• Journal of Yeungnam Medical Science
• /
• 제38권3호
• /
• pp.245-250
• /
• 2021

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limiting lymphadenitis. It is a benign disease mainly characterized by high fever, lymph node swelling, and leukopenia. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease with clinical symptoms similar to those of KFD, but it requires a significantly more aggressive treatment. A 19-year-old Korean male patient was hospitalized for fever and cervical lymphadenopathy. Variable-sized lymph node enlargements with slightly necrotic lesions were detected on computed tomography. Biopsy specimen from a cervical lymph node showed necrotizing lymphadenitis with HLH. Bone marrow aspiration showed hemophagocytic histiocytosis. The clinical symptoms and the results of the laboratory test and bone marrow aspiration met the diagnostic criteria for HLH. The patient was diagnosed with macrophage activation syndrome-HLH, a secondary HLH associated with KFD. He was treated with dexamethasone (10 mg/m²/day) without immunosuppressive therapy or etoposide-based chemotherapy. The fever disappeared within a day, and other symptoms such as lymphadenopathy, ascites, and pleural effusion improved. Dexamethasone was reduced from day 2 of hospitalization and was tapered over 8 weeks. The patient was discharged on day 6 with continuation of dexamethasone. The patient had no recurrence at the 18-month follow-up.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권14호
• /
• pp.5643-5645
• /
• 2015

Background: The aim was to see compliance to minimum data set information in carcinoma cervix histopathology reports from a team of 13 pathologists; and also to analyse the distribution of parameters like tumor size, grade, depth of cervical stromal invasion, lymph node yield and pTNM stage. Materials and Methods: All pathology reports of radical hysterectomy for carcinoma cervix operated in house within a three year duration (2010-2012), (n=204) were retrieved from medical records and analyzed for the above parameters. Results: In 2010- 59 cases, in 2011- 67 cases and in 2012- 78 cases of carcinoma cervix underwent operations in our hospital. The median age was 50.5 years and the maximum T diameter was 2.8 cms in the reports of three years. Squamous carcinoma was the commonest subtype amongst all the tumors. It was noted that 60.8% of cases had cervical stromal involvement more than half the thickness of the cervical stroma. Parametrial involvement was seen in 4.82% of cases. pTNM Staging was not mentioned in 65.06% of the cases. The mean bilateral pelvic lymph node yield count in our study was 16.6 inclusive of all the three years. Conclusions: Compliance with provision of a minimum dataset in our team of 13 pathologists was generally good. Lymph node yield in our hands is reasonable, but constant striving for greater numbers should be made. pTNM staging should be more meticulously documented. Use of proformas /checklists is recommended.

• Journal of Yeungnam Medical Science
• /
• 제36권2호
• /
• pp.115-123
• /
• 2019

Background: This study aimed to assess the in-field lymph node (LN) failure rate according to LN size and to investigate effect of LN size on the survival outcome of patients with locally advanced cervical carcinoma treated with concurrent chemoradiotherapy (CCRT). Methods: A total of 310 patients with locally advanced cervical carcinoma treated with CCRT were enrolled in retrospective study. LN status was evaluated by magnetic resonance imaging. All patients received conventional external beam irradiation and high-dose rate brachytherapy, and concurrent cisplatin-based chemotherapy. In-field LN failure rate according to LN size was analyzed. Results: The median follow-up period was 83 months (range, 3-201 months). In-field LN failure rate in patients with pelvic LN size more than 10 mm was significantly higher than that in patients with pelvic LN size less than 10 mm (p<0.001). A similar finding was observed in the infield para-aortic LN (PALN) failure rate (p=0.024). The pelvic and PALN size (${\geq}10mm$) was a significant prognostic factor of overall-survival (OS) and disease-free survival rate in univariate and multivariate analyses. The OS rate was significantly different between groups according to LN size (<10 mm vs. ${\geq}10mm$). Conclusion: A LN of less than 10 mm in size in an imaging study is controlled by CCRT. On the other hand, in LN of more than 10 mm in size, the in-field LN failure rate increase and the prognosis deteriorate. Therefore, a more aggressive treatment strategy is needed.

• 한국임상수의학회:학술대회논문집
• /
• 한국임상수의학회 2009년도 추계학술대회
• /
• pp.235-235
• /
• 2009

• Journal of Chest Surgery
• /
• 제31권11호
• /
• pp.1081-1084
• /
• 1998

연구배경 : 식도암은 근치율이 낮고, 광범위 림프절 절제후에도 그 성적이 나쁜 편이다. 따라서 경부 림프절 절제가 식도수술결과에 미치는 효과를 알아보고자 식도수술 환자에서 경부림프절 전이가 된 환자를 조사하였다 대상 및 방법 : 1994년부터 1996년 6월까지 본원에서 흉부식도암 수술을 받은 32명의 환자 중 고식적 수술을 시행받은 25명의 환자를 대상으로 하여 경부림프절 절제의 유무를 기준으로 두 그룹으로 나뉘어 연구하였다. 두 그룹 모두 흉부식도 전절제술과 동반하여 종격림프절과 복부림프절 절제를 시행하였으나 B그룹은 양측 경부림프절 절제를 추가하여 시행하였다. 결과 : 수술합병증은 두 그룹 사이에서 의미있게 차이가 나지않았다. t수술사망과 병원사망은 두 그룹 모두에서 보이지 않았다. 그러나 평균 마취시간은 B그룹에서 의밌게 더 길었다.(평균 마취시간 90분). B그룹에서 27%가 경부림프절 전이를 보였다 결론 : 그러므로 경부림프절 절제는 흉부식도암 수술에서 의미있는 수술방법이라고 할 수 있다. 장기생존율의 비교가 더 필요하리라고 생각한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권11호
• /
• pp.5505-5510
• /
• 2012

Objective: The aim of this retrospective study is to analyze the clinical and pathological factors related to the prognosis of Chinese patients with stage Ib to IIb cervical cancer. Methods and Results: 13 clinical pathological factors in 255 patients with stage Ib to IIb cervical cancer undergoing radical hysterectomy and systematic lymphadenectomy were analyzed to screen for factors related to prognosis. The cumulative 5-year survival of the 255 patients was 75.7%. The result of the univariate analysis suggested that clinical stage, cell differentiation, depth of cervical stromal invasion, parametrial tissue involvement, and lymph node metastasis were prognostic factors for patients with stage Ib to IIb cervical cancer (P<0.05). Compared with cases with involvement of iliac nodes, obturator nodes, or inguinal lymph nodes, cases with metastasis to the common iliac lymph nodes had a poorer prognosis (P<0.05). Cases with involvement of four or more lymph nodes had a poorer prognosis than those with involvement of three or fewer lymph nodes (P<0.05). Using multivariate Cox proportional hazards model regression analysis, non-squamous histological type, poor differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion were found to be independently related to patients poor prognosis (P<0.05). Conclusion: Non-squamous histological type, poor cell differentiation, parametrial tissue involvement, and outer 1/3 stromal invasion are the independent poor prognostic factors for patients with stage Ib to IIb cervical cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제32권2호
• /
• pp.151-156
• /
• 2006

술전 경부 임파절 평가의 정확성은 신체검사와 방사선학적 소견 모두에서 정확성의 한계를 보였으며, 정확성을 보다 높이기 위해서는 임상의사와 방사선의사간에 의견 교환이 중요하다고 사료된다. 그리고 필요에 따라서는 초음파 촬영, 세침 흡인세포검사(FNAC) 등의 보조적인 임파절 평가 방법을 이용하는 것도 전체 정진율을 높일 수 있을 것이다. 또한 구강암의 원발 부위가 고위험군인 경우에는 가음성도 비율이 높고, 방사선학적 검사에서 전체 정진율이 낮은 결과를 보이는 것으로 볼때, 지금까지 알려진대로 예방적 경부 곽청술을 보다 적극적으로 고려하는 것이 필요하다고 사료된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권6호
• /
• pp.3891-3895
• /
• 2013

The purpose of this study was to evaluate the association of expression of ${\alpha}5{\beta}1$-integrin with clinicopathologic features and prognosis in cervical cancer. Levels of ${\alpha}5{\beta}1$-integrin in normal cervical mucosa and cervical cancer tissue were detected with immunohistochemistry. Survival analysis by the Kaplan-Meier method was performed to assess prognostic significance. ${\alpha}5{\beta}1$-integrin expression was detected in 84.6% (143/169) cervical cancer samples, significantly different from that in normal cervical mucosa (P < 0.05). Positive expression rates of ${\alpha}5{\beta}1$-integrin in patients with poor histologic differentiation, lymph node metastasis, and recurrence were elevated. Using Kaplan-Meier analysis, a comparison of survival curves of low versus high expression of ${\alpha}5{\beta}1$-integrin revealed a highly significant difference in human cervical cancer cases (P < 0.05), suggesting that overexpression of ${\alpha}5{\beta}1$-integrin is associated with a worse prognosis.The ${\alpha}5{\beta}1$-integrin promotes angiogenesis and associates with lymph node metastasis, vascular invasion and poor prognosis of cervical cancer. The current study indicated that ${\alpha}5{\beta}1$-integrin may be an independent prognostic factor for cervical cancer patients.

• 대한두경부종양학회지
• /
• 제36권2호
• /
• pp.73-77
• /
• 2020

Ovarian cancer is common malignant disease with high mortality in the female. However, lymph node metastasis in the head and neck of ovarian cancer is very rare than in para-aortic, pelvic lymph node. A 49-year-old female patient came to our clinic with a left neck mass. After total thyroidectomy and left selective neck dissection for the cervical neck level II, III, IV, V, VI for ovarian cancer and thyroid cancer, she had already undergone chemotherapy (Paclitaxel+Carboplatin) 18 month ago. CT scan showed only lymph node enlargement in left neck level II. Positron emission tomography-computed tomography (PET-CT) revealed a hypermetabolic lesion in same area but no other hypermetabolic lesion, especially in the pelvic and abdominal cavity. Fine needle aspiration cytology revealed metastatic carcinoma. The serum level of CA-125 was elevated to 43.8U/mL, whereas other tumor markers (CA 19-9, CEA) were in the normal range. She underwent a revision of selective neck lymph node dissection for the cervical neck levels I, II, and III, and on the review of surgical pathology, metastatic carcinoma was suspected. Thus, we performed immunohistochemical staining for the tissue; as a result, it was finally diagnosed as metastatic ovarian cancer (positive for CK7, ER and PR, and negative for CK20). Adjuvant chemotherapy (Paclitaxel+Carboplatin) was planned on the tumor board, and the patient successfully received chemotherapy.

• Pediatric Infection and Vaccine
• /
• 제23권3호
• /
• pp.217-222
• /
• 2016

목적: 본 연구는 경부 림프절 비대로 시작된 가와사키병과 급성 편측 경부 림프절염 환자에서 임상 양상, 혈액검사 소견, 경부 컴퓨터단층촬영 소견에 차이가 있는지 확인하고자 하였다. 방법: 2010년 1월부터 2014년 12월까지 발열과 경부 림프절 비대로 부산대학교 어린이병원에 내원하여 경부 컴퓨터단층촬영을 시행한 환자 총 372명 중에 가와사키병으로 진단된 28명의 환자군과 편측 경부 림프절염 환자군 28명을 후향적으로 비교하였다. 결과: 경부 림프절염으로 발현된 가와사키병과 급성 편측 경부 림프절염에서 발열 기간, 항생제 사용, 경부 림프절 크기에는 차이가 없었다. 혈액검사 소견에서 CLKD 환자에서 AUCL 환자와 비교해서 총 백혈구 수, 호중구 수, 적혈구 침강 속도, C-반응단백 수치가 더 높은 것으로 나타났다(P<0.05). 경부 컴퓨터단층촬영 소견에서 후인두부 부종 소견은 두 군 간에 차이가 없었다(P=0.686). 결론: CLKD와 AUCL을 조기에 구별할 수 있는 특징적인 소견은 없는 것으로 보이기 때문에 발열과 경부 림프절 비대가 있는 환자에서 항생제 치료에도 증상 개선이 없다면 가와사키병을 고려해야겠다.