• Title/Summary/Keyword: 병리학적 진단

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A Clinical Study on Tumors of the Parapharyngeal Space (부인두강 종양의 임상적 고찰)

  • Kim Young-Min;Rho Young-Soo;Park Young-Min;Lim Hyun-Joon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.38-45
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    • 1994
  • 부인두강(Parapharyngeal space)는 비인두강과 구인두강에 인접하여 위로는 두개저, 아래로는 설골사이에 위치하는 해부학적 잠재공간으로 이곳에 발생하는 종양은 매우 드무나 다양한 병리조직학적 소견을 보이며 인접한 중요장기들로 인한 수술적 어려움으로 두경부 외과의사의 관심이 되어 왔다. 최근 CT나 MRI의 도입으로 이학적 검사가 어려웠던 이부위의 진단에 많은 도움을 얻게 되었고, 발달된 수술방법의 사용으로 크기가 매우 큰 종양도 절제가 가능하게 되었다. 저자들은 1990년 9월부터 1993년 8월까지 한림대학교 이비인후과학교실에서 술전 CT나 MRI를 시행한 후 조직검사로 확진된 부인두강 종물 22례의 후향적 임상분석을 시행하여 다음의 결과를 얻었다. 1) 양성종양이 11례(30.0%), 악성종양이 11례(50.0%)로 빈도에 차이는 없었다. 2) 종양의 조직학적 기원은 타액선종양이 10례(45.5%)로 가장 많았으며 신경종양이 4례(18.2%)였고 기타 종양이 8례(36.4%)로 다양하였다. 3) 방사선학적 진단방법으로는 18례(81.8%)에서 CT를 시행하였고 필요한 경우에 MRI를 5례(22.7%), 혈관조영술을 3례(13.6%)에서 시행하였다. 4) 치료방법으로는 악성종양은 수술 및 방사선치료 또는 항암약물요법을 병리조직검사 결과에 따라 단독 또는 병합하여 시행하였고, 양성종양의 경우에는 모두 수술을 시행하였는데 수술방법은 경이하선 접근법이 가장 많이 사용되었다. 5) 추적조사는 평균 20개월로 양성종양의 경우는 모두 종양의 재발이 없이 치료되었으나 악성종양 중 전이암 1례와 악성 임파종 1례가 사망하였다.

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Pulmonary Cryptococcosis -Report of 2 cases - (폐 효모균증 -2예 보고 -)

  • 김병호;허동명;손경락;김익수;이병기;김연재;신현웅
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.292-296
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    • 2004
  • Cryptococcus neoformans is a ubiquitous fungus found worldwide, particularly in soil contaminated by pigeon drop- pings. Pulmonary cryptococcosis occurs rarely in immunocompetent individuals. The risk of cryptococcal infection increases with the degree of immunal compromise, in human immunodeficiency virus infection especially. Pulmonary cryptococcosis is most frequently encountered as asymptomatic single or multiple pulmonary nodules found by routine chest x-ray examination. The diagnosis is most often made in these situations by the histology of the resected lesion. Acute progressive pneumonia may occur, with symptoms of cough, sputum production, fever, and weakness. The clinical picture is not pathognomonic. The yeasts are stained well by any of the special stains for fungi. Treatment is now indicated for all cases given a diagnosis of cryptococcosis, even if the diagnosis has been made by resecton of a solitary, asymptomatic pulmonary nodule.

Surgical Treatment of Pulmonary Actinomycosis Mimicking Pulmonary tuberculosis (폐결핵으로 오인된 폐방선균증의 수술적 치험 1례)

  • 백효채;이진구;강정한;정경영;구자승
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.315-317
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    • 2002
  • Pulmonary actinomycosis is a rare disease entity to undergo thoracic surgery. We experienced a 49-year-old man with pulmonary actinomycosis who was admitted due to recurrent hemoptysis. Prior to admission, he was diagnosed as pulmonary tuberculosis on the basis of his clinical manifestations and chest radiological findings. The plain chest x-ray and chest computed tomography(CT) showed a cavitary lesion in left upper lobe and was given anti-tuberculous medication, but the x-ray revealed no imprcovement. He underwent left upper lobe lobectomy with segmentectomy of lower lobe and the surgical specimen showed no evidence of mycobacterial infection, but revealed sulfur granules which is a typical pathological finding of actinomycosis. He was discharged uneventfully and is scheduled to receive 6 months of antibiotic treatment.

Radiation Therapy for Patients with Early-Stage Breast Carcinoma Treated with Breast-Conserving Surgery (조기 유방암에서 유방 보존술후 방사선 치료)

  • Shin, S.O.
    • Journal of Yeungnam Medical Science
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    • v.14 no.2
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    • pp.274-284
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    • 1997
  • 조기 유방암에 대한 바람직한 치료는 유방의 형태를 최대한 보존하면서 악성 종양을 치료하는 것이다. 이러한 목적을 충분히 달성하기 위하여 최대한 조기에 유방암을 진단하고 미용상 종양 절제술에 적합한 환자를 선택하여 절제 범위를 최소화한 유방 보존술을 시행하며 수술 후 유방 전체에 대한 근치적인 방사선 치료를 적절히 시행하면 된다. 여러 연구에서 전통적인 치료법인 근치적 또는 변형 근치적 유방 절제술의 성적과 비교하여 차이가 없으므로 조기 유방암의 치료에는 이상적인 치료법으로 인정된다. 이와 병행하여 액와부 림프절 및 전신적인 재발에 대한 진단 및 예방을 위하여 액와 림프절에 대한 충분한 외과적인 처치와 병리학적인 검사를 시행하여 불필요한 방사선 치료로 인한 부작용을 최소화하여야 한다. 만약 전신적인 치료가 요구되는 경우에는 항암제 및 내분비 요법을 병행하여 재발을 억제해야 유방 보존술의 장점을 살릴 수 있다. 결론적으로 이 치료법이 조기 유방암 환자의 삶의 질을 개선시키면서 최상의 치료 효과를 얻기 위해서는 유관 진료 각과의 의료진이 유기적으로 협조하여 조기 진단률을 높히고, 유방 보존술 및 방사선 치료 과정에서 환자들에게 치료 결과에 대한 확신을 심어주도록 열심히 노력해야 된다. 또한 치료와 연관된 부작용이나 합병증을 최대한 줄여나가는 방향으로 치료 방법을 계속 보완 발전시키는 것이 매우 중요하며 아직도 발전의 여지가 많은 이 치료법이 조기 유방암의 이상적인 치료법으로 정착하기 위해서는 향후 다양한 임상적인 경험을 통한 더 많은 연구가 필요하리라 생각한다.

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An Unusual Occurrence of Epidermoid Cyst in the Inner Mucosa of the Upper Lip: A Case Report (상순의 내측점막에서 드물게 발생한 유표피낭종의 치료 증례 보고)

  • Lee, Jihye;Choi, Namki;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.4
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    • pp.463-468
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    • 2020
  • Epidermoid cysts are rare benign lesions in the oral cavity that may be either congenital or acquired. The cysts are usually slow-growing and asymptomatic until becoming secondarily infected or large enough to interfere with mastication and speech. Consequently, diagnosis is often delayed. The condition is also uncommon in newborns and infants. Most of the lesions occur in the floor of the mouth and rarely in the upper lip. This report describes the case of a 29-month-old girl with a palpable mass in the inner mucosa of the upper lip. The lesion was surgically enucleated using an intraoral approach and histopathologically diagnosed as epidermoid cyst.

소산파 생체 광 센서

  • 박선희
    • Proceedings of the Optical Society of Korea Conference
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    • 2000.08a
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    • pp.112-117
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    • 2000
  • 생체 센서 (biosensor)란 생체 인식 요소를 구체화시킨 감지기 라고 정의할 수 있다. 생체 센서 중에서도 특히 혈액, 소변, 침 과 같은 생체 액체 성분이나 내쉬는 숨과 같은 기체 생체 성분을 분석하고 정량화하기 위한 생화학적 생체 센서는 최근에 급속한 발달을 하고 있고 이에 따라 이제까지는 시도해볼 수 없었던 새로운 개념의 질병 진단 체계가 도입되고 있다. 이제까지 병원의 임상 병리에서 주로 쓰이고 있는 생체 성분 분석은 방사선 동위원소 면역 분석$^{(1)}$ (Radio immunoassay) 방법인데 이는 항체등에 붙인 방사선 동위원소의 붕괴 시 나오는 감마선의 세기를 감지하여 성분을 정량화한다. 여기에는 방사선 물질 취급상 사용자가 제한적인 불편함이 있다. 두 가지 방법 모두 장비가 고정 배치되어 사용되기 때문에 휴대성과 같은 편리함이 없어서 일반 의사도 사용하기 어려운 점이 있다. 높은 감도, 실시간성, 경제성, 휴대성을 추구하는 생화학적 생체 센서는 이제 진단에 도입되기 시작하여 무한한 가능성을 열고 있다. (중략)

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The Diagnostic Yield and Complications of Percutaneous Needle Aspiration Biopsy for the Intrathoracic Lesions (경피적 폐생검의 진단성적 및 합병증)

  • Jang, Seung Hun;Kim, Cheal Hyeon;Koh, Won Jung;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.916-924
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    • 1996
  • Bacground : Percutaneous needle aspiration biopsy (PCNA) is one of the most frequently used diagnostic methcxJs for intrathoracic lesions. Previous studies have reponed wide range of diagnostic yield from 28 to 98%. However, diagnostic yield has been increased by accumulation of experience, improvement of needle and the image guiding systems. We analysed the results of PCNA performed for one year to evaluate the diagnostic yield, the rate and severity of complications and factors affecting the diagnostic yield. Method : 287 PCNAs undergone in 236 patients from January, 1994 to December, 1994 were analysed retrospectively. The intrathoracic lesions was targeted and aspirated with 21 - 23 G Chiba needle under fluoroscopic guiding system. Occasionally, 19 - 20 G Biopsy gun was used for core tissue specimen. The specimen was requested for microbiologic, cytologic and histopathologic examination in the case of obtained core tissue. Diagnostic yields and complication rate of benign and malignant lesions were ca1culaled based on patients' chans. The comparison for the diagnostic yields according to size and shape of the lesions was analysed with chi square test (p<0.05). Results : There are 19.9% of consolidative lesion and 80.1% of nodular or mass lesion, and the lesion is located at the right upper lobe in 26.3% of cases, the right middle lobe in 6.4%, the right lower lobe 21.2%, the left upper lobe in 16.8%, the left lower lobe in 10.6%, and mediastinum in 1.3%. The lesion distributed over 2 lobes is as many as 17.4% of cases. There are 74 patients with benign lesions, 142 patients with malignant lesions in final diagnosis and confirmative diagnosis was not made in 22 patients despite of all available diagnostic methods. 2 patients have lung cancer and pulmonary tuberculosis concomittantly. Experience with 236 patients showed that PCNA can diagnose benign lesions in 62.2% (42 patients) of patients with such lesions and malignant lesions in 82.4% (117 patients) of patients. For the patients in whom the first PCNA failed to make diagnosis, the procedure was repeated and the cumulative diagnostic yield was increased as 44.6%, 60.8%, 62.2% in benign lesions and as 73.4%, 81.7%, 82.4% in malignant lesions through serial PCNA. Thoracotomy was performed in 9 patients with benign lesions and in 43 patients with malignant lesions. PCNA and thoracotomy showed the same pathologic result in 44.4% (4 patients) of benign lesions and 58.1% (25 patients) of malignant lesions. Thoracotomy confirmed 4 patients with malignat lesions against benign result of PCNA and 2 patients with benign lesions against malignant result of PCNA. There are 1.0% (3 cases) of hemoptysis, 19.2% (55 cases) of blood tinged sputum, 12.5% (36 cases) of pneumothorax and 1.0% (3 cases) of fever through 287 times of PCNA. Hemoptysis and blood tinged sputum didn't need therapy. 8 cases of pneumothorax needed insertion of classical chest tube or pig-tail catheter. Fever subsided within 48 hours in all cases. There was no difference between size and shape of lesion with diagnostic yield. Conclusion: PCNA shows relatively high diagnostic yield and mild degree complications but the accuracy of histologic diagnosis has to be improved.

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Histopathologic Findings of Necrotizing Lymphadenitis (괴사성 림프절염의 병리조직학적 소견)

  • Shim, Young-Ran;Nam, Hae-Joo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.485-492
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    • 1993
  • Necrotizing lymphadenitis was first recognised as a self-limiting lymphadenitis by Japanese workers in 1972. It is a distinct clinicopathologic entity, but can be mistaken as malignant lymphoma. We have studied clinicopathologic features in 15 cases of necrotizing lymphadenitis. This disease occurs predominantly in young adult. Male-female ratio is 2 : 1. The commonest presentation is lateral cervical lymphadenopathy. Pain, tenderness, and fever can be seen. Biopsy of the lymph nodes from all patients demonstrates the characteristic histologic features : multifocal, relatively circumscribed nodules in the cortex and/or paracortex, consisting of a mixture of activated large lymphoid cells, histiocytes and small lymphocytes. Numerous karyorrhetic debris are present. Neutrophils and plasma cells are strikingly absent.

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Mammary Comedocarcinoma in a Dog (개에서 발생한 유선 면포암종)

  • Kim, Jae-Hoon;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.486-489
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    • 2013
  • An 18-year-old, neutered female, Yorkshire terrier was presented with abdominal mass. Large abdominal mass was located in right 4th and 5th mammary glands. Surgically excised mammary mass was submitted for histological evaluation. Microscopically, multifocal to confluent neoplastic foci were existed from superficial dermis to subcutis. Several different growth patterns such as comedo, solid, cribriform, and micropapillary were present in the neoplastic foci. Large neoplastic mammary ducts showed great invasive tendency to adjacent tissues. Many superficial lymphatic plexuses and dermal lymphatics contained numerous neoplastic cell emboli. Because comedo pattern was demonstrated by more than 50% of the neoplastic cell population, we confirmed this case as mammary comedocarcinoma according to recent classification of canine mammary tumors.

The Role of F-18 Fluorodeoxyglucose Positron Emission Tomography in Patients with Malignant Mixed Mullerian Tumors of the Uterus (자궁의 악성 혼합성 뮬러리안 종양 환자에서의 FDG PET의 역할)

  • Hidayat, Basuki;Cheon, Gi-Jeong;Chae, Min-Jeong;Kim, Moon-Hong;Kim, Min-Suk;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.1
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    • pp.16-22
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    • 2006
  • Purpose: Malignant Mixed Mullerian Tumor (MMMT) of the uterine corpus is one of the very uncommon and the most lethal tumors in the uterus. The aim of this study was to evaluate the role of FDG PET in detecting distant metastasis and residual and/or recurrent disease. Methods: Ten patients who underwent FDG PET for detecting distant metastasis and recurrence were included. focal FDG accumulation was regarded as abnormal. We also reviewed serum CA 125 levels, anatomical images, and histopathoiogical examination. Results: Three patients of 10 FDG PET showed abnormal FDG uptake. One had high serum CA 125 levels and high fractions of carcinomatous element on histopathologic examination. FDG PET showed metastatic lesions in unexpected locations, which could not be detected by anatomical images. Another had normal serum CA 125 levels with high sarcomatous element and CT could only detect a few lesions. The other had high serum CA 125 levels and also had high carcinomatous element. Seven patients who had no abnormal uptake on FDG PET had no clinical evidence of recurrence during the follow up period ($51.7{\pm}12.2$ months). The mean disease free intervals of these 7 patients were $36.4{\pm}6.0$ months. Two patients with abnormal findings had never become disease-free condition during the follow up period ($6.0{\pm}4.2$ months. Conclusion: FDG PET could be a useful modality for unexpected distant metastasis and follow up tool in patients with MMMT.