A Case of Pulmonary Alveolar Proteinosis that Improved with GM-CSF Inhalation Therapy / 대한내과학회지

Pulmonary alveolar proteinosis (PAP) is a rare condition that is treated using whole lung lavage. A recent study suggested that granulocyte-macrophage colony stimulating factor (GM-CSF) plays roles in both the pathogenesis and treatment of PAP. We present a 69-year-old man with PAP who deteriorated despite bilateral whole lung lavage; that said, his symptoms, chest X-ray findings, and pulmonary function test improved after GM-CSF inhalation therapy over 12 months. GM-CSF therapy is an effective treatment modality for PAP.

A Huge Mediastinal Organizing Hematoma Causing Reversal of Atrial Septal Defect Shunt Flow

We report a case of a 46-year-old woman who presented with subacute exertional dyspnea and severe hypoxia. A large cystic mass compressing the right side of the heart along with right-to-left atrial shunt flow through an alleged atrial septal defect (ASD) were detected on echocardiography. CT scan of the chest and MRI of the heart revealed a loculated cystic mediastinal mass with hemorrhage measuring 5.5x8 cm compressing the right atrium and ventricle. The patient underwent cyst resection and primary closure of the ASD. This report illustrates a case of an unusual symptomatic pericardial mass compressing the right atrium and ventricle in a patient with an secundum ASD.

A Huge Mediastinal Organizing Hematoma Causing Reversal of Atrial Septal Defect Shunt Flow

We report a case of a 46-year-old woman who presented with subacute exertional dyspnea and severe hypoxia. A large cystic mass compressing the right side of the heart along with right-to-left atrial shunt flow through an alleged atrial septal defect (ASD) were detected on echocardiography. CT scan of the chest and MRI of the heart revealed a loculated cystic mediastinal mass with hemorrhage measuring 5.5x8 cm compressing the right atrium and ventricle. The patient underwent cyst resection and primary closure of the ASD. This report illustrates a case of an unusual symptomatic pericardial mass compressing the right atrium and ventricle in a patient with an secundum ASD.

A Case of Esophageal Lymphoepithelioma-like Carcinoma / 대한소화기내시경학회지

Lymphoepithelioma-like carcinoma (LELC) of the esophagus is an extremely rare tumor and the prognosis is favorable. We present here a case an esophageal LELC that showed no definite progression for 5 years. An esophageal tumor was found during screening endoscopy for a 72-year-old asymptomatic Korean woman. At first the histology showed no abnormal findings. No treatment was done for the lesion. Five years later, a follow-up endoscopy showed the same tumor in the esophagus. The size and shape of the esophageal tumor seemed unchanged during the follow-up. The lesion was a round elevated lesion that measured approximately 2.5 cm in the lower esophagus. The covering mucosa looked smooth, but there were erosions on top of the tumor. Biopsy showed an undifferentiated carcinoma associated with a dense lymphocytic and plasma cell infiltration, which are typical findings of LELC.