• Tuberculosis and Respiratory Diseases
• /
• 제44권3호
• /
• pp.505-515
• /
• 1997

배 경 : 폐암환자에서 기관지 침습에 관하여 CT의 정확도를 알아보고, 수술을 시행한 폐암환자에서 CT의 역할을 알아보기 위하여 본 연구를 시행하였다. 대상 및 방법 : 저자들은 폐절제술을 시행한 95명과 엽절제술을 시행한 61명의 수술전 CT를 분석하였다. 엽절제술을 시행 환자중 7명에서는 절제한 기관지 말단에서 암세포가 발견되어 폐절제술을 시행했다. 또한 저자들은 충분한 생검을 한 수술못한 60명의 수술전 CT도 분석하였다. 3mm 이상의 기관지벽의 비후, 불규칙한 기관지벽의 비후 그리고 기관지 직경의 감소를 기관지 침습으로 정하였다. 절제한 기관지 말단의 암세포 발견(20명), 수술한 기관지 말단에서의 폐암재발(6명) 그리고 기관지 생검상 양성(수술 안한군에서 34명)을 기관지 침습으로 생각하였다. 결 과 : 기관지 침습에 관하여 CT는 예민도 (11.5%), 낮은 양성기대치 (38%), 그러나 높은 특이도 (96%), 그리고 비교적 높은 정확도 (84%)를 나타냈으며, 수술 안한 군에서는 높은 예민도(62%), 양성 기대치를 보였다. 결 론 : 시행한 폐암환자에서 CT는 폐암의 기관지 침습에 대하여 예민도와 양성 기대치가 낮았다. 이와 같은 결과로 기관지 침습에 대한 CT의 유용성은 제한적이라 생각되며, 수술전 기관지경에 의한 기관지벽 생검이 필요하리라 생각된다.

• 대한두경부종양학회지
• /
• 제13권2호
• /
• pp.206-212
• /
• 1997

H$\"{u}$rthle cell neoplasm of the thyroid gland is an uncommon, but potentially malignant lesion. However, in many instances, the malignant potential of the H$\"{u}$rthle cell neoplasm is very difficult to judge histologically. For this reason, the biologic behavior of this tumor and its optimal treatment have come under considerable debate in recent years. In order to review the clinicopathologic features of the H$\"{u}$rthle cell neoplasm and to determine its optimal treatment modalities, we studied 26 patients with path logical proof of H$\"{u}$rthle cell tumor from January 1987 to September 1997. We also performed an immunohistochemical study using the monoclonal antibodies against antigen CD34 for the angiogenic activity of this tumor and evaluated the differences of microvessel density(MVD) between benign and malignant tumors. The age of the patients ranged from 1 to 71 years with a mean of 44.2 years. There were 6 males and 20 females(M : F= 1 : 3.3). The accuracies of fine needle aspiration biopsy and frozen section were very low; 6.3% and 34.8%, respectively. There were 20 benign tumors and 6 malignant tumors(23.1%). All the malignant tumors were microinvasive(intermediate) type which had minimal capsular invasion and most of them(5 cases) were diagnosed postoperatively. Any specific clinicopathologic differences were not seen between benign and intermediate groups. Most of the cases had conservative surgeries(15 ipsilateral lobectomy-isthmusectomy, 7 subtotal thyroidectomy) while total thyroidectomy was performed in 4 cases. Of the cases with malignant tumor, 2 had ipsilateral lobectomy-isthmusectomy, 3 had subtotal thyroidectomy and the remaining 1 had total thyroidectomy. Mean size of the tumors was 3.0 cm(0.1- 8.5 cm) in the greatest diameter and multiple tumors were seen in 6 cases(23.1 %). During the follow-up period, only one recurrence(3.8%) of benign tumor occurred but distant metastasis or cause-specific death was seen in the benign or intermediate groups. Mean MVDs of the benign(n=13) and intermediate(n=6) groups were $121.7{\pm}35.3$ and $114.3{\pm}31.7$, respectively and there was no statistical significance between them. In conclusion, because of the low accuracies of fine needle aspiration biopsy and frozen section for the H$\"{u}$rthle cell neoplasm, the extent of surgery could be individualized based on permanent pathologic examination; Conservative surgery would be adequate for patients with benign or intermediate H$\"{u}$rthle cell neoplasm and total or near-total thyroidectomy for those with definite malignancy.

• Archives of Plastic Surgery
• /
• 제35권3호
• /
• pp.329-332
• /
• 2008

Purpose: Microcystic adnexal carcinoma is a rare malignant appendage tumor, first described by Goldstein et al in 1982. Here, we present our experience in treatment of a case on the lower lip. Methods: A 52-year-old female with an asymptomatic nodule on the chin, previously misdiagnosed as trichoadenoma by needle aspiration biopsy, was treated by wide excision combined with multiple circumferential frozen biopsies. Results: Pathological examination revealed typical features of microcystic adnexal carcinoma, such as basaloid and squamous cells forming nests and cord-like patterns, horn cysts, and minimal cytologic atypia. The patient has been followed up for 6 months. No sign of recurrence is noted to date. Conclusion: Differentiation from other benign adnexal neoplasms is important for its appropriate treatment. Differentiation can be difficult histologically because it is difficult to acquire an adequate biopsy due to its invasiveness, and clinically due to its asymptomatic and slow growing features. Complete excision is the key treatment, but it may not always be the best solution considering the huge defect that may result and the low incidence of metastasis & deaths owing to the tumor. We add this case to the approximately 300 cases reported worldwide with a review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제29권2호
• /
• pp.116-122
• /
• 2003

Pleomorphic adenoma is the most common salivary neoplasm mainly occurring in the major salivary glands - especially in parotid gland, which is characterized by variable histopathologic appearances and high recurrence rate with malignant transformation according to surgical situations. And this benign mixed tumor occurring in minor salivary glands is believed to shows same clinicopathologic appearances and relatively low recurrent rate compared with the case in major salivary glands. But there are few comparative studies of large series of pleomorphic adenoma occurring in minor salivary glands which includes different histopathologic appearance, clinical characteristics, treatment methods, recurrence rate, and malignant transformation. We retrospectively studied the 54 patients who were pathologically confirmed with pleomorphic adenoma occurring in minor salivary glands, and analyzed the clinico-histopathological appearance, surgical methods, recurrent cases. The results obtained are as follows. 1. The incidence of the tumor was most frequent in 4th & 5th decade, and in female. 2. Palate(90%) including hard & soft palate was the most frequent site for pleomorphic adenoma in minor salivary glands. 3. The exact duration could not be known due to asymptomatic slow growth patterns of the tumor. 4. The mean tumor size was 2.3cm. 5. 28 (52%) pleomorphic adenomas were classified as Cellular type (cell-rich), 17 (31%) specimen as Intermediate type(equal cell to stroma ratio), and 9 (17%) as Myxoid type(stroma-rich). 6. Surgically 51 cases (94%) were showed well-encapsulated tumors, but histopathologically only 34 specimen (63%) were wellencapsulated. Therefore pleomorphic adenomas in minor salivary glands also have to be excised more widely, not enucleated. And in case of suspicious malignancy or large tumor, preoperative incisional biopsy can be applied in the center of the tumor for prevention of rupture of tumor cell, and total excision with use of frozen biopsy for detection of malignancy and confirming the excision margin, and closed follow-up according to final histopathologic results is recommended.

• 대한두경부종양학회지
• /
• 제29권2호
• /
• pp.48-50
• /
• 2013

Angiomyoma is a rare, benign smooth muscle cell tumor. These tumors may be found anywhere in the body. They frequently occur in the lower extremities except venous type. Angiomyoma in the head and neck area is very rare, and only a few cases have been reported. A 63 year-old male patient visited to outpatient clinic due to size-growing nodule-like lesion in the Lt. alar area. Excisional biopsy was done for diagnosis. The lesion was totally excised with 2 mm safety margin. Frozen biopsy of the lesion was requested, and all resection margins were proved negative. To cover the raw surface, full thickness skin grafting was performed. The graft was harvested from Rt. posterior auricular area. Tie over dressing was applyed on Lt. alar area. The graft was well taken and healed without any complication in both short term and long term follow up periods of 2 weeks, 1 month, 2 months, and 6 months. Donor site completed healed without any complications. The leiomyoma is benign tumor originated from smooth muscle, and it can be classified into solid leiomyoma, angiomyoma, and epithelioid leiomyoma. Especially, the angiomyoma consists of smooth muscle cell and blood vessel, and it is originated from the tunica media of blood vessel. Angiomyoma alone frequently occurs in the lower extremities as solitary painless subcutaneous tumor. Venous type of angiomyoma in the oral cavity was reported in other references, but on the facial surface it may be the first case reported as paper. So this report can be very meaningful.

• 한국수정란이식학회지
• /
• 제23권1호
• /
• pp.43-49
• /
• 2008

본 연구는 한우 체외 수정란의 성 감별과 신선란, 동결란 및 성 감별 수정란을 이식한 후 수태율, 분만율과 유산율, 생시 체중, 임신 기간을 조사하기 위하여 수행하였다 Aspiration과 punching법으로 biopsied한 수정을 24시간 배양 후 생존율은 각각 80.0%와 90.0%로 유의적인(p>0.05) 차이는 없었다. 수정란을 성 감별한 결과, 웅성 수정란과 자성 수정란의 비율은 각각 42.1%와 52.6%였으며, 5.3%는 수정란의 성을 판정하지 못하였다. hCG를 처리한 수란우의 수태율은 46.4%로서 무처리구(38.5%)에 비하여 높은 경향이었으나, 처리구간의 유의적인 차이는 없었다. 신선란과 동결란을 수정란 이식 후 수태율은 각각 41.3와 35.0%로서 유의적인 차이는 없었다. 성 감별된 수정란과 성 감별하지 않은 체외 수정란 이식 후 수태율은 각각 27.5와 42.1%로 유의적인 차이는 나타나지 않았다. 성 감별 된 수정란과 성 감별하지 않은 체외 수정란 유래 송아지의 분만율은 각각 85.0와 87.0%이었으며, 유산율은 각각 15.2와 13.3%로서 분만율과 유산율은 유의적인 차이는 없었다. 성 감별된 수정란과 성 감별하지 않은 체외 수정란 유래 송아지의 임신 기간은 각각 281.3일(female), 283.0일(male)과 288.2일(female), 282.3일(male)이었으며, 생시 체중은 각각 23.6(female), 24.6(남)과 25.0(female), 23.8 kg(male)로 유의적인 차이는 없었다. hCG 처리한 수란우는 한우 수정란 이식 후 수태율 개선 효과는 있는 것으로 판단된다. 성 감별 수정란 이식에 의해 송아지는 생산되었으나, 수정란의 biopsy 방법, 수정란 이식 후 수태율 개선과 같은 송아지 생산 효율을 개선해야 할 것으로 사료된다. 수정란 이식의 산업화가 정착하기 위해서는 동결란과 신선란 이식 후 수태율의 개선에 대한 노력이 필요할 것으로 사료된다.

• Advances in pediatric surgery
• /
• 제2권1호
• /
• pp.33-41
• /
• 1996

This report present the result of the national survey of pediatric surgeons' preferences on diagnosis and treatment of Hirschsprung's disease(HD) carried out in 1993. The questionnaires were sent to twenty-seven members of the Korean Association of Pediatric Surgeons (KAPS) working in twenty-four institutions. The questionnaires were designed to determine the individual surgeon's preference for the methods of diagnosis and treatment of the disease. Twenty-three pediatric surgeons from twenty institutions returned completed forms. The total number of patients diagnosed with HD in 1992 was 190 in this group. The estimated incidence of HD was 1/3,900. The most important symptom was delayed meconium passing and the most preferred diagnostic procedure was barium study. Anorectal manometric examination was carried out by 13 pediatric surgeons and 19 confirmed the diagnosis before operation by rectal biopsy, 12 with full-thickness biopsy and 7 with suction. Frozen section biopsy during operation was done by 22 surgeons. Eight surgeons did one stage operation if the age of the patient is suitable. Definitive operation was usually done at the age of 6 to 11 months. The most preferred operation was Duhamel procedure done by 19. Enterocolitis was the most serious complication of HD. Most of patients had normal continence within 6 to 12 months after operation. The follow-up period was less than 6 years in 16 surgeons. The results were presented at the 9th annual meeting of KAPS in June of 1993. This is the first national survey of HD and it can provide guidelines of diagnosis and treatment of Hirschprung's disease even though it is not a detailed study of patient data.

• 대한두경부종양학회지
• /
• 제36권2호
• /
• pp.41-44
• /
• 2020

Clear cell hidradenoma is a skin adnexal tumor originating from eccrine glands. The risk of local recurrence after surgical resection exceeds 50%, and 6-19% of cases are malignant. The rarity of clear cell hidradenoma and its diverse histological findings make this type of tumor a diagnostic challenge. We present a case of recurrent clear cell hidradenoma of the posterior neck in a 70-year-old woman. The tumor recurred once after complete excision, and did not recur again after 1-cm wide excision and reconstruction with a local bilobed flap. Recurrent clear cell hidradenomas are activated by surgical stimulation, increasing the risk for metastasis. Therefore, we suggest that wide excision with confirmation of a tumor-free margin by frozen-section biopsy should be the first-line treatment for recurrent benign clear cell hidradenoma.

• Advances in pediatric surgery
• /
• 제1권1호
• /
• pp.95-99
• /
• 1995

Neuroblastoma is the most common solid malignancy in childhood. However, a neuroblastoma presenting as bilateral and multifocal is very rare. A male newborn weighing 2.7 kg was born by normal vaginal delivery at 39 weeks' gestation to a 27-year-old mother who had a normal pregnancy. He was in good condition at birth but presented palpable masses in the both upper abdomen and both side of the neck. Ultrasound examination showed the lesions to be $3{\times}3cm$ sized calcified mass in right suprarenal area and $5{\times}3cm$ sized homogenous mass in left suprarenal area. The abdominal mass was also examined by computed tomography with similar findings. With the impression of bilateral neuroblastoma or metastatic spread, the laparotomy was performed on the 13th day of life. Frozen section of biopsy of the left neck mass was obtained, which showed neuroblastoma. Intraoperative findings revealed bilateral adrenal masses which were distinct and anatomically separate. Bilateral adrenalectomy was accomplished and the initial postoperative course was uneventful. The patient was discharged for hopeless and expired at age 45 days. We present bilateral adrenal neuroblastoma considered to be simultaneous occurrence rather than metastases from one site to another.

• 대한두개안면성형외과학회지
• /
• 제9권1호
• /
• pp.38-40
• /
• 2008

Purpose: Lymphangioma circumscriptum is a rare, congenital benign hamartous malformation, caused by the saccular dilatation of lymph channels lines by normal, single cell, lymphatic endothelia that present as local eruptions of persistent, grouped, translucent vesicles. The lymphangioma circumscriptum lesions may occur on axillary fold shoulder, neck proximal limbs and buccal mucosa. We reported a rare case of lymphangioma circumscriptum on the scalp. Methods: A 15-year-old girl with a $5{\times}3cm$ sized lymphangioma circumscriptum on scalp was examined. It was defined a boundry by ultrasound. And then, a tissue crescent type expander with 120 cc normal saline was inserted on occipital area for a month. After confirmed safety margin of the excised lymphangioma circumscriptum on frozen biopsy and the scalp flap was elevated and covered with empty space. Results: A histopathologic finding revealed that lymphangioma circumscriptum. During 11 months follow up, no relapse was found. Conclusion: We described a rare case of lymphangioma circumscriptum on scalp. By using a tissue expander and excision, we achieved no recurrence and aesthetically satisfactory outcome.