• Title/Summary/Keyword: 병리조직검사

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Early and Atypical Radiologic Presentations of Pulmonary Langerhans Cell Histiocytosis: A Report of Two Cases (폐 랑게르한스 조직구 증식증의 비전형적 영상 소견: 2예에 대한 보고)

  • Kyunghwa Ryu;Bo Da Nam;Jung Hwa Hwang;Dong Won Kim;Young Woo Park;Hong Chul Oh;Soo Bin Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.756-763
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    • 2021
  • Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.

Clinical Usefulness of PET-MRI in Lymph Node Metastasis Evaluation of Head and Neck Cancer (두경부암 림프절 전이 평가에서 PET-MRI의 임상적 유용성)

  • Kim, Jung-Soo;Lee, Hong-Jae;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.26-32
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    • 2014
  • Purpose: As PET-MRI which has excellent soft tissue contrast is developed as integration system, many researches about clinical application are being conducted by comparing with existing display equipments. Because PET-MRI is actively used for head and neck cancer diagnosis in our hospital, lymph node metastasis before the patient's surgery was diagnosed and clinical usefulness of head and neck cancer PET-MRI scan was evaluated using pathological opinions and idiopathy surrounding tissue metastasis evaluation method. Materials and Methods: Targeting 100 head and neck cancer patients in SNUH from January to August in 2013. $^{18}F-FDG$ (5.18 MBq/kg) was intravenous injected and after 60 min of rest, torso (body TIM coil, Vibe-Dixon) and dedication (head-neck TIM coil, UTE, Dotarem injection) scans were conducted using $Bio-graph^{TM}$ mMR 3T (SIEMENS, Munich). Data were reorganized using iterative reconstruction and lymph node metastasis was read with Syngo.Via workstation. Subsequently, pathological observations and diagnosis before-and-after surgery were examined with integrated medical information system (EMR, best-care) in SNUH. Patient's diagnostic information was entered in each category of $2{\times}2$ decision matrix and was classified into true positive (TP), true negative (TN), false positive (FP) and false negative (FN). Based on these classified test results, sensitivity, specificity, accuracy, false negative and false positive rate were calculated. Results: In PET-MRI scan results of head and neck cancer patients, positive and negative cases of lymph node metastasis were 49 and 51 cases respectively and positive and negative lymph node metastasis through before-and-after surgery pathological results were 46 and 54 cases respectively. In both tests, TP which received positive lymph node metastasis were analyzed as 34 cases, FP which received positive lymph node metastasis in PET-MRI scan but received negative lymph node metastasis in pathological test were 4 cases, FN which received negative lymph node metastasis but received positive lymph node metastasis in pathological test was 1 case, and TN which received negative lymph node metastasis in both two tests were 50 cases. Based on these data, sensitivity in PET-MRI scan of head and neck cancer patient was identified to be 97.8%, specificity was 92.5%, accuracy was 95%, FN rate was 2.1% and FP rate was 7.00% respectively. Conclusion: PET-MRI which can apply the acquired functional information using high tissue contrast and various sequences was considered to be useful in determining the weapons before-and-after surgery in head and neck cancer diagnosis or in the evaluation of recurrence and remote detection of metastasis and uncertain idiopathy cervical lymph node metastasis. Additionally, clinical usefulness of PET-MRI through pathological test and integrated diagnosis and follow-up scan was considered to be sufficient as a standard diagnosis scan of head and neck cancer, and additional researches about the development of optimum MR sequence and clinical application are required.

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Cytopathologic Diagnosis of Bile Obtained by Percutaneous Biliary Drainage (담즙의 세포병리학적 진단에 관한 연구)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.3 no.1
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    • pp.1-11
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    • 1992
  • From the one hundred forty eight patients with evidence of biliary tract obstruction, 275 bile samples were obtained from percutaneously placed biliary drainage catheters. Of the 148 patients, ova of Clonorchis sinensis were demonstrated in 17 patients (11.5%), with the epithelial cells. Among them, one case also demonstrated coexisting adenocarcinoma. In 105 patients, the medical records were available for review and the clinical diagnoses were malignancy in 99 patients and benign lesion in 6 patients. Of the 99 patients in which clinico-radiologic diagnosis were malignant, cytologic results were positive in 23.2%. Dividing the patients Into two groups, the ones with tumor of bile duct origin (group I) and the others with tumors producing extrinsic compression of bile duct, such as periampullary carcinoma, pancreas head carcinoma or metastatic carcinoma in lymph nodes from tumors of adjacent organs (group II), the cytologic results were positive in 37% and 11.6%, respectively. In patients with histologic confirmation, the positive correlation was found in 50% and 20% in group I and group II, respectively, with remarkable difference between two groups. There were no false positives in cytologic diangosis. The overall concordance rate of cytologic diagnosis with diagnosis of clinical investigation in both benign and malignant lesions was 27.6% and the diagnostic specificity was 100%.

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Cytologic Aspect of Keratoacanthoma with Granulomatous Inflammation in a Dog (개의 육아종성 염증이 동반된 keratoacanthoma의 세포학적 고찰 증례)

  • Ji, Hyang;Kim, Dae-Yong;Ji, Dong-Bum;Choi, Ul-Soo
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.616-618
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    • 2009
  • A 5-year-old Pekinese dog was presented for evaluation of a back mass of 1 year duration. Fine needle aspiration cytology of the mass revealed numerous keratinocytes, and a lesser number of multinucleated giant cells along with a low number of spindle cells, which were suggestive of epidermal cyst or hair follicle tumor with secondary granulomatous inflammation. The mass was surgically removed and examined histologically. Microscopically there was partially encapsulated well-demarcated nodule in deep dermis and subcutis. The nodule consisted of central cyst and secondary cysts that were lined by a single or multiple layers of basaloid cells and squamous epitheliums with central laminated keratin. Multifocal aggregation of numerous macrophages and multinucleated giant cells were present. The final diagnosis was keratoacanthoma with granulomatous inflammation. The mass did not recur 5 months after surgery.

Animal Pathogenesis and Specificities of Leptospira (Korea) with Autopsied Human Tissue (Leptospira(Korea)의 병원성 및 leptospirosis 환자 조직과의 특이성)

  • 이봉기;유주현;이태윤;박전한;이원영;김주덕
    • Korean Journal of Microbiology
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    • v.23 no.4
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    • pp.291-296
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    • 1985
  • Leptospira isolated from patients and natural paddy water were further studied to confirm their serologic specificity with the bacteria in infected animal tissue and autopsied tissue of patients died with leptospirosis. And pathologic patterns of the inoculated antimal and the virulence of the bacteria in the animals were also studied. The findings are summarized as follows; $LD_{50}$ dose of the bacteria in guinea-pig were $1-2{\times}10^9$ cells and mice were found to be susceptible to them even though the degree of susceptibilities were much inferior to guinea pig. The bacteria were recovered from various organs; demonstrated massive hemorrages due to diapedesis and monocyte infiltration were observed, in some cases, intramedullary hemorrages of the infected kidnies and hematuria were recognized. All of the hyperimmune sera were strongly reacted with the tissues from autopsied human case who died of EPHF(Epidemic Pulmonary Hemorrhagic Fever) in immunofluorescent antibody tests.

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MRI-Guided Breast Intervention: Biopsy and Needle Localization (자기공명영상 유도하 유방의 중재적시술: 조직생검술 및 침위치결정술)

  • Ga Eun Park;Jeongmin Lee;Bong Joo Kang;Sung Hun Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.345-360
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    • 2023
  • In Korea, the number of institutions providing breast MRI, as well as the number of breast MRIs, has recently increased. However, MRI-guided procedures, including biopsy and needle localization, are rarely performed compared to ultrasound-guided or stereotactic biopsy. As breast MRI has high sensitivity but limited specificity, lesions detected only on MRI require pathologic confirmation through MRI-guided biopsy or surgical excision with MRI-guided needle localization. Thus, we aimed to review MRI-guided procedures, including their indications, techniques, procedural considerations, and limitations.

Intrathyroidal branchial cleft-like cyst in neonate (신생아에서 발견된 갑상샘의 아가미틈새양 낭종)

  • Kang, Joonwon;Oh, Sangmin;Sul, Jiyoung;Lee, Choongsik;Chang, Meayoung
    • Clinical and Experimental Pediatrics
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    • v.49 no.9
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    • pp.1005-1009
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    • 2006
  • A rare case is described of an intrathyroidal branchial cleft-like cyst in neonate. The patient was a newborn girl with a mass in the left lateral neck. The ultrasonography and computed tomography revealed a cystic lesion in the left thyroid. The lesion was enucleated surgically from the thyroid. Histologically, the cyst was lined by squamous or columnar epithelium and contained inflammatory cell infiltraion, thyroid and parathyroid tissue. The patient has been doing well without any evidence of thyroid dysfunction for 15 months.

Acute Hemorrhagic Myelomalacia in an English Cocker Spaniel Dog (잉글리쉬 코카 스패니얼 견에서 발생한 급성 출혈성 척수연화증)

  • Lee, Hee-Chun;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.247-250
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    • 2007
  • A 3-year-old, intact female English cocker spaniel dog was evaluated for an acute onset of tetraplegia. Utilizing magnetic resonance (MR) imaging, the cause of the neurologic deficits was determined to be an peracute hemorrhage of spinal cord. The MR study additionally demonstrated parenchymal hyperintensity on T2weighted images and similarly located hypointensity on T1weighted images. Hemorrhagic myelomalcia was suspected based on these MR characteristics, which was subsequently confirmed histopathologically.

Lung Preservation Study for Above 20 Hours of LPDG Solution in Canine Lung Allotransplactation (폐이식 실험견에서 LPDG용액을 이용한 20시간 이상 폐보존효과 관찰)

  • Park, Chang-Gwon;Gwon, Geon-Yeong;Yu, Yeong-Seon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.949-960
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    • 1997
  • Background. Limited ischemic tolerance of the lung has remained one of the factors that limits the expansion of pulmonary transplantation as a treatment for end-stage pulmonary disease. Numerous studies on safe long term preservation for lung transplantation has been performed for the purpose of developing ideal preservation solution with extracellular type or intracellular type solutions. In this. study, we examined the efficacy of L DG solution in lung preservation longer than 20 hours by comparison with modified Euro-Collins solution. Iwethods. Thirty-(our adult mongrel dogs were divided into two groups. Donor lungs were flushed with LPDG solution(n=9) or modified Euro-Collins(MEC) solution(n=8) and stored for 24 hours at 1$0^{\circ}C$. All donor lungs were perfused through the pulmonary arteries with solutions containing prostaglandin El and verapamil. Left canine lung allotransplantations wereperformed. Assessment(hemodynamic indices and arterial blood gas analysis) of left implanted lung was made by occluding the right pulmonary artery for ten minutes using pulmonary artery Cuff. Assessment was repeated at the interval of 30 minutes, one hour, and two hours later after reperfusion and then chest X-ray, computed tomogram and lung perfusion scan were obtained. In survival dogs follow-up studies were done with assessment with chest X-ray, computed tomogram of the chest and lung perfusion scan on 7th day postoperatively. After preservation above 20 hours, pathological examinations for ultrastructural findings on right lung were performed in each group. Results. With respect to arterial oxygen tension, LPDG group was superior to MEC but there was no statistical significance for 2 hours after reperfusion. Mean pulmonary artery pressure was less increased(p < 0.05) and cardiac output higher(p <0.05) than MEC group until 2 hours after reperfusion. After 2 hours of reperfusion, both groups showed transplanted lung function deteriorated gradually. Perfusion scan of the transplanted lung in LPDG group showed better perfusion rate in immediate post-reperfusion, 3 days and 7 days later respectively but there was no statistical significance and corelation with PaO2 and computed tomoRravhic views. In scanning electron microscopy of pulmonary artery after preservation, LPDG group relatively shows less irregular protrusion of the inner surface of endothelial cell of poulmonary artery than MEC group. Conclusions, e concluded that LPDG solution can offer safe lung preservation above 20 hours with adequate immunosuppressive therapy and prevention of the infection.

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The Safety and Efficacy of Mediastinoscopy in Non-small Cell Lung Cancer (비소세포폐암에서 종격동경검사의 안전성과 유용성)

  • Park In-Kyu;Cho Sang-Ho;Kim Dae-Joon;Chung Kyung-Young
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.470-474
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    • 2006
  • Background: Mediastinal lymph node metastasis is an important factor for staging and prognosis of non-small cell lung cancer (NSCLC), so accurate diagnosis is essential for treatment. Mediastinoscopy provides histopathological diagnosis of mediastinal lymphnode metastasis in NSCLC. The efficacy of mediastinoscopy was investigated. Material and Method: From Jun, 1999 to Aug, 2005, mediastinoscopic lymph node biopsy was performed to 348 patients with NSCLC. Patients characteristics, radiologic findings, mediastinoscopic results and pathologic stages were evaluated for investigation of safety and efficacy of modiastinoscopy in NSCLC. Result: There was 263 male and 85 female patients and the mean age was $62.1{\pm}8.5$ years. By radiologic study for mediastinal lymph node metastasis, 203 patients were negative and 145 patients were positive. Mean procedure time was $55.5{\pm}16.5$ minutes and biopsy was peformed at $2.2{\pm}1.0$ lymph node stations. There were only transient complications (1.7%) during the procedure, without other complication and mortality. There was 7.8% of false negative result in mediastinoscopy. Sensitivity (77.5% vs 71.9%, p=0.012), specificity (100% vs 74.4%, p=0.00), and accuracy (92.2% vs 73.6%, p=0.00) of mediastinoscopy were more superior than that of radiologic study for the diagnosis of mediastinal lymph node metastasis in NSCLC. Conclusion: Mediastinoscopy is a safe and effective modality for diagnosis of mediastinal lymph node metastasis in NSCLC.