• Journal of Yeungnam Medical Science
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• 제8권2호
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• pp.70-75
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• 1991

저자들은 최근 8년 3개월동안 영남대학교 의과대학 병리학교실에서 진단된 쇄골상부 림프절의 전이성 종양 125예를 병리조직학적으로 분석하여 다음과 같은 결론을 얻었다. 1) 원발병소는 폐와 위가 각각 54예(43%), 28예(23%)로 가장 많았다. 2) 전이성 쇄골상부 림프절의 조직학적 유형은 선암종이 71예(57%)로 가장 많았고 그외 편평상피암종, 미분화암종, 소세포암종 등은 각각 15예(12%), 11예(9%), 9예(7%)로서 비슷한 비율을 보였다. 3) 조직학적 유형이 선암종일 경우 원발병소는 위가 27예(49%)로 가장 많았고 폐 19예(34%), 담도계 6예(11%) 순이었다. 4) 조직학적 유형이 편평상피암종, 미분화암종, 소세포암종 및 분화도가 불량하여 유형을 판별할 수 없는 암종의 원발병소는 폐가 가장 많았다. 5) 원발병소를 전혀 알 수 없었던 암종 14예의 조직학적 유형은 선암종이 12예(86%)로 가장 많았다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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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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• 제78권3호
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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.

• 대한세포병리학회지
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• 제4권2호
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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.

• 대한두경부종양학회지
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• 제34권2호
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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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• 제56권1호
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• pp.18-28
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• 2004

연구 배경 : 미세침 흡인 세포검사법은 말초 림프절 비대의 원인규명에 매우 우수한 선별검사로 알려져 있으나 각 원인질환이나 림프절의 이학적 소견에 따른 유용성이나 검사한계에 대한 연구는 아직 미진하다. 방 법 : 경부 림프절 비대를 주소로 내원한 16세 이상 성인환자들 중 진단을 위해 미세침 흡인 세포검사법을 시행 받고 외과적 조직 생검, 미생물 검사, 임상적추적관찰 등을 통해 최종 진단이 가능했던 342명을 대상으로 검사의 예민도와 유용성, 문제점이 각 원인 질환이나 림프절의 이학적 소견에 따라서 어떠한지를 후향적으로 알아보았다. 결 과 : 342명의 림프절 비대 환자 중 양성 병변은 176예인 51.5 %, 결핵성 림프절염은 88예로 25.7 %, 악성 종양의 전이는 66예로 19.3 %, 그리고 림프종은 12예로 3.5 %였다. 결핵성 림프절염, 악성 종양의 전이, 림프종 등으로 최종 진단된 환자군들은 양성 병변에 비해서 높은 연령을 보였고 남성이 많았으며 빗장위 림프절을 침범한 경우가 많았다. 림프절의 이학적 특징에서도 림프절의 평균 크기가 특이 질환이 있는 군에서 양성 병변인 군에 비해서 유의하게 컸으며 20 mm 이상의 크기를 가진 환자들의 수도 유의하게 많았다. 악성 종양의 전이인 경우에는 고정화됐거나 굳은 경도를 가진 경우가 유의하게 많았다. 미세침 흡인 세포검사법은 전체적으로 88 %의 진단 예민도를 보였으며 악성 종양의 전이인 경우가 90.1 % 로 가장 높았고 림프종인 경우에 58.3% 로 가장 낮았다 양성 병변인 경우는 88.6 %, 결핵성 림프절염인 경우는 77.3 %의 예민도를 보였다. 미세침 흡인 세포검사법의 진단 예민도는 질환의 종류나 비대 기간, 림프절의 크기 등과 관련이 없었고 다만 빗장위 림프절인 경우에는 80.0 % 로 다른경부 림프절의 91.3 % 에 비해서 유의하게 낮은 예 민도를 보였다.결 론 : 미세침 흡인 세포검사법은 림프절 비대의 원인 감별에 우수한 선별진단법으로 판단되나 림프종이 의심되거나 빗장위 림프절의 경우에는 낮은 진단율을 보이므로 주의해야 한다.

• 대한두개안면성형외과학회지
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• 제21권6호
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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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• 제21권2호
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• pp.139-143
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• 2014

BCG 림프절염은 BCG 접종 후에 생기는 가장 흔한 합병증이다. BCG 림프절염은 대부분 6개월 미만의 영아에서 발생하며 접종한 부위와 같은 쪽 겨드랑이 림프절을 침범하는 경우가 많다. 본 저자들은 생후 15일에 Tokyo주 BCG 백신을 접종한 22개월 남자아이에서 왼쪽 쇄골상부 림프절 부위에 발생한 BCG 림프절염을 경험하여 이에 대해 보고한다. 우리는 림프절 흡인을 시행하여 얻은 검체에서 실시간 중합효소 연쇄반응과 region of difference (RD)에 대한 다중 중합효소연쇄반응으로 M. bovis Tokyo주에 의한 감염을 확인하였고 반복적인 흡인을 통해 치료하였다.

• Journal of Breast Cancer
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• 제21권4호
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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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• 제20권2호
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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.