• 제목/요약/키워드: Needle aspiration

검색결과 828건 처리시간 0.035초

갑상선의 $H\"{u}rthle$씨 세포 종양 ($H\"{u}rthle$ Cell Tumor of the Thyroid)

  • 정웅윤;김석주;박정수
    • 대한두경부종양학회지
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    • 제13권2호
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    • pp.206-212
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    • 1997
  • H$\"{u}$rthle cell neoplasm of the thyroid gland is an uncommon, but potentially malignant lesion. However, in many instances, the malignant potential of the H$\"{u}$rthle cell neoplasm is very difficult to judge histologically. For this reason, the biologic behavior of this tumor and its optimal treatment have come under considerable debate in recent years. In order to review the clinicopathologic features of the H$\"{u}$rthle cell neoplasm and to determine its optimal treatment modalities, we studied 26 patients with path logical proof of H$\"{u}$rthle cell tumor from January 1987 to September 1997. We also performed an immunohistochemical study using the monoclonal antibodies against antigen CD34 for the angiogenic activity of this tumor and evaluated the differences of microvessel density(MVD) between benign and malignant tumors. The age of the patients ranged from 1 to 71 years with a mean of 44.2 years. There were 6 males and 20 females(M : F= 1 : 3.3). The accuracies of fine needle aspiration biopsy and frozen section were very low; 6.3% and 34.8%, respectively. There were 20 benign tumors and 6 malignant tumors(23.1%). All the malignant tumors were microinvasive(intermediate) type which had minimal capsular invasion and most of them(5 cases) were diagnosed postoperatively. Any specific clinicopathologic differences were not seen between benign and intermediate groups. Most of the cases had conservative surgeries(15 ipsilateral lobectomy-isthmusectomy, 7 subtotal thyroidectomy) while total thyroidectomy was performed in 4 cases. Of the cases with malignant tumor, 2 had ipsilateral lobectomy-isthmusectomy, 3 had subtotal thyroidectomy and the remaining 1 had total thyroidectomy. Mean size of the tumors was 3.0 cm(0.1- 8.5 cm) in the greatest diameter and multiple tumors were seen in 6 cases(23.1 %). During the follow-up period, only one recurrence(3.8%) of benign tumor occurred but distant metastasis or cause-specific death was seen in the benign or intermediate groups. Mean MVDs of the benign(n=13) and intermediate(n=6) groups were $121.7{\pm}35.3$ and $114.3{\pm}31.7$, respectively and there was no statistical significance between them. In conclusion, because of the low accuracies of fine needle aspiration biopsy and frozen section for the H$\"{u}$rthle cell neoplasm, the extent of surgery could be individualized based on permanent pathologic examination; Conservative surgery would be adequate for patients with benign or intermediate H$\"{u}$rthle cell neoplasm and total or near-total thyroidectomy for those with definite malignancy.

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아급성 괴사성 림프절염의 임상적 고찰 (Clinical Characteristics of Subacute Necrotizing Lymphadenitis)

  • 박찬흠;김희동;박준영;조형주;전진형;박윤규;노영수
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.217-221
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    • 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.

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Canine Mast Cell Tumor에서 Adjuvant Glucocorticoids 치료 (Adjuvant Glucocorticoids Therapy in Canine Mast Cell Tumor)

  • 김명진;이재일;김영석;손화영;전무형;박창식;김명철
    • 한국임상수의학회지
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    • 제22권3호
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    • pp.264-267
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    • 2005
  • 구토와 식용부진을 3일전부터 나타내고, 2년전부터 좌측 후지 상부에 종괴를 갖고 있는 12년령, 8.0kg, 난소 제거 잡종 암캐 1두가 충남대학교 부속동물병원에 내원하였다. 환자는 fine-needle aspiration (FNA) 세포진단학 검사에 의하여 mast cell tumor로 진단하였다. Mast cell tumor 진단을 위한 WHO clinical staging system에 의하여 stage IIIa로 분류하였다. 환자는 adjuvant corticosteroid 요법에 의하여 투약되었으며, 축주의 요구에 의하여 완전 외과 절제는 실시하지 아니 하였다. 초기에 adjuvant corticosteroid 단독 요법에 의하여 종괴의 크기가 점차 감소하였으며, 환자의 전신상태는 호전되었다. 그러나 그 후에는 더 이상 glucocorticoid에 반응을 하지 아니 하였으며, 종괴의 크기가 증가하였고, 2개월 후에 간헐적 구토와 심한 호흡곤란 때문에 안락사 하였다. 비장 종괴, 십이지장 궤양, 간 종괴와 후지 상부 근육부위에 침윤된 mast cell tumor가 부검 시에 발견되었다. Mast cell tumor는 grade I 또는 II에서 그리고 .조직학적으로 well-differentiated된 상태에서 외과적 완전절제, 방사선요법, adjuvant corticosteroid 요법, 화학요법을 병용 하여야 양호한 예후를 나타낼 것으로 기대된다.

다한증 환자에서 2 mm 흉강경 기구를 이용한 미용적 교감신경절제술 (Cosmetic Thoracic Sympathectomy for Palmar Hyperhidrosis using 2mm Thoracoscopic Instruments)

  • 성숙환;최용수;조광리;김영태;김주현
    • Journal of Chest Surgery
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    • 제31권5호
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    • pp.525-530
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    • 1998
  • 일차성 다한증에 대한 흉강경을 이용한 흉부교감신경절제술은 효과적이면서도 기존의 방법에 비해 미용상의 장점이 있다고 알려져 있지만, 5 mm 또는 10 mm 기구를 이용한 흉강경 교감신경절제술은 트로카 부위의 통증과 상처의 문제를 여전히 갖고 있었다. 최근에 2 mm 흉강경 기구가 이용되기 시작하였는바, 서울대병원 흉부외과에서는 1997년 1월부터 4월까지 연속적으로 46명의 수장부 다한증 환자에서 2 mm 기구를 이용하여 양측성 교감신경절제술을 시행하였다. T2 신경절을 절제하였고 해부학적 위치가 불분명한 환자에서 T1 신경절의 하부 3분의 1을 함께 절제하였으며 액와부 발한도 호소한 4명의 환자들에서는 T3 신경절도 함께 절제하였다. 폐의 재팽창후 흉관삽입없이 트로카를 제거하였고 트로카 부위는 봉합없이 sterile tape 만 붙였다. 수술직후 전례에서 수장부 발한이 소실되었다. 수술수기에 관련된 합병증인 호너증후군, 혈흉, 상완신경총손상 등은 없었으며 아홉명(19.6%)에서 소량의 기흉이 있었으며 이 중 두 명에서는 needle aspiration이 필요하였다. 대부분의 환자에서 진통제가 필요없었으며 모든 환자가 수술당일에 퇴원하였다. 2 mm 흉강경 기구를 이용하여 심각한 합병증없이 다한증의 교감신경절제술을 안전하게 시술 가능하였으며, 미용상의 만족과 술 후 통증 감소의 결과를 얻었기에 2 mm 흉강경 기구가 기존의 5 mm나 10 mm 흉강경과 기구들에 비해 우월하다.

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의인성 기흉에 대한 임상 고찰 (Clinical Analysis of Iatrogenic Pneumothorax)

  • 최시영;문미형;권종범;김용환
    • Journal of Chest Surgery
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    • 제42권6호
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    • pp.744-748
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    • 2009
  • 배경: 이 연구를 통해 침습적인 시술이 증가 함에 따른 의인성 기흉의 원인과 그에 따른 이환율을 알고자 한다. 대상 및 방법: 2005년 1월부터 2008년 12월까지 의인성 기흉의 진단으로 입원치료를 받은 112명의 환자(20세부터 90세까지의 연령분포를 보인 65명의 남자 환자와 47명의 여자 환자)에게서 후향적으로 의무기록을 조사하였다. 결과: 의인성 기흉의 호발 원인은 경피적 폐생검(50), 중심정맥관 삽입(29), 침술(14), 흉수천자(8), 양압환기(7)의 순서였다. 60명의 환자에서 흉관삽관술을 통해 치료하였다. 평균 치료 기간은 5.8 $({\pm}4.0)$일이었다. 24명의 환자에서 재원 기간이 길어졌으며, 의인성 기흉으로 인한 사망은 없었다. 결론: 이 연구에서는 의인성 기흉의 가장 흔한 원인은 경피적 폐생검이었다. 이에 따른 사망률이나 이환율은 미미한 수준이었다. 의인성 기흉의 진단에 있어 침습적인 시술 이후의 신중한 검사 및 그에 따른 치료가 중요할 것으로 생각된다.

태변 흡인 증후군 신생아에서의 피하지방괴사 1례 (A Case of Subcutaneous Fat Necrosis in Neonate with Meconium Aspiration Syndrome)

  • 홍미애;오경창;안승인;신혜정;장진근;이병두;김병일;최중환
    • Clinical and Experimental Pediatrics
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    • 제45권11호
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    • pp.1422-1425
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    • 2002
  • 저자들은 태아 곤란증 때문에 제왕절개한 과체중아로 저산소성 손상을 받은 태변 흡인 증후군 환아에서 생후 3-4일경에 어깨와 등에 여러 개의 홍반성의 결절과 반이 발생하였고 악화와 완화를 반복했으며 2-3회의 바늘 흡인(needle aspiration)을 시행하였고 합병증 없이 1세경 소실되었던 신생아 피하지방괴사 1례을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

한우에 있어서 초음파기기를 이용한 생체내 개체별 난자 채취 빈도 및 수정란 생산효율에 관한 연구 (Effect of Ovum Pick-up Frequency on In Vitro Production of Embryos in Hanwoo Cattle)

  • 박성재;양보석;임기순;성환후;양병철;장원경;정일정;정기화;심보웅
    • 한국수정란이식학회지
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    • 제15권1호
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    • pp.1-8
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    • 2000
  • The ultrasound-guided oocytes cllection (ovum pick-up ; OPU) has become a substitution for superovlation in cattle. The objective of this study was to examine the effect of OPU frequency on the in vitro production of embryos in Hanwoo cattle. Six cycling Hanwoo cows were distributed into two groups for either once or twice weekly OPU sessions. Oocytes were collected by ultrasound-guided follicle aspiration(SA600) using a 6.5HMz transducer and attached with 18 gauge needle, with vacuum pressure of 40 mmHg. The cumulus-oocyte complexes (COCs) collected from each donor were matured in TCM 199 supplemented with 10% fetal bovine serum at 5% CO2 in air at 38.5$^{\circ}C$ for 22h and in vitro matured oocytes were co-incubated with sperm(separated by Percoll gradient) for 6h. The zygotes were co-cultured on cumulus cell monolayer in 10ul droplets in the same culture medium and conditions used for IVM for 7 days. On Day 7 of culture, development to blastocysts was examined. Although the number of oocytes collected was variable depending on individuals, overall embryo production in the twice per week OPU sessions was better that in the once per week sessions(6~21 vs 2~7 blastocysts produced, respectively). Two cows(E, A) were good oocyte donors and embryo production was superior in cow C ; however, cow F was a poor donor as compared to the others. In conclusion, these results suggest that for embryo production, twice weekly OPU sessions were better than once per week for producing embryos in vitro from Hanwoo cattle.

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유방의 침윤성 파골양 거대세포 관암종의 세포소견 - 1예 보고 - (Invasine Ductal Carcinoma with Osteoclast-Like Giant Cell in a Young Woman)

  • 강현정;최경운;곽희숙;설미영;김지연
    • 대한세포병리학회지
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    • 제18권1호
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    • pp.69-73
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    • 2007
  • Mammary carcinoma with osteoclast-like giant cells is an unusual neoplasm characterized by giant cells, mononuclear stromal cells, and hemorrhage accompanying a low grade carcinoma. We present the cytological findings in a case of invasive ductal carcinoma with osteoclast-like giant cells that was initially confused with a fibroadenoma, due to its well-demarcated and soft mass and the young age of the patient. A 28-year-old female presented with a 4.5 cm, well demarcated, soft and nontender mass in the right breast. Fine needle aspiration cytology (FNAC) showed a combination of low grade malignant epithelial cell clusters and osteoclast-like giant cells. The atypical epithelial cells were present in cohesive sheets and clusters. Osteoclast-like giant cells and bland-looking mononuclear cells were scattered. An histological examination revealed the presence of an invasive ductal carcinoma with osteoclast-like giant cells. We report here the cytological findings of this rare carcinoma in a very young woman. The minimal atypia of the epithelial cells and its soft consistency may lead to a false negative diagnosis in a young woman. The recognition that osteoclastlike giant cells are rarely present in a low grade carcinoma, but not in benign lesion, can assist the physician in making a correct diagnosis.

개에서 발생한 연부조직 섬유종 2례 (Soft Tissue Fibroma in Two Dogs)

  • 최호정;이정우;안지영;오이세;안세준;정성목;박성준;조성환;이영원
    • 한국임상수의학회지
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    • 제25권5호
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    • pp.424-428
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    • 2008
  • A 10-year-old castrated male Schnauzer (case 1) and a 13-year-old intact male Schnauzer (case 2) was referred with mass of left hind limb. We performed hemogram, serum chemistry, radiography, ultrasonography, computed tomography, fine needle aspiration and histopathology. The complete blood counts and serum biochemistry results were within the reference range. Radiography showed cutaneous mass with soft tissue density. The lesions of two dogs were revealed a definite marginated hyperechoic mass with vascularization in ultrasonography. Computed tomography showed an isodense mass in the left hind limb region with minimal contrast enhancing in case 1 and heterogenous enhancement in case 2. Cytology from ultrasonographic guided aspiration of the mass was suspected fibrous tissue-derived benign cell in two dogs. A surgical excision was performed in two dogs. In histological examination of the resected mass, cutaneous fibroma was revealed. The two patients were successfully treated by surgery and postoperative care. This report decribes and compares radiographic, ultrasonographic, computed tomographic, cytologic and histopathologic features of the cutaneous fibroma of two schnauzer dogs.

진도견에서 발생한 원발성 결막 비만세포종양 1예 (Primary Conjunctival Mast Cell Tumor in a Korean Native Jindo Dog)

  • 이재연;정성목
    • 한국임상수의학회지
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    • 제30권2호
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    • pp.131-133
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    • 2013
  • 9 년령 23 kg의 암컷 진도견이 2개월 동안의 안구 분비물을 주요증상으로 본원에 내원하였다. 초기 안검사에서 좌측 아래 안구 결막 부위에서 크기 2 cm의 길게 돌출 된 종괴를 발견하였다. 다른 안구 및 주위 조직의 이상소견을 확인하기 위해 안구초음파를 실시 하였고 모두 음성으로 판명되었다. 또한 흉 복부에 실시한 X-ray 검사에서도 특이 소견이 관찰되지 않았다. 세포학적 검사에서 다수의 원형세포와 중등도의 호산구 (eosinophils)가 관찰되었다. 종괴는 외과적으로 절제되었고 조직학적 검사를 통해 비만세포종 (mast cell tumor)로 진단되었다. 수술 후 6개월 뒤 실시한 흉복부 X-ray 및 초음파 검사에서 종양의 전이 또는 재발은 관찰되지 않았다.