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Case Presentation

2016 폐병리 - 흉영 집담회. Case Presentation. 김채리 , 이상민 , 이현주 , 오상영 이상민 , 도경현 , 김미영 , 서준범 , 송재우 , 송군식. Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology. History. 58/M Previous healthy

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Case Presentation

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  1. 2016 폐병리-흉영집담회 Case Presentation 김채리, 이상민, 이현주, 오상영 이상민, 도경현, 김미영, 서준범, 송재우,송군식 Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea Department of Radiology and Research Institute of Radiology

  2. History • 58/M • Previous healthy • 2014-4 CXR에서 이상 소견 없었음 • 2016-2-7기침이 심하였으나 공기오염 때문이라고 생각하고 신경 쓰지 않고 지냄 • 2016-2-28 dry cough 지속되며 열이 나기 시작함 • 2016-3-6 pneumonia라고 생각되어 CXR 시행

  3. Fluoroscopy-guided biopsy

  4. Metastatic Renal Cell Carcinoma without a Renal Primary Metastatic RCC to the pelvic bone Subcutaneous nodule, pancreas, parotid gland

  5. Treatment • Sirolimus (Temsirolimus) • mTOR (mammalian target of rapamycin) kinase inhibitor • 약 7개월 간 치료

  6. 5 months later

  7. 7 months later

  8. Wedge resection, RULExcision, right pleura

  9. Sensitivity of image-guided biopsy versus Surgical biopsy for Pleural Malignant Mesothelioma Radiology 2006;241:589-594 • The use of immunostaining allows for pathologic diagnosis of malignant pleural mesothelioma by using a relatively small tissue sample • The sensitivity of fine-needle aspiration biopsy was only 56% (5/9)

  10. Track seeding: Imaging guided biopsy vs. Surgical biopsy • The incidence of needle track seeding was 4.5% for image-guided core-needle biopsy and 22% for surgical biopsy • Reported track seeding rate • VATS: 50% • Image-guided biopsy:22% 15.7% 23.8% 9.1% 3.6% 4.5% SeminOncol 2002;29:26 –35 J Comput Assist Tomogr 1995;19:370 –374

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