• Asian Pacific Journal of Cancer Prevention
• /
• 제15권2호
• /
• pp.855-860
• /
• 2014

Background: The purpose of this study was to assess the relationship between different sonographic features of papillary thyroid carcinoma (PTC) on high-frequency ultrasound and cervical lymph node metastasis (CLNM). Materials and Methods: We enrolled 548 patients who underwent initial surgery for PTC between May 2011 and December 2012 in our hospital at diagnosis. The sonographic features of 513 PTC nodules in 513 eligible patients, who had single PTC nodules in their thyroid glands, were retrospectively investigated. All patients with a suspect malignant nodule (d<0.5cm) among multiple nodules were initially diagnosed by fine-needle aspiration biopsy (FNAB) to ascertain if the suspect nodule was PTC. The final diagnosis of all the thyroid nodules and existence of CLNM were based on postoperative pathology. Patients were divided into two groups: a positive group with CLNM (224 nodules) and a negative group without CLNM (289 nodules). The following factors were investigated: gender, age, echogenicity, echotexture, size, shape, location, margin, contour, calcification morphology, distance between the nodule and pre- or post-border of the thyroid capsule, vascularity and the differences between the two groups. Results: Correlation analysis showed that shorter distances between the nodule and pre- or postborder of thyroid capsule resulted in greater risk of CLNM (Spearman correlation coefficient=-0.22, p<0.0001). The significant factors in multivariate analysis were age<45yrs, larger size (d>1cm), "wider than tall" shape, extrathyroid extension and mixed flow (internal and peripheral) (p<0.05, OR=0.406, 2.093, 0.461, 1.610, 1.322). Conclusions: Significant sonographic features of PTC nodules in preoperative high-frequency ultrasound are crucial for predicting CLNM.

• Archives of Plastic Surgery
• /
• 제46권5호
• /
• pp.441-448
• /
• 2019

Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. Methods We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. Results Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a splitthickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. Conclusions We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.

• Pediatric Infection and Vaccine
• /
• 제28권2호
• /
• pp.124-131
• /
• 2021

Cryptococcus neoformans는 주로 면역이 저하된 환자에서 기회 감염을 일으키는 진균이다. 그러나 면역이 정상인 환자에서도 다양한 감염을 일으킬 수 있다. 림프절을 침범한 폐 크립토코쿠스증은 정상 면역을 가진 사람에서는 상대적으로 드물게 발생한다. 고열과 지속적인 기침을 주소로 병원에 온 17세 여자 청소년이 가슴X선 영상검사 및 컴퓨터단층촬영에서 전방 종격동에서 우측 쇄골하 부위까지 침범된 종괴를 보여 초음파 유도하 총생검 검사로 크립토코쿠스증을 진단하였다. 각종 면역 검사에서는 이상 소견이 발견되지 않았다. 환자는 2주간 암포테리신 B와 플루시토신으로 치료 후 8개월간 플루코나졸로 치료하였고 완쾌되었다. 본 증례를 통해 크립토코쿠스증의 특징을 이해하고 정상 면역 환자에게서도 크립토코쿠스증이 발생할 수 있음을 염두에 두고 진단을 내리는 것이 바람직하겠다.

• Korean Journal of Radiology
• /
• 제21권5호
• /
• pp.598-604
• /
• 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.

• Tuberculosis and Respiratory Diseases
• /
• 제71권3호
• /
• pp.180-187
• /
• 2011

Background: In mediastinal lymph node sampling in non-small cell lung cancer (NSCLC) it is important to determine the appropriate treatment as well as to predict an outcome. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a recently developed, accurate, safe technique in patients with NSCLC for sampling mediastinal lymph nodes. We sought to determine the usefulness of EBUS-TBNA in mediastinal staging with NSCLC considered to be operable. Methods: We retrospectively reviewed the records of 142 patients who underwent EBUS-TBNA for mediastinal staging in the Asan Medical Center, Korea from July 2008 to July 2010. If patients were in an operable state, they underwent subsequent surgical staging. Diagnoses based on biopsy results were compared with those based on surgical results. Results: We performed EBUS-TBNA in 184 mediastinal lymph nodes in 142 NSCLC patients. Almost all of the EBUS-TBNA samples were from the lower paratracheal (112, 60.9%) and subcarinal (57, 31.0%) lymph nodes. In 142 patients, 51 patients (35.9%) were confirmed with malignant invasion of the mediastinal lymph node by EBUS-TBNA and 91 (64.1%) patients were not confirmed. Among the 91 patients, 64 patients (70.3%) underwent surgical staging. 3 patients (4.7%) who were misdiagnosed by the EBUS-TBNA were confirmed by surgery. After Diagnostic sensitivity of EBUS-TBNA, the prediction of mediastinal metastatsis was 94.4% and specificity was 100%. The procedures were performed safely and no serious complications were observed. Conclusion: We demonstrated the high diagnostic value of EBUS-TBNA for mediastinal staging.

• 대한두경부종양학회지
• /
• 제26권2호
• /
• pp.232-235
• /
• 2010

Extraparotid Warthin's tumor(EPWT) is a rare disease entity; its incidence is about 8% of Warthin's tumor(WT). The periparotid and upper cervical lymph nodes are the most predilection sites. The lymphoid tissue of WT can act like a regional lymph node, and the necrosis and inflammation within the tumor are well known. In our cases, both 81-year-old man and 58-year-old man were visited our clinic, presented with upper lateral neck mass that had been present for the last few months. We operated the excisional biopsy in level ll of neck. The pathologic examination was proven to be EPWT. We report the unique two cases of extraparotid Warthin's tumor with literature review.

• 대한기관식도과학회지
• /
• 제5권1호
• /
• pp.96-101
• /
• 1999

For many years it has been reported that seemingly benign neck cysts may contain carcinoma. Cystic metastases have often mistaken for either branchial cleft cysts or benign mass. Authors experienced two cases which presents cystic cervical metastatic cancer One was a tonsillar carcinoma and the other was a tongue carcinoma. Patients with a cystic squamous carcinoma in the neck likely have a primary in upper aero-digestive system and It is known that the tonsil is most common site. Radiologic examination and fine needle aspiration biopsy of the cyst proved to be non-diagnostic. The development of cervical lymph node metastases before clinical signs of carcinoma of the tonsil is also well recognized. So, in old patients, thorough head If neck examination, panendoscopy and ipsilateral tonsillectomy is mandatory to identify a primary carcinoma prior to cyst excision.

• 대한세포병리학회지
• /
• 제9권2호
• /
• pp.227-231
• /
• 1998

Infectious mononucleosis(IM) Is an acute self-limiting lymphoproliferative disorder associated with infection by the Epstein-Barr Virus(EBV), with the characteristic triad of fever, sore throat, and cervical or generalized lymphadenopathy. And also there are atypical lymphocytes in the peripheral blood. Cytological findings of IM lymphadenitis are characterized by a florid immunoblastic and atypical lymphoid cell proliferation. However, the small number of cases were studied by fineneedle aspiration cytology(FNAC) even though there was a complexity of lymph node pathology. It is important to recognize the reactive pattern of IM that would initiate EBV study and to avoid unnecessary biopsy We studied findings of lymph node FNAC from 4 patients with EBV infection confirmed by EBV-specific serologic studios. All of the cases were positive for viral capsid antigen(VCA) and one case was positive for anti-EBV nuclear antigen(EBNA). Cytologically, all of the cases exhibited high cellularity and atypia with great numbers of large immunoblastic lymphocytes.

• 종양간호연구
• /
• 제9권2호
• /
• pp.145-154
• /
• 2009

Purpose: The purpose of this study was to obtain information about the experiences of sensations after breast cancer surgery characterized by prevalence, frequency, and severity, distresses, and disturbances in ADL using the BSAS (Breast Sensation Assessment Scale) and to develop the standardized Korean BSAS. Methods: Thirty two women from 3 to 100 days after breast cancer surgery (BCS) completed Roberta's BSAS. The 18 sensations of BSAS were translated using the references of Lee's Korean Pain Rating Scale and English-English, English-Korean dictionaries and the consultation from two native Americans, one bilingual permanent resident of the States, and one nursing professor. The Korean-translated BSAS has high reliability in test-retest. Likert type 4-point scale and 100 mm VAS were used for assessment. Results: Certain sensations remained prevalent (tender, pull, pain), frequent (numb, nag, throb), severe (throb, shoot, numb), causing distress (throb, penetrate, shoot), and influencing on ADL (throb, penetrate, nag). The most frequently experienced sensation other than BSAS was itching. There was little difference in the prevalence of symptom experiences between sentinel lymph node biopsy and axillary lymph node dissection. Conclusion: The women after BCS are suffering from neuropathic sensations. The Korean- translated BSAS could be used in effectively assessing breast sensations after BCS in Korean women.

• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
• /
• pp.110-110
• /
• 1993

괴사성 임프절염(기구찌 병)은 원인이 알려지지 않은 새로운 질병으로서 주로 젊은 여자의 경부 임프절을 침범하여 임프절 비대를 일으키며, 대부분 수개월 내에 자연 소실되는 양호한 임상 경과를 보인다. 임상적으로 국소 임프절 비대가 특징적이며 때로는 압통, 발열, 체중 감소, 백혈구 수의 감소 또는 적혈구 침강 속도의 증가를 보이며 악성 임프종 및 결핵과의 감별을 요한다. 특징적인 조직 병리학적소견은 임프절의 괴사, 세포핵 붕괴 등을 보이고 형질세포의 침윤은 없다. 저자들은 1990년 3월부터 1993년 1월까지 괴사성 임프절염으로 확진된 19례를 검토한 후 본 질환의 보다 정확한 진단과 적절한 치료를 위하여 보고하는 바이다.