• Title/Summary/Keyword: 림프절 절제

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Relationship Between Tumor Angiogenesis, Stage and Prognosis in Non-Small Cell Lung Cancer (비소세포 폐암에서 종양 혈관신생과 병기 및 예후와의 관련성)

  • Lee, Won-Yeon;Kim, Chong-Ju;Shin, Pyo-Jin;Cho, Mee-Yon;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.557-567
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    • 2001
  • Background : Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. Method : Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post operative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet endothelial cell adhesion molecule, PECAM). Results : Microvessel counts(MVCs) in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage I and II or N0 stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). Conclusion : In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status(limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.

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Clinicopathologic Features and Prognostic Factors for Patients with Large Gastric Tumors (대형 위암의 임상병리학적 분석 및 예후)

  • Jang, You-Jin;Park, Jung-Min;Kim, Jong-Han;Park, Sung-Soo;Kim, Chong-Suk;Mok, Young-Jae
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.244-249
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    • 2006
  • Purpose: Tumor size has been reported to be one of the prognostic factors in the preoperative setting and 8 cm has been confirmed as a cut-off value for large gastric tumors with respect to postoperative complications. The aim of this study was to investigate the clinicopathologic features and the prognosis in patients with tumors larger than 8 cm in diameter. Materials and Methods: We retrospectively studied 2,260 patients with gastric cancer who underwent a gastrectomy from 1983 to 2001 at the Department of Surgery, Korea University College of Medicine. For a comparative analysis we divided the cases into the large and the small groups according to tumor size. The clinicopathological factors associated with large gastric tumors were analyzed by using univariate and multivariate analyses. To determine which variables were independent prognostic factors for overall survival, we applied the Cox proportional hazards model and we used P<0.05 as the cutoff value for statistical significance. Results: Univariate and multivariate analyses disclosed that tumor location (P<0.001), resection type (P<0.001), curability (P<0.001), depth of invasion (P<0.001), number of metastatic lymph nodes (P<0.001), differentiation (P<0.001) and combined resection (P<0.001) were significantly different between the two groups. The independent factors for survival identified by using the Cox proportional hazards model for large gastric tumors were nodal status (P<0.001), curative resection (P<0.001), depth of invasion (P=0.010), type of resection (P=0.018) and age (P=0.033). Conclusion: Large gastric tumors showed more aggressive local findings than their smaller counterparts. In patients with large gastric tumors, a curative resection was the most important factor for the prognosis. Therefore, we suggest that every effort should be made to do a curative gastrectomy and an accurate preoperative examination. (J Korean Gastric Cancer Assoc 2006;6:244-249)

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Epithelioid Sarcoma in Lower Eextremity - A Case Report - (하지에 발생한 유상피 육종 - 증례 보고 -)

  • Chun, Young-Soo;Kim, Sang-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.172-177
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    • 2008
  • The epithelioid sarcoma is a rare high grade soft tissue sarcoma that affects young usually male, adults or adolescents. The most common localization is the hand and the forearm, followed by the leg and the foot. In most cases, the sarcoma grows slowly, involves the dermis, subcutis, or deeper soft tissues in the distal extremities. Epithelioid sarcoma is a slowly growing tumor with a high propensity for local recurrences and lymph node metastases. This neoplasm is likely to be confused with a variety of benign and malignant conditions. The treatment consists of wide surgical excision, chemotherapy and radiotherapy. We report the cases of 16-year-old girl with an epithelioid sarcoma on the lower extremity.

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Multimodal Treatment of Pleuropulmonary Blastoma -Two case report- (흉막폐아세포종(Pleuropulmonary Blastoma) -치험 2예 보고-)

  • 박준석;한정호;구홍회;김진국
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.614-618
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    • 2003
  • Pleuropulmonary blastoma (PPB) is a rare intrathoracic neoplasm, found solely in childhood. The usual symptoms are dyspnea, chest discomfort, recurrent respiratory infections, fever, dry cough, and chest pain. The progress of PPB is usually aggressive and its progress is generally poor. Lymphatic spread to the hilar and mediastinal nodes can occur Distant metastasis is found in brain, bones, and intra-abdominal organs. Surgical resection is the treatment of choice. When the disease Is too extensive for surgical resection, neoadjuvant chemotherapy can be used. We report 2 cases of pleuropulrnonary blastoma in children successfully treated with multimodal therapy.

Clinical Features of Subacute Necrotizing Lymphadenitis in Children (소아 아급성 괴사성 림프절염의 임상적 특징)

  • Hong, Ji Young;Bae, Sun Hwan;Kim, Wan Sup
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.994-999
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    • 2002
  • Purpose : There is a predilection for subacute necrotizing lymphadenitis(SNL) in young Asian women. Few pediatric cases have been reported. This study was performed to evaluate clinical features of children with SNL. Methods : We retrospectively analyzed clinical features of 23 cases of SNL under 15 years of age identified in Nowon Eulji Hospital from February 1995 to January 2002. Two cases were diagnosed by excisional biopsy and 21 cases by fine needle aspiration. Results : The ages ranged from 14 months to 14 years(mean $8.1{\pm}3.8$ years). The male to female ratio was 1 : 1.6. Ten cases(10/23) were diagnosed in 2000. The onset was more frequent in spring. The common presenting symptoms were neck mass(22/23), pain(12/20) and fever(8/18). Fever subsided within two weeks in seven out of eight and lymphadenopathy resolved within five months in 14 out of 15. The mean WBC count was $7,664{\pm}3,454/mm^3$. Elevated levels of ESR(10/ 12) and lactate dehydrogenase(5/6) and positive reaction for CRP(3/4) were frequent. Radiologically measured greatest diameter of the enlarged lymph nodes was less than 2 cm in 14 out of 15. One case occurred in a child with alopecia areata and one case with type 1 diabetes. Clinical outcomes were good in 23 cases. Conclusion : SNL should be considered in children with cervical lymphadenopathy regardless of fever or pain. SNL seems not rare in pediatric groups in Korea.

A Case of Complete Remission after Palliative Chemotherapy and Salvage Radiotherapy for Lymph Node Recurrence in Advanced Gastric Cancer (근치적 절제술 후 림프절 재발이 발생한 진행성 위암에 대한 고식적 치료 1례)

  • Jong Seok Joo;Hyun Yong Jeong;Hee Seok Moon;Jae Kyu Sung;Sun Hyung Kang
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.108-112
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    • 2015
  • A 54-year-old male patient who was diagnosed with advanced gastric cancer underwent a distal gastrectomy, D2 lymph node dissection, and adjuvant chemoradiotherapy. After a year, in a follow-up PET-CT, lymph node metastases were observed in the neck and abdomen, and therefore, the patient underwent chemotherapy. After treatment, the follow-up PET-CT revealed a growth of the posterior neck lymph node. Thus, an excisional biopsy was performed, and the growth was diagnosed as metastatic adenocarcinoma. Therefore, the patient received chemotherapy with FOLFIRI. Another follow-up PET-CT after chemotherapy revealed a growth in the right inguinal lymph node, and the patient underwent salvage radiotherapy for this lesion. The PET-CT taken for the response evaluation showed no evidence of further metastasis of the lymph node. We hereby report a case of advanced gastric cancer with neck and inguinal lymph node recurrence showing complete remission after palliative chemotherapy and salvage radiotherapy.

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Tuberculous Cervical Lymphadenitis (결핵성 경부 임파선염)

  • Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.957-963
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    • 1997
  • 결핵성 임파선염은 아직도 한국에서 많이보는 질환이며 젊은여자 성인 특히 아시아인이나 흑인에서 가장 흔하다. 이 질환은 두경부에 흔히 무통성으로 서서히 림프절이 커지는 양상을 보이나 인체내 결절이 있는 어디나 오며 종격동 결절에도 온다. scrofula(선통(腺病))는 다양한 종양, 비종양성 종괴, 감염질환 특히 경부임파선염 풍과 구별되야만 한다. 비록 병력, 역학, 임상양상 흉부 엑스선 그리고 결핵반응검사로써 만족할만한 진단을 내리지만 절제생검으로 조직 및 배양이 필요하기도 하다. 궤양이나 만성 누공 형성을 막기위해 부분생검이나 절개 및 배농은 반드시 피해야 한다. 치료는 항결핵화학요법이며 가끔 외과적 적출술이 약물요법과 더불어 요구되기도 한다.

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Large Cell Neuroendocrine Carcinoma of the Lung - A case report - (대세포 신경내분비암-1례 보고-)

  • 김연수;류지윤;김민경;장우익;김욱성
    • Journal of Chest Surgery
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    • v.35 no.12
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    • pp.909-913
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    • 2002
  • The large cell neuroendocrine carcinoma is uncommon and its diagnostic criteria was recently established as pulmonary neuroendocrine carcinoma. A 74-year-old man who was a heavy smoker without symptoms was presented with a lung mass in right lower lobe. He was diagnosed as having large cell neuroendocrine carcinoma by needle biopsy. He was treated with right lower lobe lobectomy and mediastinal lymph node dissection. We experienced one case of large cell neuroendocrine carcinoma of lung and report it with reference.

Robotic Lateral Compartment Selective Neck Dissection in Well-Differentiated Thyroid Carcinoma (갑상선 분화암에서 로봇을 이용한 측경부 림프절 절제술)

  • Tae, Kyung
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.83-88
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    • 2011
  • Robotic thyroidectomy has been developed to minimize neck scarring, and several authors have described its feasibility and safety, and have reported surgical outcomes comparable with conventional open thyroidectomy. The da Vinci surgical system robot provides a three-dimensional $10-12{\times}$magnified view of the surgical area. It also provides hand-tremor filtration, fine motion scaling, and precise and multi-articulated hand-like motions. Recently, robotic technology has also been applied to lateral compartment neck dissection in thyroid cancer. We have developed a new novel selective neck dissection procedure by a gasless unilateral axillo-breast (GUAB) approach with a da Vinci Surgical System for well-differentiated thyroid carcinoma to avoid a long visible neck scar. Based on our early experience, robotic selective neck dissection by GUAB approach is a safe, feasible and cosmetically excellent procedure. It can be an alternative to conventional open surgery in the highly selected patients with well-differentiated thyroid carcinoma. The oncologic safety of robotic selective neck dissection should be verified with long-term follow-up data.

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Clinicopathologic Characteristics of Stage IV Early Gastric Cancer (IV기 조기위암의 임상병리학적 특성)

  • Kim, Min Kuk;An, Ji Yeong;Choi, Min Gew;Noh, Jae Hyung;Sohn, Tae Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.136-140
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    • 2008
  • Purpose: Stage IV early gastric carcinoma (EGC) is a rare disease. We report here on 10 cases of EGC that showed metastasis in more than 15 lymph nodes. Materials and Methods: A total of 8354 cases of gastric carcinoma in patients who underwent surgical procedures between January 2001 and January 2007 at Samsung Medical Center were studied, and 10 cases were classified as stage IV EGC. We investigated their clinicopathologic characteristics. Results: There were 5 males and 5 females. Their ages at operation ranged from 46 to 76 years with a mean age of 61. All of the 10 patients had undergone curative resection for gastric cancer. The pathological diagnosis confirmed that all of the patients had tumor confined to the submucosa. The median size of the tumors was 5.3cm and the mean number of dissected nodes was 45.5 with a mean number of 22.2 involved nodes. Six cases were classified as the diffuse type and 4 were classified as the intestinal type by Lauren's classification. Histologically, 3 cases were signet ring cell carcinoma, 3 were poorly differentiated, 2 were moderately differentiated and 2 were well differentiated adenocarcinoma. Endolymphatic invasion was found in 9 cases. The median follow-up was 31 months. Adjuvant chemotherapy was done in 9 patients, and the patient who did not receive chemotherapy died by cerebrovascular accident. 2 patient had recurrence of gastric cancer and 7 survived without recurrence. Conclusion: More cases should be collected and further studies on the molecular and cellular tumor characteristics are required to characterize these tumors that show aggressive lymphatic spread.

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