Journal of Yeungnam Medical Science

Case report

Idiopathic multicentric Castleman disease presenting progressive reticular honeycomb infiltration of lung and immunoglobulin G and immunoglobulin G4 dominant hypergammaglobulinemia: a case report: Hyun-Je Kim, Young-Hoon Hong; J Yeungnam Med Sci. 2022;39(2):153-160. Published online July 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01039

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Abstract PDF: Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

Focused Review article

An update on the role of bronchoscopy in the diagnosis of pulmonary disease: June Hong Ahn; Yeungnam Univ J Med. 2020;37(4):253-261. Published online August 28, 2020; DOI: https://doi.org/10.12701/yujm.2020.00584

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Bronchoscopy has evolved over the past few decades and has been used by respiratory physicians to diagnose various airway and lung diseases. With the popularization of medical check-ups and growing interest in health, early diagnosis of lung diseases is essential. With the development of endobronchial ultrasound, ultrathin bronchoscopy, and electromagnetic navigational bronchoscopy, bronchoscopy has been able to widen its scope in diagnosing pulmonary diseases. In this review, we have described the brief history, role, and complications of bronchoscopy used in diagnosing pulmonary lesions, from simple flexible bronchoscopy to bronchoscopy combined with several up-to-date technologies.

Citations

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Archivos de Bronconeumología.2024; 60(4): 250. CrossRef
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Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment
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Journal of Korean Medical Science.2021;[Epub] CrossRef
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Review article

Pathological interpretation of connective tissue disease-associated lung diseases: Kun Young Kwon; Yeungnam Univ J Med. 2019;36(1):8-15. Published online January 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00101

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Abstract PDF

Connective tissue diseases (CTDs) can affect all compartments of the lungs, including airways, alveoli, interstitium, vessels, and pleura. CTD-associated lung diseases (CTD-LDs) may present as diffuse lung disease or as focal lesions, and there is significant heterogeneity between the individual CTDs in their clinical and pathological manifestations. CTD-LDs may presage the clinical diagnosis a primary CTD, or it may develop in the context of an established CTD diagnosis. CTD-LDs reveal acute, chronic or mixed pattern of lung and pleural manifestations. Histopathological findings of diverse morphological changes can be present in CTD-LDs airway lesions (chronic bronchitis/bronchiolitis, follicular bronchiolitis, etc.), interstitial lung diseases (nonspecific interstitial pneumonia/fibrosis, usual interstitial pneumonia, lymphocytic interstitial pneumonia, diffuse alveolar damage, and organizing pneumonia), pleural changes (acute fibrinous or chronic fibrous pleuritis), and vascular changes (vasculitis, capillaritis, pulmonary hemorrhage, etc.). CTD patients can be exposed to various infectious diseases when taking immunosuppressive drugs. Histopathological patterns of CTD-LDs are generally nonspecific, and other diseases that can cause similar lesions in the lungs must be considered before the diagnosis of CTD-LDs. A multidisciplinary team involving pathologists, clinicians, and radiologists can adequately make a proper diagnosis of CTD-LDs.

Citations

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Multidisciplinary Approach to the Diagnosis of Idiopathic Interstitial Pneumonias: Focus on the Pathologist’s Key Role
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Original Article

Microbiologic distribution and clinical features of nontuberculous mycobacteria in the tertiary hospital in Daegu.: Kyung Soo Hong, June Hong Ahn, Eun Young Choi, Hyun Jung Jin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee; Yeungnam Univ J Med. 2015;32(2):71-79. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.71

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Abstract PDF

BACKGROUND
Recent studies have shown that the nontuberculosis mycobacterium (NTM) recovery rate in clinical cultures has increased within Korea. However, another study conducted by a secondary hospital within Daegu reported different results. Therefore, the purpose of this study is to understand and evaluate the microbiological distribution and clinical features of NTM in Daegu. METHODS: A retrospective study was conducted on 11,672 respiratory specimens undergoing acid fast bacilli (AFB) culture from 6,685 subjects who visited Yeungnam University Respiratory Center from January 2012 to December 2013. RESULTS: Of the 11,672 specimens undergoing AFB culture, 1,310 specimens (11.2%) showed positive results. Of these specimens, NTM was recovered from 587 specimens, showing a recovery rate of 44.8%. Identification test for NTM was performed on 191 subjects; the results were as follows: M. avium-intracellulare complex (MAC) 123 (64.4%), M. abscessus 20 (10.5%), M. kansasii 12 (6.3%), and 33 other NTM germ strains. Of the 382 subjects with NTM, 167 were diagnosed with pulmonary NTM disease (43.7%), however virulence differed depending on NTM strain. Multivariate analysis showed that nodular bronchiectasis, the nodules, and finding consistent with cavity under imaging study were statistically significant for triggering pulmonary NTM disease. AFB culture showing MAC and M. abscessus was statistically significant as well. Positive predictive value for NTM polymerase chain reaction (NTM-PCR) was 88.6%. CONCLUSION: Results for NTM recovery rate within the Daegu area were similar to those for the Seoul metropolitan area. We can assume that NTM infection is increasing in our community, therefore AFB-positive subjects (1) should undergo NTM-PCR, (2) should have their culture results checked for differentiation of mycobacterium tuberculosis complex (MTB) from NTM, and (3) undergo NTM identification test to confirm its type. Administration of treatment with the above results should be helpful in improving the patients' prognosis.

Citations

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Epidemiological Characteristics of Nontuberculous Mycobacterial Pulmonary Disease in South Korea: A Meta-analysis of Individual Participant Data
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The Korean Journal of Clinical Laboratory Science.2021; 53(3): 225. CrossRef
Study on the Prevalence of Lung Disease of Non-Tuberculosis Mycobacterium Isolated from Respiratory Specimens in Gwangju Second Hospital over the Last 10 Years
Hae-Gyeong Baek
The Korean Journal of Clinical Laboratory Science.2020; 52(4): 349. CrossRef
Recovery Rates of Non-Tuberculous Mycobacteria from Clinical Specimens Are Increasing in Korean Tertiary-Care Hospitals
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Journal of Korean Medical Science.2017; 32(8): 1263. CrossRef

Case Report

Fast-growing multiple symmetric lipomatosis.: Jin Hwa Choi, Byung Su Kim, Seung Hyun Sohng, Hyo Jin Lee, Dong Hoon Shin, Jong Soo Choi, Young Kyung Bae; Yeungnam Univ J Med. 2014;31(1):48-51. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.48

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Abstract PDF: Multiple symmetric lipomatosis (MSL) is a rare disease characterized by symmetrical massive fatty deposits on the face, neck, shoulders, and upper trunk. We report a 74-year-old man who complained of painless subcutaneous nodules on his posterior neck that developed 3 weeks earlier. In a week, variably-sized similar lesions developed on both his shoulders and upper extremities. At the time of his hospital visit, several firm nodules as big as a walnut to a child's fist and with the normal-skin-hue were observed on his posterior neck, both shoulders, upper extremities, and trunk. The histological examination of his upper left arm revealed more mature adipocytes without encapsulation in the subcutaneous tissue. MSL was generally known to occur slowly over months or years. However, this is an unusual case that showed a fast-growing nature.

Original Article

Comparison of Postoperative Results after Pneumonectomy between Lung Cancer and Infectious Lung Disease Groups: Jang Hoon Lee, Jung Cheul Lee; Yeungnam Univ J Med. 2007;24(2 Suppl):S304-309. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S304

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Abstract PDF: Background
：Pneumonectomy has been known with higher rate of morbidity and mortality. Thereby, we evaluated patients who received pneumonectomy for lung cancer and infectious lung disease related to postoperative morbidity and mortality. Materials and methods：The retrospective study was undertaken in 55 patients who had undergone pneumonectomy at Yeungnam University Hospital from January 1996 to December 2004. We devided into two groups, lung cancer group (group A, n=40) and infectious lung disease group (group B, n=15) and then compared and analyzed.
Results
：The mean age was higher in group A and there was statistical significance (60.8 9.4 vs 45.7 12.1, p<0.001). With preoperative pulmonary function test, FEV1, FVC were higher in group A and there were statistical significane (p<0.001, p=0.006). With preoperative lung perfusion scan, the perfusion ratio of affected lung and postoperative predicted FEV1 were higher in group A and there were statistical significance (p<0.001, p=0.007). According to MRC dyspnea scale, change of respiratory difficulty of group A had statistical significance (p<0.001). There were a total 20 postoperative complications (36.4%) of which arrhythmia 7, postoperative bleeding 5, empyema and/or bronchopleural fistula 3, pneumonia 2, adult respiratory distress syndrome 1, vocal cord palsy 1. The postoperative complication rate was no difference between two groups (37.5% vs 33.3%) but arrhythmia developed in group A only. There were 3 postoperative mortalities, all in group A.
Conclusion
：Preoperative pulmonary function test and postoperative predicted FEV1 were lower in group B, however, postoperative complication rate was no difference between two groups and mortality developed in group A only. Because of lesser resected lung volume and well adopted in long term diseased period, there was lesser hemodynamic change in infectious lung disease. So postoperative mortality not developed in infectious lung disease group due to arrhythmia and respiratory failure.

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