Spontaneous Bacterial Empyema in a Patient with Liver Cirrhosis / 감염

Spontaneous bacterial empyema (SBEM), a relatively rare complication of liver cirrhosis, is characterized by a bacterial infection of the transudative pleural fluid without obvious infection focus within the thoracic cavity. The analysis of pleural fluid shows characteristic 'infected transudate' with occasional identification of causative organism as in spontaneous bacterial peritonitis. The outcome is relatively favorable with early identification of the disease and subsequent proper an-tibiotic therapy alone. Closed horacotomy is not nece- ssary in most cases and may be even more hazardous. We report a case of SBEM in a 37-year old male patient with hepatitis B-virus associated liver cirrhosis, who recovered with antibiotic therapy alone.

A Case of Broncho-esophageal fistula associated with Bronchiectasis / 결핵

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment. To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.

A Case of Bronchial Granular Cell Tumor / 결핵

Granular cell tumor (GCT) of tracheobronchial tree is a rare neoplasm comprising approximately 6-10% of all GCT and about 1.6% of all benign tumors of the tracheobronchial tree. Since the first observation of GCT in the bronchus by Kramer in the late 1930s, less than 100 cases have been reported in tracheobronchial tree, and probably no such case have been published in Korea yet. Here we report an experience concerning 53 year-old women with an active pulmonary tuberculosis, who also was diagnosed to have a bronchial GCT on bronchoscopy and immunohistochemistry of the specimens.