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A 60-year-old woman was referred for 64-slice multidetector computed tomography because of the incidental findings of abnormality on a chest radiograph. Her computed tomography showed an absent right lung and a rudimentary main bronchus ending in a blind pouch; this established the diagnosis of pulmonary aplasia. We report here on a rare case of incidentally found right pulmonary aplasia, and we include a brief review of the relevant literature.

Malignant melanoma accounts for 1.5% of all reported cancers with prevalence increasing in the past decade. Skin is the most common site for primary malignant melanoma, but it can involve virtually every organ system where melanin cells exist. They can frequently metastasize to the liver, lung, brain and bone before the primary lesion in the skin is clinically evident (1). Here, we report a case of malignant melanoma representing superior mediastinal mass without extrathoracic primary lesion.

증례 보고 39세 남자가 건강검진상 시행한 흉부 X선 사진에서 이상소 견으로 호흡기내과 외래에 방문하였다. 환자는 동반되는 호흡 기 증상은 없었고 다른 기저 질환의 병력이나, 외상, 입원, 수술 의 기왕력은 없었다. 가족력상에도 특이사항이 없었다. 흉부 후전 사진상에서 왼쪽 폐첨부에 흉막하종양 또는 폐종 양이 의심되었다(Fig. 1A). 이후 시행된 흉부전산화단층촬영 (Chest CT; 이하 CT)상에서 경계가 명확한 여러 개의 타원형 종양이 좌상부 흉강에서 발견되었으며 두 번째 늑골에 연하여 흉막에 넓게 접하고 있었으며 주변조직과의 경계는 명확하였 다. 조영증강 후 CT에서 여러 개의 타원형 종양은 조영증강이 안 되는 균질한 저음영을 보였으며 내부에 조영증강되는 고형 부분은 없었다(Fig. 1B). 흉강경상에서 두 번째 늑골사이 공간에 위치하며 두 번째 늑 간신경을 따라서 분포하는 다발성 종양이 있었고(Fig. 1C) 종 양을 완전 절제하였으며 다발성 종양은 흉막, 늑간근과 늑골 로부터 쉽게 분리되었다. 육안상 종양은 연한 노란색을 띠고 매끈한 피막으로 둘러싸 여 있었으며 내부에는 많은 수의 낭성 종양과 여러 개의 작은 결절들이 있었다(Fig. 1D). 작은 결절들에 대한 현미경 검사에 서는 여러 개의 결절 모두에서 방추형 세포가 주로 보였으며, 세포 밀도가 낮고 여러 개의 낭성변성을 보였다(Fig. 1E). 이에 Case Report pISSN 1738-2637 J Korean Soc Radiol 2012;66(3):267-270

Neurofibromatosis type I is an autosomal dominant disease with variable clinical manifestations related to dermatologic, neurologic, skeletal, and endocrine system. Lung parenchymal involvement such as lung fibrosis and massive bullous emphysema is infrequent. Here, we report on a 36-year-old man with symptoms of dyspnea, and who has a spontaneous pneumothorax, multiple bullae, and pathologically confirmed neurofibromatosis type I.

= Abstract = The term tracheal bronchus refers to an abnormal bronchus that comes directly off of the lateral wall of the trachea (above the carina and supplies ventilation to the upper lobe. Tracheal bronchi occur almost exclusively on the right trachea and are associated with other congenital anomalies. In addition tracheai bronchus may be related to other inflammatory conditions with persistent wheezing such as recurrent pneumonia chronic bronchitis and bronchiectasis which is a result of the relatively poor local drainage of the involved bronchi. An infant with recurrent wheezing is likely to be a challenge for a clinician in the evaluation of the etiology of airway obstruction and in the differential diagnosis of wheezy breathing. The authors report a case of an 8-month-old female infant with a ventricular septal defect who presented with stridor and recurrent respiratory infection and finally was finally diagnosed with a tracheal bronchus using computed tomography and a bronchoscopy. Therefore tracheal bronchus should be included in the differential diagnosis of any child who presents with chronic or recurrent respiratory tract symptoms such as coughing wheezing stridor and recurrent respiratory infection particularly in children with other congenital deformities. (Korean J Pediatr 2008;51:660-664

An acute aortic thrombosis in the absence of atherosclerosis, aortic dissection, or aneurysm is an infrequent clinical entity and has been rarely reported in the literature. However, because of serious complications such as an embolism that can be fatal, one should always pay attention to the possibility of its occurrence. We report two cases of an acute aortic thrombosis of lung cancer patients treated with chemotherapy and a review of the literature.

The clinical and radiographic findings of lung cancer have been well established many journals. Even if the radiographic findings of lung cancer show a typical pattern, the specific cell type of lung cancer sometimes needs to be determined prior to a pathological diagnosis. For example, the usual finding of a squamous cell carcinoma is similar to other cancer types such as an adenocarcinoma or a small cell carcinoma but with a lower incidence. Therefore, it should not be used to make a diagnosis of the cell type prior to a pathological diagnosis. Many unusual findings of lung cancer, so called atypical pattern have been reported, but atypical findings are widely accepted. The more important thing is not to diagnose a specific cell type of cancer but to differentiate it from other benign conditions such as tuberculosis, fungal infections or organizing pneumonia. This paper presents typical information of the cell type of lung cancer along with the atypical radiographic findings.

We report a very rare case of mediastinal tuberculosis in a 57-year old woman who presented with a large mediastinal cyst on chest radiography. She had a 10-year history of exertional dyspnea, but felt comfortable at a rest. A subsequent chest CT suggested a mediastinal cyst with mediastinal lymphadenopathy and communicating pericardial sac. She underwent a thoracotomy and excision of the mass, which was histologically revealed to be of tuberculous origin. Although rare, the apparent increase in the incidence of tuberculosis may result mediastinal cysts being diagnosed mediastinal tuberculosis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.

Many disorders and abnormalities are accompanied by cavitary lesoin of the lung and one of the most common causes of cavitary lung disease are primary and metastatic lung neoplasms. but cavitary formation of primary lung cancer is not frequent and cavitary or cystic pulmonary metastases of this is also rare. We report a case of cavitary pulmonry metastases of primary lung cancer proven by bronchoscopic biopsy and chest CT. The patients was 60 year-old heavy smoker who had no known underlying lung diseases 7 years ago and complained chronic cough. The chest CT showed primary lung cancer in right low lobe with multiple cavitary or cystic metastases in both lungs and multiple lymphatic metastases.

Leiomyomas are the most common benign tumors found in the esophagus. They are mostly solitary and multiple diffuse lesions are rare, occurring in only 2.4% of cases (1). We describe the case of a 13-year-old boy with a history of Alport syndrome who complained of progressive dysphagia and postprandial vomiting, and in whom diffuse leiomyomatosis of the esophagus was diagnosed. Chest PA showed mediastinal widening, and a barium study revealed diffuse esophageal wall thickening with dilatation, and obstruction at the level of the distal esophagus. Manometry showed increased pressure in the lower esophagus, and CT demonstrated diffuse thickening of the entire esophageal wall and an intraluminal mass in the distal esophagus. Follow-up CT three years later showed further esophageal wall thickening, as well as luminal narrowing. By means of distal esophagectomy, diffuse leiomyomatosis involving the entire esophageal wall and intraluminal mass was diag-nosed.

Purpose : To evaluate the incidence and type of low attenuation seen on high resolution computed tomogra-phy (HRCT) performed after artificially induced pulmonary embolism. Materials and Methods : Using permanent embolic materials, pulmonary embolism was induced in ten Yorkshire pigs. Pre- and postembolic pulmonary angiography was performed, and HRCT was performed im-mediately and 1, 3, and 6 weeks after embolization. The incidence and type of low attenuation of all segments, as seen on HRCT, was evaluated. Low attenuation was classified as mottled, lobular, segmental, or peripheral. The pigs were sacrified after 6 weeks and contact radiographs were obtained. Results : Low attenuation developed in eight of ten pigs. Pulmonary angiography revealed arterial occlusion in 15 large and 19 small segmental arteries (34 of 45 segments). In the remaining 11 segments, follow-up HRCT demonstrated areas of low attenuation. This was present in 25 of 35 segments (71%) as seen on HRCT images obtained immediately; in 16 of 41 segments (39 %) on images obtained 1 week after embolization; in 17 of 41 segments (41 %) on those acquired at 3 weeks; and in 25 of 45 segments (56 %) on those acquired at 6 weeks. The overall incidence of low attenuation was 83/166 (50 %). The types of low attenuation were mottled in 32/83 cases, lobular in 13/83, segmental in 13/83, and peripheral in 25/83. In large segmental arterial occlusion, the incidence of low attenuation on HRCT was 100% immediately, 57% at 1 week, 60% at 3 weeks, and 80 % at 6 weeks. In small segmental arterial occlusion, the incidence was 47%, 25 %, 11 %, and 21 % respectively. The overall incidence of low attenuation was 40/55 (73 %) in large segmental arterial occlusion and 18/71 ( 25%) in small segmental arterial occlusion. Conclusion : Low attenuation on HRCT is a finding of pulmonary embolism and is more common on HRCT performed immediately after embolization (71%) and in large segmental arterial occlusion (73%). Low attenu-ation on HRCT is an ancillary finding and may be useful in the diagnosis of pulmonary embolism.

Purpose : To evaluate the correlation between CT and pathologic findings of pulmonary fat embolism in rabbits. Materials and Methods : In 16 rabbits, pulmonary fat embolism was induced by intravenous injection of autol-ogous bone marrow(mean 3.3 mL). Chest CT scans were obtained immediately(within 1 hour), and 1, 3, and 7 days after embolization. The rabbits were divided into four groups. Group 1 underwent CT scanning immedi-ately after embolization, group 2 immediately and 1 day after embolization, group 3 immediately, 1 day and 3 days after embolization, group 4 immediately, 1 day, 3 days and 7 days after embolization. Pathologic speci-mens were obtained immediately after the last CT scan. Results : The earliest CT findings of pulmonary fat embolism in rabbits were peripheral lung lucency(16/16, 1 00 %), perivascular ground-glass (12/16, 75.0 %) and enlargement of the central pulmonary artery(11/16, 6 8 .8 %). Pathologically, perivascular ground-glass opacity correlated with extensive perivascular alveolar con-gestion and enlargement of the central pulmonary artery correlated with perivascular connective tissue edema and reactive pulmonary arterial engorgement. Peripheral lung lucency was probably caused by embolic occlu-sion of the pulmonary artery and decreased perfusion and air trapping induced by arterial and bronchial s-pasm associated with hypoxia. CT scans obtained 1 and 3 days after embolization showed nodules and patchy ground-glass opacity and consolidation. Aggregation of nodules resulted in patch opacities. Pathologically, pul-monary nodules correlated with focal inflammation surrounding an artery and parenchymal opacity correlat-ed with parenchymal consolidation and hemorrhagic edema. CT scans and pathologic specimens obtained 7 days after embolization showed improvement of parenchymal lung abnormalities. Conclusion : Pulmonary fat embolism in rabbits show CT and pathologic findings which vary with dynamic change. Typical earliest findings of pulmonary fat embolism were peripheral lung lucency, perivascular ground-glass opacity and enlargement of the central pulmonary artery.

We report the case of a 20-year-old female with lymphoma of the breast. Mammography showed an asymmetric pattern of confluent densities without any discrete mass. Sonography revealed diffuse heterogenous echoic mass intermingled with low-and medium level echoes. We present the clinical, radiographic and histologic features of primary breast lymphoma with a brief review of the literatures.

Superior mediastinal widening on chest radiograph in patients with trauma has been considered the hallmark of mediastinal hemorrhage. The usual causes of superior mediastinal widening are hematoma, aortic rupture, and rupture of the esophagus or tracheobronchial tree. Very rarely, a cause of superior mediastinal widening is leakage of the cerebrospinal fluid. This report descrbes a case of superior mediastinal widening from traumatic cerebrospinal fluid leakage with spinal fracture.