• Asian Pacific Journal of Cancer Prevention
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• 제15권11호
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• pp.4677-4681
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• 2014

Background: This study aimed to characterize the histopathological pattern of lymph node pathology among Saudi patients and to highlight the age and gender variations of these lesions as base line data. Materials and Methods: We retrospectively analyzed the data from lymph node biopsy specimens received at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December 2013. Results: Of the 289 lymph node biopsy specimens received, 154 (53.3%) were from males and 135 (46.7%) from females giving a male: female ratio of 1.14:1. Age of the patients ranged from 2.5 to 96 years with a mean age 33.9 years. The commonest lymph node group affected was the cervical (30.4%) followed by axillary (9.7%) and inguinal (8.7%). Malignant lymphoma [71 Hodgkin's disease (HD), 57 non Hodgkin's lymphoma (NHL)] 128 (44.3%), reactive hyperplasia 68 (23.5%), and tuberculosis 41 (14.2%) were the common causes of lymph node enlargement. While HD, reactive hyperplasia and tuberculosis were commonest in young adult patients (10-29 years old) and rare above the age of 50 years; NHL was the predominant cause of lymph node enlargement above 50 years. Conclusions: Lymph node biopsy plays an important role in establishing the cause of lymphadenopathy. Among the biopsied nodes, lymphomas were the most common (44.3%) followed by non-specific reactive hyperplasia (23.5%) and tuberculous lymphadenitis (14.2%).

• 대한정형외과학회지
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• 제54권6호
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• pp.509-518
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• 2019

목적: 악성 종양 환자에서 림프절 전이를 발견하는 것은 초기에 정확한 병기 및 예후와 관련된 정보를 알 수 있고 수술 후 보조치료(adjuvant therapy)의 필요성을 평가해서 조기에 치료를 할 수 있도록 해주기 때문에 중요하다. 본 연구를 통해 정형외과 영역의 악성 종양 환자를 평가함에 있어 양전자 방출 컴퓨터 단층 촬영기(positron emission tomography/computed tomography, PET/CT)가 sentinel lymph node biopsy와 비교하여 유용한지를 알아보고자 한다. 대상 및 방법: 2008년부터 2018년까지 악성 근골격계 종양으로 진단받고 PET/CT를 촬영한 환자 251명 중 72명의 환자를 선별하여 후향적 분석을 시행하였다. 림프절 전이가 의심되는 환자군은 조직검사를 시행하였다. 분석은 의무기록, 임상정보, PET/CT 영상 및 판독 소견, 병리 결과를 통해 시행하였으며, 임상경과 및 병리검사 결과를 PET/CT 결과와 비교하여 PET/CT의 정확도를 평가하였다. 결과: 환자의 나이는 14세에서 88세까지 분포하였고, 평균 추시 기간은 2.4년이었으며, 22명에서 림프절의 전이가 확인되었다. 육종 및 비육종 종양에서 PET/CT 영상의 민감도, 특이도, 양성예측도, 음성예측도는 전문가의 소견을 함께 고려할 경우 상당히 상승하는 것을 확인하였다. 결론: 본 연구를 통하여 전문가의 소견을 함께 고려한다면, 림프절의 전이를 발견하는 데 PET/CT의 유용성은 증가할 것으로 생각된다.

• Journal of Breast Cancer
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• 제21권4호
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• pp.442-446
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• 2018

Purpose: The definition of nodal pathologic complete response (pCR) after a neoadjuvant chemotherapy (NAC) just included the evaluation of axillary lymph node (ALN) without internal mammary lymph node. This study aimed to evaluate the feasibility of internal mammary-sentinel lymph node biopsy (IM-SLNB) in patients with breast cancer who underwent NAC. Methods: From November 2011 to 2017, 179 patients with primary breast cancer who underwent operation after NAC were included in this study. All patients received radiotracer injection with modified injection technology. IM-SLNB would be performed on patients with internal mammary sentinel lymph node (IMSLN) visualization. Results: Among the 158 patients with cN+ disease, the rate of nodal pCR was 36.1% (57/158). Among the 179 patients, the visualization rate of IMSLN was 31.8% (57/179) and was 12.3% (7/57) and 87.7% (50/57) among those with $cN_0$ and cN+ disease, respectively. Furthermore, the detection rate of IMSLN was 31.3% (56/179). The success rate of IM-SLNB was 98.2% (56/57). The IMSLN metastasis rate was 7.1% (4/56), and all of them were accompanied by ALN metastasis. The number of positive ALNs in patients with IMSLN metastasis was 3, 6, 8, and 9. The pathology nodal stage had been changed from $pN_1/pN_2$ to $pN_{3b}$. The pathology stage had been changed from IIA/IIIA to IIIC. Conclusion: Patients with visualization of IMSLN should perform IM-SLNB after NAC, especially for patients with cN+ disease, in order to complete lymph nodal staging. IM-SLNB could further improve the definition of nodal pCR and guide the internal mammary node irradiation.

• Journal of Gastric Cancer
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• 제10권4호
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• pp.175-181
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• 2010

Purpose: There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and postresection diagnoses. Materials and Methods: We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009. Results: Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissec-tion, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia. Conclusions: The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.

• Radiation Oncology Journal
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• 제32권3호
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• pp.132-137
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• 2014

Purpose: To evaluate non-sentinel lymph node (LN) status after sentinel lymph node biopsy (SNB) in patients with breast cancer and to identify the predictive factors for disease failure. Materials and Methods: From January 2006 to December 2007, axillary lymph node (ALN) dissection after SNB was performed for patients with primary invasive breast cancer who had no clinical evidence of LN metastasis. A total of 320 patients were treated with breast-conserving surgery and radiotherapy. Results: The median age of patients was 48 years, and the median follow-up time was 72.8 months. Close resection margin (RM) was observed in 13 patients. The median number of dissected SNB was two, and that of total retrieved ALNs was 11. Sentinel node accuracy was 94.7%, and the overall false negative rate (FNR) was 5.3%. Eleven patients experienced treatment failure. Local recurrence, regional LN recurrence, and distant metastasis were identified in 0.9%, 1.9%, and 2.8% of these patients, respectively. Sentinel LN status were not associated with locoregional recurrence (p > 0.05). Close RM was the only significant factor for disease-free survival (DFS) in univariate and multivariate analysis. The 5-year overall survival, DFS, and locoregional DFS were 100%, 96.8%, and 98.1%, respectively. Conclusion: In this study, SNB was performed with high accuracy and low FNR and high locoregional control was achieved.

• Tuberculosis and Respiratory Diseases
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• 제78권3호
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• pp.276-280
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• 2015

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권2호
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• pp.183-188
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• 2010

Leiomyosarcoma is a malignant neoplasm of smooth muscle origin and mostly originate from the wall of uterus and gastrointestinal tract, but primary leiomyosarcoma of the oral cavity is extremely rare. This tumor has a very poor prognosis due to high recurrence and metastasis rate, with 5 year survival rate of 32%. And regional lymph node metastasis is uncommon event. Complete wide surgical excision is the treatment of choice. A 64-year old man who had a painful ulcerative lesion on the labial & palatal gingiva of #11, 21 visited our department, and was diagnosed as leiomyosarcoma through a biopsy. Partial maxillectomy was carried out, with no following radiotherapy or chemotherapy. After months follow-up, there has been no evidence of recurrence or metastasis. But after months, we clinically find out two enlarged immobile palpable lymph node in right submandibular area of patient. So a biopsy was performed via an extraoral incision under local anesthesia. Histopathologic diagnosis diagnosis of the biopsy was lymph node metastasis of prior existed leiomyosarcoma. We report a case of a primary leiomyosarcoma occurred in a 64 year-old male patient involving the anterior maxillary region with regional lymph node metastasis with a review of literature.

• Korean Journal of Radiology
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• 제25권3호
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• pp.319-320
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• 2024

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7049-7054
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• 2014

Background: Almost half of the breast cancer patients with positive sentinel lymph nodes have no additional disease in the remaining axillary lymph nodes. This group of patients do not benefit from complete axillary lymph node dissection. This study was designed to assess the clinicopathologic factors that predict non-sentinel lymph node metastasis in Iranian breast cancer patients with positive sentinel lymph nodes. Materials and Methods: The records of patients who underwent sentinel lymph node biopsy, between 2003 and 2012, were reviewed. Patients with at least one positive sentinel lymph node who underwent completion axillary lymph node dissection were enrolled in the present study. Demographic and clinicopathologic characteristics including age, primary tumor size, histological and nuclear grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and number of harvested lymph nodes, were evaluated. Results: The data of 167 patients were analyzed. A total of 92 (55.1%) had non-sentinel lymph node metastasis. Univariate analysis of data revealed that age, primary tumor size, histological grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio, were associated with non-sentinel lymph node metastasis. After logistic regression analysis, age (OR=0.13; 95% CI, 0.02-0.8), primary tumor size (OR=7.7; 95% CI, 1.4-42.2), lymphovascular invasion (OR=19.4; 95% CI, 1.4-268.6), extracapsular invasion (OR=13.3; 95% CI, 2.3-76), and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio (OR=20.2; 95% CI, 3.4-121.9), were significantly associated with non-sentinel lymph node metastasis. Conclusions: According to this study, age, primary tumor size, lymphovascular invasion, extracapsular invasion, and the ratio of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes, were found to be independent predictors of non-sentinel lymph node metastasis.

• 대한의사협회지
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• 제61권11호
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• pp.662-669
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• 2018

The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.