Kyongyob Min - Academia.edu (original) (raw)
Papers by Kyongyob Min
The Journal of the Japan Society for Respiratory Endoscopy
The static properties of the lungs have been explained by energy-change considerations on the ela... more The static properties of the lungs have been explained by energy-change considerations on the elasticity, but this article explains the elasticity of the lungs by entropy-change considerations. Entropy of the individual lobule was defined by application of stochastic geometry on aggregated alveolar polyhedrons. Entropy of the lungs is the result of integrating a number of lobular entro-pies through the fractal bronchial tree. Entropy of the lungs was thus determined by the individual lobular entropy and the connectivity of the bronchial tree to the lobular bronchioles. Thermody-namic considerations on the static conditions of the pulmonary system composed of the lungs and the chest wall have provided a theoretical approach to understand the subdivisions of lung vo-lume as the entropy-change of lungs. Entropy-change considerations on the elasticity of the lungs have shown that alveolar collapse and subsequent alveolar induration as the primary pathway for the loss of elasticity in th...
Kyobu geka. The Japanese journal of thoracic surgery, 2016
A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Ches... more A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Chest computed tomography revealed a collapsed lung and floating membrane, which was the lowermost part as a tear-shaped shadow. After the chest tube was inserted and surgical management was performed using a video-assisted thoracoscopic approach. At surgery, the visceral and parietal layers of pleura forming the mesoazygos were not fused, and azygos vein had a partial mobility. There was no adhesion between an upper lobe and visceral pleura. A stapling bullectomy was performed. The azygos lobe is a common malformation and has a reported incidence of 0.05~0.4% on health screening. The presence of an azygos lobe is usually assumed to be of no significance. We report a case and discuss the problems that it posed for surgical management.
Rinsho byori. The Japanese journal of clinical pathology, 2015
Evaluation of the lung function involves the measurement of many factors. The closing volume (CV)... more Evaluation of the lung function involves the measurement of many factors. The closing volume (CV) curve is clinically important as an index of uneven alveolar ventilation and airway closure. Although conventional methods for CV measurement are usually based on the pattern of the exhaled nitrogen (N2) concentration curve with respect to the lung volume, it is often difficult to measure the steep pattern of patients with chronic obstructive pulmonary disease (COPD). In this paper, we proposed a new method called the "N2 first derivative (fdN) wave method" for measuring CV. The N2 concentration of the CV curve was transformed to a derivative with respect to the lung volume, which revealed the existence of cardiogenic oscillations. Discrimination between phases III and IV was straightforward based on the difference in the slope or in the amplitude of oscillations of the fdN wave. Our new method was able to distinguish phase IV from phase III using the difference in amplitude o...
Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-yea... more Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-year-old man with difficulty in breathing for 3 days was referred to our hospital. He had a history of angiosarcoma of forehead 4 months before. A chest computed tomography (CT) scan showed left pneumothorax with multiple cystic changes and ground grass attenuations of bilateral lungs, which had obviously increased in recent 2 months. Pulmonary metastases with secondary pneumothorax was highly suspected by the serial CT findings. He was treated with tube thoracostomy and the instillation of a sclerosing agent (minocycline hydrochloride 200 mg). Seven weeks after his initial presentation, he died from obstructive pneumonia and an autopsy was held. Histologic examinations revealed that the tumor foci were peripheral, multiple and generally formed nodules. These cells were cluster differentiation (CD)31 and CD34 positive and negative for calretinin, cytokeratin, carcinoembryonic antigen (CEA),...
Respiratory variables, including tidal volume and respiratory rate, display significant variabili... more Respiratory variables, including tidal volume and respiratory rate, display significant variability or the biological variability (BV). Recent studies have suggested that the BV would contain clinical information. The author has been trying to reveal why BV can contain clinical information by application of a stochastic optimal control theory for noisy spontaneous breathing. The author has obtained a Shrodinger’s wave equation for describing noisy breathing. Regarding to Bohm’s model of quantum theory, the author has proposed a new potential field (BV), which would act to integrate cells to an organ. It is necessary to measure biological variability in order to understand what a living organ is.
of fractal geometry to propose a new mechanism of airway-parenchymal interdependence
International Journal of Theoretical and Applied Mathematics
Heliyon
Current trends in monitoring system are leading to the adoption of volumetric capnogram (Vcap). T... more Current trends in monitoring system are leading to the adoption of volumetric capnogram (Vcap). The first derivative wave analysis (FDWA) of Vcap represented the cardiogenic oscillations (CarO) as a propagated wave and the slope of phase III (S III) as a constant. Until today the genesis of CarO and S III is however under debate. In this study, we defined motion profiles of erythrocytes in the pulmonary parenchyma as pulsated-run and randomwalk, on the basis of which we obtained a new mathematical expression describing FDWA of Vcap. The mathematical model of Vcap provided theoretical explanation concerned with motion profiles of erythrocytes about the genesis of CarO and S III. As the results, the mathematical model predicted the close relationship between S III and the transfer factor of carbon monoxide, which will be used for estimating validity of this mathematical model. In addition, the velocity of propagated wave in the phase III was suggested as a new physiological variable to estimate elastic properties of pulmonary arterioles, and a new measuring method of V D was proposed based on the theoretical reason, as well. Clinical investigations of the new V D to test its efficacy of monitoring are needed.
American Review of Mathematics and Statistics
Since 2011, patients with chronic obstructive pulmonary disease (COPD) have been classified into ... more Since 2011, patients with chronic obstructive pulmonary disease (COPD) have been classified into four categories (A to D). Investigators of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study reported stability and changeover time in the distribution of A-B-C-D categories of ECLIPSE cohorts. The rule of change, however, in the distribution seems different among different cohorts, and remains to be clearly defined. We analyzed the ECLIPSE data by Bayes probability model and obtained a mathematical expression of a set of matrices for the rule of change to define the rule of change in the distribution of A-B-C-D categories. Applying the matrices to each category group in the ECLIPSE revealed that there are common distributions of categories among the category groups. We extended this result to each COPD patient as the distribution of A-B-C-D categories of changing conditions over time. Our proposal is optimizing the care and treatment for each COPD patient by targeting the current condition classified with the A-B-C-D categories..
Kyobu geka. The Japanese journal of thoracic surgery, 2016
A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Ches... more A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Chest computed tomography revealed a collapsed lung and floating membrane, which was the lowermost part as a tear-shaped shadow. After the chest tube was inserted and surgical management was performed using a video-assisted thoracoscopic approach. At surgery, the visceral and parietal layers of pleura forming the mesoazygos were not fused, and azygos vein had a partial mobility. There was no adhesion between an upper lobe and visceral pleura. A stapling bullectomy was performed. The azygos lobe is a common malformation and has a reported incidence of 0.05~0.4% on health screening. The presence of an azygos lobe is usually assumed to be of no significance. We report a case and discuss the problems that it posed for surgical management.
Open Journal of Molecular and Integrative Physiology, 2013
Classic respiratory mechanics is a branch of vectorial mechanics, which aims to recognize all for... more Classic respiratory mechanics is a branch of vectorial mechanics, which aims to recognize all forces acting on the respiratory system. Another branch of mechanics, analytical mechanics, has been used for analyzing the motions of complicated systems with constraints through equilibrium among scalar quantities such as kinetic energy and potential energy. However, until now, there have not been any studies concerning about analytical respiratory mechanics. In this paper, the author has obtained two types of motion equations (linear and nonlinear) for the airflow limitation from formulation of the analytical respiratory mechanics. Reconstructed flow-volume trajectories of the linear equation revealed a new relationship among the slope of the linear portion of trajectory, the coefficient of the dissipation function and the coefficient of the potential function. Reconstructed trajectories of the nonlinear equation suggested that a curved flow-volume trajectory would be caused by the emergence of regional hypoventilated clusters with airtrapped lobules. In conclusion, analytical respiratory mechanics will provide the basis for analyzing the mechanical properties of the respiratory system concerning pulmonary functional images made by newly developed technologies.
Rinsho byori. The Japanese journal of clinical pathology, 2015
Evaluation of the lung function involves the measurement of many factors. The closing volume (CV)... more Evaluation of the lung function involves the measurement of many factors. The closing volume (CV) curve is clinically important as an index of uneven alveolar ventilation and airway closure. Although conventional methods for CV measurement are usually based on the pattern of the exhaled nitrogen (N2) concentration curve with respect to the lung volume, it is often difficult to measure the steep pattern of patients with chronic obstructive pulmonary disease (COPD). In this paper, we proposed a new method called the "N2 first derivative (fdN) wave method" for measuring CV. The N2 concentration of the CV curve was transformed to a derivative with respect to the lung volume, which revealed the existence of cardiogenic oscillations. Discrimination between phases III and IV was straightforward based on the difference in the slope or in the amplitude of oscillations of the fdN wave. Our new method was able to distinguish phase IV from phase III using the difference in amplitude o...
Open Journal of Molecular and Integrative Physiology, 2011
Rationale: There is accumulating evidence that a group of stem/progenitor cells (SPCs) maintain a... more Rationale: There is accumulating evidence that a group of stem/progenitor cells (SPCs) maintain alveolar epithelial integrity. Pulmonary emphysema is characterized by the histological finding of the loss of alveolar epithelial integrity along with corresponding bronchiolar fibrosis. Objectives: Based on the concept of autopoiesis (the capacity to produce oneself), we proposed a mathematical model in the maintenance of alveolar epithelial integrity as related to the genesis of pulmonary emphysema and fibrosis. Methods: A tessellation automaton model was used to describe the autopoietic dynamics of the bronchiolo-alveolar epithelial surface. The alveolar septal volume enclosed by the epithelial surface is a distributed system of discrete elements, which move by random walk in the manner of Brownian motion. Assuming that the numbers of components and events in the automaton are large, an approximate theoretical treatment in terms of differential equations is possible, allowing a set of partial differential equations to be produced. Results: 1) Assuming the loss of progenitor cells through the epithelial-mesenchymal transition (EMT), a sharp bifurcation between two qualitatively distinct regions of the phase space (one that is repaired completely, and another that has disappeared entirely) clearly appeared. 2) Thus, from the system of discrete and spatial partial differential equations, we obtained a system of ordinary differential equations in equilibrium conditions that defined a close relationship between the degree of emphysema, the density of alveolar septal fibroblasts, and the mean concentration of SPCs. Conclusions: A mathematical model of the autopoietic maintenance of the alveolar epithelial surface suggested a close relationship between alveolar emphysema and fibrosis and EMT in lungs affected by chronic obstructive pulmonary disease.
Open Journal of Molecular and Integrative Physiology, 2012
Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, and generally correlates ... more Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, and generally correlates with severity of asthma. Understanding the protection mechanism against excessive airway narrowing and how it breaks down is fundamental to solving the problem of asthma. In this paper we have proposed a stochastic modeling the airway smooth muscle bundle for reproducing AHR such as an increased sensitivity of the airways to an inhaled constrictor agonist, a steeper slope of the dose-response curve, and a greater maximal response to agonist. A large number N of contractile muscle cells was assumed to repeat themselves in between contraction and relaxation asynchronously. Dynamic equilibrium of statistic physics was applied to the system of ASM bundle. Thus, the relation of dose to response of a piece of ASM bundle was described by
The Journal of the Japanese Association for Chest Surgery, 2015
Kyobu geka. The Japanese journal of thoracic surgery, 2015
Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-yea... more Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-yearold man with difficulty in breathing for 3 days was referred to our hospital. He had a history of angiosarcoma of forehead 4 months before. A chest computed tomography (CT) scan showed left pneumothorax with multiple cystic changes and ground grass attenuations of bilateral lungs, which had obviously increased in recent 2 months. Pulmonary metastases with secondary pneumothorax was highly suspected by the serial CT findings. He was treated with tube thoracostomy and the instillation of a sclerosing agent (minocycline hydrochloride 200 mg). Seven weeks after his initial presentation, he died from obstructive pneumonia and an autopsy was held. Histologic examinations revealed that the tumor foci were peripheral, multiple and generally formed nodules. These cells were cluster differentiation(CD)31 and CD34 positive and negative for calretinin, cytokeratin, carcinoembryonic antigen (CEA), t...
The Journal of the Japan Society for Respiratory Endoscopy
The static properties of the lungs have been explained by energy-change considerations on the ela... more The static properties of the lungs have been explained by energy-change considerations on the elasticity, but this article explains the elasticity of the lungs by entropy-change considerations. Entropy of the individual lobule was defined by application of stochastic geometry on aggregated alveolar polyhedrons. Entropy of the lungs is the result of integrating a number of lobular entro-pies through the fractal bronchial tree. Entropy of the lungs was thus determined by the individual lobular entropy and the connectivity of the bronchial tree to the lobular bronchioles. Thermody-namic considerations on the static conditions of the pulmonary system composed of the lungs and the chest wall have provided a theoretical approach to understand the subdivisions of lung vo-lume as the entropy-change of lungs. Entropy-change considerations on the elasticity of the lungs have shown that alveolar collapse and subsequent alveolar induration as the primary pathway for the loss of elasticity in th...
Kyobu geka. The Japanese journal of thoracic surgery, 2016
A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Ches... more A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Chest computed tomography revealed a collapsed lung and floating membrane, which was the lowermost part as a tear-shaped shadow. After the chest tube was inserted and surgical management was performed using a video-assisted thoracoscopic approach. At surgery, the visceral and parietal layers of pleura forming the mesoazygos were not fused, and azygos vein had a partial mobility. There was no adhesion between an upper lobe and visceral pleura. A stapling bullectomy was performed. The azygos lobe is a common malformation and has a reported incidence of 0.05~0.4% on health screening. The presence of an azygos lobe is usually assumed to be of no significance. We report a case and discuss the problems that it posed for surgical management.
Rinsho byori. The Japanese journal of clinical pathology, 2015
Evaluation of the lung function involves the measurement of many factors. The closing volume (CV)... more Evaluation of the lung function involves the measurement of many factors. The closing volume (CV) curve is clinically important as an index of uneven alveolar ventilation and airway closure. Although conventional methods for CV measurement are usually based on the pattern of the exhaled nitrogen (N2) concentration curve with respect to the lung volume, it is often difficult to measure the steep pattern of patients with chronic obstructive pulmonary disease (COPD). In this paper, we proposed a new method called the "N2 first derivative (fdN) wave method" for measuring CV. The N2 concentration of the CV curve was transformed to a derivative with respect to the lung volume, which revealed the existence of cardiogenic oscillations. Discrimination between phases III and IV was straightforward based on the difference in the slope or in the amplitude of oscillations of the fdN wave. Our new method was able to distinguish phase IV from phase III using the difference in amplitude o...
Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-yea... more Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-year-old man with difficulty in breathing for 3 days was referred to our hospital. He had a history of angiosarcoma of forehead 4 months before. A chest computed tomography (CT) scan showed left pneumothorax with multiple cystic changes and ground grass attenuations of bilateral lungs, which had obviously increased in recent 2 months. Pulmonary metastases with secondary pneumothorax was highly suspected by the serial CT findings. He was treated with tube thoracostomy and the instillation of a sclerosing agent (minocycline hydrochloride 200 mg). Seven weeks after his initial presentation, he died from obstructive pneumonia and an autopsy was held. Histologic examinations revealed that the tumor foci were peripheral, multiple and generally formed nodules. These cells were cluster differentiation (CD)31 and CD34 positive and negative for calretinin, cytokeratin, carcinoembryonic antigen (CEA),...
Respiratory variables, including tidal volume and respiratory rate, display significant variabili... more Respiratory variables, including tidal volume and respiratory rate, display significant variability or the biological variability (BV). Recent studies have suggested that the BV would contain clinical information. The author has been trying to reveal why BV can contain clinical information by application of a stochastic optimal control theory for noisy spontaneous breathing. The author has obtained a Shrodinger’s wave equation for describing noisy breathing. Regarding to Bohm’s model of quantum theory, the author has proposed a new potential field (BV), which would act to integrate cells to an organ. It is necessary to measure biological variability in order to understand what a living organ is.
of fractal geometry to propose a new mechanism of airway-parenchymal interdependence
International Journal of Theoretical and Applied Mathematics
Heliyon
Current trends in monitoring system are leading to the adoption of volumetric capnogram (Vcap). T... more Current trends in monitoring system are leading to the adoption of volumetric capnogram (Vcap). The first derivative wave analysis (FDWA) of Vcap represented the cardiogenic oscillations (CarO) as a propagated wave and the slope of phase III (S III) as a constant. Until today the genesis of CarO and S III is however under debate. In this study, we defined motion profiles of erythrocytes in the pulmonary parenchyma as pulsated-run and randomwalk, on the basis of which we obtained a new mathematical expression describing FDWA of Vcap. The mathematical model of Vcap provided theoretical explanation concerned with motion profiles of erythrocytes about the genesis of CarO and S III. As the results, the mathematical model predicted the close relationship between S III and the transfer factor of carbon monoxide, which will be used for estimating validity of this mathematical model. In addition, the velocity of propagated wave in the phase III was suggested as a new physiological variable to estimate elastic properties of pulmonary arterioles, and a new measuring method of V D was proposed based on the theoretical reason, as well. Clinical investigations of the new V D to test its efficacy of monitoring are needed.
American Review of Mathematics and Statistics
Since 2011, patients with chronic obstructive pulmonary disease (COPD) have been classified into ... more Since 2011, patients with chronic obstructive pulmonary disease (COPD) have been classified into four categories (A to D). Investigators of the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study reported stability and changeover time in the distribution of A-B-C-D categories of ECLIPSE cohorts. The rule of change, however, in the distribution seems different among different cohorts, and remains to be clearly defined. We analyzed the ECLIPSE data by Bayes probability model and obtained a mathematical expression of a set of matrices for the rule of change to define the rule of change in the distribution of A-B-C-D categories. Applying the matrices to each category group in the ECLIPSE revealed that there are common distributions of categories among the category groups. We extended this result to each COPD patient as the distribution of A-B-C-D categories of changing conditions over time. Our proposal is optimizing the care and treatment for each COPD patient by targeting the current condition classified with the A-B-C-D categories..
Kyobu geka. The Japanese journal of thoracic surgery, 2016
A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Ches... more A-21-year old man presented with dyspnea and a chest radiograph showed a right pneumothorax. Chest computed tomography revealed a collapsed lung and floating membrane, which was the lowermost part as a tear-shaped shadow. After the chest tube was inserted and surgical management was performed using a video-assisted thoracoscopic approach. At surgery, the visceral and parietal layers of pleura forming the mesoazygos were not fused, and azygos vein had a partial mobility. There was no adhesion between an upper lobe and visceral pleura. A stapling bullectomy was performed. The azygos lobe is a common malformation and has a reported incidence of 0.05~0.4% on health screening. The presence of an azygos lobe is usually assumed to be of no significance. We report a case and discuss the problems that it posed for surgical management.
Open Journal of Molecular and Integrative Physiology, 2013
Classic respiratory mechanics is a branch of vectorial mechanics, which aims to recognize all for... more Classic respiratory mechanics is a branch of vectorial mechanics, which aims to recognize all forces acting on the respiratory system. Another branch of mechanics, analytical mechanics, has been used for analyzing the motions of complicated systems with constraints through equilibrium among scalar quantities such as kinetic energy and potential energy. However, until now, there have not been any studies concerning about analytical respiratory mechanics. In this paper, the author has obtained two types of motion equations (linear and nonlinear) for the airflow limitation from formulation of the analytical respiratory mechanics. Reconstructed flow-volume trajectories of the linear equation revealed a new relationship among the slope of the linear portion of trajectory, the coefficient of the dissipation function and the coefficient of the potential function. Reconstructed trajectories of the nonlinear equation suggested that a curved flow-volume trajectory would be caused by the emergence of regional hypoventilated clusters with airtrapped lobules. In conclusion, analytical respiratory mechanics will provide the basis for analyzing the mechanical properties of the respiratory system concerning pulmonary functional images made by newly developed technologies.
Rinsho byori. The Japanese journal of clinical pathology, 2015
Evaluation of the lung function involves the measurement of many factors. The closing volume (CV)... more Evaluation of the lung function involves the measurement of many factors. The closing volume (CV) curve is clinically important as an index of uneven alveolar ventilation and airway closure. Although conventional methods for CV measurement are usually based on the pattern of the exhaled nitrogen (N2) concentration curve with respect to the lung volume, it is often difficult to measure the steep pattern of patients with chronic obstructive pulmonary disease (COPD). In this paper, we proposed a new method called the "N2 first derivative (fdN) wave method" for measuring CV. The N2 concentration of the CV curve was transformed to a derivative with respect to the lung volume, which revealed the existence of cardiogenic oscillations. Discrimination between phases III and IV was straightforward based on the difference in the slope or in the amplitude of oscillations of the fdN wave. Our new method was able to distinguish phase IV from phase III using the difference in amplitude o...
Open Journal of Molecular and Integrative Physiology, 2011
Rationale: There is accumulating evidence that a group of stem/progenitor cells (SPCs) maintain a... more Rationale: There is accumulating evidence that a group of stem/progenitor cells (SPCs) maintain alveolar epithelial integrity. Pulmonary emphysema is characterized by the histological finding of the loss of alveolar epithelial integrity along with corresponding bronchiolar fibrosis. Objectives: Based on the concept of autopoiesis (the capacity to produce oneself), we proposed a mathematical model in the maintenance of alveolar epithelial integrity as related to the genesis of pulmonary emphysema and fibrosis. Methods: A tessellation automaton model was used to describe the autopoietic dynamics of the bronchiolo-alveolar epithelial surface. The alveolar septal volume enclosed by the epithelial surface is a distributed system of discrete elements, which move by random walk in the manner of Brownian motion. Assuming that the numbers of components and events in the automaton are large, an approximate theoretical treatment in terms of differential equations is possible, allowing a set of partial differential equations to be produced. Results: 1) Assuming the loss of progenitor cells through the epithelial-mesenchymal transition (EMT), a sharp bifurcation between two qualitatively distinct regions of the phase space (one that is repaired completely, and another that has disappeared entirely) clearly appeared. 2) Thus, from the system of discrete and spatial partial differential equations, we obtained a system of ordinary differential equations in equilibrium conditions that defined a close relationship between the degree of emphysema, the density of alveolar septal fibroblasts, and the mean concentration of SPCs. Conclusions: A mathematical model of the autopoietic maintenance of the alveolar epithelial surface suggested a close relationship between alveolar emphysema and fibrosis and EMT in lungs affected by chronic obstructive pulmonary disease.
Open Journal of Molecular and Integrative Physiology, 2012
Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, and generally correlates ... more Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, and generally correlates with severity of asthma. Understanding the protection mechanism against excessive airway narrowing and how it breaks down is fundamental to solving the problem of asthma. In this paper we have proposed a stochastic modeling the airway smooth muscle bundle for reproducing AHR such as an increased sensitivity of the airways to an inhaled constrictor agonist, a steeper slope of the dose-response curve, and a greater maximal response to agonist. A large number N of contractile muscle cells was assumed to repeat themselves in between contraction and relaxation asynchronously. Dynamic equilibrium of statistic physics was applied to the system of ASM bundle. Thus, the relation of dose to response of a piece of ASM bundle was described by
The Journal of the Japanese Association for Chest Surgery, 2015
Kyobu geka. The Japanese journal of thoracic surgery, 2015
Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-yea... more Angiosarcoma is rare but highly malignant tumor arising from vascular endothelial cells. A 85-yearold man with difficulty in breathing for 3 days was referred to our hospital. He had a history of angiosarcoma of forehead 4 months before. A chest computed tomography (CT) scan showed left pneumothorax with multiple cystic changes and ground grass attenuations of bilateral lungs, which had obviously increased in recent 2 months. Pulmonary metastases with secondary pneumothorax was highly suspected by the serial CT findings. He was treated with tube thoracostomy and the instillation of a sclerosing agent (minocycline hydrochloride 200 mg). Seven weeks after his initial presentation, he died from obstructive pneumonia and an autopsy was held. Histologic examinations revealed that the tumor foci were peripheral, multiple and generally formed nodules. These cells were cluster differentiation(CD)31 and CD34 positive and negative for calretinin, cytokeratin, carcinoembryonic antigen (CEA), t...