• Journal of Yeungnam Medical Science
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• v.8 no.2
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• pp.70-75
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• 1991

Supraclavicular lymph nodes are unique in that they can attract metastases from almost anywhere in the body and most common sites of metastasis from an unknown primary source. 125 cases which had been diagnosed as metastatic supraclavicular lymph node during the period between May 1983 and August 1991, were analysed pathologically, and the following distinctive characteristics could be outlined : 1) The most frequent sites of metastasis from primary lesions are lunge(43%), stomach(23%), lymphoreticular(6%), biliary(5%), esophagus(2%), and pancreas(2%). 2) Histologic examination of metastatic supraclavicular lymph node revealed adenocarcinoma(57%), squamous cell carcinoma(12%), undifferentiated carcinoma(9%), small cell carcinoma(7%), malignant lymphoma(6%), malignant melanoma(1%) and undetermined carcinoma(8%). 3) In cases that histologic type was adenocarcinoma, the most frequent primary sites were stomach(38%), lung(27%) and biliary(8%). 4) In cases that histologic types were squamous cell caricinoma, undifferentiated carcinoma, small cell carcinoma and undetermined carcinoma, the most frequent primary site was lung.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2509-2514
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• 2013

Background: The purpose of this study was to identify predictive factors for supraclavicular lymph node recurrence (SCLR) in N1 breast cancer patients and define a high-risk subgroup who might benefit from supraclavicular nodal radiotherapy (RT). Materials and Methods: From January 1995 to December 2009, 113 breast cancer patients with 1 to 3 positive axillary lymph nodes were enrolled in this study. All patients underwent breast-conserving surgery (BCS) or modified radical mastectomy (MRM). RT was given to all patients who received BCS. Among the patients given MRM, those with breast tumors >5 cm in size received RT. Regional nodal irradiation was not applied. Systemic chemotherapy was given to 105 patients (92.9%). Patient data were retrospectively reviewed and analyzed to identify predictive factors for SCLR. Results: The median follow-up duration was 6.5 years, with 5- and 10-year actuarial SCLR rates of 9.3% and 11.2%, respectively. Factors associated with SCLR on univariate analysis included histologic grade, number of dissected axillary lymph nodes, lymphovascular invasion, extracapsular extension (ECE), and adjuvant chemotherapy. On multivariate analysis, histologic grade and ECE remained significant. The patient group with grade 3 and ECE had a significantly higher rate of SCLR compared with the remainder (5-year SCLR rate; 71.4% vs. 4.0%, p<0.001). Conclusions: Histologic grade and ECE status are significant predictive factors for SCLR. Supraclavicular nodal RT is necessary in N1 breast cancer patients featuring histologic grade 3 and ECE.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.276-280
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• 2015

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.

• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.140-145
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• 1993

Langerhans cell histiocytosis or histiocytosis X is a disease of unknown etiology characterized by proliferation of mature histiocytes. While a few descriptions of the cytologic features of eosinophilic granuloma ocurring in the bone have been published, reports of cytologic findings of lymph node-based Langerhans cell histiocytosis are very rare. We report the cytologic findings of a case of Langerhans cell histiocytosis diagnosed by fine needle aspiration cytology from the left supraclavicular and right inguinal lymph nodes in a 65-year-old male. Cytologic smears showed characteristic reticuloendothelial cells which have elongated, folded, grooved nuclei and abundant pale cytoplasms. Particularly, nuclei were highly irregular and multilobated. A few mitotic figures were present. The cytologic diagnosis was confirmed by tissue biopsies from the left supraclavicular and right inguinal lymph nodes. Proliferation of histiocytes were also present in the skin. Immunohistochemistry for S-100 protein, vimentin, $\alpha1-antichymotrypsin$ and lysozyme showed positive staining. Electron microscopy disclosed Birbeck granules.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.17-21
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• 2018

Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.18-28
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• 2004

Background : Many diseases like lung cancer and tuberculosis can involve cervical lymph node. Fine needle aspiration cytology(FNAC) was known as a useful screening test for the evaluation of enlarged lymph node. But the usefulness and limitations of FNAC according to disease category or physical characteristics of lymph node were not yet fully established. Methods : Retrospective analysis of three hundred forty two adult patients who performed FNAC due to enlarged cervical lymph nodes at the Seoul Municipal Boramae Hospital during the period from January 1999 to December 2002 and final diagnosis could be made by surgical biopsy, microbiology or clinical observation. Results : Among the 342 cases, 176(51.5 %) were finally diagnosed as benign nature ncluding reactive hyperplasia, Kikuchi's disease and acute suppuration. Eighty eight(25.7 %) were diagnosed as tuberculous lymphadenitis, 66(19.3 %) as metastasis, and 12(3.5 %) as lymphoma. Tuberculosis, metastasis, and lymphoma all showed significantly larger diameter, longer duration of lymph node enlargement. There were higher frequency of supraclavicular involvement in the cases of tuberculosis and metastasis. The overall diagnostic sensitivity of FNAC was 88.0 %, and 88.6 % in benign nature lesion, 77.3 % in tuberculosis, 90.1% in metastasis and 58.3 % in lymphoma. The diagnosis of tuberculosis was made by FNAC in 68 cases (77.3 %) among 88 cases. Lung cancer(43.9 percent) was most frequent cause of cervical lymph node metastasis. Diagnostic sensitivity of FNAC was significantly lower in the supraclavicular than other cervical lymph node(80 % vs. 91.3 %) and not correlated with disease nature, node size or number. Conclusion : Though FNAC was a reliable screening test for enlarged cervical lymph node enlargement, the diagnostic sensitivity was low in the case of lymphoma or when the enlarged lymph node was located at the supraclavicular area.

• Archives of Craniofacial Surgery
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• v.21 no.6
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• pp.376-379
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• 2020

Supraclavicular lymph node (SCLN) flap is a common donor site for vascularized lymph node transfer for the treatment of lymphedema. Chyle leakage is a rare but serious complication after harvesting SCLN flap in the neck. We report a case of chyle leakage at the SCLN donor site and its successful management. A 52-year-old woman underwent SCLN transfer for treatment of lower extremity lymphedema. After starting a regular diet and wheelchair ambulation on the 3rd postoperative day, the amount of drainage at the donor site increased (8-62 mL/day) with the color becoming milky, which suggested a chyle leak. Despite starting a low-fat diet on the 4th postoperative day, the chyle leakage persisted (70 mL/day). The patient was started on fat-free diet on the 5th postoperative day. The amount of drainage started to decrease and the drain color became more clear within 24 hours. The drainage amount remained less than 10 mL/day from the 8th postoperative day, and we removed the drain on the 12th postoperative day. There was no seroma or other wound complications at follow-up 4 weeks after the operation. The current case demonstrates that a fat-free diet can be a first-line treatment for low output chyle leakage after a SCLN flap.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.139-143
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• 2014

Bacille Calmette-$Gu\acute{e}rin$ (BCG) lymphadenitis is the most common complication of BCG vaccination. It commonly occurs in infants aged <6 months involving ipsilateral axillary lymph nodes. We described BCG lymphadenitis in a 22-month-old boy presenting swelling of left supraclavicular lymph node that was confirmed by real-time polymerase chain reaction (PCR) and the multiplex PCR targeting the region of difference (RD).

• Journal of Breast Cancer
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• v.21 no.4
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• pp.463-467
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• 2018

Metastasis from primary cancer to the thyroid is uncommon in breast cancer. Here we present a case of lobular breast carcinoma that metastasized to the thyroid. A 54-year-old woman without symptoms was admitted to our institution for staging of the lymph node above the left clavicle. An $^{18}F$-fluoro-deoxy-D-glucose positron emission tomography scan was performed for staging, and low uptakes were observed in the left supraclavicular and cervical lymph nodes. High uptake was seen in the posterior and lower left lobe of the thyroid. Histologic findings indicated lobular breast carcinoma (positive GATA3, loss of E-cadherin expression) metastatic to the thyroid with a luminal profile. Immunohistochemical analysis was negative for primary thyroid or parathyroid carcinoma. To our knowledge, this is the first report of a patient presenting a metastatic invasive lobular carcinoma in the thyroid and lymph nodes without a prior diagnosis of breast cancer.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.97-100
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• 1998

Systemic lupus erythematosus is a severe cutaneous-systemic disorder of unknown etiology, It is represented with erythematous patches on the face in a so-called butterfly distribution, and characteristically classified as an autoimmune disease with antinuclear antibodies. The autoimmune diseases such as systemic lupus erythematosus, $Sj{\ddot{o}}gren$ syndrome, rheumatoid arthritis have been associated with lymphoid malignancy - leukemia, malignant lymphoma - which could involve various organs(spleen, liver, brain, mediastinal lymph node, supraclavicular lymph node, inguinal lymph node, cervical lymph node etc.). Many authors have studied about the association of systemic lupus erythematosus and malignant lymphoma, but exact etiology is still unknown. A common viral etioloty for systemic lupus erythematosus has been suggested since virus-like particles have been found in the glomerular endothelium of patients with systemic lupus erythematosus. These oncogenic viruses may be responsible for the higher frequency of malignant lymphoma in patients with systemic lupus erythematosus. In the other theory, the causes of malignant lymphoma are the defect of immune system due to systemic lupus erythematosus and the long-term use of therapeutics for treatment of systemic lupus erythematosus. When the cellular immune system(delayed hypersensitivity) is impaired by immunosuppressive drugs, it is likely that the body is no longer able to recognize and reject malignant cells as they arise; they continue to grow and divide unhindered. The impairment of the cellular immune system may allow growth of oncogenic virus or the survival of neoplatic tissues. 47-year old female patient treated systemic lupus erythematosus with steroid and immunosuppressive drugs for 5 years visited to our hospital due to elevated mass on left upper anterior maxilla area. By performing biopsy, we diagnosed this lesion as malignant lymphoma and referred to oncologist for chemotherapy. So we report a case of malignant lymphoma due to systemic lupus erythematosus with review of literatures.