• 제목/요약/키워드: Cervical lymph nodes

검색결과 153건 처리시간 0.024초

식도종양의 외과적 치료 (Surgical Treatment of Esophageal Cancer)

  • 육을수
    • Journal of Chest Surgery
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    • 제28권2호
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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.

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소아 갑상선 결절의 수술 (The Surgical Management of Pediatric Thyroid Nodule)

  • 오흥권;김현영;박귀원;정성은;김우기
    • Advances in pediatric surgery
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    • 제12권2호
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    • pp.183-191
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    • 2006
  • Thyroid nodules are less common in children than in adults and their management is still controversial. The clinical presentations, operations, complications, histopathologic findings, and postoperative progressions of 34 pediatric patients that underwent thyroidectomy for palpable thyroid nodule at the Department of Surgery, Seoul National University Children Hospital between 1986 and 2003 were studied retrospectively by reviewing medical records and telephone interviews. The mean age of the patients was 11.8 years old. There were 23 females (67.6 %) and 11 males (32.4 %). Surgical indications were clinical need of histological confirmation (n=15), unresponsiveness to thyroxin replacement therapy (n=10), suggestion of the carcinoma on fine needle aspiration cytology (n=5), cosmetic purpose-a huge benign nodule (n=2), completion thyroidectomy for medullary thyroid carcinoma (n=1), and prophylactic thyroidectomy in a MENIIpatient (n=1). Unilateral Lobectomy was performed in 20 patients (57.1 %), subtotal thyroidectomy in 8 (22.9 %), total thyroidectomy in 5 (14.7 %), and completion thyroidectomy in 1 (2.9 %). Lymph node dissection was performed in 9 cases. Benign tumor was found in 23 patients (67.6 %), adenomatous goiter (n=18) and follicular adenoma (n=5). Malignant tumor was found in 11 children (32.4 %), 9 papillary carcinomas (26.5 %), and 2 medullary carcinomas (5.9 %). Of the 9 papillary carcinomas, 7 cases (77.8 %) had lymph node metastasis. No lymph node metastasis was found in 2 medullary carcinomas. Complications developed in 5 cases - transient hypocalcaemia (n=2), and temporary hoarseness (n=3). There was no mortality. Median follow-up period was 7.4 years (0.5-18 years). One patient showed recurrence in cervical lymph nodes 10 years after surgery and modified radical neck dissection was performed. Because of the high incidence of malignancy and advanced stage at initial presentation, more meticulous diagnostic work up is necessary for children with thyroid nodule, and more radical surgical treatment should be performed when malignant nodule is suggested.

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개의 임파육종(淋巴肉腫)의 일예보고 (Visceral Lymphosarcoma in a Dog)

  • 박응복;성재기;이창우;김정환
    • 대한수의학회지
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    • 제25권2호
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    • pp.175-181
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    • 1985
  • 3주간에 걸쳐 심한 수척, 혈뇨, 질루, 구토중상과 경부종류(頸部腫瘤)가 촉진된 18개월령 암컷의 Great Dane개가 임상적으로 검사되고 사후에 부검되었다. 경부종류(頸部腫瘤)의 주사침 생검에서 관찰한 세포소견에서 종양세포가 대식구 유래임을 짐작하였고 종양조직 표본에서도 주요 구성세포는 조직구의 특성을 나타내고 있었다. 육안적으로는 임파절, 편도선 및 비장에서 큰 결정상의 종양괴를 확인하였다. 이상과 같은 종양의 생검 및 조직소견과 육안소견의 특징에서 본 종양예는 다중심성으로 발생한 조직구성 임파육종(淋巴肉腫)으로 진단되었다.

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경부 이소성 흉선종 1예 보고 (A Case Report of Accessory Cervical Thymus)

  • 이기윤;전용순;남정수;이난주;윤혜경
    • Advances in pediatric surgery
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    • 제14권1호
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    • pp.83-87
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    • 2008
  • Accessory cervical thymic tissue has been rarely reported. However, it should be included in the differential diagnosis of neck masses in children, along with branchial anomalies, lymph nodes and other tumors. This lesion occurs along the descending line of the thymus between the angle of mandible and superior mediastinum. A 2-month-old infant presented with an asymptomatic left sided neck mass. MRI revealed a well defined homogeneous mass in the deep lobe of left parotid gland. At operation, an easily identified soft tissue mass was found in the left submandibular area, measuring $3{\times}1.5cm$. It was completely excised. Microscopic examination revealed normal thymic tissue.

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자심활혈탕(滋腎活血湯)이 전신성홍반성낭창(全身性紅斑性狼蒼) 동물모델에 미치는 영향(影響) (Effect of Jasinwhalhyul-tang on MRL/MpJ-Ipr/Ipr Mouse Model with Systemic Lupus Erythematosus)

  • 최훈섭;조충식;김철중
    • 대한한의학회지
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    • 제29권1호
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    • pp.67-84
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    • 2008
  • Objective : The main purpose of this study was to evaluate the effect of Jasinwhalhyul-tang (Zishenhuoxue-tang, JWT) on MRL/MpJ-Ipr/Ipr mouse model with systemic lupus erythematosus. Methods: The effect of JWT on MRL/MpJ-Ipr/Ipr mice that have autoimmune disease similar to SLE in humans was evaluated after JWT per oral in the present study. Mice were administered with Jasinwhalhyul-tang (Zishenhuoxue-tang, JWT) (80 or 400mg/kg) or distilled water for control group from experimental week 10 for 22 weeks. Results : The amount of erythematosus skin lesion and proteinuria were significantly decreased. The size and weight of cervical lymph nodes and spleen were significantly reduced. The ratio between activated $CD3^+CD69^+$ T-cells and undifferentiated $CD3^+CD4^-CD8^-$ T-cells in lymph nodes, spleen and kidney was effectively reduced. The gene expression of TGF-$\beta$ in spleen and kidney was increased. The amount of anti-dsDNA IgG in blood was decreased. The gene expression of TGF-$\beta$ in normal mouse spleen cells was increased depending on concentration by treatment of with T cell stimulating agent. In the histological examination of skin and kidney, the amount of infiltration of immune cells involved in the inflammatory response was decreased. Conclusions : According to the above results, JWT should be considered as an applicable therapeutic agent to SLE in clinical practice. Further research is required to investigate other efficacies of JWT on SLE.

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Sjogren 증후군과 동반된 Monocytoid B-Cell Lymphoma 1례 (A Case of Monocytoid B-Cell Lymphoma Associated with Sjogren Syndrome)

  • 이정훈;백상흠;양훈식;홍영호
    • 대한기관식도과학회지
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    • 제6권1호
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    • pp.102-107
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    • 2000
  • Monocytoid B-cell lymphoma is uncommon, low grade lymphoma originating from monocytoid B lymphocytes. Monocytoid B-cell lymphoma usually presents as a localized lymphadenopathy. Peripheral lymph nodes are most often involved, particularly those in the frequent in the head and neck area. A distinctive feature is the association of monocytoid B-cell lymphoma with autoimmune diseases. Sjogren Syndrome had been present in 22% of patient with monocytoid lymphoma. Extranodal involvement by monocytoid lymphoma was reported in the salivary gland, breast, thyroid, and stomach. There were also occasional extensions to the liver and retroperitoneum. The bone marrow and peripheral blood involvement by monocytoid lymphoma is very rare, which is frequently seen in hairly cell leukemia. Fever, weight loss, and other constitutional signs are usually absent. Most patients have no symptoms, and the only sign is enlarged lymph nodes. The clinical course remains indolent; most patients are in complete remission and recurrence with progression to a high-grade lymphoma of large cell type was recorded only in a few cases. Authors experienced a case of monocytoid B-cell lymphoma associated with Sjogren Syndrome mistaken to simple cervical lymphadenitis in a 60-year-old female. We report this case with a review of literatures.

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Adenoid cystic carcinoma of the sublingual gland: A case report

  • Song, Ji-Young
    • Imaging Science in Dentistry
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    • 제46권4호
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    • pp.291-296
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    • 2016
  • Adenoid cystic carcinoma (ACC) of the sublingual gland is an extremely rare neoplasm. The clinicopathological characteristics of ACC are slow-growing swelling with or without ulceration, perineural spread, local recurrence, and distant metastasis. This report describes a 58-year-old male who had a slowly growing swelling without ulceration on the right side of the mouth floor that had been present for 1 month. In a radiological examination, the mass showed multilocular cystic features and no bony or tongue muscle invasion. No enlarged cervical lymph nodes were detected. Excisional biopsy and histological analysis showed that the lesion was ACC. In addition to reporting a rare case of ACC, this report also discusses the differential diagnosis and treatment of ACC with a review of the relevant literature.

외측경부낭종을 동반한 갑상선유두상암종 1례 (A CASE OF CYSTIC PAPILLARY CARCINOMA OF THYROID GLAND ASSOCIATED WITH LATERAL NECK CYST)

  • 임상철;박호영;최정섭
    • 대한기관식도과학회지
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    • 제2권2호
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    • pp.268-273
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    • 1996
  • Cystic lesions of the neck are frequently encountered on clinical basis. The usual differential diagnosis includes branchial cleft, cystic hygroma, dermoid cyst, tuberculous lymphadenitis, benign detached goiterous thyroid cyst, and Cavitation epidermoid carcinoma. Most of cysts are benign and malignant cysts are rare. The most common form of cystic malignancy in the lateral neck is cystic degeneration of epidermoid carcinoma metastatic to cervical lymph nodes. Cystic neoplasia may result from malingnant changes occurring within the wall of a previously benign cyst Complete head and neck examination on the primary focus is important Especially, when palpation of thyroid is negative, thyroid carcinoma is easily overlooked. Recently, we experienced papillary carcinoma of the thyroid seen as lateral neck cyst. So we report this case with review of literatures.

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갑상선암의 경부 림프절 전이 진단을 위한 미세침세척액 티로글로불린 측정법 (Thyroglobulin Measurement in Fine Needle Aspirates for Diagnosing Cervical Lymphnode Metastasis from Differentiated Thyroid Malignancy)

  • 고희영;김승수;이춘호
    • 핵의학기술
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    • 제14권2호
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    • pp.181-185
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    • 2010
  • 갑상선암 환자의 경부 림프절에서 미세침흡인생검술(fine needle aspiration biopsy, FNAB)을 시행하며 얻은 미세침세척액의 티로글로불린(thyroglobulin, Tg)측정법의 진단적 성적과 유용성을 알아보고자 FNAB 세포검사의 결과와 비교하였다. 갑상선암의 경부림프절 전이가 의심되어 초음파 시행한 총 37명의 환자 48개의 FNAB 검체를 대상으로 하였고, 수술 후 조직검사결과 또는 장기간 영상 추적검사를 기준으로 하여 세포검사와 미세침세척액 티로글로불린(FNAB-Tg)측정법을 비교하여, 각 검사의 특이도, 민감도 및 정확도를 평가하였다. 추가적으로 Tg-항체가 양성일때 FNAB-Tg 검사에는 어떠한 영향을 미치는지 Tg-항체 검사를 같이 시행한 34명을 대상으로 분석하여 보았다. FNAB 검체의 세포검사에서 전이 음성인 36개 검체 중 35개 검체에서 음성을 보였고, 전이 양성인 12개 검체 중 9개 검체에서 양성을 보였다. FNAB-Tg측정법의 경우 전이 음성인 36개의 검체 중 32개의 검체에서 음성을 보였고, 전이 양성인 12개의 검체 중 12개 검체 모두 양성을 보였다. 따라서 세포검사의 민감도와 특이도는 각각 75.0% (9/12)와 97.2% (35/36)였고, 위음성이 25% (3/12)였다. 반면에 FNAB-Tg 측정법의 민감도와 특이도는 각각 100% (12/12)와 88.9% (32/36)였고, 위양성이 11.1% (4/36)였다. 정확도는 두 검사 모두 91.7% (44/48)였다. Tg-항체에 대한 검사 결과를 얻을 수 있는 34명을 따로 분석한 결과, Tg-항체의 존재 유무가 FNAB-Tg 측정법의 진단 성능에 영향을 주지 않음을 확인할 수 있었다. FNAB 검체를 이용한 세포검사는 특이도가 높고 반면, FNAB-Tg 측정법은 민감도가 높은 검사임을 확인할 수 있었다. 따라서 림프절 전이가 의심되는 갑상선환자에서 FNAB를 시행할 때 세포검사와 FNAB-Tg 측정법은 동시에 시행되어야 할 상호보완적인 검사들이다.

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Sonographic Diagnosis of Cervical Lymph Node Metastasis in Patients with Thyroid Cancer and Comparison of European and Korean Guidelines for Stratifying the Risk of Malignant Lymph Node

  • Sae Rom Chung;Jung Hwan Baek;Yun Hwa Rho;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • 제23권11호
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    • pp.1102-1111
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    • 2022
  • Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.