• 제목/요약/키워드: benign tumors

검색결과 868건 처리시간 0.029초

푸마르산 수산화효소 유전자 결함에 따른 다발성 피부 평활근종의 치험례 (Multiple Cutaneous Leiomyoma Derived from the Mutation in Fumarate Hydratase Gene: A Case Report)

  • 김융수;탁경석;조정남;정찬민;오석준;이민진
    • Archives of Plastic Surgery
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    • 제34권5호
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    • pp.659-662
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    • 2007
  • Purpose: Multiple skin leiomyoma and uterine myoma bearing autosomal dominant traits are benign smooth muscle tumors which originate in skin or female uterus. Skin leiomyoma occurs after gene mutation originating from arrector pili muscle of hair follicle where its clinical manifestations vary significantly from person to person. Our department hereby reports the histological findings and genetic evaluations of this very rare disease. Methods: A 57-year-old woman presented in our institute with multiple tumors in the left and central parts of her back that started to appear since 19 years ago. The patient was diagnosed as having uterine myoma 15 years ago and underwent hysterectomy. Biopsy has been done on the specimen, and genomic DNA was separated from Fumarate hydratase gene for it to go through PCR amplification. The results of PCR amplification were aligned by sequencer. Results: According to the results of biopsy, tumor cells were spindle-shaped and were aligned in a bundle where there was no dysplasia or mitosis. Moreover, these cells had abundant eosinophilic cytoplasm with elongated nucleus, and benign leiomyoma that showed positive reactions to SMA stain were found. In genetic examination, mutations such as heterozygous single nucleotide substitutions were found in alignments of amplified DNA. Conclusion: Multiple skin leiomyoma and uterine myoma are relatively uncommon diseases that are transmitted through autosomally dominant traits from genetic mutations. When a patient's chief complaint lies upon skin-colored or brown masses that occur in multiples appearing in the trunk or extremities with characteristic clinical symptoms and histological findings, and when the patient's family history is acknowledged such as skin or uterine leiomyoma or renal tumor, necessary genetic examination on multiple skin leiomyoma and uterine myoma could be done, and thereby precise diagnosis could also be made.

Unusual Radiologic Findings and Pathologic Growth Patterns on Choroid Plexus Papillomas

  • Kim, Tae-Wan;Jung, Tae-Young;Jung, Shin;Kim, In-Young;Moon, Kyung-Sub;Jeong, Eun-Hui
    • Journal of Korean Neurosurgical Society
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    • 제51권5호
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    • pp.272-275
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    • 2012
  • Objective : Choroid plexus papillomas (CPPs) are generally regarded as benign tumors with typical radiologic and pathologic findings. However, they sometimes have unusual findings. We have analyzed radiologic findings and pathologic growth patterns on CPPs. Methods : The study group included 5 male and 5 female patients (age range, 3 months to 58 years : median, 29 years). The study group included 3 pediatric and 7 adult patients. All patients underwent surgery; 9 patients had a gross total resection and 1 patient had a subtotal resection. We analyzed the radiologic findings (location, size, mottle-like appearance, enhancement, calcifications, and hydrocephalus) and pathologic growth patterns (typical papillary, papillary and solid, and papillary and tubular). Results : The median follow-up duration was 21.3 months (range, 4-47.8 months). There were no recurrences after initial treatment. All patients had benign CPPs. Pediatric CPPs were 3.2 cm masses (range, 2.7-4 cm) with homogeneous enhancement and a mottle-like appearance, which pathologically showed the papillary growth pattern. Hydrocephalus was present in all pediatric patients. Postoperatively, subdural hygroma had occurred in two patients. In adults, CPPs were located in the fourth ventricle in 6 patients and suprasellar area in 1 patient. The size varied from 0.5-4.2 cm. Hydrocephalus and calcifications occurred in 3 and 4 patients, respectively. Three patients showed the heterogeneous enhancement without a mottle-like appearance and pathologically showed combined papillary and solid growth in 2 patients and papillary and tubular growth in one. Postoperatively, two patients with large masses had injuries of the brainstem and underwent shunt procedures for aggravation of hydrocephalus. Conclusion : CPPs may show unusual radiologic findings, which preoperatively give the difficulty to be differentiated from other tumors. CPPs with unusual radiologic findings showed the combined pathologic growth patterns.

악하선 절제술의 임상적 연구 (A CLINICAL STUDY OF SUBMANDIBULAR GLAND EXCISION)

  • 정인교;김종렬;김욱규;신상훈;김용덕;변준호;박봉욱;장원석
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권6호
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    • pp.545-550
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    • 2004
  • Salivary glands, major and minor, are susceptible to a wide variety of pathologic conditions. Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. We evaluated 84 patients who had been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital from January, 1989 to December, 2002 and had been performed submandibular gland excision. The results are as follows : 1. The patients undertaken the excision of the submandibular gland showed an age range of 16 to 71 years. The average was 49.1. 2. They consisted of 60 males(71.4%) and 24 females(28.6%), having 2.5 : 1 of genda ratio. 3. The most common symptom was swelling in 41 cases(48.8%), followed by the pain in 23 cases(27.4%). Other symptoms included mass, dysphagia, facial abnormaly and neck dyscinesia. 4. 42 cases(50.0%) showed sialadenitis and sialodochitis associated with salivary calculus. 5. According to the histopathologic study, all cases consisted of 17 neoplasmatic conditions(20.3%) and 67 non-neoplasmatic(79.7%). The neoplasmatic cases included 13 benign tumors and 4 primary malignant tumors. Sialadenitis and sialodochitis associated with or without salivary calculus were most marked, found in 50 cases(59.3%), in the non-neoplasmatic conditions. Pleoomorphic adenoma showed the highest frequency of the benign tumor.

기관지 선종의 외과적 치료[17례 보고] (Surgical Treatment of Bronchial Adenoma - Reports of 17 Cases -)

  • 문석환
    • Journal of Chest Surgery
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    • 제25권3호
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    • pp.247-257
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    • 1992
  • Bronchial adenoma, firstly described by Muller[1882] had been reported on the subject stressed their benign nature prior to 1940`s, but these tumors including carcinoid tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma are now known to possess the various degree of malignant natures from benign course, low grade malignant potential to distant lymphatic or hematogenous metastasis or combination. Although histologically diffeerent, four varieties except carcinoid tumor which is a spectrum of neu-roendocrine tumor originating Kulchitsky cell of the bronchial epithelium and form the part of the APUD tumor spectrum, are morphologically and in many respects clinically similar to the corresponding tumor of the salivary gland is a specific varient of adenocarcinoma that occurs most commonly in the major and minor salivary gland and less frequently tra-cheobronchial tree, esophagus etc. To better understand the clinical characteristics and assess more precisely the malignat nature of bronchial adenoma, we studied 17 cases of bronchial adenoma, which had been experienced at the Department of Thoracic and Cardiovascular surgery of Catholic University Medical College from April 1977 to september 1991. Seventeen cases of bronchial adenoma consist of 2 carcinoid tumors, 6 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas and one pleomorphic adenoma. There is a slight predominace of male patients[10/17] and the age of pt studied varied with a higher incidence occurring between the ages of 40 years and 60 years[mean age, 46.5 years]; the youngest being 15 years and oldest 69 years. Their leading complaints were hemoptysis[4], exertional dyspnea[8], fever & chilness [4], and symptoms mimicking the bronchial asthma[4]. Diagnosis was aided by the radiologic studies such as chest X-ray, polytomography, CT scan, brochography and bronchoscopy. The preferred locations of fumor were in the trachea[4], main stem bronchus[3], bronchus intermedius[3], bronchus of RUL[2], LUL[1], RLL[1], LLL[3] with no peripheral location. Modalities of treatments were single or combination of surgical resection, radiation therapy, chemotherapy. Complete resections were permitted in 12 cases with late recurrences of 4 cases ranging from 6 months to 10 years: pneumonectomy[4], lobectomy[4], bil-obectomy[2], sleeve resection[2]. Gross findings of resected specimens in 14 cases showed that 4 cases were polyp-like pedunculated mass[entirely intraluminal mass] with intact mucosa, 8 cases were broad-bas-ed sessile mass[predominatly intraluminal] and the main portions were located below the mucosa similar to tip of iceburg[predominantly extraluminal] in 2 cases. Follow-up information was availble in all 17 cases ; eight were alive without evidence of disese ranging from 1 month to 13 years. But seven cases died of the causes related to tumor[6 cases within 12 months, one case 10 years after pneumonectomy]. We concluded that 8 cases[47%] of 17 cases were metastasizing bronchial adenoma and precise survival rate cannot be answered by the scanty materials available for study.

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고립성 섬유성 흉막 종양의 수술적 절제 (Surgical Resection of Solitary Fibrous Tumors of the Pleura)

  • 장지원;김관민;심영목;한정호;이경수;김진국
    • Journal of Chest Surgery
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    • 제37권5호
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    • pp.432-437
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    • 2004
  • 배경 : 고립성 섬유성 흉막 종양(SFTP)은 중피하 중간엽에서 기원한 매우 드문 종양으로, 임상 경과나 적절한 수술적 절제의 범위 및 추적 관찰 결과 등에 대해 알려진 바가 매우 제한적이다. 대상 및 방법: 9년간(1994∼2003) 양성 및 악성 고립성 섬유성 흉막 종양으로 수술적 절제를 받은 환자를 대상으로 후향적 연구를 시행하였다. 결과: 총 22명의 환자(남 14, 여 8)가 포함되었고 평균 연령은 50.2세 (25∼83세)였다. 진단 당시 증상을 나타낸 환자는 13명(59%)이었고 가장 흔한 증상은 호흡 곤란이었다. 개흉술이 14예, 비디오 흉강경을 이용한 수술이 8예에서 행해졌으며, 종괴만을 절제한 경우는 12예, 주변 구조물을 포함한 광범위 절제를 행한 경우는 10예였다 모든 경우에 완전 절제술이 가능하였으며 수술 사망은 없었다. 수술 후 병리학적 진단 결과 양성 종양이 11예, 악성 종양이 11예였다. 추적 관찰 중 국소 재발 2예, 전신 전이가 6예에서 있었으며 재발과 전이는 모두 악성에서만 발생하였다. 결론: 진단 당시 증상이 있는 환자, 광범위 절제술, 재발 등은 모두 악성형에서 유의하게 많았다. 아직까지는 수술적 완전 절제가 가장 적절한 치료로 알려져 있으나, 재발과 전이를 억제하기 위한 수술 전후 전신 치료의 방법에 대해서 더 많은 연구가 필요할 것으로 생각된다.

연부조직 종양의 진단적 접근 (Diagnostic Approach to a Soft Tissue Mass)

  • 전영수;송승현
    • 대한정형외과학회지
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    • 제54권4호
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    • pp.293-301
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    • 2019
  • 사지와 몸통의 연부조직 종양은 정형외과 의사가 직면할 수 있는 흔한 문제이다. 비록 연부조직 종양은 대부분 양성이지만 정형외과 의사는 양성과 악성 종양을 구별할 수 있는 특징을 알고 있어야 한다. 연부조직 종양의 임상적 특징 및 역학을 이해하게 되면 올바른 진단 및 수술적인 치료를 할 수 있게 된다. 종양의 크기와 깊이는 종양의 진단을 위해 가장 중요한 요소이다. 종양의 감별 진단을 하기 위해서 우선적으로 상세한 병력청취와 자세한 신체 검사가 필요하며, 이후 단순 방사선 촬영, 초음파, 자기공명영상(magnetic resonance imaging), 양전자 방출 단층촬영술(positron emission tomography), 컴퓨터 단층촬영(computed tomography), 뼈 스캔, 혈관 조영술 등의 다양한 영상 촬영법을 사용하여 종양을 진단하고 진단된 종양의 특성을 확인하여야 한다. 특히 초음파 검사는 외래에서도 쉽게 수행할 수 있어 유용하다. 그러나 검사자의 숙련도에 따라 검사 정확도의 차이가 발생할 수 있다는 단점이 있다. 종양의 생검을 통한 조직검사는 종양에 대한 모든 영상 검사를 시행한 후 최종적으로 시행하는 것이 원칙이다. 조직 검사를 시행할 때는 세심한 주의를 기울여야 하며, 최종적인 진단 후에는 치료를 위해 다각적인 접근을 시행하여야 하며 필요한 경우에는 경험 있는 근골격계 종양전문의사에게 의뢰하는 것이 필요하다.

타액선 종양의 임상적 고찰 (A Clinical Study on Salivary Gland Tumors)

  • 장경훈;장유철;정환우;양훈식;김훈;김춘길
    • 대한기관식도과학회지
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    • 제3권2호
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    • pp.277-286
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    • 1997
  • 저자들은 1988년부터 1996년까지 중앙대학교 부속병원에서 수술적으로 치료한 47례의 타액선 종양환자를 대상으로 다음과 같은 결론을 얻었다. 1) 호발연령은 50대에서 가장 높았으며 악성종양의 경우 양성종양보다 호발연령이 높았다. 2) 여자에서 남자보다 호발하며 그 비율은 1.5;1 이었다. 3) 발생부위는 이하선이 가장 많아 48.9% 였으며, 악하선, 소타액선의 순이었으며 소타액선 종양은 구개에서 가장 많이 발생하였다. 4) 악성의 빈도는 소타액선에서 발생한 경우가 가장 높았으며, 악하선, 이하선 순이었다. 5) 가장 많은 증상은 무통성의 종물이었다. 6) 세침흡인 세포검사의 진단적 정밀도는 88.9% 였다. 7) 가장 흔한 타액선종양은 혼합종으로 전체의 57.4 %였다. 8) 악성종양 중 경부임파절 전이율은 22.2%였다. 9) 수술적 치료후 합병증의 발생률은 19.1% 였으며 일시적 안면신경마비가 가장 많았다.

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악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용 (Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors)

  • 김진희
    • 한국콘텐츠학회논문지
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    • 제19권3호
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    • pp.365-374
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    • 2019
  • 악성종양은 양성종양과 달리 전이가 가능하고 재발이 쉬울 뿐 아니라 생존율 및 삶의 질이 떨어지는 질환이다. 국내의 경우 악성종양 치료 시 건강보험심사평가원이 제시한 항암화학요법 일반원칙에 따라 일괄적으로 치료하는 경향이 있다. 하지만 근래에는 일방적인 약물치료보다는 동반진단제를 사용을 권고하는데 이는 바이오마커를 이용한 분자진단기법으로 동반진단하여 치료 전에 환자의 약물 반응을 예측할 수 있기 때문이며, 국내외 식품의약품안전처에서는 의약품의 반응성 및 안전성을 확보하기 위하여 신약개발단계에서 동반진단제를 함께 개발하기를 권고한다. 본 종설에서는 악성 고형암을 중심으로 동반진단제의 개발방향 및 개발현황을 문헌고찰을 통해 분석하였고, 동반진단제로 사용되는 다양한 분자진단기법, 예컨대 면역조직화학염색법, 중합효소연쇄반응법, 제자리부합법, 차세대염기서열분석법 등에 따른 동반진단제 개발현황 및 미국 식품의약품안전청의 승인사례를 조사하여 최신 동반진단 개발동향을 함께 살폈다. 그리고 동반진단제 개발과정에서 기술적 사항으로 허가시점에 맞춘 분자진단기술을 선택과 진단제에 대한 명확한 기전이해와 더불어 치료와 동반진단제의 융합을 제언하였고, 사회적으로 동반진단제에 대한 공공보험의 급여책정이 필요함을 제언하였다.

Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[18F]FDG PET/CT

  • Pei-Ju Chuang;Hsiu-Po Wang;Yu-Wen Tien;Wei-Shan Chin;Min-Shu Hsieh;Chieh-Chang Chen;Tzu-Chan Hong;Chi-Lun Ko;Yen-Wen Wu;Mei-Fang Cheng
    • Korean Journal of Radiology
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    • 제25권3호
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    • pp.243-256
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    • 2024
  • Objective: We aimed to investigate whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[18F]FDG PET/CT for endoscopy-detected ampullary tumors 5-87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13-36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80-13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41-19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00-14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16-21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874-0.956] vs. 0.815 [0.732-0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816-0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

외인성 기관협착 (Tracheal Stenosis by Extraluminal Compression)

  • 최종욱;김용환;박정수;정광윤;민헌기;최건
    • 대한기관식도과학회지
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    • 제2권1호
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    • pp.57-62
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    • 1996
  • Tracheal stenosis can be classified into intrinsic stenosis secondary to tracheal inflammatory lesion or mass effect and extrinsic stenosis secondary tumors of thyroid, esophagus and mediastinum. Extrinsic stenosis which is frequently encountered in clinical setting could be often overlooked due to mild symptom. Recently, even with the increasing interest in extrinsic tracheal stenosis there are limitation in it's diagnosis and treatment. The purpose of this study is to provide guidance in the diagnosis and treaonent of extrinsic tracheal stenosis. Here, we report the etiology, symptoms, radiologic findings, pulmonary fuction finding, treatment and its results in 26 cases of extrinsic tracheal stenosis. Causes of extrinsic tracheal stenosis included compression of aiway by thyroid benign tumor in 13 cases to be the most common, next by thyroid malignancy in 9 cases, metastatic mediastinal turner in 2 cases, 1 case each for esophageal cancer and parathyroid cancer. In 3 cases simple tracheal resection and end to end anastomosis were done, 1 cases underwent total laryngectomy, and 8 cases were treated by conservative management, where all cases failed in treatment. The remaining 14 cases were successfully treated by removing the causes and maintaining tracheal tube insertion for amount of time. Extrinsic tracheal stenosis due to benign conditions were treated satisfactorily by removing mass, however with the malignant causes there was considerable amount of difficulty in treatment.

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