• Title/Summary/Keyword: Cystic Lesion

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OK-432 Intralesional Injection Therapy for Lymphangioma in Children (소아 림프관종의 OK-432 병변내 주사요법)

  • Kim, Kyung-Hun;Kim, Hyun-Hahk;Lee, Suk-Koo;Seo, Jeong-Meen;Chang, Weon-Young;Lee, Byung-Boong
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.142-146
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    • 2001
  • Lymphangioma is a congenital malformation of the lymphatic system, commonly seen in the neck. Operation was the treatment of choice but it is difficult to resect the lymphangiomas completely. The aim of this study is to evaluate the result of intralesional injection of OK-432 as a treatment strategy of lymphangioma in children. Medical records of 51 cases of lymphangioma from March 1996 to February 2001 were reviewed retrospectively. Intralesional injection of 0.1mg OK-432 in 10ml normal saline was performed after the aspiration of as much fluid as possible. The location of the lesion was the face and neck in 26 patients, the chest wall in 14, the extremities in 9, and the abdominal wall in 2. The cystic type was present in 45 patients and the cavernous type in 6. Four postoperative recurrent cases were included. Fluid aspiration from the lesion was impossible in 5 patients. Development of fever after injection was observed in 27 patients and local inflammatory reaction was in 5 patients. There was no scar formation at injection sites. Complete shrinkage was observed in 20 patients, remarkable shrinkage in 23, slight shrinkage in 3, and no response in 5. Cystic type or aspiration-possible cases showed better outcome than cavernous type or aspiration-impossible cases. All of four recurrent cases after surgical excision showed at least remarkable shrinkage. These results indicate that intralesional injection of OK-432 is a safe and satisfactory treatment modality of lymphangiomas in children and might be considered as a treatment of choice, even in recurrent cases.

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Pulmonary Sequestration of Unusual Location, Extralobar and intralobar Type -Report of two cases - (비정상적 위치에서 발생한 외엽형 및 내엽형 폐 격절증 - 2예 보고 -)

  • 박해문
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.308-314
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    • 1989
  • Pulmonary sequestration is a congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two forms recognized: extralobar and intralobar. Extralobar form is a very rare congenital malformation, usually located in the lower chest, and may be found in newborn infants at the time a congenital diaphragmatic hernia is repaired. Large sequestrated segments may be cause acute respiratory distress in the neonate. The condition is asymptomatic in 15 per cent of patients. This report presents two cases of pulmonary sequestration which misdiagnosed a superior mediastinal tumor and a benign lung tumor. First case was 30-year-old male patient and chief complaints were dyspnea, dry cough and right chest pain. Chest X-ray showed a homogenous increased density of smooth margin at the right superior mediastinal area and suggested a benign mediastinal tumor. And so explothoracotomy was made without other special studies. Second case was 28-year-old male patient. One month ago, he had tracheostomy and right closed thoracostomy due to massive hemoptysis and spontaneous hemothorax. Chest X-ray showed a benign cystic lesion at RLL area. At the time of operation, in first case, a mass of adult fist size was placed medial to the right upper lobe and densely adhesive to trachea, SVC and esophagus. Blood supply of the mass was bronchial arteries of trachea and RUL bronchus and drained to SVC and azygos vein through anomalous systemic veins. There was no bronchial communication on Frozen biopsy. In 2nd case, large cystic lesion contained old blood hematoma was located in RLL and anomalous blood vessel from thoracic aorta was drained to posterior segment of RLL. In operation field, intralobar pulmonary sequestration was diagnosed, and RLL lobectomy was carried out.

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Non Functioning Parathyroid Cyst : A Case Report (비기능성 부갑상선 낭종 1예)

  • Choi, Dong-Il;Yim, Sang-Ho;Moon, Seung-Young;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.174-177
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    • 2009
  • Parathyroid cyst are rare lesion of the neck and superior mediastinum. They are classified as either functional or nonfunctional based on the presence or absence of hyperparathyroidism. They typically present as a palpable neck mass, or as an incidental finding during neck surgery. So, it must be included within the differential diagnosis of a neck lump. A 48-year old woman was admitted to our hospital for evaluation of left anterior neck mass. Physical finding showed soft, movable, non-tender mass on the lower left third of the neck. Laboratory findings revealed normal thyroid function and normal serum calcium level. On previous history, patient underwent two times sono-guided fine needle aspiration at local clinic, and about 10cc clear watery aspirate was noted. Computerized tomography findings showed non-enhancing hypodense cystic lesion on left thyroid area with tracheal deviation to right side. Preoperative diagnosis was thyroid cyst, and thyroidectomy was planed. Intra-operative finding showed huge cystic mass occupying the left thyroid area and smooth, shiny, semitransparent thin cyst wall was noted, which was loosely attached to the thyroid. The cyst was easily dissected free from the thyroid and surrounding tissues. After cyst removal, pathological study confirmed as a parathyroid cyst.

Preoperative Diagnostic Value of Fine Needle Aspiration(FNA) Cytology of Palpable Thyroid Nodules (갑상선 결절에 대한 세침흡입 세포검사의 수술전 진단적 가치)

  • Jeon Byeong-Min;Lee Byeong-Wook;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.192-199
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    • 1994
  • Since 1950s, fine needle aspiration(FNA) cytology has become increasingly popular and numerous reports have demonstrate its accuracy, safety and cost-effectiveness. To evaluate the role of diagnostic FNA cytology in the thyroid nodule, authors compared preoperative cytologic findings with postoperative histologic diagnosis in two hundred two thyroid nodules underwent surgical resection at Department of Surgery, Pusan Paik Hospital. from July 1990 to December 1993. FNA and thyroidectomy was performed primarily by one Head and Neck surgeon and specimen was interpreted by several pathologists. One hundred seventy two FNAs(85%) were interpreted as positive for benign lesion or carcinoma and thirty(15%, cystic in 25, non-cystic lesion in 5 cases) were unsatisfactory specimens for interpretation. The preoperative cytologic diagnosis of 172 cases revealed 'benign' in 112. 'suspicious cancer' in 10 and 'cancer' in 50 cases. Postoperative pathologic diagnosis showed 'nodular goiter' in 64. 'benign tumor' in 43, 'thyroiditis' in 4 and 'cancer' in 61 cases. The value of preoperative FNA diagnosis for thyroid cancer yielded a sensitivity of 85.2%, a specificity of 92.7%, false negative rate 5.2%, false positive rate 4.5% and positive predictive value and overall accuracy were 86.6% and 90.1% respectively. Preoperative rate of malignancy could be increased up to 35.5% by using FNA.

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TREATMENT OF ODONTOGENIC CYST USING DECOMPRESSION (감압술을 이용한 치성 낭종의 치료)

  • Choi, Byung-Jai;Suh, Moon-Sun;Kim, Seong-Oh;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.418-422
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    • 2002
  • Cyst is a cavity filled with fluids and semi-fluids that is lined with epithelial cells. Odontogenic cysts are those that form within the jaw which origin from dental follicles, enamel epithelium remnants of the crown, Malassez epithelial cell rest and basal cell layer of the oral epithelium. In such cases, treatment methods such as enucleation, marsupialization, decompression, surgical excision etc. can be used according to the lesion's characteristics, size, relationship with the surrounding tissue, patient's age and developmental status. This case was to report an odontogenic cyst caused by an impacted immature permannent tooth and its treatment. The cyst was removed by decompression. Cystic cavity was healed with bone tissue and the impacted permanent tooth erupted without any recurred cystic lesion.

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Surgical management of idiopathic bone cavity: case series of consecutive 27 patients

  • You, Myoung-Sang;Kim, Dong-Young;Ahn, Kang-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.2
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    • pp.94-99
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    • 2017
  • Objectives: Idiopathic bone cavity (IBC) is an uncommon intra-osseous cavity of unknown etiology. Clinical features of IBC are not well known and treatment modalities of IBC are controversial. The purpose of this study was to investigate the clinical characteristics of 27 IBC patients who underwent surgical exploration. Materials and Methods: A total of 27 consecutive patients who underwent surgery due to a jaw bone cavity from April 2006 to February 2016 were included in this study. Nine male and 18 female patients were enrolled. Patients were examined retrospectively regarding primary site, history of trauma, graft material, radiographic size of the lesion, presence of interdental scalloping, erosion of the inferior border of the mandible, complications, results of bone graft, and recurrence. Results: Female dominance was found. Maxillary lesion was found in one patient, and bilateral posterior mandibular lesions were found in two patients. The other patients showed a single mandibular lesion. The posterior mandible (24 cases) was the most common site of IBC, followed by the anterior mandible (5 cases). Two patients with anterior mandibular lesion reported history of trauma due to car accident, while the others denied any trauma history. Radiographic cystic cavity length over 30 mm was found in 10 patients. Seven patients showed erosion of the mandibular inferior border. The operations performed were surgical exploration, curettage, and bone or collagen graft. One bilateral IBC patient showed recurrence of the lesion during follow-up. Grafted bone was integrated into the native mandibular bone without infection. One patient reported necrosis of the mandibular incisor pulp after operation. Conclusion: Differential diagnosis of IBC is difficult, and IBC is often confused with periapical cyst. Surgical exploration and bone graft are recommended for treating IBC. Endodontic treatment of involved teeth should be evaluated before operation. Bone graft is recommended to reduce the healing period.

Correlation of Ultrasound and Scintigraphic Findings in Scrotal Disease (음낭 질환의 초음파 및 씬티그라피에 관한 방사선학적 연구)

  • Shin, Kyoung-Ja;Rhee, Chung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.1
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    • pp.62-73
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    • 1990
  • Recently ultrasound and scintigraphic study are most useful modality for diagnosis of scrotal diseases. They are able to determine the nature, anatomic extent of the lesion, and possible to differential diagnosis of the scrotal lesion. The ultrasound and scintigraphic findings were analyses in 59 patients of confirmed scrotal disease at Seoul Red Cross Hospital from June 1986 to Aug. 1989. The results were as follows. 1) Most patients were below the 30 years old age (69.4%), and most prevalent age was $11\sim30$ Yrs. in trauma, $31\sim40$ Yrs. in inflammation, and $51\sim60$ Yrs. in mass lesion of scrotum. 2) The diagnostic accuracy of scrotal disease was 94.9% in ultrasound and 72% in scintigraphic study. The ultrasound study showed high accuracy in all kind of scrotat disease, but scintigraphy showed only high detection rate in inflammatory disease. 3) Scrotal ultrasound is first choice of study for the diagnosis of scrotal lesion, and useful determine the cystic or solid lesion and anatomic extent of disease. However it can't be differentiate the acute epididymitis with acute testicular torsion. 4) Scrotal scintigraphy is useful study for the diagnosis of acute painful scrotal disease, and showed specific findings in acute epididymitis and acute torsion for differential diagnosis. 5) In consideration of age, history and clinical findings of patient, appropriate study will be chosen firstly in ultrasound and scintigraphy, and combined all of findings of these studies will be helpful for the accurate diagnosis and adequate treatment of scrotal disease.

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A COMPARATIVE CLINICAL STUDY ON DECOMPRESSION AND ENUCLEATION TO TREAT CYSTIC LESIONS OF THE JAWS (악골내 낭종성 병소의 감압술과 적출술에 관한 임상적 연구)

  • Jung, Young-Soo;Paek, Song-Hum;Lee, Eui-Wung;Park, Hyung-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.1
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    • pp.43-48
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    • 2004
  • Purpose: Among the various surgical methods used for the effective treatment of cystic lesion in the jaws historically, decompression procedure has some of superior prognosis compare to direct enucleation. In order to propose the efficacy of decompression we performed this retrospective study to compare decompression procedure with one-stage enucleation in clinical results and prognosis. Patients and Methods: We reviewed 175 patients who had been histopathologically diagnosed cystic lesions from 1996 to 2000 in our department. Patients who had been received decompression alone or secondary enucleation after decompression were 31 cases, and enucleation alone were 144 cases. The age and sex of the patients, the area, size, and histological type of the lesions, and detailed operation and complications including recurrence were investigated. The minimal follow-up period was 2 years. Results: In 31cases of decompression, male patients were 22cases(71%) similar to male predilection(62.3%) in total 175 cases. Cystic lesions were developed evenly in all age groups totally. Decompression was mainly performed in teenagers but enucleation was used in elder decades. In decompression cases the lesions were located in mandibular posterior, maxillary posterior, mandibular anterior, and maxillary anterior in order, which had some differences in total and enucleation cases. In enucleation cases, less than 3cm in size was 77.1% but larger than 3cm was 93.5% in decompression cases. Histopathologically, dentigerous cysts(54.8%), unicystic ameloblastomas(16.1%), and odontogenic keratocysts(12.9%) were seen in decompression cases and no recurrence or metaplasia and infection was observed. On the other hand, permanent tooth loss, numbness, recurrence, and so on were accompanied after enucleation. Conclusion: Although decompression procedure has disadvantages such as many of visiting times and slow recovery of the surgical defect, decompression is the best choice of treatment for large cystic lesions of the jaws, because it prevents functional and cosmetic defect, allows bone regeneration, and makes easy secondary enucleation.

A Case of Ectopic Cystic Thymoma (이소성 낭성 흉선종 1예)

  • Lee, Jae Hyung;Kim, Il Ok;Lee, Hee Kyung;Min, Kyueng Whan;Kim, Sang Heon;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Chan Kum;Kang, Jung Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.331-335
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    • 2007
  • A thymoma commonly occurs in the superior mediastinum or the upper part of the anterior mediastinum but can be located in other places in rare cases. Cystic degeneration in a thymoma is a relatively common but focal event. In rare cases, the process proceeds to the extent that most if not all of the lesion becomes cystic. We report a case of a patient with a paracardial cystic thymoma in the lower aspect of the anterior mediastinum. A 49-year-old woman was referred to our hospital because of a mass discovered incidentally on a chest X-ray. She showed no symptoms or signs. Contrast-enhanced chest CT scan revealed a $5{\times}5cm$ sized, well-marginated, right paracardial cystic mass with a curvilinear and oval enhancing solid portion. A Surgical resection was performed. The mass was discontinuous with normal thymic tissue. Microscopy revealed a type B1 thymoma with prominent foci of medullary differentiation according to the WHO classification. There was no capsular or local invasion. The postoperative course was uneventful and the patient was discharged in good health.

A Case of Tuberous Sclerosis with Pulmonary Involvement (폐를 침범한 결절성 경화증 1예)

  • Ahn, Jong-Ho;Suh, Gee-Young;Kim, Young-Whan;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.433-437
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    • 1992
  • Tuberous sclerosis is a syndrome characterized by the facial skin lesion, epilepsy, and mental retardation. Pulmonary involvement is uncommon, but when the lung is involved by tuberous sclerosis it shows characteristic reticulonodular infiltration and cystic changes. We experienced a 34-year-old female patient of known tuberous sclerosis admitted due to pneumothorax. Chest PA showed diffuse fine reticulonodular infiltration and chest CT revealed diffuse cystic changes of the lung. Pleurodesis with tetracycline was done to prevent recurrence, but chylothorax occurred four months after the treatment. Pleurosis was tried again and anti estrogen treatment began.

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