• 대한기관식도과학회지
• /
• 제5권1호
• /
• pp.96-101
• /
• 1999

For many years it has been reported that seemingly benign neck cysts may contain carcinoma. Cystic metastases have often mistaken for either branchial cleft cysts or benign mass. Authors experienced two cases which presents cystic cervical metastatic cancer One was a tonsillar carcinoma and the other was a tongue carcinoma. Patients with a cystic squamous carcinoma in the neck likely have a primary in upper aero-digestive system and It is known that the tonsil is most common site. Radiologic examination and fine needle aspiration biopsy of the cyst proved to be non-diagnostic. The development of cervical lymph node metastases before clinical signs of carcinoma of the tonsil is also well recognized. So, in old patients, thorough head If neck examination, panendoscopy and ipsilateral tonsillectomy is mandatory to identify a primary carcinoma prior to cyst excision.

• 대한두경부종양학회지
• /
• 제15권2호
• /
• pp.217-221
• /
• 1999

Background and Objectives: Subacute necrotizing lymphadenitis or Kikuchi's disease has now become recognized in many parts of the world as a well-defined clinicopathologic entity. It typically affects cervical lymph nodes of young women, and subsides spontaneously within a few months without recurrences. The purpose of this study is to report the clinicopathologic finding, radiologic finding and many laboratory tests to elaborate the criteria that are useful in distinguishing this entity from inflammatory disease, granulomatous disease, lymphoma, malignant disease. Material and Methods: Authors evaluated 22 patients, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy or fine needle aspiration cytology with retrospective chart review. Results: The patient population consisted of 21 women and 1 men. The mean age was 25 years old(range 17 to 42 years). All patient had palpable neck mass and associated fever, headache, weight loss, otalgia, diarrhea, night sweating. and associated disorder is dermatitis, hepatitis B, SLE, Hashimoto's thyroiditis, albinism et al. The multiple bilateral involvement of cervical lymph node was 20 cases(91%) and multiple unilateral 18 cases(82%), multiple bilateral 2 cases(9%). Solitary involvement was 2 cases(9%), mean size of involved lymph node was 2.0cm. In laboratory tests, leukopenia 17 cases(72%), elevated ESR 12 cases(54%), elevated GOT, GPT 3 cases(13%). In CT finding, lymph nodes enhanced in homogeneous fashion, and there was no evidence of central necrosis. Conclusion: Subacute necrotizing lymphadenitis, Kikuchi's disease may be easily confused clinically, pathologically, radiologically with malignant lymphoma, inflammatory disease, granulomatous disease. We should consider open biopsy of lymph node in the patient which had unilateral multiple cervical lymph node and in laboratory tests, were leukopenia, elevated ESR, especially in young women. otherwise, result of fine needle aspiration biopsy is nonspecific, excisional biopsy is recommended in order to differentiate other disease.

• 한국수의병리학회지
• /
• 제1권1호
• /
• pp.61-65
• /
• 1997

Epizootic streptococal infction is one of the common disease in guinea pig. We have confirmed 54 case of epizootic streptococal infection in guinea pig by histopathology and epidemiology. Grossly infection is characterized by the presense one to several enlarged lymph nodes particularly of the mandible cervical lymph nodes and accompanied by pleuropneumonia. Histologically there were lymphadenitis with abscesses surrounded by loose connective tissue fibrinopurulent pneumonia pleuritis myocarditis pericarditis and peritonitis. Epidemiological survey revealed that mortality was high in young adult female(15.1%) and changeable weather season such as spring and fall. From findings it was suggested that epizootic streptococal infection of guinea pig begin to infect in breeding colony around weaning period and died from that infection at animal facility during the quarantine period.

• 대한영상의학회지
• /
• 제82권2호
• /
• pp.423-428
• /
• 2021

Progressive transformation of germinal centers (이하 PTGC)는 드물게 나타나는 양성 림프절 질환으로, 주로 만성적인 림프절 비대의 형태로 나타난다. 주로 한 개 또는 여러 개의 림프절의 무통성 비대로 나타나며, 가장 흔히 침범하는 부위는 경부 림프절, 다음으로 액와부와 서혜부 림프절로 알려져 있다. 일부 환자들에서는 조직병리에서 림프종이 함께 존재하기도 하지만, PTGC 자체는 전암병변으로 인식되지는 않는다. 조직학적으로 PTGC로 진단되는 경우도 적지만, 이에 대한 영상의학적 소견은 거의 보고된 바가 없다. 이에 저자들은 침윤성 유방암 환자에서 수술 후 반대편 액와부 림프절 비대로 나타나 전이성 림프절로 오인한 PTGC 증례의 영상 소견을 보고하고자 한다.

• Pediatric Infection and Vaccine
• /
• 제3권2호
• /
• pp.194-199
• /
• 1996

Cryptococcosis is a rare in normal child and the majority of cases usually occur in patients with defective cell-mediated immunity. Infection is acquired by inhalation of organisms from the environment and disseminated via the blood stream to any organ of the body. We experienced a 7 year old girl who presented with fever, both cervical lymphadenopathy, hepatomegaly under the impression of lymphoma. However lymph node biopsy revealed cryptococcal budding and culture of lymph nodes yielded cryptococcus neoformans. The radiologic finding showed huge, multiple cervical lymph node enlargement spreading to mediastinum and abdomen. The immune fuction in term of T cell, B cell, serum immunoglobulin, complement and neutrophil function tests was normal. The patient was treated with amphotericin B and flucytosine for 6 weeks and responded to the treatment well. We report this case with brief review of the related literatures.

• 대한후두음성언어의학회지
• /
• 제30권1호
• /
• pp.61-64
• /
• 2019

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Vocal fold paralysis secondary to sarcoidosis is extremely rare but it can develop as a result of compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We report the case of a 56-year-old woman who presented with unilateral vocal fold paralysis and enlarged supraclavicular lymph nodes. Computed tomography of the neck revealed multiple, enlarged, and matted lymph nodes at the cervical level of IV. An ultrasound-guided core needle biopsy of the lymph node was performed, and a histopathological diagnosis of sarcoidosis was made by validating the presence of noncaseating granuloma. After implementation of steroid therapy, the patient exhibited immediate recovery from vocal fold paralysis. Although an extremely rare disease, sarcoidosis should be included in the differential diagnosis of vocal fold paralysis. Accurate diagnosis and prompt steroid treatment may reduce the morbidity of patients with vocal fold paralysis secondary to sarcoidosis.

• 대한두경부종양학회지
• /
• 제36권2호
• /
• pp.9-15
• /
• 2020

Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents. Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed. Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age £15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance. Conclusion: For DTC of children and adolescents (£18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.

• Advances in pediatric surgery
• /
• 제6권2호
• /
• pp.95-99
• /
• 2000

Thyroid carcinoma is relatively rare in children. Eight cases of thyroid carcinoma were among 18 patients operated upon for thyroid tumors at Pediatric Surgery, Asan Medical Center in 11 years' period between 1989 and 2000. Five patients were boys and three were girls. The age distribution ranged from 10 to 14 years with a median age of 11.6 years. We studied clinical presentations, diagnostic workup, pathology, treatment, and follow-up (recurrence, mortality, and survival). All patients presented with anterior neck mass but one with multiple cervical lymph nodes enlargement. Familial history of thyroid cancer was seen in one case. All patients had a cold nodule by 1-131 thyroid scan. Fine needle aspiration (FNA) biopsy was performed in all patients. The right lobe was involved in four patients and the left lobe in two. Two had both lobes involvement. Pathologically, six cases were papillary carcinoma, one was follicular carcinoma, and one insular carcinoma. Four patients underwent unilateral lobectomy and isthmectomy. Total thyroidectomy was performed in three patients. The insular carcinoma case was preoperatively diagnosed as follicular neoplasm by FNA. After confirmation of the pathology by initial right thyroid lobectomy, total thyroidectomy was subsequently done. Cervical lymph node metastases were presented in three cases (37.5%), and lung metastasis in two cases (25%). Three patients received postoperative I-131 ablation. After a median follow-up of 53 months, all patients were alive without evidence of recurrence. In conclusion, thyroid carcinoma in children is frequently associated with lymph nodes involvement and distant metastasis, however, the prognosis is relatively good.

• 대한두경부종양학회지
• /
• 제19권2호
• /
• pp.142-147
• /
• 2003

Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion: FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.

• 대한영상의학회지
• /
• 제81권6호
• /
• pp.1486-1491
• /
• 2020

기쿠치병은 주로 아시아에 거주하는 젊은 여성에서 경부 림프절 비대와 열을 주소로 나타나는 조직구 괴사성 림프절염이며 자연적으로 치유되는 양성질환이다. 기쿠치병이 전형적으로 발현하는 위치가 아닌 림프절에서 발생하면 진단이 어려워지고 악성 질환으로 오인되기도 한다. 저자들은 2주간 지속되는 발열을 주소로 내원하여 시행한 초음파와 CT, 18F-fluorodeoxyglucose PET/CT에서 비장 종대와 경부, 액와부, 복강, 후복강, 서혜부 림프절 비대를 보여 림프종을 의심하였던 15세 여자 환아 증례를 보고한다. 복강 림프절 절제술로 기쿠치병을 진단하였다. 이후, 환자는 스테로이드로 보존적인 치료를 받고 발열 증상이 호전되어 퇴원하였다.