• Title/Summary/Keyword: Enlarged lymph node

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Extraordinary Response of Metastatic Pancreatic Cancer to Chemotherapy (항암 치료에 좋은 반응을 보였던 전이성 췌장암 증례)

  • Shin, Dong Woo;Kim, Jinkook;Lee, Jong-chan;Kim, Jaihwan;Hwang, Jin-Hyeok
    • Journal of Digestive Cancer Reports
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    • v.7 no.1
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    • pp.22-25
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    • 2019
  • A 58-year-old woman presented with right flank and back pain for one month. After undergoing an abdominal computed tomography (CT), she was referred to our hospital. The abdominal CT showed a hypodense pancreatic tail mass with multiple retroperitoneal lymph node metastases. Positron emission tomography-computed tomography (PET-CT) scan showed high 18F-FDG uptake in pancreatic tumor and enlarged lymph nodes. Endoscopic ultrasound fine needle aspiration (EUS-FNA) revealed adenocarcinoma, which stained strongly in hENT1 (human equilibrative nucleoside transporter 1) on immunohistochemistry. She received gemcitabine 1,000 mg/m2 + nanoparticle albumin-bound paclitaxel 125 mg/m2 as a palliative chemotherapy. Follow-up abdominal CT and PET-CT after 4 cycles of chemotherapy showed that both pancreatic mass and the metastatic retroperitoneal lymph nodes were nearly disappeared. We report a case of 58-year-old female with metastatic pancreatic cancer who had a dramatic response to palliative chemotherapy (gemcitabine plus nanoparticle albumin-bound paclitaxel).

Anthracofibrosis Mimicking Lung Cancer on CT: MR Imaging Findings (CT상 폐암과 유사하게 보이는 기관지 탄분 섬유화증의 자기공명영상 소견)

  • 류대식;이덕희;정승문;최수정;박성빈;박만수;강길현
    • Investigative Magnetic Resonance Imaging
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    • v.5 no.1
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    • pp.18-23
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    • 2001
  • Purpose : To describe the MRI findings in the bronchial anthracofibrosis mimicking lung cancer on CT examination. Materials and methods : Ten patients, who showed CT findings mimicking lung cancer, were selected among fifty patients of bronchial anthracofibrosis proven by bronchoscopic biopsy, consisting of two men and eight women, ranging in age from 58 to 79 years old faverage age, 68 years old). CT scan and MRI were performed in all patients (n=10). Percutaneous lung biopsy on mass was performed in one patient. MRI findings were analyzed with the emphasis on the signal intensity of the mass (n=4), collapsed lung (n=4) and Iymph node (n=10) on axial T1 and T2-weighted images by two radiologists in consensus. No contrast enhancement was used in all cases. Results : CT scan revealed mass (n=4), atelectasis with obstructive pneumonia(n=4) and bronchial wall thickening(n=2). All patients showed enlarged medistinal Iymph nodes(n=10). The mass showed low signal intensity on T1WI and T2WI (n =4). The collapsed lung in patients with atelectasis indicated intermediate signal intensity on T1WI and low signal intensity on T2WI (n= 4). Nine patients showed low sisnal intensity of Iymph node on T1WI and T2WI, except one patient who showed central high signal intensity with peripheral rim of low signal intensity in right lower paratracheal llmph node on T2WI. Conclusion : Low signal intensity of a mass, collapsed lung, and lymph nodes on T2WI in anthracofibrosis patients may be helpful in differentiation of the lesion from lung cancer.

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Soft Tissue Infection with Mycobacterium abscessus on the Chin of a Healthy Child: A Case Report (건강한 소아의 턱에 발생한 Mycobacterium abscessus에 의한 연부조직 감염: 증례 보고)

  • Kim, Hong-Ryul;Kim, Deok-Woo
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.289-292
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    • 2010
  • Purpose: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. Methods: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1 cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. Results: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. Conclusion: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.

Peritonitis associated with Streptococcus equi subsp. zooepidemicus in a thoroughbred horse (더러브렛 말의 Streptococcus equi subsp. zooepidemicus 감염에 의한 복막염)

  • Cho, Jung-Joon;Kang, Sang-Chul;Yang, Hyoung-Seok;Yang, Jae-Hyuk;Son, Won-Geun;Bae, Jong-Hee;Kim, Jae-Hoon
    • Korean Journal of Veterinary Research
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    • v.47 no.3
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    • pp.315-319
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    • 2007
  • Fibrinopurulent peritonitis and abdominal abscesses associated with Streptococcus (S.) equi subsp. zooepidemicus is reported in a 1-year-old female thoroughbred horse. The horse died after showing 5-day history of the cold, severe abdominal distention, abdominal breathing, hyperthermia, anorexia, and loss of intestinal sound. At necropsy, several liters of turbid yellowish green fluid were seen in the abdominal cavity. Yellowish creamy and fibrinous or bloody materials were presented on the serosa of various abdominal organs that were intensively adhered with each other. Spleen and mesenteric lymph node were remarkably enlarged. Affected lobes of the lung showed severe congestion, hemorrhage and doughy consistency. Histologically, the lung showed hemorrhagic pneumonia with diffuse congestion and edema. Severe diffuse fibrinopurulent peritonitis with Gram-positive bacterial cocci and adjacent fibrosis were showed in the serosa of various abdominal organs such as liver, spleen, stomach, and intestine. And multifocal abscess pouches were presented in the granulation tissue of abdominal viscera. S. equi subsp. zooepidemicus was isolated from the peritoneal swab, abdominal organs, and lung. Hematogenous dissemination of bacteria from hemorrhagic pneumonia is proposed as the route of infection in this case.

Computed Tomographic Findings of Adenocarcinoma of the Esophagocardia Region in a Pekingese Dog with Brachycephalic Syndrome

  • Cho, Yugyeong;Nam, Yunjeong;Chae, Sooyoung;Jeong, Youjin;Song, Youngmok;Kim, Soyoung;Choi, Hojung;Lee, Youngwon
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.295-298
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    • 2017
  • A 6-year-old female Pekingese dog, weighing 3.85 kg was presented with regurgitation, ptyalism, weight loss and anorexia. The dog was cachexic and severely dehydrated. Physical examination of the dog confirmed upper respiratory noise, which was classified as a stridor most apparent on inspiration, respiratory effort with stenotic nares. Upper respiratory signs were thought to be caused by brachycephalic syndrome. On the lateral thoracic radiograph, the caudal one third of the esophagus was visible as a soft tissue band. CT revealed oval-shaped, soft tissue attenuating mass in size of $2.3{\times}1.0{\times}1.1cm$ arising from caudal one third of the esophagus. The mass was protruding from esophageal wall to lumen and irregular margined with heterogenous contrast enhancement. The wall of cardia and fundus was focally thickened. Gastric lymph node was enlarged with contrast enhancing. On histopathologic examination, esophageal mass was confirmed as papillary adenocarcinoma, and the gastric sample showed the same result. In human, adenocarcinoma commonly occur in esophagus and cardia, but it has not been commonly reported in veterinary medicine. This report described computed tomographic features of adenocarcinoma of the esophagocardia region in a Pekingese dog with brachycephalic syndrome.

A Case of Posttransplant Lymphoproliferative Disease(PTLD) Following Renal Transplantation in a Child (소아에서 신이식후 발생한 Posttransplant Lymphoproliferative Disease(PTLD) 1례)

  • Eun, Byung-Wook;Park, Eun-Sil;Lee, Seong-Yong;Hahn, Hye-Won;Jang, Ju-Young;Park, Kyung-Mi;Kim, Chul-Woo;Kang, Gin-Han;Ko, Jae-Seong;Ha, Il-Soo;Lee, Hoan-Jong;Cheong, Hae-Il;Seo, Jeong-Kee
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.123-130
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    • 2002
  • Posttransplant lymphoproliferative disease (PTLD) represents a diverse lymphoproliferative disorder ranging front nonspecific reactive hyperplasia to malignant immunoblastic sarcoma developed in a setting of immunosuppression following organ or cellular transplantation. It is often associated with Epstein-Barr virus (EBV) infection and high dose immunosuppression. PTLD after renal transplantation was reported at first in adult in Korea in 1997. In children there have been several cases of PTLD after liver transplantation but PTLD after renal transplantation has not been reported. This is a case report of PTLD developed 4 months after renal transplantation in a 9-year-old boy. The major clinical manifestations were fever, multiple lymph nodes enlargement and blood-tinged stool. EBV was detected by in-situ hybridization in the enlarged cervical lymph node and the colonic tissue. Histological examination revealed B-cell lineage. Use of ganciclovir and reduction of the immunosuppression level resulted in complete remission of PTLD. This is the first pediatric case report of PTLD following renal transplantation in Korea. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 123-30)

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Local Rifampicin Instillation Therapy for Suppurative Bacillus Calmette-Guérin Lymphadenitis (BCG 접종에 의한 화농성 림프절염의 Rifampicin 국소 주입 요법)

  • Kim, Mee Jeong;Jang, Seong Hee;Ahn, Young Min;Kang, Mi Kyoung;Kim, Sang Jae
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.454-458
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    • 2002
  • Purpose : Bacillus Calmette-$Gu\acute{e}rin$(BCG) lymphadenitis is one of the most common complications of BCG vaccination. The involved lymph nodes usually subside spontaneously, but they may become enlarged and form an abscess. Treatment of these infants is controversial. The Pan American Health Organization recommends local isoniazid or rifampicin instillation for patients with suppurative BCG lymphadenitis. Methods : The study group comprised 37 patients who presented with BCG lymphadenitis over the last three years. BCG lymphadenitis was diagnosed if the affected patient developed an ipsilateral axillary or supraclavicular lymphadenitis, with no other identifiable cause for the lymphadenitis. We used rifampicin instillation therapy for patients with suppurative BCG lymphadenitis. Results : Lymphadenitis regressed spontaneously in three patients. Thirty four patients showed a progression to abscess formation. Among 34 patients with suppurative lymphadenitis, drainage developed spontaneously during the follow-up period in nine patients before therapy. Twenty five patients received needle aspiration and local rifampicin instillation therapy. Reaspiration was performed in seven patients. One of these patients still has large lymph nodes after the second attempt. Conclusion : Needle aspiration and local rifampicin instillation therapy into the node is a safe and effective form of treatment for suppurative BCG lymphadenitis.

Significance of the Failure Patterns in Cervical Lymph Nodes Achieving a Complete Response to Radical Radiotherapy (근치적 방사선치료에 완전반응을 보인 경부 림프절에서의 재발 양상 및 그 의의)

  • Nam, Ji-Ho;Kim, Won-Taek;Ki, Yong-Kan;Kim, Dong-Hyun;Choi, Young-Jin;Cho, Kyu-Sup;Lee, Jin-Choon;Lee, Byung-Joo;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.28 no.1
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    • pp.9-15
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    • 2010
  • Purpose: This study was performed to examine the neck failure patterns after a complete response (CR) to definitive radiotherapy for advanced head and neck cancer patients, as well as evaluate the clinical significance of the results of this study. Materials and Methods: Between 1987 and 2008, the clinical data of patients who had been treated with radical radiotherapy for primary squamous cell carcinomas and enlarged cervical lymph nodes was analyzed retrospectively. Ultimately, the cases that showed CR of the cervical lymph node lesions to full-dose radiotherapy were included in this study. The recurrent rate and sites in the cervical lymphatic area were evaluated periodically by radiologic imaging studies, along with some factors which might have affected the rate of recurrence. Results: A total of 73 patients who achieved CR in neck area after radiotherapy were included in this study. The rate of subsequent neck failure among those patients was 19.2%. There was only a 5.5% failure rate in the 55 patients who underwent radiotherapy in their primary site. Eighty percent of the recurrent cases were found within 3 years (median follow-up, 68 months). The majority of neck recurrent cases (47%) were accompanied with the failure of the primary lesions. The initial response of the primary site and the method of radiotherapy simulation were significant prognostic factors associated with the nodal recurrence rate. Conclusion: The recurrence rate of cervical nodes in patients with CR to radiotherapy in the primary site and neck area was about 5%. These patients could be followed up with close observation without a planned neck dissection.

Common Disease Codes in Pediatric Inpatients (1997-2008) (소아청소년과 입원환자의 흔한 질병 코드들(1997-2008): 감염질환 중심의 단일기관 연구)

  • Park, Ji-Eun;Lee, Soo-Young;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.54-60
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    • 2011
  • Purpose : In this study, we listed common diseases in pediatric inpatients and evaluated the distribution of diseases by period and age group, in order to estimate the epidemiologic trend. Methods : Patients who were admitted to the Department of Pediatrics between 1997 and 2008 were included. Demographic characteristics, date of admission, and International Classification of Diseases (ICD) code of patients were indentified. Study period was divided into two; early (1997-2002) and late (2003-2008), and age of patients were grouped into four; infancy, early childhood, late childhood, and adolescence. Results : A total of 33,513 patients were admitted for 12 years. In the list of ICD code, Pneumonia (J12-J18; 21.2%) was the most prevalent, followed by gastroenteritis (A00-A09; 17.8%), bronchiolitis (J21; 11.9%), and so on. Common diseases ranked from 1 to 10 comprised the majority (79.1%) of all the inpatients. There was increase in the number of inpatients with respiratory infectious disease (bronchiolitis, otitis media, and sinusitis), enlarged lymph node, or impetigo/cellulitis, but decrease in the number of inpatients with aseptic meningitis, intussusceptions, measles, or nephritic/nephrotic syndrome. The distribution of diseases also showed age group-specific difference. Conclusion : The distribution of diseases by period and age group was different. The epidemiologic trend should be considered in developing the management of strategy for the Department of Pediatrics.

A Case of Diffuse Large B-cell Lymphoma transformed from Primary Thyroid MALT Lymphoma (갑상선 MALT 림프종으로부터 전환된 미만성 거대 B세포 림프종 1예)

  • Young Rok Jo;Youn Jin Cho;Ju Yeon Pyo;Hye Ran Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.13-17
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    • 2023
  • Diffuse large B cell lymphoma (DLBCL) is main subtype of primary thyroid lymphoma and can be histologically transformed from a low-grade B-cell lymphoma. The characteristics and treatment guidelines of these particular DLBCL have not been fully established. The mainstay of treatment of primary thyroid DLBCL is multimodality treatment with chemotherapy and radiotherapy. Meanwhile, surgery can be considered only for diagnosis or alleviation of airway compressive symptoms. A 57-year-old female visited our outpatient clinic for recently enlarged long-held anterior neck mass. A thyroid mass compressing the airway and esophagus was identified on imaging, which was diagnosed as MALT lymphoma by excisional biopsy. After staging, the patient underwent total thyroidectomy with regional lymph node dissection for treatment of stage IIE MALT lymphoma and relieving airway compromise symptoms. The final diagnosis was DLBCL transformed from MALT Lymphoma, and chemotherapy was additionally performed. We report this rare experience with a review of literature.