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RISS 인기검색어
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- 저자 : 김승률 ( Kim Seung Lyul ) (검색결과 1 건)
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이종인 ( Lee Jong In ),이상수 ( Lee Sang Su ),원구태 ( Won Gu Tae ),안강현 ( An Gang Hyeon ),이성우 ( Lee Seong U ),백순구 ( Baeg Sun Gu ),김승률 ( Kim Seung Lyul ),용석중 ( Yong Seog Jung ),신계철 ( Sin Gye Cheol ),정순희 ( Jeong 대한내과학회 1993 대한내과학회지 Vol.44 No.2
N/A Background : Because there aremany different reporting results about the etologies of solitary pulmonary nodules (SPNs), we cannot know the exact incidence of each causative disease. SPNs have a good prognosis relatively even if it is a malignant lesion. In Korea, where there is a high incidence of pulmonary tuberculosis, the differential diagnosis of SPNs should be performed. Methods : Among 351 patients who visited Wonju Chistian Hospital for SPNs in chest x-ray between 1982 and 1989, we evaluated 74 patients in whom the causes of SPNs could be elucidated by sputum AFB study, cytology, histolgic study, chest of solitary pulmonary nodule (SPN) seen at the Wonju Christian Hospital from 1982 to 1989. The followings were obtained. 1) The malignancies of SPN 74cases were 25 cases (33.7%). The primary lung carcinomas were 24 cases : The epidermoid carcinomas of these were 11 cases (45.8%), metastasis I case, tuberculoma 42 cases, and the other 7 cases. 2) The age distribution of benign lesions was from 19 to 73 years old with the mean age of 46 years old, and the age distribution of malignancies was from 17 to 77 years old with the mean age of 57 years old. The 23 cases (92.0%) of malignant nodules were more than 40 years old. The malignant frequency of SPN in a group of age more than 40 years old was 40.3% and in a group of age less than 40 years old, it was 11.7%. The malignant frequency was directly proportional to the increase of age(p<0.05). 3) The 3 cases of SPN were detected accidentally during physical up, all were benign. The 14 cases were detected during the evaluation of other diseases, 12 cases were benign. The 23 cases (40%) of 57 cases were symptomatic. Chest pain, dyspnea, and weight loss frequency in a group of less than 3cm in size was 11.9% and in a group of less than 3cm in size, it was 62.5% (p<0.05). 6) Calcifications were noted in 15 cases of 74 cases on the plain films, all were 7 central types, 7 diffuse types and 1 popcorn type. One of malignant cases had calcification on the chest CT scar. Among the 59 cases with non-calcified nodules, 25 cases were malignant (42.3%). The mean Hounsfield Unit of benign lesions was 182.5U and that of malignancies was 94U, there was a statistical difference between both groups(p<0.01). 7) The 21 cases (50%) of tuberculomas were located at the apicoposterior segment of upper lobe or the superior segment of lower lobe, but the 7 cases (28%) of malignancies were located at above sites. 8) The diagnostic accuracy of sputum study was 9.4% and that of fiberoptic bronchoscopy (FOB) was 33.3%. The diagnostic accuracy of transbronchial lung biopsy (TBLB) and transthoracic needle aspiration biopsy (TTNAB) was 57.4%. The percentage of primary lung cancer among SPNs which are larger than 3cm in size, occurring in the age of older than 40 years old and with no calcifications on radiologic examintion should be suspected as malignancies and diagnosed with sputum study, fiberoptic bronchoscopy, TBLB, and TTNAB.
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