• Advances in pediatric surgery
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• 제6권2호
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• pp.95-99
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• 2000

Thyroid carcinoma is relatively rare in children. Eight cases of thyroid carcinoma were among 18 patients operated upon for thyroid tumors at Pediatric Surgery, Asan Medical Center in 11 years' period between 1989 and 2000. Five patients were boys and three were girls. The age distribution ranged from 10 to 14 years with a median age of 11.6 years. We studied clinical presentations, diagnostic workup, pathology, treatment, and follow-up (recurrence, mortality, and survival). All patients presented with anterior neck mass but one with multiple cervical lymph nodes enlargement. Familial history of thyroid cancer was seen in one case. All patients had a cold nodule by 1-131 thyroid scan. Fine needle aspiration (FNA) biopsy was performed in all patients. The right lobe was involved in four patients and the left lobe in two. Two had both lobes involvement. Pathologically, six cases were papillary carcinoma, one was follicular carcinoma, and one insular carcinoma. Four patients underwent unilateral lobectomy and isthmectomy. Total thyroidectomy was performed in three patients. The insular carcinoma case was preoperatively diagnosed as follicular neoplasm by FNA. After confirmation of the pathology by initial right thyroid lobectomy, total thyroidectomy was subsequently done. Cervical lymph node metastases were presented in three cases (37.5%), and lung metastasis in two cases (25%). Three patients received postoperative I-131 ablation. After a median follow-up of 53 months, all patients were alive without evidence of recurrence. In conclusion, thyroid carcinoma in children is frequently associated with lymph nodes involvement and distant metastasis, however, the prognosis is relatively good.

• 한국임상수의학회지
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• 제29권5호
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• pp.400-403
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• 2012

10년령의 수컷 푸들이 복부팽만, 등쪽 몸통 부위 탈모, 간비대와 혈청 알칼리인산분해효소의 지속적인 상승으로 전북대학교 수의과대학 동물병원에 내원하였다. 간 생검 및 미세침흡인세포 검사법과 PAS 염색을 실시한 결과 공포성 간병증 및 간세포에 글리코겐이 침착된 것을 확인 하였다. ACTH 자극 시험 실시 전 후 코티솔 및 부신과 관련된 성 호르몬의 농도를 측정하였다. 측정결과 안드로스텐디온, 프로게스테론 및 수산화 프로게스테론의 상승을 관찰할 수 있었으며 코티솔농도는 정상 범위내에 존재하였다. 진단은 성호르몬과 관련된 비정형의 부신피질 기능 항진증으로 내렸으며 치료는 트릴로스탄으로 하였다. 치료 8주 후 등 부위의 탈모를 포함한 임상증상들이 개선되었다.

• Tuberculosis and Respiratory Diseases
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• 제45권1호
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• pp.191-196
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• 1998

Follicular bronchitis/bronchiolitis is pathologically characterized by peribronchiolar lymphoid follicles, which is one of reactive pulmonary lymphoid disorders. It is associated with 1) the result of infections such as mycoplasma, chlamydia etc., 2) immunodeficiency syndromes, 3) connective tissue diseases such as rheumatoid arthritis and Sjogren's syndrome and 4) local or systemic hypersensitivity reaction. And it can be also developed without obvious causes and associated diseases(idiopathic). Radiologically it represents as bilateral interstitial patterns of pulmonary infiltrates. In this case, a 49 year-old woman was presented with intermittent cough and sputum. On chest X-ray and CT, $5\times4$ cm sized mass in right upper lobe and paratracheal lymphadenopathies were detected, by which lung malignancy was suspected. Bronchoscopy, trans bronchial lung biopsy and transthoracic needle aspiration showed non-specific findings only. After right upper lobectomy, we could confirm a case of follicular bronchiolitis which presented as an unusual mass-like radiologic finding.

• Tuberculosis and Respiratory Diseases
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• 제46권3호
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• pp.409-413
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• 1999

Malignant melanoma develops from the melanocyte and the most common primary site is skin, followed by mucosa and retina. Even though any other tissue where melanocytes reside could be the primary site of the malignant melanoma, the one developed in the mediastinum is rarely reported. We experienced a patients of 54 years old woman whose initial symptom was progressive dyspnea for one month, and proved to have the anterior mediastinal mass with pleural effusion and the small mass in the abdominal soft tissue. The needle aspiration biopsy from the mediastinal mass showed the consistent findings with malignant melanoma. We concluded the mediastinum was the primary site of the malignant melanoma of this patient because we couldn't find any other evidence of primary tumor in skin, oral and gastrointestinal mucosa, and retina. She has been treated with combined chemotherapy with dacarbazine, cisplatin and vinblastine. Her symptom was improved after chemotherapy and follow up chest CT after three cycles of chemotherapy showed the decreased tumor size in the mediastinum.

• Tuberculosis and Respiratory Diseases
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• 제67권3호
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• pp.244-248
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• 2009

Primary myelofibrosis is characterized by replacement of bone marrow with fibrotic tissue and the development of extramedullary hematopoiesis. Extramedullary hematopoiesis primarily involves the spleen and liver, but can also occur in the lungs. We report the case of an 80-year-old male who was admitted for evaluation of a lung mass and persistent thrombocytopenia. A percutaneous needle aspiration from the mass in the right lower lung showed myelopoietic cells with fatty tissue. A bone marrow biopsy revealed a hypercellular marrow with an increased number of atypical megakaryocytes. The final diagnosis was a prefibrotic stage of primary myelofibrosis leading to extramedullary hematopoiesis in the lung.

• Tuberculosis and Respiratory Diseases
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• 제38권1호
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• pp.65-69
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• 1991

Primary liposarcoma of the mediastinum is a very rare and relatively slow growing tumor. Since the original description by Pallase and Roubier in 1916, there have been about 55 reported cases in world literature until 1985. Recently, we experienced one case of a primary mediastinal liposarcoma with malignant effusion. A 51-year-old man complained of dyspnea and chest discomfort. The chest plain films and computerized tomogram showed a huge mass of the posterior mediastinal space. The needle aspiration biopsy was done in the huge mass and the histologic examination revealed mediastinal round-cell type liposarcoma. Patient refused surgery or chemotherapy after establishing the diagnosis. About 6 months later, the metastatic pleural effusion was noted. After discharge, he was lost to follow up since then. The clinical and therapeutic features of the previously reported cases of primary liposarcoma arising in the mediastinum have been reviewed. Surgery may served to establish a tissue diagnosis, to relieved the patient's symptoms and result occasionally in a cure but radiotherapy or chemotherapy is ineffctive.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.103-106
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• 2000

종격동 지방육종 자체가 드문 질환이기 때문에 의심하는 것이 중요하며 빠른 진단과 완전한 외과적 절제와 부가적 치료가 환자의 치료성적을 좌우하는 가장 중요한 인자임을 알아야 할 것이다. 연세대학교 의과대학 흉부외과학교실에서는 완전 절제가 가능하였던 거대한 원발성 종격동 지방육종 l예를 치험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제22권5호
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• pp.839-844
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• 1989

There appears to be significant problems remained in the treatment of tuberculous empyema with BPF in spite of several surgical methods: decortication, thoracoplasty, and pleuropneumonectomy. We presented one case of tuberculous empyema with BPF. The patient was 42-year-old male and his chief complaint was hemoptysis. In past history, he was treated with left closed thoracostomy and antituberculous medication for two months, 16 years ago. Chest X-ray, tomogram and C. T, revealed a huge mass with central necrosis in the lower 2/3 of left thoracic cavity and shifting of the mediastinal structure to the right. Needle aspiration cytology was undifferentiated large cell carcinoma. Left thoracotomy was made under the impression of lung cancer and pleuropneumonectomy was done. Operative findings; thick walled empyema sac filled with hematoma and BPF, the mediastinum was fixated due to fibrosis and calcification of the pleura and the mediastinum. Postoperative biopsy was consistent with tuberculosis. In the postoperative course, there was massive hemorrhage and so reoperation was done. But there was no active bleeding focuses in the thoracic cavity at the time of reoperation. Massive transfusion, coagulant therapy and intermittent clamping and declamping of the chest tube were carried out. Especially, serum calcium level was chronically decreased and so large amount of calcium gluconate was infused for the calcium level to be normal. Total transfused blood; whole blood was 33 pints, packed cell was 63 pints and fresh frozen plasma was 70 pints. At the postoperative[reop] 45th day, intrathoracic hemorrhage was stopped and the chest tube was removed. In conclusion, this suggest that uncontrollable bleeding after pleuropneumonectomy of the tuberculous empyema with BPF could be treated without reoperation in case of the mediastinal fixation due to fibrosis and calcification of the pleura and the mediastinum.

• 대한종양외과학회지
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• 제14권2호
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• pp.135-141
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• 2018

Purpose: Axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) are important for staging of patients with node-positive breast cancer. However, these can be avoided in select micrometastatic diseases, preventing postoperative complications. The present study evaluated the ability of axillary lymph node maximum standardized uptake value (SUVmax) on positron emission tomography-computed tomography (PET-CT) to predict axillary metastasis of breast cancer. Methods: The records of invasive breast cancer patients who underwent pretreatment (surgery and/or chemotherapy) PET-CT between January 2006 and December 2014 were reviewed. ALNs were preoperatively evaluated by PET-CT. Lymph nodes were dissected by SLNB or ALND. SUVmax was measured in both the axillary lymph node and primary tumor. Student t-test and chi-square test were used to analyze sensitivity and specificity. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) analyses were performed. Results: SUV-tumor (SUV-T) and SUV-lymph node (SUV-LN) were significantly higher in the triple-negative breast cancer (TNBC) group than in other groups (SUV-T: 5.99, P<0.01; SUV-LN: 1.29, P=0.014). The sensitivity (0.881) and accuracy (0.804) for initial ALN staging were higher in fine needle aspiration+PET-CT than in other methods. For PET-CT alone, the subtype with the highest sensitivity (0.870) and negative predictive value (0.917) was TNBC. The AUC for SUV-LN was greatest in TNBC (0.797). Conclusion: The characteristics of SUV-T and SUV-LN differed according to immunohistochemistry subtype. Compared to other subtypes, the true positivity of axillary metastasis on PET-CT was highest in TNBC. These findings could help tailor management for therapeutic and diagnostic purposes.

• 대한두경부종양학회지
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• 제40권1호
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• pp.37-41
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• 2024

Carcinoma ex pleomorphic adenoma is an uncommon malignant salivary gland tumor that arises from a long-standing pleomorphic adenoma. The carcinomatous component of carcinoma ex pleomorphic adenoma can possess virtually any histologic subtype of salivary gland cancer. We experienced a case of a 61-year-old patient who presented with a right parotid mass that was initially palpated 20 years ago, with a sudden increase in size in the last few months. Radiological and cytological findings from fine needle aspiration biopsy could not exclude malignancy. Total parotidectomy and selective neck dissection were performed for treatment, and carcinoma ex pleomorphic adenoma with mixed carcinoma components of salivary duct carcinoma and myoepithelial carcinoma was diagnosed. After receiving postoperative radiation of 6000 cGy over 6 weeks, there has been no recurrence up to the 18-month follow-up. We report this rare case of carcinoma ex pleomorphic adenoma with mixed malignancy subtypes, accompanied by a review of literature.