• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.170-174
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• 2003

Pleomorphic adenoma is the most common benign tumor in the parotid gland and a parotidectomy with preservation of the facial nerve is a widely accepted treatment. We experienced a case of huge pleomorphic adenoma arising in the parotid gland with suspicious skin invasion. This present case was 67-year-old male presenting huge parotid mass $(12{\times}7cm)$ that has been present for 30 years and this tumor showed rapid-growing nature recently. The overlying skin surface was ulcerated with serous discharge and tightly adherent to the mass. The risk of malignant transformation of a pleomorphic adenoma increases with the duration of disease. The preoperative tentative diagnosis was carcinoma ex pleomorphic adenoma in the parotid gland. The initial pathologic diagnosis of fine needle aspiration biopsy was unsatisfactory smear. After parotidectomy, the histologic examination revealed that the parotid tumor was benign pleomorphic adenoma. We present a case of huge pleomorphic adenoma with skin invasion in the parotid gland with review of literatures.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.133-136
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• 2003

Background and Objectives: Kikuchi's disease or subacute necrotizing lymphadenitis is a cause of persistently enlarged lymph nodes unresponsive to antibiotic therapy. It affects predominantly young women under the age of 30, and it is seen primarily in the Asian population. Although this disease usually follows a benign course, all describing a clinical entity that has been mistaken for malignant lymphoma, lupus, and an assortment of infectious diseases. The purpose of this study is to report clinical characteristics and treatment outcome in order to contribute to the precise diagnosis and treatment. Materials and Methods: We reviewed 27 cases, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy during the past 5 years from January 1998 to December 2002. Results: It occurred more often in females (20 cases ; 74%) than males (7cases ; 26%), and it was seen more frequently in the second and third decades (21 cases ; 78%). Cervical lymphadenopathy were usually multiple (24 cases, 89%) and measured less than 2cm (20 cases, 74%). The posterior cervical and deep jugular chains are the most common location(34 cases ; 81%). Leukopenia(18 cases, 67%) and elevated ESR(20 cases, 75%) were commonly noted in laboratory data. Conclusions: It is easy that Kikuchi's disease is mistaken for malignant lymphoma. So we should consider fine needle aspiration or open biosy of lymph node for histologic diagnosis in patients who have localized cervical lymphadenopathy unresponsive to antibiotic therapy.

• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.603-606
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• 2009

본 연구는 폐 병소의 경피적 흡인 생검을 시행하는데 있어 기흉 발생에 영향을 미치는 요인을 7가지로 나누어 분석하여, 국소적인 폐 병소를 보인 25~85세 사이의 104명의 환자를 대상으로, 병변의 위치, 병변의 크기, 병변의 깊이, 성별, 나이, 생검 시간, 생검 횟수로 나누어 기흉 발생과의 연관성을 연구하였다. 그 결과는 다음과 같다. 1. 위치에 따른 기흉 발생률은 우하엽에서 27.3%, 우상엽 24.3%, 좌하엽 15%, 좌상엽 12% 순으로 나타났으며, 병변의 크기에 따른 기흉 발생률은 0~2.0cm에서 24.0%, 2.1~4.0cm에서 18.2%, 4.1cm 이상에서 20.0%이었으며, 병변의 깊이에 따른 기흉 발생률은 0cm에서 6.7%, 0.1~2.0cm에서 24.2%, 2.1cm이상인 경우가 26.8%이며, 성별에 따른 기흉의 발생은 남성 21.7%, 여성 17.1%로 나타났으며, 나이에 따른 기흉 발생은 40세 이하가 25%, 41~50세가 11.7%, 51~60세가 14.3%, 61~70세가 24.1%, 70세 이상이 24.1%로 나타났고, 생검 시행 횟수에 따른 기흉 발생률은 4회 이상에서 28.6%, 2회 이하에서 20.5%, 3회에서 17.4%로 각각 나타났다. 이 모두는 통계적으로 유의한 차이는 없었다(P=0.484, 0.859, 0.088, 0.581, 0.758, 0.658). 2. 생검에 걸리는 시간에 따른 기흉 발생률은 0~10.0분에서 3.8%, 10.1~20.0분에서 24.2%, 21분 이상에서 40%로 시간이 오래 걸릴수록 기흉 발생률은 증가하였으며 통계적으로 유의한 차이가 있었다(P=0.005).

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.112-121
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• 1994

During the 7 years period from March 1987 to Febrary 1994, 344 patients with thyroid nodules, were admitted and operated at Department of Surgery, Collage of Medicine, Hallym university. We obtained following results: 1) The thyroid nodules were prevalent in female with ratio 1:17.1, both benign and malignant nodules were prevalent in the forth decade(37.8%:25.8%). 2) The duration of illness within 6 months was most common: 47.1% and within 1 years was 66.6%. 3) The most prominent symptoms & sign were palpable mass in anterior neck(96.8%). 4) The right-sided thyroid nodules were most common. 5) Thyroid scaning and thyroid function test were found to be not much value in differentiating malignancy. 6) Accuracy of the fine needle aspiration cytology was 75.5%. 7) There were 251 cases(73.0%) of benign and 93 cases(27.0%) of malignant nodules: most frequent benign nodule was adenomatous goiter(67.7%) and the most frequent malignant nodule was papillary adenocarcinoma (86.0%). 8) The most commonly performed surgical procedure was unilateral lobectomy with isthmectomy in both benign(41.0%) and malignant(33.3%). 9) Postoperative complications are as follows: transient hypothyroidism 22cases, transient hoaseness 16 cases, hypothyroidism 6 cases, wound infection 4 cases, hematoma 3 cases, permanent hoaseness 2 cases.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.91-101
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• 1994

Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.177-181
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• 1999

Objective: The clinical significance of mass screening for thyroid carcinoma remains unclear. This study was carried out to clarify the value of mass screening for thyroid carcinoma. Materials and Methods: From December 1997 through July 1998, a total of 1,401 subjects who were enrolled to receive breast screening or follow-up examination for breast cancer were included in this study. Thyroid glands were examined by 10 MHz ultrasonography by one experienced radiologist. The patients with thyroid nodules were classified into 2 groups according to their potential risk of malignancy by ultrasonographic findings(high-risk : hypoechogenicity, microcalcification, irregular margin, taller than wider shape). High-risk patients were advised to undergo fine-needle aspiration biopsy and thyroidectomy. The characteristics of the thyroid cancers detected by ultrasonographic mass screening were compared by those of clinical thyroid cancer excluding male patients during the same period. Results: Thyroid nodules were detected in 353(25.2%) of the subjects and 259(73.4%) were listed in the low-risk group and 94(26.6%) in high-risk group. Among 94 patients in the high-risk group, 43 underwent thyroidectomy and 37 turned out to have thyroid carcinomas. Thus, the detection rates for carcinoma were 2.6% of all subject, 10.5% of the detected nodules, 36.4% of the high risk women and 86.0% of the operated cases. The tumor size was significantly smaller in the mass-screening group than in the clinical cancer group(p<0.05). However, there was no statistical differences between two groups in the prevalences of neck node involvement and extracapsular invasion and the patients distributions by AMES score, MACIS score and TNM stage. Conclusion: Ultrasonogrpahic mass screening may be useful for the early detection of thyroid carcinoma in women who are scheduled to have breast examination.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.1
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• pp.38-42
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• 2004

Because of the lack of resources on the importance of cell block, the diagnosis of cytologic specimen has been overlooked. Out of 1,243 cases of non-gynecologic cytology specimen, about 87.1% has been proven to be diagnostically useful. About 0.9% of those were rendered diagnostic by cell block alone. If cell block was not made it could have resulted in misdiagnosis. The effect on making cell block might not be directly linked to the patient but to the pathologist, it can be a helpful secondary tool in lowering the chance of giving false negative results hence. Giving the patient the opportunity of an adequate treatment. This study has proven that cell block has diagnostic value in non-gynecologic cytology. We are doing our best to increase the production rate of cell block and to improve the quality of cytology smears and cell block, so that we can increase the accuracy of diagnosis.

• Advances in pediatric surgery
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• v.6 no.2
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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.

• Tuberculosis and Respiratory Diseases
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• v.55 no.5
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• pp.526-530
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• 2003

Bronchogenic cysts are generally presented as a well defined mass that have thin and smooth wall in the intrapulmonary or mediastinal area by simple chest radiographs. We present the case of a 20-year-old man with a ill-defined left upper lobe mass, found by chest radiographs. At the preoperative examinations, chest computed tomography showed ill-defined mass with Hounsfield Number 26, and nonspecific findings were shown by the bronchoscopy and percutaneous needle aspiration. The patient was undertaken the left upper lobectomy. The surgical specimen contained a ill-defined mass, measuring $2{\times}3$ cm. On the section of the mass, a cyst containing dark brown thick materials was noted. The cyst was unilocular, and the wall showed a trabeculation. Microscopically, the cystic mass was lined with ciliated pseudostratified columnar epitheliums and surrounded by smooth muscle and cartilage.

• Journal of Veterinary Clinics
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• v.22 no.3
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• pp.288-295
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• 2005

Five dogs at the age of 2-13 years, with variant respiratory signs like as dry cough, dyspnea, exercise intorelance and lameness were presented. On thoracic radiographs, all dogs had abnormalities such as soft tissue density, round mass image, increased pulmonary infiltration and pleural effusion. All dogs were diagnosed as adenocarcinoma on cytopathologic examinations by fine needle aspiration with ultrasound guidance. Computed tomography was performed in three cases to evaluate clinical stage. Primary papillary adenocarcinoma was confirmed after necropsy in one case.