• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.81-84
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• 2017

Langerhans cell histiocytosis (LCH) is a heterogeneous disease, characterized by accumulation of dendritic cells with features similar to epidermal Langerhans cells. It is a rare entity that may involve various organ levels such as the skeletal, pulmonary, hematopoietic and lympho-vascular systems. The patient was a 1-year-old female presented with fever associated with otorrhea and palpable cervical lymph node for 4 days. Neck ultrasonography and Computed tomography imaging revealed multiple enlarged lymph nodes suggesting suspicious malignant morphology. Lymph node biopsy was performed under general anesthesia. Histological and immunophenotypic examination showed the lymph node to be consistent with LCH. The patient was given chemotherapy.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.194-199
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• 1996

Cryptococcosis is a rare in normal child and the majority of cases usually occur in patients with defective cell-mediated immunity. Infection is acquired by inhalation of organisms from the environment and disseminated via the blood stream to any organ of the body. We experienced a 7 year old girl who presented with fever, both cervical lymphadenopathy, hepatomegaly under the impression of lymphoma. However lymph node biopsy revealed cryptococcal budding and culture of lymph nodes yielded cryptococcus neoformans. The radiologic finding showed huge, multiple cervical lymph node enlargement spreading to mediastinum and abdomen. The immune fuction in term of T cell, B cell, serum immunoglobulin, complement and neutrophil function tests was normal. The patient was treated with amphotericin B and flucytosine for 6 weeks and responded to the treatment well. We report this case with brief review of the related literatures.

• Tuberculosis and Respiratory Diseases
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• v.50 no.5
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• pp.630-635
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• 2001

Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT findings of splenic tuberculosis are multiple, well-defined, round or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One patient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.21-28
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• 2000

Background:Subacute necrotizing lymphadenitis or Kikuchi's disease is unknown ethiology and self-limiting process. This disease predominantly affects young women age but rarely affects pediatrics, and usually manifests as lymphadenopathy and fever. Even though this disease is self-limited, benign process, many cases are misidentified as malignant lymphoma. The purpose of this study is to report the clinicopathologic finding, radiological finding and many labolatory test and to compare with characteristics of adult patients in this disease. Meterial and Methods:We reviewed 27 pediarics patients with subacute necrotizing lymphadenitis by excision biopsy or fineneedle aspiration cytology.Result:The most common symptomes were palpation of cervical lymh node(88.9%) and fever(66.7%). The common site of the involvement was cervical lymph node. The multiple involvement was 93% and bilateral involvement was 59%. Leukopenia(52%) and elevated erythrocyte sedimentation rates(93%) appeared in abnormal laboratory data. Microscopically, the characteristic finding was the wide area of florid nuclear dusts engulfed by histiocytes and well-circumscrbed area with eosinophilic fibrinoid material. There was a striking degree ofkaryorrhexis and an absence of granulocyte with paucity of plasma cell. All patients recovered with the conservative treatment and there was no specific complication and recurrence. Conclusion : We reviewed pediatric patients with this disease. Characteristics of this disease inpediatric patients were similar to adult patients.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.714-718
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• 2020

Herpetic mastitis is extremely rare, and its imaging findings remain unclear. We report a case of herpes simplex mastitis in an adolescent woman and describe the clinical and ultrasound features. The patient showed unilateral nipple and areolar skin thickening and axillary lymphadenopathy on B-mode ultrasonography. Doppler ultrasonography revealed multiple linear and branching blood flows in the areolar area. The lesion was verified as herpes simplex mastitis via a skin biopsy. This report shows that the radiologic features of herpes simplex mastitis may be similar to those of Paget's disease because of localized nipple and areolar skin thickening and increased vascularity.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.201-210
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• 2000

Purpose : We observed response to PPD skin test and local side reactions among subjects who received inoculation with Tokyo 172 BCG strain by percutaneous method using multiple puncture device. Methods : 138 infants and young children were enrolled at Yongdong Severance Hospital and 7 private clinics. 5TU PPD skin test were performed at 4 months after inoculation. The local reactions at multiple puncture site were observed in 3 days, 4~6 weeks, 36 weeks, and 48 weeks after inoculations and physical check up was done for evaluation of lymphadenopathy. Results : During 48 weeks of observation period, 96 subjects among 138 who were enrolled were followed up completely with records of PPD skin test and observation of local side reactions, presenting with the photos. The size of the induration after 48 hours of PPD skin test, was less than 5mm in six subjects(6.3%), greater than 10mm in sixty seven subjects(70.0%) and greater than 12mm in forty six subjects(47.9%). All subjects showed inflammatory reaction and pustules at multiple puncture sites and only just small papules, ulcer and pustules remained 4-6 weeks later. Eight to twelve weeks later, all local inflammatory skin reactions disappeared with remaining crust. After 48 weeks, 4(4.2%) subjects showed no scar with only faint stain on the puncture site. More than 70% of subjects showed more than 10 faint pin-point scars on the sites. However, the size of scar was clearly smaller compared to that of intradermal inoculation. There were no cases of lymphadenopathy. Conclusion : We observed good immune response to 5TU PPD skin test among the infant and young children who were immunized with percutanous inoculation of Tokyo 172 BCG strain. We could not find any severe local scar at inoculation sites. A degree of satisfaction of the parents whose children received the percutaneous injection was very high.

• Tuberculosis and Respiratory Diseases
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• v.71 no.6
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• pp.464-469
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• 2011

Adalimumab is a full human monoclonal antibody that inhibits tumor necrosis factor-alpha (TNF-${\alpha}$). This has recently been shown to be effective in the treatment of rheumatoid arthritis (RA), ankylosing spondylitis, and other conditions. Sacoidosis is known to be the target for adalimumab but we describe a patient who has developed sarcoidosis with lung involvement during adalimumab therapy for RA. A 48-year-old woman, who was treated with adalimumab for 5 months, was admitted because of chronic cough and both hilar lymphadenopathy on chest radiography. Chest computed tomography revealed the enlargement of multiple lymph nodes in the right supraclavicular, subcarinal, both hilar and right axillary area. She was diagnosed with sarcoidosis based on the biopsy of supraclavicular lymph node, skin and lung through video-associated thoracoscopic surgery, which was non-caseating epitheloid cell granuloma and excluded from a similar disease. She was treated for sarcoidosis with prednisolone and methotrexate instead of adalimumab.

• Journal of Korean Traditional Oncology
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• v.16 no.2
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• pp.1-8
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• 2011

Background : Approximately 50% of patients with low-grade endometrial stromal sarcoma (LGESS) develops recurrent disease, mainly in lung or pelvis. Peritoneal metastasis of LGESS is an extremely rare phenomenon. Optimal treatment for metsatatic LGESS has not been established. Case : A 43-year-old woman had been diagnosed with LGESS with aortocaval lymphadenopathy. Despite of surgical resection, adjuvant radiation, chemotherapy and hormonal therapy, multiple lung and peritoneal metastasis developed after 15 months from initial treatment. Additional chemotherapy was done, but disease progressed. She had treatment with the allergen-removed Rhus verniciflua Stokes (aRVS) from November 2010 to May 2011. About 5 months to progression was observed. Conclusion : We suggests that aRVS could be an alternative treatment option for the metastatic LGESS patients. Further clinical studies on the efficacy of aRVS against metastatic LGESS are needed.

• Korean Journal of Head & Neck Oncology
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• v.16 no.2
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• pp.212-215
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• 2000

Background and Objective: Kikuchi's disease(KD) is an idiopathic, self-limited lymphadenopathy that was described as a distinctive type of necrotizing lymphadenitis affecting primarily cervical lymph nodes of young adults independently by Kikuchi and Fujimoto et al at first in 1972. The purpose of this study is a knowledge about clinicopathologic findings, many laboratory tests and differentiation of KD from other lymphadenitis due to lymphoma, systemic lupus erythematosus(SLE) and many viral disease. Materials and Methods: Thirty-four case of KD collected at Chonnam University Hospital in Kwang-Ju from 1992 through 2000 were evaluated with retrospective chart review. Results: The patients were consisted of 11 men and 23 women. All patients had tender or nontender cervical mass and fever was the most common associated symptom. The others was pain, weight loss, chills, cold sweating and headache et al. Multiple bilateral involvement of cervical lymphnodes was 25 cases(74%) and solitary involvement was 9 cases(26%). In laboratory tests, leukopenia was 12 cases(75%), elevated ESR 5 cases (34%) and elevated LDH 11 cases(69%). Conclusion: KD is necessary to differentiate from lymphoma and SLE, because of the different of therapeutic modality and prognosis. The diagnosis is established on the basis of histopathologic studies with excisional biopsy of lymph node.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.92-97
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• 2004

Posttranplantations lymphoproliferative disease (PTLD) is a common and life-threatening complication for soid organ transplantation associated with the use of chronic immunosuppression and Epstein-Barr virus. There is no standardized treatment algorithm, but numerous management strategies are vaiable. Partial splenic embolization (PSE) had been demonstrated to be an effetive alternatie to splenectomy for patients hypersplenism and portal hypertension. PSE has the advantages of non-invasive intervention and resolution of the complications of hypersplenism. We report the effect of the PSE in a 6-year old male liver transplantation recepient with PTLD who has undergone persistent hypersplenism post-transplant. We reduced immunosuppression agent, started antiviral agent. We started with interferon and IV globulin one month after admission. Hepatosplenomegaly and cervical lymphadenopathy were improved. But fever was not subside. We selectively embolized the lower pole of the spleen to achieve a 50~60% reduction in flow as determined by angiography. After embolization, fever subside and peripheral blood findings were improved. Follow up abdominal CT revealed reduced volume of spleen due to ischemic change and there was no multiple enlarged mesenteric lymphnode compared to preembolization state. We thick that PSE is a safe an effetive treatment modality of PTLD with persistent hypersplenism in patients twho failed to medical treatment.