• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.152-155
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• 2013

Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.133-136
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• 2003

Background and Objectives: Kikuchi's disease or subacute necrotizing lymphadenitis is a cause of persistently enlarged lymph nodes unresponsive to antibiotic therapy. It affects predominantly young women under the age of 30, and it is seen primarily in the Asian population. Although this disease usually follows a benign course, all describing a clinical entity that has been mistaken for malignant lymphoma, lupus, and an assortment of infectious diseases. The purpose of this study is to report clinical characteristics and treatment outcome in order to contribute to the precise diagnosis and treatment. Materials and Methods: We reviewed 27 cases, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy during the past 5 years from January 1998 to December 2002. Results: It occurred more often in females (20 cases ; 74%) than males (7cases ; 26%), and it was seen more frequently in the second and third decades (21 cases ; 78%). Cervical lymphadenopathy were usually multiple (24 cases, 89%) and measured less than 2cm (20 cases, 74%). The posterior cervical and deep jugular chains are the most common location(34 cases ; 81%). Leukopenia(18 cases, 67%) and elevated ESR(20 cases, 75%) were commonly noted in laboratory data. Conclusions: It is easy that Kikuchi's disease is mistaken for malignant lymphoma. So we should consider fine needle aspiration or open biosy of lymph node for histologic diagnosis in patients who have localized cervical lymphadenopathy unresponsive to antibiotic therapy.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.91-101
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• 1994

Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

• Journal of Veterinary Clinics
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• v.40 no.5
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• pp.382-386
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• 2023

A 2-year-old, 12.5 kg, castrated male, mixed-breed dog was presented with a 1-year history of pruritus and progressive alopecia. On physical examination, no remarkable findings were detected including body condition score (5/9). A dermatological examination of the dog revealed generalized erythema, papules or plaques, especially on the face, auricle, dorsum, and shoulder. A fine-needle aspiration of the dorsum and face lesions revealed various numbers of macrophages with foamy cytoplasm and multinucleated giant cells. A bacterial culture test showed the growth of Staphylococcus pseudintermedius. A complete blood cell count was unremarkable and biochemical abnormalities included hyperglobulinemia (4.8 g/dL, reference interval 2.5-4.5 g/dL), mild hypertriglyceridemia (277 mg/dL, reference interval 10-100 mg/dL) and mild hypercholesterolemia (383 mg/dL, reference interval 110-320 mg/dL). Additional diagnostic tests were performed to identify the underlying cause of hyperlipidemia. Canine pancreatic lipase immunoreactivity (<50 ng/mL, reference interval 0-200 ng/mL) and total T4 (1.4 ㎍/dL, reference interval 1.1-5.6 ㎍/dL) were within the reference intervals. For a definitive diagnosis, skin biopsy specimen was collected from the papular lesions on the dorsum by using a 4 mm biopsy punch. A histopathological examination revealed numerous large macrophages with abundant foamy cytoplasm in the dermis. The foamy macrophages were located diffusely between the collagen fibers. Extracellular amorphous lipid deposits were also presented in the dermal tissue. A definitive diagnosis of cutaneous xanthoma was made based on clinical signs and cytological and histopathological results.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.530-548
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• 2020

Thyroid radiology practice is a medical practice in which thyroid diseases are diagnosed using imaging modality and treated by imaging-based interventional techniques, and the primary care target is thyroid nodular disease. Diagnosis of thyroid nodules is primarily done by ultrasound imaging and biopsy; thyroid nodules can be treated by non-surgical interventional treatment and thyroidectomy. Ethanol ablation is the first-line treatment for cystic benign nodules, and radiofrequency ablation is used for the treatment of benign solid nodules and recurrent thyroid cancers. Thyroid radiology practice has an essential clinical role in diagnosis and nonsurgical treatment of thyroid nodular diseases, and treatment should be performed based on standard care guidelines for proper patient care. In order to provide the best care to patients with thyroid nodular disease, it is desirable to treat patients in the radiology outpatient clinic. Thyroid radiology practice centered on outpatient clinic practice needs to be expanded.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.92-109
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• 2023

In patients with thyroid nodules, ultrasonography (US) has been established as a primary diagnostic imaging method and is essential for treatment decision. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is a pattern-based, US malignancy risk stratification system that can easily diagnose nodules during real-time ultrasound examinations. The 2021 K-TIRADS clarified the US criteria for nodule classification and revised the size thresholds for nodule biopsy, thereby reducing unnecessary biopsies for benign nodules while maintaining the appropriate sensitivity to detect malignant tumors in patients without feature of high risk thyroid cancer. Thyroid radiology practice has an important clinical role in the diagnosis and non-surgical treatment of patients with thyroid nodules, and should be performed according to standard practice guidelines for proper and effective clinical care.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.579-583
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• 1994

A 22-year old female visited CNUH due to palpable neck mass. Cytologic examination of a fine needle aspiration was performed and the result was Pap class II. Routine chest x-ray shows solitary pulmonary nodule. For rule-out malignancy, FNA at neck mass was repeated and pathologic finding was dysplasia. She was admitted to MI department for evaluation of solitary pulmonary nodule and percutaneous needle aspiration was done. Pathologic diagnosis was adenoid cystic carcinoma. Thereafter, the lesions were treated by excisional biopsy of submandibular gland mass with left supraomohyoid neck dissection and wedge resection of right lower lobe at ENT department and thoracic and cardiovascular surgery department, respectively. Final diagnosis was adenoid cystic carcinoma arising in submandibular gland with solitary lung metastasis. According to TMN staging system, surgical staging is stage IV of T2N0M1. Clinical follow-up to postoperative 13 months in this case showed that she is alive and well without evidence of recurrence.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.598-604
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• 2020

Objective: Proper management of lymph nodes (LNs) with ultrasonographic (US) indeterminate features in thyroid cancer patients remains elusive. We aimed to evaluate the malignancy risk and US findings predictive of malignancy for US indeterminate LNs in preoperative thyroid cancer patients through node-by-node correlation. Materials and Methods: A total of 348 LNs in 284 thyroid cancer patients, who underwent fine-needle aspiration or core-needle biopsy between December 2006 and June 2015, were included. We determined the malignancy risks for US probably benign, indeterminate, and suspicious categories. For US indeterminate LNs, which had neither echogenic hilum nor hilar vascularity in the absence of any suspicious finding, US findings were compared between benign and metastatic LNs using Mann-Whitney U test and Fisher's exact test. Results: US imaging diagnoses were probably benign in 20.7% (n = 72) cases, indeterminate in 23.6% (n = 82), and suspicious in 55.7% (n = 194). Malignancy risk of US indeterminate LNs (19.5% [16/82]) differed from those of the US probably benign (2.8% [2/72]) (p = 0.002) and US suspicious LNs (78.4% [152/194]) (p < 0.001). Among US indeterminate LNs, there were no significant differences in short, long, and long-to-short diameter (L/S) ratios between benign and metastatic LNs (3.9 vs. 3.8 mm, p = 0.619; 7.3 vs. 7.3 mm, p = 0.590; 1.9 vs. 1.9, p = 0.652). Conclusion: US indeterminate LNs were frequently encountered during preoperative evaluation and had intermediate malignancy risk. Given the lack of discriminative power of size criteria and L/S ratio, clinical factors such as surgical strategy and node size should be considered for proper triage of US indeterminate LNs in thyroid cancer.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.62-66
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• 2004

Pilomatricoma is a benign neoplasm of the hair follicle origin which most common occur in the head and neck, particularly in the cheek and preauricular region. This neoplasm is superficially located and stony, hard consistency on palpation and sometimes shows reddish or bluish discoloration on the overlying skin. The diagnosis is confirmed by histopathologic examination. Radiologic evaluation is little diagnostic and fine needle aspiration biopsy often misdiagnose because both tissues from basaloid cell component and shadow cell component should be obtained for correct diagnosis. And Otolaryngologist should consider the possibility of philomatricoma when childhood or early adulthood persion visits with hard, supferficial mass on the parotid or cheek area. The treatment of choice is surgical excision with clear resection margin. In many instances, overlying skin excision is needed. We report 4 cases of philomatricoma arising from preauricular, cheek and posterior neck.

• Tuberculosis and Respiratory Diseases
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• v.39 no.2
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• pp.199-204
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• 1992

A 46 years old male showed radiologically a single cavitary nodular lesion in right upper lung, which extended to the regional chest wall. This finding has to be made into differential diagnosis of numerous pulmonary diseases including infections such as mycobacterial, fungal or bacterial, granulomatous diseases, and neoplasms. For the definite diagnosis, fine needle aspiration biopsy guided by biplane fluoroscopy was performed. The aspirates contained several sulfur granules, in the center of which many gram positive, filamentous organisms were compactly intermingled. Such a findings was compatible with pulmonary actinomycosis. Now the lesions is cleared out by medical treatment with amoxicillin for 3 months.