg in normal dog, the toxicity of cisplatin itself was not observed. With further study about the technique of ILP with cisplatin it would be effective to deliver high concentration of cisplatin into the target tissue minimizing lung damage.