• International journal of thyroidology
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• 제11권2호
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• pp.117-122
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• 2018

Metastases to regional cervical lymph nodes occur frequently in patients with thyroid cancer. The appropriate management of regional lymph node is important to achieve good disease control and to classify risk stratification for adjuvant radioactive iodine. However, there are some occasions that neck dissection is difficult and embarrassing in thyroid cancer. Especially, extensive or unusual nodal metastases bring challenges and makes neck dissection more difficult. Carotid artery management is one of the most difficult procedure in neck dissection. The management of patients who have persistent or recurrent cervical metastasis involving the carotid artery has been controversial and treatment dilemma to the surgeon. Metastasis of well differentiated thyroid cancer to the retropharyngeal lymph nodes is rare but occasionally encountered. The complete surgical excision is usually recommended for retropharyngeal lymph node metastasis of well differentiated thyroid cancer. An extensive mediastinal dissection in advanced differentiated thyroid carcinoma is occasionally required. This paper will review recent reports of management of advanced nodal metastasis of thyroid cancer and share the author's personal experience.

• Clinical and Experimental Pediatrics
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• 제53권9호
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• pp.855-858
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• 2010

Kawasaki disease (KD) causes multisystemic vasculitis but infrequently manifests with deep neck infections, such as a peritonsillar abscess, peritonsillar or deep neck cellulitis, suppurative parapharyngeal infection, or retropharyngeal abscess. As its etiology is still unknown, the diagnosis is usually made based on typical symptoms. The differential diagnosis between KD and deep neck infections is important, considering the variable head and neck manifestations of KD. There are several reports on KD patients who were initially diagnosed with retropharyngeal abscess on on computed tomography scans (CT). However, the previously reported cases did not have abscess or fluid collection on retropharyngeal aspiration. Therefore, false-positive neck CT scans have been obtained, until recently. In this case, suspected neck abscess in patients with KD unresponsive to intravenous immunoglobulin could signal the possible coexistence of suppurative cervical lymphadenitis.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4393-4399
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• 2015

Background: To explore the independent prognostic factors for the recurrence/metastasis of patients with locoregionally advanced nasopharyngeal carcinoma (LANPC). Materials and Methods: A total of 604 patients initially diagnosed as LANPC by pathohistology in Fujian Provincial Cancer Hospital were selected to analyze the relationship between the clinical pathological patterns, therapeutic protocols and clinical stages with the recurrence/metastasis of LANPC. Results: The 1-, 3- and 5-year locoregionally recurrent rates of LANPC patients were 2.0%, 9.5% and 12.9% respectively, with average recurrent period being 78 months. Univariate analysis results indicated that clinical stages had certain influence on the recurrent period of LANPC patients. However, COX regression models showed that ages, genders and clinical stages were not the independent prognostic factors influencing the recurrence. The 1-, 3- and 5-year metastatic rates of LANPC patients were 6.6%, 17.5% and 18.8% respectively, with average metastatic period of 73 months. Univariate analysis results demonstrated that ages, N stages, clinical stages, locations of lymph node, retropharyngeal lymph node and extracapsular invasion of lymph node had certain influence on the metastatic period of LANPC patients. Additionally, further COX regression analysis results suggested that T stages, reduction protocols and extracapsular invasion of lymph node were the independent prognostic factors influencing the metastasis of patients with LANPC, in which T stages and extracapsular invasion of lymph node were the pestilent factors while reduction protocols the protective factor. Conclusions: Induction chemotherapy is beneficial to LANPC patients with initial treatment, and the metastatic rate decreases greatly after the application of reduction chemotherapy.

• Clinical and Experimental Pediatrics
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• 제52권2호
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• pp.251-255
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• 2009

가와사끼병은 급성 전신적 염증성 질환으로, 그 원인은 아직 밝혀지지 않았고, 임상양상은 비특이적으로 많은 소아의 감염성 질환이나 면역학적 질환에서도 볼 수 있다. 저자들은 발열과 경부 임파선병증을 보인 두 증례에서 경부 전산화단층촬영상 인두후부의 농양과 유사한 소견을 보였으나 항생제 치료에 반응하지 않으며 인두 후부의 흡인술에서도 농양이 없던 경우로, 시간이 지나면서 전형적인 가와사끼 증상의 출현과 함께 심초음파에서 방실 판막의 역류를 보여 늦게 진단할 수 있었다. 본 증례에서처럼 발열과 경부임파선병증으로 나타나는 경우에도 가와사끼병을 의심해야 하며, 이 경우 전산화단층촬영에서 인두후부의 농양 유사 병변은 위양성 소견으로 볼 수 있다. 경부임파선병증이 적절한 항생제치료에도 불구하고 발열 등의 증상이 지속되는 경우에는, 심초음파를 포함한 검사를 조기에 시행하여 불필요한 내과적, 외과적 치료를 줄여야 할 필요가 있겠다.

• 한국임상수의학회지
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• 제28권1호
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• pp.154-158
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• 2011

A 8-year-old female Shih-tzu dog (weighting 4.5 kg) with history of both hindlimb lameness and cervical mass was presented to Veterinary Teaching Hospital, Gyeongsang National University. In physical examination, ataxia, kyphosis, back pain and cervical mass were identified. Marked periosteal new bone formation of the fourth lumbar vertebra and soft tissue opacity mass of cervical region were observed in survey radiographs. Transverse computed tomography (CT) scan obtained at the lumbar and cervical lesions shown a well defined multilobulated bony mass and partially destructive lytic lesions the fourth lumbar vertebral body and a enlarged retropharyngeal lymph node with heterogeneous contrast enhancement and moderately enhancing left tonsillar mass. Neoplastic squamous epithelium which have developed vessel and lymphocyte infiltration in surrounding tissue were confirmed based on histopathologic examination. Based on the diagnostic findings the dog was diagnosed as a cervical lymph node metastases of tonsillar squamous cell carcinoma.

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

• 대한한방내과학회지
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• 제43권1호
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• pp.79-89
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• 2022

This study examined the clinical effects of Korean medicine therapy in a patient with hypopharyngeal cancer treated with chemotherapy. A 53-year-old male patient suffering from hypopharyngeal cancer was treated with docetaxel as well as acupuncture and herbal medicine. Tumor size was measured by computed tomography (CT) and adverse events were evaluated according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 5.0. After two months of combined treatment, the size of the tumor mass was reduced at the left side of the neck, posterior to the CCA and at the lymph node in the left retropharyngeal area and medial aspect of the carotid sheath. The adverse events of chemotherapy also improved. This study indicates that Korean medicine therapy, such as acupuncture and herbal medicine, may lessen the side effects of chemotherapy and may be effective in the treatment of hypopharyngeal cancer.