• Title/Summary/Keyword: 점막하 종양

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Superficial Esophageal Carcinoma Coexisting with Esophageal Leiomyoma (식도의 평활근종과 공존하는 표재성 식도암)

  • Park Ji Kwon;Chon Soon-Ho;Kim Young Hak;Chung Won Sang;Kim Hynck;Lee Cheol Burm
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.76-79
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    • 2005
  • The coexistence of mesenchymal tumor and carcinoma in the esophagus is extremely rare. We report a case of squamous cell carcinoma located at the mucosal surface over leiomyoma of the esophagus. A 76-year-old man with complaints of 3 months onset of odynophagia was diagnosed preoperatively as squamous cell carcinoma over submucosal tumor with calcification. Esophagectomy and esophagogastrostomy were performed through the right thoracotomy and upper median laparotomy. The patient is doing well without evidence of recurrence in the 25 months after resection. We discuss the pathogenesis and possible relations between the two tumors.

A Case of Giant Gastric Schwannoma Accompanied with Bleeding (출혈을 동반한 거대 위 신경초종 1예)

  • Kim, Je-Yeon;An, Ji-Yeong;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.47-51
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    • 2006
  • The origin of a submucosal tumor is difficult to determine by endoscopic biopsy. One type of submucosal tumor, which originates in Schwann cell, a schwannoma represents 0.2% of all gastric tumors. We experienced the case of a 57-year-old female patient with a gastric schwannoma presenting with melena and anemia. Computed tomography and upper gastrointestinal endoscopy showed a protruded huge mass from 3 cm below the cardia to angle. Seven endoscopic biopsies indicated only necrotic debri and granulation tissue, chronic gastritis. Because we suspected an advanced gastric cancer, or lymphoma with bleeding, It was performed an operation for an exact diagnosis and a treatment for bleeding. A-post-operative histopathological, immunohistochemical examination led to the final diagnosis of a gastric schwannoma.

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Expression and Clinical Significance of the N-myc Downstream Regulated Gene-1 in Hypopharyngeal Cancer (하인두암에서의 N-myc Downstream Regulated Gene-1 발현의 임상적 의의)

  • Sohn, In-Kyung;Han, Nam-Soo;Shin, Yoo-Seob;Kim, Jang-Hee;Kim, Chul-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.1
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    • pp.22-26
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    • 2011
  • 목 적 : 두경부 암은 발생 순위에서 전체 6위에 해당하는 다빈도 암이나 최근 20여년 동안의 노력에도 불구하고 두경부 암의 독톡한 특성상 생존률에서 뚜렷한 향상을 보이지 못하고 있다. 특히, 하인두 암은 원발 부위의 점막하 침윤이 흔하며, 주변 림프절 전이와 원격 전이가 흔하고, 2차 원발 암종 발생이 흔하여 두경부 암 중에서도 가장 불량한 예후를 보이고 있는 악성 종양이다. 최근에 이러한 암을 치료하고 진단하기 위한 방법으로 분자생물학적 접근법들이 많이 시도 되고 있으며, 그 중 하나로 N-myc downstream regulated gene-1(Ndrg-1)이라는 유전자가 유방, 전립선, 방광 암 등의 타 악성 종양에서 종양의 전이 및 진행 양상과 관련되어 있다는 보고가 있었다. 이에 본 연구는 하인두 암에서의 Ndrg-1의 발현 양상을 살펴보고 이와 임상 양상과의 연관관계를 살펴보고자 하였다. 방 법 : 1996년부터 2003년까지 수술 받은 하인두 암 환자 56명을 대상으로 면역조직화학검사를 시행하여 Ndrg-1 발현을 확인하였고, 3명의 신선 조직을 대상으로 RT-PCR, Western blot을 시행하였다. 결 과 : Ndrg-1은 RT-PCR에서 정상 조직과 악성종양 조직 모두에서 비슷한 수준으로 발현되었다. 그러나 Western blot에서는 정상 조직에서 뚜렷한 증가 양상을 보여 타 연구와 동일한 결과를 보였고, 이는 불필요하며 비효율적인 mRNA수준에서의 발현이 있지만 최종적인 단백 산물 발현에서는 암종의 진행과 연계되어 악성 종양 진행군에서 발현이 억제되는 결과로 해석된다. 면역조직화학검사에서는 정상 상피조직에서 Ndrg-1 발현이 확인되었으며, 통계적으로 유의하지는 않으나 불량한 예후를 가진 그룹에서 대체로 발현이 억제되는 악성 종양과의 역 연관 관계를 확인할 수 있었고, 특히 림프절 전이를 보인 그룹과 그렇지 않은 그룹 사이에서는 통계적으로 유의미한 결과가 확인되었다. 결 론 : 즉, 림프절 전이가 없는 그룹에서 Ndrg-1이 종양의 전이에 관여할 것이라는 타 연구와 일관된 결과로 하인두 암에서도 그 역할이 있음을 나타내는 결과라 할 수 있다.

Intramural Bronchogenic Cyst of the Esophagus -A case report- (식도 근육층에 함몰된 기관지성 낭종 -1예 보고-)

  • Cho Yang Hyun;Choi Young Ho;Ryu Se Min;Kim Hyun Koo;Sim Jae Hoon;Sohn Young-sang;Kim Hark Jei
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.870-872
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    • 2005
  • Bronchogenic cysts are anomalous cystic lesions of foregut and usually located in the lung or mediastinum. Generally intramuscular cysts of the esophagus are considered as enterogenous foregut malformations. We report a young adult with an intramural bronchogenic cyst causing dysphagia and heartburn. It was located in the muscular layer of the esophagus and was removed without any damage to the mucosa. Histopathologic findings revealed that it was a bronchogenic cyst.

The Clinicopathologic Characteristics of Neuroendocrine Tumor of the Stomach (위에 발생한 신경내분비 종양의 임상병리학적 고찰)

  • Lee, Chul-Min;Shin, Yeon-Myung
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.204-209
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    • 2008
  • Purpose: The goal of this study was to review the clinicopathologic characteristics of neuroendocrine tumor (NET) of the stomach. Materials and Methods: We retrospectively reviewed the medical records of 13 patients who were diagnosed with neuroendocrine tumor from January 1999 to August 2007 at Kosin Medical Center; 4,159 gastric cancer patients were treated surgically during the same time. The average follow up period was 14.3 months. Results: The majority of 13 patients were men (male-female ratio: 11:2) and the average age of patients with NET was 59.4 years (range: 42~72 years). The presenting symptoms were mostly epigastric pain and soreness. The tumor was limited to the mucosa or submucosa in two cases, and the tumor extended beyond the muscle layer in 11 cases. The mean size of the tumor was 7.0 cm, ranging from 0.7 cm to 15 cm. The type of the NEC (according to the WHO classification) was type 3 for eight patients, type 4 for four patients and type 1 for one patient. Regional lymph node metastasis was noted in 11 patients. Four cases showed recurrence of disease and the site of recurrence included liver in two patients, multiple organs (including the peritoneum and lung) in one patient and multiple organs (including liver, pancreas and duodenum) in one patient. The recurrent cases were type 3 and type 4 and the average survival period of the recurrent patients was 12.8 months. Conclusion: The majority of neuroendocrine tumors of the stomach were at an advanced stage at the time of diagnosis. These tumors frequently recurred in the liver and they have a poor prognosis.

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Esophageal Plexiform Schwannoma -A case report- (식도 얼기형 신경집종 -1예 보고-)

  • Jang, Jae-Seok;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.875-878
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    • 2006
  • A 39-year-old man presented with a esophageal submucosal tumor on regular check up examination. Preoperative exams showed the typical submucosal tumor as leiomyoma and operative procedure was enucleation for complete resection. Postoperative pathologic diagnosis including histologic and immunohistochemical study was compatible with plexiform schwannoma. Plexiform schwannoma is one of the least common variant of schwannoma that typically shows a plexiform or multinodular pattern. To our knowledge, there is rare case report of plexiform schwannoma originating in the esophagus and we report ore case with related literature.

Relationship between gastric mucosal eosinophilia and the presence of Helicobacter pylori in Republic of Korea Air Force soldiers (대한민국 공군 장병을 대상으로 한 위점막 조직 호산구 증가증과 유문나선균 간의 관계 연구)

  • Kim, Hyun-Soo;Lee, Sang-Hwa;Lee, Seok;Choi, Won-Ho;Kim, Ji-Ho
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.20 no.1
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    • pp.34-38
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    • 2012
  • 호산구는 염증 반응에 의해 활성화되며, 주로 기생충 감염이나 알러지 질환 등에 대한 면역 작용을 담당한다고 알려져 있다. 호산구 증가증은 약물 반응, 알러지, 국소적인 기생충 감염 등에 의한 경우가 많지만, 자가면역성 질환이나 종양에 의한 경우도 있다. 최근 연구를 통해 위염의 대표적인 원인균 중 하나인 유문나선균 역시 위점막에서 나타나는 조직 호산구 증가증의 원인이 될 수 있다고 밝혀지고 있으나, 유문나선균에 의한 호산구 증가증 발생 기전이나 빈도는 아직까지 확립되지 않고 있다. 위점막 내 호산구 침윤과 동반되는 위염은 복통, 오심, 구토, 설사, 장폐색 등을 일으킬 뿐만 아니라, 아토피성 피부염, 천식, 위식도 역류, 염증성 장질환 등의 발생과 관련이 있다고 보고되고 있다. 위염 및 다양한 관련 질환에 의한 증상은 공중 근무자들의 임무 수행 능력을 저하시켜 항공기 사고를 발생시킬 수 있는 가능성을 가지고 있다는 점에서 항공의학적으로 매우 중요하며, 실제로 호산구성 위염이나 유문나선균 감염의 치료 여부가 공중 근무자에게 일시적 또는 영구적 비행임무정지를 부과할 수 있는 기준이 되기도 한다. 본 연구에서는 대한민국 공군 장병 환자를 대상으로 내시경을 통해 얻은 위점막 조직 내 호산구수를 측정하고, 이를 위점막 표면의 유문나선균 존재 유무와 관련지어 보았다. 111명 중 20명의 환자에서 한 고배율 시야 당 30개 이상의 호산구가 관찰되었고, 63명의 환자의 위점막 표면에서 유문나선균을 확인하였다. 또한 위점막 내 호산구의 밀도와 유문나선균의 존재 간의 관계는 통계학적으로 유의하였다. 본 연구의 결과는 대한민국 공군 장병을 대상으로 하여 조직 호산구 증가증과 유문나선균의 빈도 및 상호 관계를 최초로 분석했다는 점에서 의의가 있으며, 추후 유문나선균이 어떤 기전으로 위점막 조직 내 호산구의 증가에 관여하는지에 대한 연구를 진행하기 위한 기초 자료로서 활용될 수 있을 것이다.

Feature Analysis of Endoscopic Ultrasonography Images (내시경 초음파 영상의 특징 분석)

  • Kim, kwang-beak;Kang, hyo-joo;Kim, mi-jeong;Kim, gwang-ha
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.390-397
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    • 2009
  • Endoscopic ultrasonography is a medical procedure in endoscopy combined with ultrasound to obtain images of the internal organs. It is useful to have a predictive pathological manifestation since a doctor can observe tumors under mucosa. However, it is often subjective to judge the degree of malignant degeneration of tumors. Thus, in this paper, we propose a feature analysis procedure to make the pathological manifestation more objective so as to improve the accuracy and recall of the diagnosis. In the process, we extract the ultrasound region from the image obtained by endoscopic ultrasonography. It is necessary to standardize the intensity of this region with the intensity of water region as a base since frequently found small intensity difference is only to be inefficient in the analysis. Then, we analyze the spot region with high echo and calcium deposited region by applying LVQ algorithm and bit plane partitioning procedure to tumor regions selected by medical expert. For detailed analysis, features such as intensity value, intensity information included within two random points chosen by medical expert in tumor region, and the slant of outline of tumor region in order to decide the degree of malignant degeneration. Such procedure is proven to be helpful for medical experts in tumor analysis.

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The Role of Endoscopy for Tumorous Conditions of the Upper Gastrointestinal Tract in Children (내시경으로 진단된 소아 상부 위장관의 종양성 질환에 대한 고찰)

  • Kim, Hye Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.31-40
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    • 2005
  • Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.

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Ultrastructural Alterations in the Gastric Mucous Epithelial Cells of Mouse Inoculated with Ehrlich Carcinoma Cells, Induced by 5-Fluorouracil, Mitomycin C or Acriflavine-Guanosine Compound (AG60) (5-Fluorouracil, Mitomycin C 및 Acriflavine-Guanosine 복합제가 Ehrlich 암세포를 이식한 생쥐 위점막 점액상피세포의 미세구조에 미치는 영향)

  • Ko, Eun-Ju;Park, Kyung-Ho;Park, Dae-Kyoon;Kim, Duk-Soo;Ko, Jeong-Sik
    • Applied Microscopy
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    • v.41 no.1
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    • pp.1-11
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    • 2011
  • This experiment was performed to evaluate the morphological responses of the gastric epithelial cells of the mouse, inoculated with Ehrlich carcinoma cells in the inguinal area, following administration of 5-fluorouracil, mitomycin C or Acriflavine-Guanosine compound (AG60). In this study, each mouse was inoculated with $1{\times}10^7$ Ehrlich carcinoma cells subcutaneously in the inguinal area. From next day after inoculations, 0.2 mL of saline, 5-fluorouracil (30 mg/kg), mitomycin C ($400{\mu}g/kg$) or AG60 (30 mg/kg) were injected to the animals every other day, respectively. Each animals were sacrificed after 7th injection and tissue were taken from the gastric mucosa. Thereafter, the ultrathin sections were stained with uranyl acetate and lead citrate. In the 5-fluorouracil-, mitomycin C- or AG60-treated mice, myelin figures and multivesicular bodies within the gastric mucous epithelial cells were observed more frequently than those of the normal control. In the 5-fluorouracil-treated mice, membrane structures containing a few mucous granules in the luminal space were observed. Indeed, bulging cytoplasmic process containing mucous granules protruding into the gastric lumen were observed in the mitomycin Ctreated mice. Therefore, this study suggested that AG60 as compared with 5-fluorourail and mitomycin C may effective medicine without damage to the secretion ability of gastric mucous epithelial cells.