ABSTRACT
A 72-year-old woman underwent a close examination because of chest computed tomography (CT) scan revealed a nodule in the left lower lobe of the lung. Positron emission tomography( PET) showed strong accumulation of fluorodeoxyglucose (FDG) in the lesion. Since lung cancer was strongly suspected, video-assisted thoracoscopic lung biopsy was performed. The lesion was diagnosed as organizing pneumonia by pathology. PET is widely used to distinguish between benign and malignant lung nodules, but FDG accumulation can also be seen in benign diseases such as inflammatory lesions. Abnormal accumulation can also be seen in organizing pneumonia, but strong FDG accumulation such as in this case is relatively rare, and it was difficult to distinguish it from lung cancer.
Subject(s)
Lung Neoplasms , Organizing Pneumonia , Pneumonia , Female , Humans , Aged , Lung Neoplasms/pathology , Fluorodeoxyglucose F18 , Radiopharmaceuticals , Pneumonia/diagnostic imaging , Positron-Emission Tomography/methodsABSTRACT
Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal and predominantly inherited disorder. A 43 year-old woman was admitted to our hospital for right spontaneous pneumothorax and the thoracoscopic pulumonary wedge resection was performed. A chest computed tomography (CT) scan before surgery showed multiple bilatetal thin walled pulmonary cysts predominant to the lower mediastinum side of the lung field. Since her brother had history of pneumothorax with BHD syndrome. Diagnosed by deoxyribonucleic acid (DNA) sequence analysis of his BHD gene, she was diagnosed as BHD syndrome.
Subject(s)
Birt-Hogg-Dube Syndrome , Cysts , Lung Diseases , Pneumothorax , Humans , Male , Female , Adult , Pneumothorax/etiology , Pneumothorax/genetics , Birt-Hogg-Dube Syndrome/complications , Birt-Hogg-Dube Syndrome/genetics , Birt-Hogg-Dube Syndrome/diagnosis , Lung Diseases/diagnosis , Tomography, X-Ray Computed , Thorax , Cysts/diagnosisABSTRACT
A 55-year-old woman was referred to our department for further examination for chest abnormal shadow in the right lower lobe. Chest computed tomography (CT) showed two nodules in the right lower lobe and positron emission tomography( PET)-CT showed abnormal accumulation of fluorodeoxyglucose (FDG) only in the main lesion. Because of lung cancer could not be denied, she underwent a partial resection of the right lower lobe. The main lesion was diagnosed as granuloma and the other was tumorlet by pathology. Although pulmonary tumorlet is considered a proliferation of neuroendocrine cells rather than a neoplastic lesion, it is sometimes difficult to distinguish it from a neoplastic lesion because its histologic morphology resembles carcinoid or small cell carcinoma.
Subject(s)
Lung Neoplasms , Nontuberculous Mycobacteria , Female , Humans , Middle Aged , Lung , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/surgery , Lung Neoplasms/complications , Positron-Emission Tomography , Fluorodeoxyglucose F18ABSTRACT
A 57-year-old man was referred to our department for further examination for chest abnormal shadow in the right upper lobe. Positron emission tomography (PET)-computed tomography (CT) showed abnormal accumulation of fluorodeoxyglucose (FDG). Because of lung cancer could not be denied, he underwent right upper lobectomy and the nodule was diagnosed as adenocarcinoma by pathology. A chest CT performed one and a half years after surgery showed multiple lung nodules and was diagnosed as recurrence. Since the deletion mutation of exon19 was confirmed in the epidermal growth factor receptor( EGFR) gene mutation analysis, gefitinib( 250 mg/day) daily administration was started. Multiple lung nodules were almost banished promptly, but severe skin rash developed, so gefitinib administration was reduced to 250 mg/every second day and the skin rush disappeared. In spite of reduced dose antitumor effect was maintained for two years without recurrence of skin rash.
Subject(s)
Exanthema , Lung Neoplasms , ErbB Receptors/genetics , Fluorodeoxyglucose F18 , Gefitinib/therapeutic use , Humans , Lung/pathology , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/surgery , Male , Middle Aged , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/drug therapyABSTRACT
A 60-year-old woman was referred to our department for further examination for chest abnormal shadow in the right upper lobe. She had a past history of rheumatoid arthritis. Positron emission tomography-computed tomography (PET-CT) showed mild abnormal accumulation of fluorodeoxyglucose (FDG). Because of lung cancer could not be denied, she underwent partial resection of the right upper lobe and the nodule was diagnosed as a rheumatoid nodule by pathology.
Subject(s)
Lung Neoplasms , Rheumatoid Nodule , Biopsy , Female , Humans , Lung , Lung Neoplasms/diagnostic imaging , Middle Aged , Positron Emission Tomography Computed Tomography , Rheumatoid Nodule/diagnostic imagingABSTRACT
A 50-year-old man was admitted to our hospital for severe pneumonia. An anterior mediastinum tumor and the hypogammaglobulinaemia were detected during treatment of pneumonia, and Good's syndrome was diagnosed. The clinical characteristics of Good's syndrome are increased susceptibility to bacterial infections and opportunistic viral and fungal infections. We planned thymectomy with the perioperative supplementation of immunoganmmagloblin to prevent perioperative infectious complications after pneumonia recovered completely. Extended thymo-thymectomy was performed. Pathological examination revealed type AB thymoma. The hypogammaglobulinaemia did not improved following thymectomy, and the patient had to be treated by immunoglobulin supplementation to maintain adequate trough immunoglobulin G( IgG) values.
Subject(s)
Agammaglobulinemia , Immunologic Deficiency Syndromes , Thymoma , Thymus Neoplasms , Humans , Immunologic Deficiency Syndromes/complications , Male , Middle Aged , Thymectomy , Thymoma/complications , Thymoma/surgery , Thymus Neoplasms/complications , Thymus Neoplasms/surgeryABSTRACT
OBJECTIVE: Because extensively drug-resistant tuberculosis has emerged, adequate control of drug-resistant tuberculosis has become increasingly important. We report on our experience using liberal adjuvant resectional surgery as part of aggressive treatment for multidrug-resistant tuberculosis. METHODS: We retrospectively reviewed the records of 56 consecutive patients who underwent pulmonary resections for multidrug-resistant tuberculosis between January 2000 and June 2007. There were 42 males and 14 females (mean age, 46 years; range, 22-64 years). Isolates were resistant to a mean of 5.6 drugs (range, 2-10 drugs). Multi-drug regimens employing 3 to 7 drugs (mean, 4.6 drugs) were initiated in all patients. Indications for surgery were a high risk of relapse for 37 patients, persistent positive sputum for 18, and 1 with associated empyema. RESULTS: The 56 patients underwent 61 pulmonary resections (3 completion pneumonectomies, 19 pneumonectomies, 33 lobectomies, and 6 segmentectomies). Bronchial stumps were reinforced with muscle flaps in 54 resections. Operative mortality and morbidity rates were 0% and 16%, respectively. All patients attained postoperative sputum-negative status. Relapse occurred in 5 patients; 3 were converted by a second resection, and 1 responded to augmentation of chemotherapy. Late death occurred for 2 patients without evidence of relapse. Among 54 survivors, 53 (98%) were considered cured. CONCLUSION: Surgical treatment that complements medical treatment has proved safe and efficacious for patients with multidrug-resistant tuberculosis. In an era with extensively drug-resistant tuberculosis, an aggressive treatment approach to multidrug-resistant tuberculosis continues to be justified until a panacea for this refractory disease is available.