• Title/Summary/Keyword: 림프절병증

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Sarcoid-Like Reaction after Complete Remission of Malignancy: CT and 18F-FDG PET/CT Features for the Differential Diagnosis from Lymph Node Metastasis (악성종양의 완전관해 후 발생한 사르코이드증 유사 반응: 림프절 전이와의 감별진단에 유용한 CT와 18F-FDG PET/CT 소견)

  • Hyun Ji Kang;Yookyung Kim;June Young Bae;Jung Hyun Chang;Soo-Hyun Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.903-913
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    • 2021
  • Purpose To identify the imaging features indicative of sarcoid-like reactions in patients with intrathoracic lymphadenopathy after complete remission of malignancies. Materials and Methods This study enrolled five patients with histopathologically confirmed sarcoid-like reactions that developed after cancer remission. The clinical features and findings of CT and 18F-fluorodeoxyglucose (FDG) PET/CT were assessed. Results The underlying malignancies included breast, nasopharyngeal, colon, and endometrial cancer and lymphoma. The time intervals between complete remission of malignancy and the diagnosis of sarcoid-like reaction ranged from 6 to 78 months. CT findings of sarcoid-like reaction included bilateral hilar and mediastinal lymphadenopathies (n = 5), pulmonary nodules (1-15 mm) with peribronchovascular, fissural, or subpleural distribution, and interlobular interstitial thickening in the lungs (n = 4). 18F-FDG PET/CT revealed hypermetabolic uptake in the mediastinal and hilar lymph nodes and both lungs in the absence of extrathoracic uptake (n = 3). The sarcoid-like reactions resolved in all patients after corticosteroid treatment. Conclusion In patients with complete remission of malignancies, newly developed bilateral hilar and mediastinal lymphadenopathies with or without pulmonary nodules of perilymphatic distribution, in the absence of recurrence at the primary tumor site and extrathoracic metastasis, may suggest a sarcoid-like reaction. Such cases warrant histologic evaluation of the lymph nodes to prevent unnecessary systemic chemotherapy.

Primary Rectal Syphilis Mimicking Lymphoma: A Case Report and Literature Review (림프종으로 오인될 수 있는 원발성 직장 매독: 증례 보고와 문헌 고찰)

  • Hyunyoung Bae;Jungheum Cho;Hyuk Jung Kim;Suk Ki Jang;Hee Young Na;Jin Ho Paik
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.801-806
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    • 2024
  • Primary rectal syphilis is a rare disease that can be misdiagnosed as lymphoma or other rectal cancers on sigmoidoscopy or CT. Here, we report a case of primary rectal syphilis mimicking rectal malignancy in a 23-year-old male who presented with a rectal mass and multiple lymphadenopathies. In this case report and literature review, we focused on the CT findings and endoscopic observations of primary rectal syphilis. Infectious diseases, such as rectal syphilis, should be considered in the differential diagnosis of young patients with unusual rectal lesions and disproportionately extensive lymphadenopathies.

The Synchronous Occurrence of Splenic Marginal Zone Lymphoma in a Patient with Early Gastric Cancer: A Case Report (조기 위암과 동반된 비장 변연부 림프종 1예)

  • Park, Hyo-Jun;Kim, Keung-Mi;Choi, Min-Gew;Noh, Jae-Hyung;Sohn, Tae-Sung;Bae, Jae-Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.63-67
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    • 2009
  • Splenic marginal zone lymphoma (SMZL) is a rare type of non-Hodgkin's lymphoma (NHL). We report here on a patient who displayed the synchronous occurrence of SMZL and early gastric cancer (EGC). The patient was a 74 year-old male with liver cirrhosis. An EGC in the gastric antrum was diagnosed and the preoperative abdomen computed tomography scan revealed splenomegaly and intra-abdominal lymphadenopathy. We performed subtotal gastrectomy and the postoperative pathologic examination revealed adenocarcinoma limited to the gastric mucosa and SMZL in the lymph nodes. The patient recovered from the surgery without complications and is now awaiting chemotherapy. SMZL has an indolent clinical course with good long-term survival and so there is the possibility of the occurrence of a second primary malignancy. Rare cases of a second primary malignancy being diagnosed along with SMZL have been described in the literature. Patients with SMZL should be carefully followed after treatment to detect the possible occurance of a second primary malignancy.

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SCHWANNOMA OF THE SUBLINGUAL GLAND : REPORT OF A CASE (설하선에 발생된 신경초종)

  • Lee Eun-Sook;Choi Soon-Chul;Park Tae-Won;You Deong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.2
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    • pp.461-466
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    • 1994
  • 신경초종은 신경초에서 발생되는 성장이 느린 양성 종양으로 단발성이며 드물다. 이 종양은 말초 신경,자율 신경,뇌신경의 Schwann세포에서 발생된다. 두경부 영역의 두개외 신경성 종양은 드물며 특히 타액선에서 발생되는 예는 드물다. 저자들은 20세 여자 환자에서 아래와 같은 소견을 나타내는 신경초종을 경험하였기에 보고하는 바이다. 1.주소는 좌측 악하선 부위의 종창이었으며 촉진시 3×4㎝의 단단한 종괴가 만져졌으나 동통이나 림프절병증은 없었다. 2. 일반방사선사진에서 종괴와 관련된 골변화는 없었으나 초음파 영상에서는 불균질한 반사 양상을 보이는 종괴가 좌측 악하선 영역에서 관찰되었다. 3. 자기공명영상으로 병소의 정확한 위치를 확인할 수 있었다. 병소의 경계는 명확하였으나 신호 강도는 균일하지 않았으며 T1 강조 영상에서는 근육과 유사한 신호 강도를 보였으나 T2 강조 영상에서는 근육보다 높은 신호 강도를 나타냈다. 4. 조직 병리학적으로 Antoni type B 부위보다는 A 부위가 지배적이었으며 Verocay body도 나타났다. 종양 세포는 anti-S-100 염색에 양성으로 반응하였다.

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Non-Functioning, Malignant Pancreatic Neuroendocrine Tumor in a 16-Year-old Boy: A Case Report (16세 남아에서 발생한 췌장의 비기능성 악성 신경내분비 종양: 증례 보고)

  • Lim, Se-Woong;Lee, Young-Hwan;Choi, See-Sung;Cho, Hyun-Sun
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.2
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    • pp.145-150
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    • 2010
  • We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.

A Case of Amyloidosis Presenting as Lymphadenopathy at the Porta Hepatis (간문 주위 림프절병증으로 발현된 아밀로이드증 1예)

  • Lee, Ja In;Kim, Joon Sung;Kim, Byung Wook
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.209-212
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    • 2018
  • We report a rare case of systemic amyloidosis with gastrointestinal and lymph node involvement. A 64-year-old woman was admitted to our hospital with dyspepsia and weight loss. Initial esophagogastroduodenoscopy (EGD) revealed nonspecific findings, and abdominal computed tomography showed necrotizing lymphadenopathy at the porta hepatis. Laparoscopic lymph node biopsy was performed under suspicion of tuberculous lymphadenopathy, but a definite diagnosis was not established. Follow-up EGD performed 6 months later revealed multiple telangiectasia-like lesions at the gastric body, and endoscopic biopsy revealed amyloid deposition. Through additional blood and urine protein electrophoresis, the patient was finally diagnosed with systemic amyloidosis associated with multiple myeloma. She was treated with dexamethasone, thalidomide, and bortezomib; however, she died 3 months after diagnosis because of pneumonia and multiple organ failure.

Discussion of COVID-19 Vaccination and Axillary Lymph Nodes Uptake in 18F-FDG PET/CT (18F-FDG PET/CT에서 코로나 백신접종과 액와 림프절 섭취에 대한 고찰)

  • Min-Chan, Kim;Yong-Hoon, Choi;Han-Sang, Lim;Jae-Sam, Kim
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.2
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    • pp.32-36
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    • 2022
  • Purpose There are reports that the COVID-19 vaccine causes false positive uptake of axillary lymph nodes. Therefore, this paper intends to evaluate the change in SUVmax of axillary lymph nodes with the period after the COVID-19 vaccination. Materials and Methods In 134 breast cancer patients who were tested for 18F-FDG PET/CT at Severance hospital, 3.7 MBq/kg of 18F-FDG was intravenously injected and scanned for 2 minutes per bed after 60 minutes. The equipment was Discovery 600 (GE Healthcare, MI, USA). The period was divided into four groups, 0 to 2 weeks, 3 to 6 weeks, 7 to 10 weeks, and 11 weeks or more. SUVmax was measured after checking the uptake of axillary lymph nodes on the ipsilateral side of vaccination and the Kruskal-Wallis test was performed using SPSS Statistics 28 (IBM Corp., Armonk, NY, USA). Results From 0 to 2 weeks groups to 11 weeks or more group, the average of SUVmax was measured in the order of 5.52, 2.85, 1.82, and 1.7. As a result of the Kruskal-Wallis test, there was a significant difference between 0 to 2 weeks group from all other groups (P < 0.05), and there was no significant difference between the remaining three groups. Conclusion The SUVmax of axillary lymph nodes decreased over the period after the COVID-19 vaccination and no significant difference was found after 3 weeks of vaccination. Therefore, it is recommended to record COVID-19 vaccination information before examination.

Rectal Syphilis Mimicking Malignancy: A Case Report (악성 종양으로 오인된 직장 매독 감염: 증례 보고)

  • Sunjin Ryu;Bo-Kyeong Kang;Mimi Kim;Chul-Min Lee
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.637-642
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    • 2024
  • Rectal syphilis is a rare form of syphilis presentation and its symptoms, endoscopic and radiologic findings are nonspecific. Rectal syphilis typically presents with features such as concentric rectal wall thickening, mucosal hyperemia, perirectal fat stranding, and lymphadenopathy. Rectal cancer exhibits asymmetric wall thickening and lymph node necrosis, aiding in the differentiation between these two diseases. However, due to the considerable overlap in their respective manifestations, distinguishing between rectal syphilis and rectal cancer is extremely challenging without considering the patient's medical history. Rectal syphilis often leads to unnecessary tests or delayed treatment, as it can be mistaken for other benign diseases such as inflammatory bowel diseases in addition to rectal cancer. In this case report, we aim to provide a detailed report on the endoscopic, imaging, and pathological findings based on our experience with a case of suspected rectal malignancy that turned out to be rectal syphilis.

Rosai-Dorfman Disease as a Solitary Lesion of the Tibia (경골에 단독으로 발생한 Rosai-Dorfman병)

  • Kong, Chang-Bae;Lee, Jung-Wook;Cho, Sang-Hyun;Song, Won-Seok;Cho, Wan-Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.32-35
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    • 2014
  • Rosai-Dorfman disease (RDD) is an idiopathic histioproliferative disorder of lymph node and extranodal site. Bone involvement is very rare. We report a case of extranodal RDD of the tibia in 32-year old male. The patient presented with pain with no evidence of lymphadenopathy. Clinico-radiologic diagnosis was metastatic carcinoma or Langerhans cell histiocytosis, but, histopathologic examination confirmed the diagnosis with RDD. We performed curettage on the osteolytic lesion of tibia. In South Korea, there was no report about RDD of the extremity and we want to report this case with review of the literature.

A case of antiepileptic drug hypersensitivity syndrome by lamotrigine mimicking infectious mononucleosis and atypical Kawasaki disease (전염성 단핵구증과 비전형적 가와사키병과 유사한 lamotrigine에 의한 항경련제 과민증후군 1예)

  • Yoo, Su Jung;Park, Ihl Sung;Suh, Eun Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.389-391
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    • 2009
  • Antiepileptic drug hypersensitivity syndrome (AHS), a delayed immunological reaction, is a relatively rare side effect of antiepileptic drugs and is usually overlooked. An array of symptoms can occur one to eight weeks after treatment with an antiepileptic drug. Symptoms may be as simple as a fever, skin rash, or lymphadenopathy, but may eventually involve internal organs and cause fatal outcomes. Additionally, because the symptoms resemble the features of various arrays of diseases and the reported mortality rate is approximately 10%, the importance of early diagnosis and ability to differentiate AHS from other diseases cannot be overemphasized. We report a case of a 14-year-old girl with AHS caused by lamotrigine, which mimicked atypical Kawasaki disease and infectious mononucleosis.