• 대한세포병리학회지
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• 제1권2호
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• pp.158-163
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• 1990

Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyalinization. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present. In the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.

• 대한골관절종양학회지
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• 제15권1호
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• pp.69-74
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• 2009

슬와부위의 연부조직육종은 사지의 연부조직 육종 중 5% 이하를 차지하는 드문 질환이다. 주요 혈관과 신경이 지나가는 슬와, 주와, 서혜부와 같은 구획외 공간에서는 사지 구제술 시 적절한 절제연을 얻으면서 절제를 시행하기가 쉽지 않으며 불가피하게 변연부 절제를 시행해야 하는 경우도 있다. 슬와부 종양 절제시는 후방 도달법을 시행하는 경우가 일반적이다. 크기가 작고 주변 조직에 유착이 없는 종양일 경우 후방 도달법으로 신경다발막과 혈관외막을 박리하여 종양을 쉽게 절제할 수 있다. 그러나 종양의 크기가 크고 주변조직으로 침범이 있는 경우에는 종양의 절제 자체가 어려울 수 있다. 이런 경우는 절단술의 상대적 적응증이며 종양이 전방 및 후방 구획을 동시에 침범하였을 경우에는 절단술이 불가피하다고 생각되는 경우가 많았다. 저자들은 전방 및 후방 구획을 동시에 침범한 연부조직종양을 골 외측으로 종괴를 형성한 골종양으로 간주하여 근위 경골과 비골을 종양과 함께 절제함으로써 적절한 절제연을 얻으면서 사지구제술이 가능하였기에 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7989-7993
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• 2014

Background: The Khon Kaen Cancer Registry (KKCR) was established in 1984. Previous population-based incidences and survivals of childhood cancer in Thailand were determined using a short cancer registration period. Materials and Methods: Data were retrieved of all children residing in Khon Kaen, between 0-15 years, diagnosed as having cancer and registered in the KKCR (1985-2009). The follow-up censored date was December 31, 2012. The childhood cancers were classified into 12 diagnostic groups, according to the International Classification of Childhood Cancer. The incidence was calculated by the standard method. Survival of childhood cancer was investigated using the KKCR population-based registration data and overall survival calculated using the Kaplan Meier method. Results: In the study period, 912 newly diagnosed cases of childhood cancer were registered. The respective mean and median age was 6.4 (SD=4.6) and 6 (0-14) years. The age-peak for incidence was 0-4 years. The age-standardized rate (ASR) was 83 per million. Leukemia was the most common cancer (N=360, ASR 33.8) followed by neoplasms of the central nervous system (CNS, N=150, ASR 12.8) and lymphoma (N=79, ASR 7.0). The follow-up duration totaled 101,250 months. The death rate was 1.11 per 100 person-months (95%CI: 1.02 -1.20). The 5-year overall survival was 52% (95%CI: 53-56.9) for all cancers. The respective 5-year overall survival for (1) acute lymphoblastic leukemia (ALL), (2) acute non-lymphoblastic leukemia (ANLL), (3) lymphoma, (4) germ cell tumors, (5) renal tumors, (6) retinoblastoma, (7) soft tissue tumors, (8) CNS tumors, (9) bone tumors, (10) liver tumors, and (11) neuroblastoma was (1) 51%, (2) 37%, (3) 63%, (4) 74%, (5) 67%, (6) 55%, (7) 46%, (8) 44%, (9) 36%, (10) 34%, and (11) 25%. Conclusions: The incidence of childhood cancer is lower than those of western countries. Respective overall survival for ALL, lymphoma, renal tumors, liver tumors, retinoblastoma, soft tissue tumors is lower than that reported in developed countries while survival for CNS tumors, neuroblastoma and germ cell tumors is comparable.

• 대한골관절종양학회지
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• 제1권1호
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• pp.77-83
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• 1995

1. 연부 조직과 골 조직사이에서의 악성 섬유성 조직구종의 근본적인 조직학적 차이는 없었다. 2. 악성 섬유성 조직구종은 조직학적 소견이 다양하므로, 확진을 위해서는 다른 종양을 반드시 배제하여야한다. 3. 재발시 다른 형태의 조직 소견을 보여줄 수 있기 때문에 정확한 진단을 위해 환자의 과거력 및 과 거의 조직학적 검토가 필수적이라 사료된다.

• 대한소아치과학회지
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• 제26권1호
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• pp.157-161
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• 1999

1. Periphelal odontoma는 매우 드문 질환으로 확진을 위해서는 생검이 필수적이다. 2. Peripheral odontoma는 치은의 종창을 동반하며 서서히 성장하는 임상적 특징을 가진다. 3. 골내 치아종과 마찬가지로 peripheral odontoma의 치료로는 완전한 외과적 절제가 추천되고 예후 또한 양호하다.

• 대한족부족관절학회지
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• 제14권2호
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• pp.169-172
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• 2010

Purpose: The authors have experienced various lesions that simulate ganglion of the foot on the ultrasonography. The purpose of this study is to evaluate ultrasonographic findings of soft tissue lesions, which were interpreted as ganglion but confirmed as different lesions in the foot. Materials and Methods: We reviewed a database of patients with ganglion on the ultrasonography from two different institutions. There were 109 patients who underwent both ultrasonography and surgical confirmation. Twenty one lesions were identified, of which initial interpretation on the ultrasonography included ganglion which pathology revealed to be different lesions. All images were evaluated by one musculoskeletal radiologist, regarding size, margins, internal echogenicity of lesions, and presence of posterior enhancement. Results: Of 21 lesions, there were 6 fibrous tumors including fibroma, giant cell tumor of tendon sheath, and fibromatosis, 3 hemangiomas, 2 epidermal inclusion cysts, 2 chondromas, 2 angioleiomyomas, 1 trichilemal cyst, 1 neurofibroma, 1 granular cell tumor, 1 neurilemmoma, 1 neuromyxoma, and 1 nodular hidradenoma. Mean size of the lesion was 1.1 cm. Margins were smooth in 10, mild lobulation in 8 and marked lobulation in 3 lesions. Lesions were hypoechoic in 16, anechoic in 4 and isoechoic in 1 case. Posterior acoustic enhancement was definitely present in 5 lesions. Conclusion: On the ultrasonography, various soft tissue lesions of the foot may be confused with ganglion. During surgical resection care should be given even to a simple ganglion as it might turn up to be a solid lesions such as fibrous tumors.

• 대한골관절종양학회지
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• 제9권2호
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• pp.178-189
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• 2003

목적: 근골격계 종양의 종류에 따른 케모카인 발현 양상을 보고, 원발성 골육종과 재발된 골육종, 골육종의 항암화학요법 전과 후의 발현 차이가 있는지를 조사하고자 한다. 대상 및 방법: 종양조직을 얻을 수 있었던 원발성 양성 및 악성 근골격계 종양 10예, 재발된 골육종 1예, 화학요법 후의 골육종 1예 및 정상조직의 대조군 1예를 대상으로 하였다. RNA를 분리한 다음, 역전사 중합효소 연쇄반응(RT-PCR )과 RNase protection assay (RPA)를 이용하여 싸이토카인과 케모카인의 발현을 조사하였다. 각각의 종양간에 발현도 차이가 있는지를 알기 위하여 SPSS를 사용한 Fisher's exact test를 이용하여 통계적 처리를 하였다. 결과: IL-8과 TNF-${\alpha}$는 모든 조직에서 발현되었고, IFN-${\gamma}$는 2예 외에 모두 발현하였으며, RANTES의 경우 연부조직 종양 5예, 골종양 4예에서, GRO${\alpha}$는 연부조직 종양 1예, 골종양 2예에서 발현되었고, MCP-1과 IP-10의 경우 악성 골종양군에서는 2예만, 나머지에서는 모두 발현되는 다양한 양상을 보였다. 원발성 골육종에 비해 재발된 골육종 조직에서의 발현은 IFN-${\gamma}$를 제외하고, 전반적으로 발현도가 훨씬 강하였으며, 모든 종류의 케모카인 및 사이토카인들이 발현되었다. 화학요법 후에는 RANTES와 IFN-${\beta}$만이 발현되었으며, TGF${\beta}$ isoform 중 TGF${\beta}_1$ 유전자의 발현만 관찰되었다. 결론: 대상의 수가 적어 통계적 분석을 통한 정확한 자료의 제시는 불가능하였으나, 연부조직 종양과 골종양에 있어 일부 케모카인 및 사이토카인의 발현 차이가 있음을 확인하였고, 골육종의 경우 IFN-${\gamma}$ 및 TGF-${\beta}$ isoform의 발현 분석이 종양의 재발과 치료 후 변화에 대한 지표에 응용될 가능성이 있음을 제시하였다.

• 대한골관절종양학회지
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• 제2권1호
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• pp.33-37
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• 1996

From January 1994 to August 1995 we performed 270 cases of fine needle aspiration cytology for bone and soft tissue lesions. Among them 137 cases were diagnosed histologically. Sixty-seven cases were benign and 70 cases were malignant. We analysed these on the aspect of sensitivity, specifity, positive predictive value, negative predictive value of the cytologic examination. Malignant cases consisted of bone tumor 29 cases; soft tissue tumor 25 cases; and metastatic tumor 16 cases. The sensitivity and specifity of the aspiration cytology for malignant tumor were 67.8% and 97%, respectively. The positive and negative predictive value of aspiration cytology were 97.4% and 72.7%, respectively. Among them 40 cases were primary bony lesions; 14 benign lesions, 26 malignamt bone tumors. Sensitivity of aspiration cytology for these primary bony lesion was 90%(18/20) and its specifity was 100%(13/13). Three cases showed atypical cells in cytology but with biopsy we could find them as one benign and two malignancies. Two cases of manignancy showed negative result in cytology; one was parosteal sarcoma of proximal femur and the other was osteosarcoma of proximal tibia which was biopsied already at other hospital. Although the overall sensitivity and specifity for malignant bone and soft tissue tumors were relatively low and not so predictable, the fine needle aspiration cytology for primary bony lesion was useful in the differential diagnosis of benign or malignancy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9949-9953
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• 2014

Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

• 대한골관절종양학회지
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• 제11권1호
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• pp.32-39
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• 2005

목적: 최근에는 연부 종양의 진단에 FDG-PET을 이용하기 위한 연구가 다양하게 이루어지고 있다. 그러나, 그 임상적 유용성에 대해서는 알려져 있지 않다. 이 연구의 목적은 기존의 진단법과 비교하여 FDG-PET의 유용성을 평가하는 데 있다. 대상 및 방법: 연구 대상은 2001년 3월에서 2002년 3월 사이에 연부 조직 종양으로 진단받은 29명의 환자(남자 16명, 여자 13명, 평균 47세)를 대상으로 하였다. 모든 환자군에서 기존의 검사법과 FDG-PET을 시행하였다. 타당성 검증에서 국소 병변은 모든 경우 조직검사로 판단하였고, 전이 병변은 조직 검사와 6개월 간의 추시 결과로 판단하였다. 각각의 진단은 독립적으로 시행되었으며, 진단의 정확도와 누적 비용-정확도율을 측정하였다. 결과: 국소 병변의 진단에서 MRI와 FDG-PET의 민감도, 특이도, 정확도는 각각 91%, 57%, 83% 와 95%, 43%, 83%이었다. 원격 전이의 진단에서 기존의 검사법과 FDG-PET의 민감도, 특이도, 정확도는 각각 77%, 89%, 87% 와 92%, 94%, 93%이었다. 누적 비용-정확도율은 145,000원/% 이었다. 종양의 등급별 민감도 분석에서 고등급의 종양이 가장 비용-효용성이 높았다. 결론: 국소부위의 재발과 잔존 종양의 진단에서 FDG-PET의 정확도는 MRI와 차이가 없었다. 반면, 원격 전이의 진단은 FDG-PET이 기존의 검사 보다 정확하였다. 고등급 종양의 경우 저등급 종양보다 FDG-PET의 유용성이 큰 것을 알 수 있었다.