• The Korean Journal of Cytopathology
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• v.18 no.1
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• pp.87-91
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• 2007

Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.

• Clinical and Experimental Vaccine Research
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• v.12 no.4
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• pp.319-327
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• 2023

Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.

• Journal of Environmental Health Sciences
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• v.45 no.3
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• pp.203-212
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• 2019

Objective: A total of five students at same middle school were reported to be diagnosed with pediatric leukemia (n=2), non-Hodgkin's lymphoma (NHL, n=1) and aplastic anemia (n=2) between 2016 and 2017. The aims of this study are to assess exposure to environmental hazardous agents known to be associated with the risk of leukemia and to examine whether the environment of school is associated with the risk leukemia. Method: A total of 11 environmental agents causing childhood leukemia were monitored using international certified method in schools where patients had ever attended. Radon & Thoron detector was used to monitor real-time airborne radon and thoron level ($Bq/m^3$). Clinician interviewed two among nine patients who agreed to participate in this study in order to examine the association of demographic and genetic factors by individually. Leukemia, NHL, and aplastic anemia were grouped into lymphohematopoietic disorder (LHP). Results: Except for airborne radon level, no environmental agents in school and household where patients may be exposed were found to higher than recommended airborne level. Clinical investigation found no individual factors that may be associated with the risk of LHP. Higher airborne radon level than Korea EPA's airborne radon criteria ($148Bq/m^3$) was monitored at most of several after-class room of one elementary school, where two leukemia patients graduated. Significant radon level was not monitored at class-room. Significant exposure to radon of patients was not estimated based on time-activity pattern. Conclusions: Our results have concluded that there have been no environmental factors in school and household environment that may be associated the risk of LHP.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.49-53
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• 2018

Primary non-Hodgkin's lymphoma (NHL) rarely involves the parotid gland and its incidence is only 1.7% to 3.1% of all salivary gland neoplasms. The mucosa associated lymphoid tissue (MALT) is the most common subtype of NHL, followed by follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL). However, two distinct types of lymphomas occurring synchronously in the parotid gland and cervical lymph node have not been reported earlier. A 72-year-old man with rubbery-hard and fixed mass on the left parotid area came to our clinic. We performed the left total parotidectomy with ipsilateral excision of lymph node (level II), and he was finally diagnosed as DLBCL in parotid gland and FL in upper neck. It is presumed that the DLBCL appeared to be a transformation from FL. We report the unique and rare disease entity with brief literature review.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.69-72
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• 2008

Lymphomas of the nasal sinuses are relatively uncommon and represent less than 1% of all head and neck malignancies. Most common symptoms are nasal obstruction, epistaxis, rhinorrhea. We report a case of primary extranodal diffuse large B-cell non-Hodgkin's lymphoma in nasal sinuses accompanying with exophthalmos. A 70-year-old male patient was referred to our hospital with exophthalmos and severe septal deviation. We conducted endoscopic biopsy with septoplasty and biopsy result was diffuse large B-cell lymphoma. He received chemotherapy(R-CHOP) and radiotherapy. At follow-up, he remained free of disease.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.3
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• pp.278-288
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• 2019

Objectives: The objectives of this study are to summary controversy over health risks among semiconductor workers, to review major cancer risk results conducted in semiconductor operation and to evaluate occupational health activities in Korea for controlling hazardous agents generated in semiconductor operations Methods: Major occupational health issues that has been social controversies among semiconductor workers since 2007 were reviewed through an extensive literature, report and article review. Results: Since a female semiconductor worker aged 22 died from leukemia in 2007, job-association of a number of former semiconductor workers with various types of cancer and rare diseases have been denied by the Korea Workers' Compensation and Welfare Service (KWCWS), but some of them were later awarded compensation as an occupational disease by the administrative court. Two epidemiologic cancer risk studies conducted in Korea found increased risks in leukemia and non-Hodgkin's lymphoma among semiconductor workers. Various legal occupational health activities taken in semiconductor industry were found to fail to assess a complex characteristics of semiconductor operations, such as drastic changes in chemical use, processes, and technology, multiple exposure. National compensation regulation also showed the limitation to evaluate job-association of semiconductor workers who had worked in semiconductor operation. Conclusions: National legal measures should be taken to improve several occupational health activities and duties for protecting workers. In addition, the KWCWS program should be revised so that all workers who meet minimal job or environment associations can be compensated.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.118-122
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• 2019

Paraneoplastic pemphigus (PNP) is a rare and often fatal autoimmune blistering disease accompanied by both benign and malignant neoplasms. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by PNP patients. Oral ulcers are initial lesions in various autoimmune diseases like pemphigus, bullous pemphigoid, erythema multiforme, graft-versus-host, lichen planus, it does not improved despite of high-dose steroid therapy. We report a-35-year-old female who presented oral ulceration, lip crust and skin lesions. By doing several examinations, such as enzyme-linked immunosorbent assay, incisional biopsy with indirect immunofluorescence, she was diagnosed PNP with non-Hodgkin's lymphoma on pancreas.

• Tuberculosis and Respiratory Diseases
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• v.78 no.1
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• pp.31-35
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• 2015

An 18-year-old woman was evaluated for a chronic productive cough and dyspnea. She was subsequently diagnosed with mediastinal non-Hodgkin lymphoma (NHL). A covered self-expandable metallic stent (SEMS) was implanted to relieve narrowing in for both main bronchi. The NHL went into complete remission after six chemotherapy cycles, but atelectasis developed in the left lower lobe 18 months after SEMS insertion. The left main bronchus was completely occluded by granulation tissue. However, the right main bronchus and intermedius bronchus were patent. Granulation tissue was observed adjacent to the SEMS. The granulation tissue and the SEMS were excised, and a silicone stent was successfully implanted using a rigid bronchoscope. SEMS is advantageous owing to its easy implantation, but there are considerable potential complications such as severe reactive granulation, stent rupture, and ventilation failure in serious cases. Therefore, SEMS should be avoided whenever possible in patients with benign airway disease. This case highlights that SEMS implantation should be avoided even in malignant airway obstruction cases if the underlying malignancy is curable.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.711-734
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• 1994

Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.192-196
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• 1993

Malignant T cell lymphoma is a morphologically and immunologically distinct subtype of non-Hodgkin's lymphoma. One of the most striking clinical findings is relatively high incidence in males in their twenties or thirties with cervical, supraclavicular and axillary lymphadenopathy (50%), mediastinal mass (50%) or less commonly with extranodal disease. More than 90% of patients present with stage III or IV disease and approximately 60% of patients develop bone marrow infiltration. Clinical trials are needed to optimize therapeutic strategies, since these tumors have a poor prognosis and need to be treated aggressively. A 17-year-old male was admitted to the hospital because of chest pain. Chest PA and CT scan revealed massive pleural effusion and soft tissue masses with destructive change of right third and eighth ribs Histologic diagnosis of pleura and chest wall mass revealed high grade, pleomorphic T cell type, malignant lymphoma.