Broad-spectrum antimicrobial drugs (vancomycin, aztreonam, azithromycin, and fluconazole) were given but the patient's respiratory status rapidly deteriorated and he was intubated on hospital day 2. Bronchoscopy showed alveolar hemorrhage, and he underwent video-assisted thoracoscopy and right lung wedge resection.
We herein reported a patient presenting focal p-GGN on middle lobe of the right lung who underwent surgical resection with its pathological diagnosis turned out to be typical carcinoid tumor.
The patient had a right lung tumor, and partial resection of the tumor revealed fibrotic changes in the lung interstitium with heavy infiltration of IgG4-positive plasma cells, without malignant change.
In the present case, the predicted postoperative FEV1.0 after right EPP alone, right EPP plus left upper division segmentectomy, and right EPP plus left upper lobectomy were 0.96, 0.70, and 0.43 L/mm2, respectively, indicating that the patient may marginally tolerate right EPP alone and may not tolerate right EPP combined with left lung resection.
Following upper and middle lobe resection of the right lung (03/2000) and external beam irradiation therapy with 70 Gy (06/2007), the patient underwent multiple operations for residual tumor.
As either radiation-induced sarcoma or a local recurrence of EWS was suspected, we performed extirpation of the tumor and chest wall (the left second to the fourth ribs), partial resection of the right lung, and reconstruction of the chest wall (Figure 2b).
At 6 months after the lung metastasis detection, she underwent a thoracoscopic lung surgery of partial resection of S6 of the right lung and S3 and S5 of the left lung and a left lung lower lobectomy.
For pathological diagnosis, the patient underwent thoracoscopic surgery with wedge resection of two lesions from the right lung.
During follow-up, no other tumors appeared, and wedge resection of the lower lobe of the right lung was performed in September 2010.
In experienced hands and careful patient selection, the safety of lung resection for NTM lung disease, particularly thoracoscopic right middle lobe lobectomy and lingulectomy, seems good [ 79].
