• Nuclear Medicine and Molecular Imaging
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• v.40 no.6
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• pp.309-315
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• 2006

Purpose: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell canter (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings. Materials & Methods: Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test. Results: Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively. Conclusion: There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7061-7064
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• 2014

Background: To assess the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of intraoperative gross examination (IGE) of uterine specimens in determining deep myometrial invasion and cervical invasion compared to final histology. Materials and Methods: The clinical, surgical and histological data of all FIGO stage I-II endometrial cancer (EC) patients who had primary surgery were reviewed. Results of the IGE for myometrial invasion and cervical invasion were compared to the final histology. The sensitivity, specificity, PPV, NPV, and accuracy of the IGE in determining deep myometrial invasion and cervical invasion were calculated. Association between clinico-pathological factors and discrepancy between IGE and final histology in the determination of myometrial invasion was also assessed. A p-value of <0.05 was considered significant. Results: From January 2007 to December 2012, 179 patients diagnosed with clinical stage I-II endometrial cancer underwent surgical staging. The sensitivity and specificity of IGE in detecting deep myometrial invasion were 42.4% and 90.0%, respectively, and the PPV and NPV were 67.6% and 76.1%. The overall accuracy of IGE was 74.3%. The sensitivity and specificity of IGE in identifying cervical invasion were 28.6% and 97.5%, respectively, while the PPV and NPV were 60.0% and 91.1%. The overall accuracy of IGE was 89.4%. Conclusions: The sensitivity of IGE for detecting deep myometrial invasion and cervical invasion in early-stage EC is too low to be used alone. Alternative methods including intraoperative frozen section analysis, preoperative three dimensional ultrasound, and preoperative magnetic resonance imaging should be strongly considered.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.65-70
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• 2002

Background and Objectives: Recently the tenn 'papillary microcarcinoma' has been proposed to designate carcinoma of 10 mm or less in diameter. In some cases, cervical lymph node metastasis preceding the occurrence of the primary tumor may be the first and sole manifestation of the disease. The objective of this study is to assess the clinical features of cervical metastasis in papillary microcarcinoma of thyroid glands. Materials and Methods: 9 cases with papillary microcarcinoma with neck metastasis were analyzed retrospectively. 5 cases are men and 4 are women. All patients complained of painless, movable neck mass. The symptom had been present from 1 month to 36 months. We reviewed clinical history, imaging studies, the results of fine needle aspiration, the surgical method, the pathologic results. Results: In 9 cases, no abnormalities of the thyroid gland were shown by imaging studies and thyroid scan. 3 cases were diagnosed by fine needle aspiration cytology. the others were not. Total thyroidectomy and neck dissection were performed in 9 cases and then pathology reports showed 2 case of multiple, 2 case of contralateral single and 5 cases of unilateral single thyroid microcarcinoma. They have no recurrence during follow-up period. Conclusions: Cervical metastasis from papillary microcarcinoma is variable clinical manifestation. The diagnosis of cervical metastasis from papillary microcarcinoma should be considered in patient with neck mass. We recommend total thyroidectomy with neck dissection and postoperative radioactive iodine ablation therapy in neck metastasis from papillary thyroid microcarcinoma.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8793-8796
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• 2014

Objective: To explore the influence of serum vascular endothelial growth factor (VEGF) level on therapeutic outcome and diagnosis/prognostic value in patients with cervical cancer. Materials and Methods: A total of 37 patients diagnosed with cervical cancer by biopsy were selected and treated with concurrent chemoradiotherapy. Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted before treatment to assess VEGF levels, and its relationships with clinicopathological features and short-term therapeutic effects were analyzed. Results: The median VEGF level in 37 patients before treatment was 647.15 (393.35~1125.16) pg/mL. Serum VEGF levels in patients aged <50 years, in International Federation of Gynecology and Obstetrics (FIGO) stage IIIa~IVa, with lymph node metastasis and tumor size >4 cm were significantly increased (P<0.05). The complete remission (CR) rate was 48.7% (18/37), partial remission (PR) rate was 35.1% (13/37), stable disease (SD) rate was 13.5% (5/37) and progressive disease (PD) rate was 2.70% (1/37), so the objective remission rate (ORR) after treatment was 83.8% (31/37). Logistic regression analysis showed that tumor size and serum VEGF level before treatment were independent risk factors affecting the therapeutic outcome, and the higher the level of serum VEGF, the worse the prognosis when tumor size>4 cm. Some 56.8% of patients manifested with myelosuppression, 37.8% with leucopenia, 24.3% with thrombocytopenia, 5.41% with diarrhea, 46.0% with nausea and vomiting, 21.6% with hair loss and 8.11% with hepatic and renal injury during the treatment. Conclusions: Serum VEGF level may reflect the degree of malignancy of cervical cancer and predict therapeutic effect, which is of great importance to cancer diagnosis and prognosis.

• Radiation Oncology Journal
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• v.35 no.1
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• pp.39-47
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• 2017

Purpose: The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. Materials and Methods: We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. Results: We reviewed 247 patients-149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0-3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. Conclusion: In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.129-135
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• 2007

Purpose : Kikuchi disease is a subacute necrotizing lymphadenitis characterized by fever, cervical lymphadenopathy and benign self-limiting course in young women especially, but rare in children. Their etiopathology is still unknown, but involved viruses and autoimmune mechanism were proposed. We investigated the clinical and laboratory characteristics of Kikuchi disease in children. Methods : Five patients were diagnosed of Kikuchi disease from January 2001 to June 2006 in Kyunghee University Hospital. We reviewed their medical records retrospectively and analyzed clinical and laboratory findings. Results : The mean age of 5 patients (male to female ratio; 2:3) was 9 yr 9 mon(range: 8 yr 2 mon-12 yr 6 mon). The chief complaints were sustained fever and cervical lymph node that was unilateral, tender and swollen. All patients were treated with antibiotics before diagnosis was made, and rash developed in 2 patients. One patient showed necrotic change in ultrasound with which we suspected Kikuchi disease. Three patients were examined by CT scan additionally. The interval between admission and cervical lymph node excisional biopsy ranged from 6 days to 15 days, and mean period was 9.6 days. All pathological findings were compatible to necrotizing lymphandenitis. Conclusion : Unnecessary laboratory and imaging studies, and treatment with antibiotics tend to be done before making diagnosis, and that caused prolonged hospitalization. Therefore we studied the clinical and laboratory characteristics of Kikuchi disease in children.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.188-190
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• 2012

Kikuchi's disease (KD) is an idiopathic and self-limiting necrotizing lymphadenitis that predominantly occurs in young females. It is common in Asia, and the cervical lymph nodes are commonly involved. Generally, KD has symptoms and signs of lymph node tenderness, fever, and leukocytopenia, but there are no reports on treatment for the associated myofacial pain. We herein report a young female patient who visited a pain clinic and received a trigger point injection 2 weeks before the diagnosis of KD. When young female patients with myofascial pain visit a pain clinic, doctors should be concerned about the possibility of KD, which is rare but can cause severe complications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.4
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• pp.276-279
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• 2012

The development of multiple primary tumors is a problem leading to the treatment of patients diagnosed with gingival squamous cell carcinoma (SCC). The occurrence of multiple primary cancers in patients with SCC of the head and neck is uncommon. Thyroid carcinomas have been found incidentally in the cervical lymph nodes after histopathologic examination. A 72-year-old male with SCC of the lower gingiva at the clinical stage T2N0M0 was treated with partial mandibulectomy and selective neck dissection. Histopathologic examination showed the foci of papillary thyroid carcinoma metastasis. The patient subsequently underwent total thyroidectomy. We report a case of papillary thyroid carcinoma associated with SCC of the oral gingiva along with a review of literatures.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.170-176
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• 1995

Fourty nine patients out of 127 esophageal cancer were managed surgically from January 1986 to December 1991, at the Department of Thoracic and Cardiovascular Surgery, Jeonbuk National University Hospital. Most frequent preoperative symptom was dysphagia and its mean duration was 3.1 months. In histopathologic examination, squamous cell carcinomas were 44 cases [89.8% , and adenocarcinomas 5 [10.2% . The tumor location were the upper esophagus in 6.1%, middle esophagus in 57.2%, lower and cardiac portion of stomach in 36.7%. Involved and metastatic organs, which were detected perioperatively, were celiac lymph nodes in 6 cases, aorta 2, stomach 2, pericardium 2, cervical lymph node 1. The esophagus was resected radically, and the procedures for esophageal replacement were performed with esophagogastrostomy in 45 cases, esophagocologastrostomy 3, and esophagojejunostomy 1. Postoperative complications occurred in 16 cases [hospital morbidity = 32.6% ,anastomotic leak 3, anastomotic stricture 2, respiratory insufficiency 2, hemoperitoneum 1, chylothorax 1, intussusception 1, empyema 1, non-A,non-B hepatitis 1, and mediastinitis 1. Hospital deaths were experienced 3 cases [ hospital mortality = 6.1% . The 6 month, one, two, and five year actuarial survival rates were 85.7%, 71.4%, 57.1%, and 27.9%, respectively. One year survival rates of stages were 100% in stage I, 90.9% in stage IIa, 63.6% in stage IIb, 25.0% in stage III, and 7.2% in stage IV.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1486-1491
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• 2020

Kikuchi disease is a type of benign, self-limiting necrotizing lymphadenitis that occurs most commonly in young women and usually manifests as palpable cervical lymph nodes and fever. Patients with an unusual location of lymph node involvement can be misdiagnosed with malignant disease. Here, we report a case of Kikuchi disease in a 15-year-old girl presenting with persistent fever for 2 weeks. Imaging studies, including ultrasonography, CT, and ¹⁸F-fluorodeoxyglucose PET/CT, revealed splenomegaly and enlarged lymph nodes in the neck, axilla, abdomen, retroperitoneum, and inguinal region. Laparoscopic excision of the celiac lymph nodes confirmed histiocytic necrotizing lymphadenitis, also known as Kikuchi disease. Conservative treatment with corticosteroids improved the patient's condition.