• Title/Summary/Keyword: 말초성 T-세포성 림프종

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Usefulness of F-18 FDG PET/CT in Staging of Peripheral T Cell Lymphoma (말초성 T 세포 림프종의 병기 설정시 F-18 FDG PET/CT의 유용성)

  • Kang, Yun-Hee;Lim, Seok-Tae;Kim, Dong-Wook;Jeong, Hwan-Jeong;Sohn, Myung-Hee;Yim, Chang-Yeol
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.369-374
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    • 2008
  • Purpose: F-18 FDG PET/CT has excellent sensitivity and specificity for staging non-Hodgkin lymphomas, but to the author's knowledge few studies to date have evaluated FDG PET/CT in peripheral T cell lymphoma. We evaluated the usefulness of F-18 FDG PET/CT in staging of patients with peripheral T cell lymphoma, especially indolent cutaneous T cell lymphomas. Materials and Methods: Twenty five patients (M:F=17:8, age $53.7{\pm}14.8$ yrs) with biopsy-proven indolent cutaneous T cell (CL) or noncutaneous T cell lymphomas (NCL) underwent PET/CT scans for staging at baseline. Peak standardized uptake values (p-SUV) of all abnormal foci were measured and compared between cutaneous and noncutaneous lesions. F-18 FDG PET/CT was performed on 6 patients with indolent CL and on 19 patients with NCL. Results: All 6 patients with indolent CL had no significant FDG avidity in the skin despite histologically positive cutaneous lesions. However, FDG avidity appeared in extracutaneous lesions (lymph nodes) in two patients with CL where CT imaging suggested lymphoma involvement (mean p-SUV $4.26{\pm}0.37$ in noncutaneous lesions in CL). In NCL, FDG avidity was demonstrated in all lesions where CT imaging suggested lymphoma involvement (mean p-SUV, $8.52{\pm}5.00$ in noncutaneous lesions in NCL). Conclusion: F-18 FDG PET/CT has the limitation of usefulness for the evaluation of the skin in indolent CL. In contrast, F-18 FDG PET/CT is sensitive in staging evaluation of extracutaneous lesions regardless of CL or NCL.

Purine Nucleoside Phosphorylase (PNP) Activity of Lymphocytes and T Cell Subsets in Peripheral Blood in Thyroid Tumors (갑상선 종양에 있어서 말초형 림프구의 Purine Nucleoside Phosphorylase (PNP) 활성과 T 세포 아형에 관한 연구)

  • Kim, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.1-7
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    • 1992
  • To elucidate alteration of purine nucleoside phosphorylase (PNP) activity of peripheral lymphocytes and helper/inducer and suppressor/cytototxic T cells in patients with thyroid tumors, the author examined PNP activity, and $CD4^+\;and\;CD8^+$ cells of peripheral blood in 20 cases of simple goiter, 9 cases of thyroid adenoma and 20 cases of thyroid cancer as well as 11 cases of adult healthy subjects as control. Diagnoses were established on the basis of commonly accepted clinical and biochemical criteria in simple goiter and were confirmed histopathologically in thyroid adenoma and cancer. All blood was obtained from veins of the patients and control subjects in Pusan National University Hospital during the period of January to August, 1991. The results obtained were summarized as follows: 1) The PNP activity was significantly decreased or tended to be decreased in thyroid adenomas and cancers as compared with control subjects and simple goiters. 2) The percentage of CD8 cells was significantly decreased or tended to be decreased in thyroid cancers as compared with simple goiters, thyroid adenomas and control subjects. 3) The CD4/CD8 ratio was significantly increased or tended to be increased in thyroid cancer as compared with simple goiters, thyroid adenomas and control subjects. On the basis of the results, it can be suggested that the immunodysfunction in thyroid cancer may be due to decreased suppressor/cytotoxic T cells, and the estimation of PNP activity of peripheral lymphocyte is a helpful test in detecting the immune status in thyroid tumors.

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피부 병변은 닭 마렉병 진단에 결정적 단서를 제공한다

  • 조경오;박남용
    • Korean Journal of Veterinary Pathology
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    • v.6 no.2
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    • pp.101-104
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    • 2002
  • 닭의 전신장기에 림프종 발생이 특정인 마렉병(Marek's disease; MD)은 림프구성 백혈병(Lymphoid leukosis; LL)과 병리학적 소견이 매우 유사하여 감별이 요구된다. 마렉병 바이러스(Marek's disease virus; MDV)는 질병초기에서 후기에 이르기까지 모낭상피세포에 세포용해성 감염을 지속적으로 일으킨다. 세포용해성 감염이 있는 모낭상피세포는 변성내지 괴사되어 있고 핵내봉입체가 관찰된다. 또한 세포용해성 감염이 있는 모낭상피세포 바로 밑의 진피와 깃털 수질(feather pulp)내의 혈관주위에 림프구 침윤이 관찰된다. 이러한 피부병변은 MD의 특징적인 병변들로서 LL과 감별할 수 있는 결정적인 단서이다. 본 고에서는 MD에 관한 전반적인 것과 특히 MD 진단을 위한 피부병변의 유용성에 대해서 자세히 논하고자 한다. 양계산업에 문제를 야기하고 있는 림프구 증식성 종양은 크게 마렉병(Marek’s disease; MD)과 백혈병(Lymphoid leukosis; LL)이 있다. 이들 질환의 원인체들이 분리되기 전까지는 이들 질병들은 발병부위에 따라 질병명을 붙였다. 즉, 내부장기냐 근육에 발생한 것은 visceral lymphomatosis, 피부에 발생한 것은 skin leukosis, 말초신경의 병변은 poly­n neuritis, neuritis, neurolymphomatosis gallinarum, range paralyis로 불리었다. 또한 눈에 발생한 것은 blindness, gray eye, iritis, uveitis, ocular lymphomatosis라고 불리었다. 1961년에 Biggs는 이러한 림프구 증식성 질병을 마렉병과 백혈병 으로 분류하자는 제안을 하였고, 드디어 1960년대 중반에 림프구 증식성 병변 중의 일부에서 herpesvirus가 분리되어서 Biggs가 제안한 병명인 마렉병을 본격적으로 사용하게 되었다. MD는 마렉병 바이러스(Marek’s disease virus; MDV)가 원 인제로서 닭에 전염성이 강한 염증성에서 종양성의 병변을 내부장기, 피부, 근육, 안구, 중추신경계, 말초신경계 등에 일 으킨다. MDV는 림프종을 유발하기 때문에 처음에는 사람에서 림프종을 유발하는 Epstein-Bar 바이러스와 관련이 있을 것으로 생각되어 gamma-herpesvirus로 분류되었지만, MDV의 게놈 구조와 세포배양에서 빠르게 성장한다는 점 때문에 지금은 alpha-herpesvirus로 재분류 되었다. MDV는 바이러스 중화시험과 한천 겔 침강법에 의해서 3개의 혈청형으로 분류 된다. 혈청형 1은 종양원성 바이러스와 종양원성 바이러스의 계대배양에 의한 약독주가 있다. 혈청형 2는 자연적으로 발 생하는 비종양원성 닭의 MDV이고, 혈정형 3은 바종양원성 칠면조 herpesvirus (HVT)이다. 림프종을 유발하는 MDV 감염은 4개의 과정, 즉 초기 세포용해성 감염, 잠복감염, 후기 세포용해성 감염, 마지막으로 종양화로 나눌 수 있다. 감염의 경로를 보면, 흡입된 MDV는 폐의 대식세포에 감염한 후 전선 장기로 MDV를 전파 시킨다. 특히, 흉선, F냥, 비장 등의 림프구에 초기 세포용해성 감염을 일으키는데, B 림프구가 주로 감염된다. 세포용해성 감염음 방어하기 위해 몰려든 T 림프구가 활성화가 되면, T 세포도 감염되게 된다. 잠복감염은 여러 가지 사이토카인 등 을 포함한 면역반응에 의해서 일어나며, 이 때 잠복감염된 세포는 특히 혈중의 T 세포라고 한다. 혈중 MDV 감염세포 는 피부 모낭상피세포, 선장 등 상피세포 유래의 조직에 MDV를 전파 시켜서 이들 조직에서 후기 세포용해성 감염이 일어나게 한다. 후기 세포용해성 감염을 유발하는 것은 이러한 MDV가 감염된 혈중 림프구라는 증거는 혈중의 세포 외에는 감염성 바이러스가 없기 때문이다. 후기 세포용해성 감염이 있는 후 육안적 혹은 현미경적으로 검출이 가능한 림프종이 여러 장기에서 관찰된다. MDV가 감염되면 병변 발생부위에 따라서 다양한 임상증상이 발생한다. 즉 내부장기에 병변이 있을 경우는 침울, 체중감소, 산란율 저하 등이 발생하며, 신경계는 발생부위별 신경증상이 일어난다. 이러한 장기나 조직에서는 육안적으로 백색에서 회백색의 종양성 병변이 관찰된다. 말초신경에 병변이 발생한 경우에는 특히 좌골신경 및 신경총에서 호발하는데, 이들 조직은 편측성 혹은 양측성으로 종창되어 있다. 안구는 간혹 육안적으로 식별이 가능한 홍채 퇴색 및 증식 병변이 관찰된다. 피부형 MD는 특히 육용계에서 문제가 되고 있으며, 산란계의 내장형 MD가 발생한 경우에도 피부를 자세히 설펴보면 피부형 MD를 간혹 관찰할 수 있다. 피부형 MD는 모낭주위에 원형의 결절형태로 발생하는데, 이들 병변이 커지면 바로 옆의 병변과 융합 되어 큰 결절을 형성하기도 한다. (중략)

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Two Cases of Peripheral T-Cell Lymphoma Arising in Inferior Turbinate (하비갑개에 발생한 말초성 T세포 림프종 2례)

  • 김보형;강성호;임대준;조영찬
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.184-187
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    • 2001
  • Peripheral T-cell lymphoma, which characterized by progressive ulceration and necrosis of the upper aerodigestive tract or midline facial structures, is rare disease in the otolaryngologic field. We recently experienced a case, revealed histopathologically peripheral T-cell lymphoma, involving inferior turbinate without any evidence of involving other organs. In this paper, we report two cases of peripheral T-cell lymphoma who was treated chemotherapy and concurrent radiation therapy.

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Primary Central Nervous System Involvement in Peripheral T-Cell Lymphoma: A Case Report (원발성 중추신경계 말초 T 세포성 림프종: 증례 보고)

  • Seung Hee Byun;Da Mi Kim;In Ho Lee;Chang June Song;Kyung Hwan Kim;Song Yi Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.255-260
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    • 2021
  • Primary central nervous system T-cell lymphoma (PCNSTL) is an extremely rare type of brain tumor. There are only few reports on the imaging findings of patients with PCNSTL. Herein, we report the imaging findings of a patient with peripheral T-cell lymphoma-not otherwise specified that presented with numerous small nodular and patchy strongly enhancing lesions on MRI.

A Case of Peripheral T-cell Lymphoma with Diffuse Bilateral Pulmonary Infiltration and Whole Body Rash (양측 미만성 폐침윤과 전신 홍반을 동반한 말초 T세포 림프종)

  • Lee, Seung Hyeun;Ha, Eun Sil;Kim, Jung Ha;Jung, Jin Yong;Lee, Kyung Joo;Kim, Se Joong;Lee, Eun Joo;Hur, Gyu Young;Jung, Ki Hwan;Jung, Hye Cheol;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.566-570
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    • 2005
  • Primary pulmonary non-Hodgkin's lymphoma (NHL) account for 0.4% of all types of lymphoma. Most cases are of the mucosa-associated lymphoid tissue (MALT) type, low grade B-cell lymphoma, but cases of the T-cell type are rare. The radiological findings frequently show hilar or mediastinal lymphadenopathy, but lung parenchymal involvement is uncommon. Here, a case of a patient, who presented with fever, generalized erythema, diffuse pulmonary infiltration and pleural effusion, diagnosed as a peripheral T-cell lymphoma, is reported.

Fine Needle Aspiration Cytology of Peripheral T Cell Lymphoma, Lymphoepithelioid Cell Type - Report of A Case Mimicking Tuberculous Lymphadenitis - (림프유상피형 말초 T세포 림프종의 세침흡인 세포학적 소견 - 결핵성 림프절염과 감별이 어려웠던 1예 -)

  • Park, Ho-Sung;Hong, Jong-Myung;Chung, Myoung-Ja;Moon, Woo-Sung
    • The Korean Journal of Cytopathology
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    • v.10 no.2
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    • pp.185-189
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    • 1999
  • The diagnosis of peripheral T cell lymphoma is difficult due to the varying size and shape of the neoplastic lymphoid cells and the frequent admixture of nonneoplastic mature lymphyocytes, histiocytes, eosinophils, and plasma cells. We report a case of peripheral T cell lymphoma, lymphoepithelioid ceil type, which was difficult to differentiate from tuberculous lymphadenitis due to the aggregates of epithelioid histlocytes mimicking granuloma and the past history of pulmonary tuberculosis. Fine needle aspiration cytology of the inguinal lymph node in a 63-year-old male was characterized by hypercellular aspirates composed of a mixture of small and intermediate-size lymphoid cells and large lymphoid cells with background of confluent epithelioid histiocytes. The neoplastic lymphocytes demonstrated significant nuclear irregularity with protrusion and indentations of the nuclear membrane, prominent nucleoli, and frequent mitotic figures. The diagnosis of peripheral T cell lymphoma was confirmed by histological and immunohistochemical studios.

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Analysis of Lymphocyte Subsets in Peripheral Blood after Radiotherapy (악성 종양 환자에서 방사선 치료 전, 후의 림프구 아형 분석)

  • Choi, Young-Min;Kim, Jeung-Kee;Lee, Hyun-Sik;Hur, Won-Joo;Kim, Jung-Man
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.229-236
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    • 1996
  • Purpose : To evaluate the changes of differential counts and lymphocyte subsets in cancer patients' leukocyte before and after radiotherapy. Materials and Methods : From Dec. 1994 to Mar 1995, the changes of leukocyte and its subsets in 16 patients who received radiotherapy in the Dept. of Radiation Oncology of Dong-A University Hospital were investigated. Radiation was delivered from 2700 cGy to 6660 cGy with median dose of 5400 cGy. The results of pre- and Post-radiotherapy were analyzed by paired T-test. The results of patients Who received < 50 Gy and $\geq$ 50 Gy were analyzed by Wilcoxon test. Results : Before and after radiotherapy, there was not any significant differences in the counts of leukocyte, granulocyte and monocyte. A remarkable decrease was noted in lymphocyte counts after radiotherapy(p=0.015). T cells, B cells and natural killer cells were also decreased in number after radiotherapy but it was not significant statistically. 1 helper cells and T suppressor cells were also decreased in number(p>0.05). The ratio of T helper/suppressor cell was decreased from 1.52 to 1, 11 and it was significant statistically(p=0.016). The portion of T suppressor cell among all T cells was increased after radiotherapy (p=0.0195). No significant difference was observed in the analysis of leukocyte and its subsets between patients who received < 50 Gy and $\geq$ 50 Gy, Conclusion : Radiotherapy caused remarkable decrease in lymphocyte count and its subsets. Among all lymphocyte subsets, T helper cell might be the most vulnerable to radiation, considering decreased ratio of T helper/suppressor cell count after radiotherapy.

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A Case Study of Soeumin with Peripheral T-cell Lymphoma who Showed Symptomatic Improvement including Fever, Myalgia, Performance Status, and Headache after Treated with Osuyubujaijung-tang and Geopoong-san (오수유부자이중탕(吳茱萸附子理中湯) 및 거풍산(祛風散)으로 발열, 통증, 전신활동도, 두통 호전을 보인 소음인 말초성 T세포 림프종 환자 1례)

  • Choi, Seong-Heon;Song, An-Na;An, Ji-Hye;Kim, Eun-Hee;Park, So-Jeong;Kim, Kyung-Suk;Lee, Soo-Kyung
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.4
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    • pp.100-108
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    • 2012
  • Objectives : The aim of this study was to report the improvement of fever, myalgia, performance status, and headache after treatment with Osuyubujaijung-tang and Geopoong-san in a Soeumin with Peripheral T-cell lymphoma. Methods : We retrospectively reviewed the medical records, medical laboratory and image scans of 80-year-old male patient diagnosed as peripheral T-cell lymphoma. He couldn't conduct any conventional chemotherapy due to poor performance status, ECOG 4. Results : The symptoms of myalgia, poor performance status, and neck pain improved, and fever was reduced with Osuyubujaijung-tang. Headache was subsided with Geopoong-san. Conclusions : A patient with peripheral T-cell lymphoma suffering from fever, myalgia, poor performance status, neck pain and headache showed the improvement of symptoms with treatment of Osuyubujaijung-tang and Geopoong-san. After 4 months treatment, the patient could conduct self care, physical activity and social affairs.

National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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