• Title/Summary/Keyword: Enlarged lymph node

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A Case of Unilateral Vocal Fold Paralysis Secondary to Sarcoidosis (사르코이드증에 의한 일측 성대 마비 1예)

  • Lee, Oh-Hyeong;Bang, Jooin;Lee, Dohee;Cho, Jung-Hae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.61-64
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    • 2019
  • Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Vocal fold paralysis secondary to sarcoidosis is extremely rare but it can develop as a result of compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We report the case of a 56-year-old woman who presented with unilateral vocal fold paralysis and enlarged supraclavicular lymph nodes. Computed tomography of the neck revealed multiple, enlarged, and matted lymph nodes at the cervical level of IV. An ultrasound-guided core needle biopsy of the lymph node was performed, and a histopathological diagnosis of sarcoidosis was made by validating the presence of noncaseating granuloma. After implementation of steroid therapy, the patient exhibited immediate recovery from vocal fold paralysis. Although an extremely rare disease, sarcoidosis should be included in the differential diagnosis of vocal fold paralysis. Accurate diagnosis and prompt steroid treatment may reduce the morbidity of patients with vocal fold paralysis secondary to sarcoidosis.

Surgical treatment of tracheal stenosis due to paratracheal tuberculous lymphadenitis.* (결핵성 임파결절에 의한 기관 협착증 치험 1)

  • 강채규
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.213-217
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    • 1987
  • ; A 15 years old girl was operated due to tuberculous paratracheal lymph node enlargement resulted in marked narrowing of lower part of trachea. She had suffered from sputum expectoration difficulty, which was developed dyspnea and cyanosis. 1st operation was simple removal of enlarged paratracheal lymph node through Rt. thoracotomy but restenosis sign developed 2 months later in spite of Anti-Tbc. medication. 2nd operation was resection of constricted tracheal portion [2.5cm] 8 end to end anastomosis under Extra Corporeal Circulation. Under Extra Corporeal Circulation trachea reconstruction offered many conveniences during operation. Till now, she has been follow up checked for one year, she was very good post-operation state without any restenosis signs.

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Cervical Lymph Node Metastases of Tonsillar Squamous Cell Carcinoma in a Shih-tzu (시츄견에서 경부 림프절로 전이된 편도 편평세포암종)

  • Jung, Dong-In;Lee, Kyung-Woo;Park, Ki-Tae;Wang, Ji-Hwan;Yeon, Seong-Chan;Lee, Hyo-Jong;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.154-158
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    • 2011
  • A 8-year-old female Shih-tzu dog (weighting 4.5 kg) with history of both hindlimb lameness and cervical mass was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, ataxia, kyphosis, back pain and cervical mass were identified. Marked periosteal new bone formation of the fourth lumbar vertebra and soft tissue opacity mass of cervical region were observed in survey radiographs. Transverse computed tomography (CT) scan obtained at the lumbar and cervical lesions shown a well defined multilobulated bony mass and partially destructive lytic lesions the fourth lumbar vertebral body and a enlarged retropharyngeal lymph node with heterogeneous contrast enhancement and moderately enhancing left tonsillar mass. Neoplastic squamous epithelium which have developed vessel and lymphocyte infiltration in surrounding tissue were confirmed based on histopathologic examination. Based on the diagnostic findings the dog was diagnosed as a cervical lymph node metastases of tonsillar squamous cell carcinoma.

Cutaneous epitheliotropic T-cell lymphoma with Sézary syndrome in a dog

  • Lee, Song in;Lee, Han Joon;Seo, Kyoungwon;Song, Kunho
    • Korean Journal of Veterinary Service
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    • v.44 no.4
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    • pp.309-313
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    • 2021
  • A 12-year-old, spayed female, Toy-poodle dog presented in progressive, pruritic carpal mass and mandibular papule. The skin lesions and enlarged superficial lymph nodes were surgically removed. According to histopathology and immunohistochemistry, the patient diagnosed as cutaneous epitheliotropic T-cell lymphoma with lymph node metastasis. Chemotherapy with L-asparaginase, lomustine and prednisolone was initiated. The patient deteriorated despite treatment and was admitted to the hospital. Blood tests revealed significant leukocytosis. Circulating large lymphocytes with convoluted and cerebriform nuclei seen in peripheral blood led to presumption of Sézary cells. Thus, considering skin, lymph nodes and blood involvement, Sézary syndrome was diagnosed.

Comparison of Size Criteria in Mediastinal Lymph Node Involvement of Adenocarcinoma of Lungs (폐 선암의 종격동 림프절 전이에 있어서 림프절 크기 기준의 비교)

  • Gu, Ki-Seon;Kuk, Hiang;Koh, Hyeck-Jae;Yang, Sei-Hun;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.542-547
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    • 1999
  • Background: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarci-noma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria(15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. Methods: Numbers of sample are 60 cases(male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, III 24, IIIA 13. Results : Mean long diameter of lymph node involvement is 16.0($\pm8.0$) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0($\pm3.2$) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index. negative predictive index. accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. Conclusion: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.

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Clinical Evaluation on Transbronchial Needle Aspiration (TBNA) of Subcarinal Lymph Node in Lung Cancer (폐암에서 기관 분기부하 림프절의 경기관지 침흡인 세포검사에 관한 연구)

  • Kang, Yu-Ho;Choi, In-Seon;Jung, Ik-Ju;Park, Jai-Hee;Lee, Shin-Seok;Lee, Min-Su;Kim, Young-Cheol;Park, Kyung-Ok;Jung, Sang-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.177-184
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    • 1993
  • Background: Accurate staging of bronchogenic carcinoma is important in determining resectability and metastasis of tumor to the subcarinal nodes is generally believed to indicate poor prognosis. The technique of Transbronchial needle aspiration (TBNA) has offered a safe & effective way to asscess mediastinal lymph node involvement in the staging of lung cancer. We performed TBNA in patients who were suspected lung cancer to evaluate the clinical usefulness of the TBNA. Method: TBNA of the subcarinal lymph node was performed at the time of initial diagnostic bronchoscopy in 60 patients with suspected lung cancer, and 42 cases of histologically proved bronchogenic cancer were analized. Results: The frequency of adequate samples by transbronchial needle aspiration (TBNA) was 81% and the positive rate of malignant cells by TBNA was 14.7%. There were no differences in positive rates by tumor cell types. In patients with thickened carina on bronchoscopy, the TBNA was positive in 33.3% as compared to 5.3% of normal carina on bronchoscopy, and the difference was statistically significant (p<0.05). In patients with enlarged subcarinal lymph node on chest CT, the positive rate of malignant cells (50.0%) was higher than that of normal sized subcarinal lymph node on chest CT (4.8%) (p<0.01). There were no specific complications in the TBNA procedure. Conclusion: TBNA is a relatively safe procedure and it offers the possibility of avoiding the cost and morbidity of surgical staging in patients especially whose carina is thickened on bronchoscopy and whose subcarinal LN was enlarged on chest CT.

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Chronic Ovine Copper Toxicosis in Korea (국내에서 발생한 면양의 만성 동중독증 예의 관찰)

  • 김대용;권오경;서일복
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.455-459
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    • 1998
  • Ten sheeps from one farm had sudden onset of anorexia, jaundice and hemoglobinuria and died within 3 days after showing clinical signs during 3 months period. Postmortom examination was performed on one case and copper concentrations in the livers kidney and serum of the necmpsied minim were analysed. Grossly, the conjunctive, subcutaneous tissue and abdominal fat were generally icteric. The liver was enlarged with yellowish orange in color. The kidney was enlarged with dark red in color and the urinary bladder was filled with dark red urine. Histopathologically, centrilobular hepatocellular necrosis, neutrophilic infiltrations bile stasis and aggregation of fine granules-laden macrophages in the portal area were noted in the liver. Most of the Bowman's spaces and renal tubules were filled with homogenous eosinophilic fluid. Extramedullary hematopoiesis was noted in the submandibular lymph node. Copper concentrations in serum, liver and kidney of the necropsied animal were 25.0, 2732.8 and 471.3 ppm respectively. Based on the gross and histopathological findings and the high copper concentrations in the organs, this case was diagnosed as chronic copper toxicosis. Possible etiology on this outbreak is also discussed.

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Neck Node Bolus Technique in the Treatment of Nasopharyngeal Carcinoma with Intensity-modulated Radiotherapy

  • Phua, Chee Ee;Ung, Ngie Min;Tan, Boon Seang;Tan, Ai Lian;Eng, Kae Yann;Ng, Bong Seng
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6133-6137
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    • 2012
  • Purpose: To study the effect of bolus versus no bolus in the coverage of the nodal tumour volume with intensity-modulated radiotherapy (IMRT) for the treatment of nasopharyngeal carcinoma (NPC). Methods and Materials: This retrospective study used data from 5 consecutive patients with NPC who were treated with bolus for large neck nodes using IMRT from November 2011-January 2012 in our institute. All these patients were treated radically with IMRT according to our institution's protocol. Re-planning with IMRT without bolus for these patients with exactly the same target volumes were done for comparison. Comparison of the plans was done by comparing the V70 of PTV70-N, V66.5 of PTV70-N, V65.1 of PTV70-N and the surface dose of the PTV70-N. Results: The mean size of the largest diameter of the enlarged lymph nodes for the 5 patients was 3.9 cm. The mean distance of the GTV-N to the skin surface was 0.6 cm. The mean V70 of PTV70-N for the 5 patients showed an absolute advantage of 10.8% (92.4% vs. 81.6%) for the plan with bolus while the V66.5 of PTV70-N had an advantage of 8.1% (97.0% vs. 88.9%). The mean V65.1 also had an advantage of 7.1% (97.6% vs. 90.5%). The mean surface dose for the PTV70-N was also much higher at 61.1 Gy for the plans with bolus compared to only 23.5 Gy for the plans without bolus. Conclusion: Neck node bolus technique should be strongly considered in the treatment of NPC with enlarged lymph nodes treated with IMRT. It yields a superior dosimetry compared t o non-bolus plans with acceptable skin toxicity.

Lymph Node Metastasis after Spontaneous Regression of Non-Small Cell Lung Cancer

  • Jeong, Jae Hwa;Choi, Pil Jo;Yi, Jung Hoon;Jeong, Sang Seok;Lee, Ki Nam
    • Journal of Chest Surgery
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    • v.52 no.2
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    • pp.119-123
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    • 2019
  • Spontaneous regression of lung cancer is a very rare and poorly understood phenomenon. A 64-year-old man presented to Dong-A University Hospital with a shrunken nodule in the right lower lobe. Although the nodule showed a high likelihood of malignancy on needle aspiration biopsy, the patient refused surgery. The nodule spontaneously regressed completely in the next 17 months. However, the subcarinal lymph node was found to be enlarged 16 months after complete regression was observed. We pathologically confirmed metastasis of squamous cell carcinoma and performed neoadjuvant chemotherapy, surgery, and adjuvant chemoradiation. Regardless of tumor size reduction, it is preferable to perform surgery aggressively in cases of operable lung cancer.

Analysis of Mediatinal Lymph Nodes with Internal Low Density on Contrast Enhanced CT Scan (조영종강 전산화단층촬영상 내부 저밀도 음영을 보이는 종격동 림프절의 분석)

  • Ryu, Young-Hoon;Choe, Kyu-Ok;Hong, Yong-Kook;Kim, Sung-Kyu;Chang, Joon;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.264-279
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    • 1997
  • Background : To analyze the morphologic characteristics of low density lymph node in etiologic differentiation of lymphadenopathy, emphasizing the different features between tuberculosis and lung cancer, on contrast enhanced CT scan. Method : A total of 64 patients who showed low density lymph nodes on chest CT scan were analyzed. Primary causes were tuberculosis (n=28), lung cancer (n=27), malignant lymphoma (n=5) and metastasis from extrathoracic malignancies (n=4). CT scan was performed with 10mm slice thickness and 7 characteristic features were evaluated : location, size, presence or absence of the nonnecrotic lymph node, calcification, perinodal fat obliteration, thickness and evenness of the enhancing rim. Results : In patients with tuberculous lymphadenopathy, lymph nodes with uneven (68.0%) and thick (62.1%) enhancing rim were more common than lung cancer (p<0.05). Low density lymph nodes with less than 1 cm in size were found only in tuberculous lymphadenopathy(n=10). In 48.2% of patients with lung cancer, more than 1 nonnecrotic enlarged lymph node were coexisted, whereas 21.4% in patients with tuberculous lymphadenopathy(p=0.06). However, the size, location and calcification were not statistically significant between tuberculous lymphadenopathy and lung cancer. Conclusion : Tuberculous lymphadenopathy is strongly suggested when enhancing rim of enlarged lymph nodes is uneven and thick, when the coexisting nonnecrotic lymph nodes are few in number and when central low density is encountered in normal sized lymph nodes.

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