• Title/Summary/Keyword: endoscopic biopsy

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Primary Non-Hodgkin's Gastric Lymphoma (원발성 위 림프종)

  • Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.1 no.4
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    • pp.215-220
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    • 2001
  • Purpose: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. Materials and Methods: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. Results: The lower one-third of the stomach was the most frequent site ($42\%$), and the most frequent chief complaint was epigastric pain ($54\%$). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases ($82\%$), a carcinoma in 15 cases ($13\%$), an ulcer in 4 cases ($4\%$), and a gastrointestinal stromal tumor in 1 case ($1\%$). The stage distributions by Musshoff's criteria were 71 cases ($54\%$) of stage IE, 36 cases ($27\%$) of stage $II_{1}E$, 8 cases ($6\%$) of stage $II_{2}E$, 2 cases ($2\%$) of stage IIIE, and 15 cases ($11\%$) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases ($23\%$) of low grade, 96 cases ($73\%$) of intermediate grade, and 5 cases ($4\%$) of high grade. Chemotherapy-related complications occurred in 25 cases ($22\%$) while operation-related complications occurred in 6 cases ($5\%$). Seventeen patients ($13\%$) only underwent surgery, 19 ($14\%$) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients ($73\%$) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was $85\%$ in stage I or II and $47\%$ in stage III or IV (P=0.0000). Conclusion: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.

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da Vinci Robot-Assisted Esophagectomy for Esophageal Cancer: A Case of Esophago-gastrostomy through the Retrosternal Route - A case report - (식도암 환자에서 da Vinci 로봇을 이용한 식도암 수술 (흉골하 통로를 통한 식도-위 문합술) - 1예 보고 -)

  • Jeong, Sang-Seok;Choi, Pill-Jo;Woo, Jong-Soo;Kim, Si-Ho;Bang, Jung-Hee;Park, Kwon-Jae
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.396-400
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    • 2009
  • Operations using the da Vinci robot have performed in for many surgeries, but the adoption of robotics to general thoracic surgery has been slow. The patient (age 74, male) visited our hospital complaining of hiccups and dysphagia. The CT scan and endoscopic biopsy revealed esophageal cancer (squamous cell carcinoma). We performed transthoracic esophagectomy using a da Vinci robot and this was followed by gastric tube mobilization via laparoscopy. Cervical esophago-gastric anastomosis was done using the hand-sewn method. The gastric tube was brought into the neck through the retrosternal route. The patient was discharged without any complications. We report here on a case of successful da Vinci robotic esophgagectomy.

Lye Stricture of the Esophagus Complicated by Carcinoma

  • 유회성;이호일;이정호
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.225-230
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    • 1973
  • Five cases of esophageal cancer developed at the site of esophageal lye stricture were reported. Duration of lye stricture was between 13 and 40years, and all 5 cases had taken normal diet without appreciable troubles after recovery from the acute stage of burn till the suspected onset of esophageal malignaney. Outstanding symptoms of this grave condition were rather acute progressive dysphagia and frequent episodes of esophageal foreign bodies, Diagnosis could be confirmed easily by endoscopic biopsy in suspected eases, and all were epidermoid carcinoma histopathologically. Curative resection of this condition was made in neither of the cases, and their prognoses were more grave than other esophageal malignancies in our experience. The development of esophageal carcinoma at the site of corrosive esophagitis with resulting benign stricture has now been suspected as a cause and effect relationship between these two conditions, and Kiviranta: stated that the incidence of esophageal cancer in patients with lye stricture of longer duration is a thousand times higher than normal population. During last one decade the authors experienced 5 cases of esophageal carcinoma developed at the site of lye stricture of the esophagus among about 350 cases of lye burned esophagus at the Department of Thoracic & Cardiovascular Surgery, the National Medical Center in Seoul, Korea. In Korea they still use lye as a detergent in rural area, and there are still many persons ingesting lye for suicidal attempt or on accident. Lye stricture of the esophagus is, therefore, the most common esophageal disease needing surgical procedures, and the authors believe that there will be much more eases of lye stricture complicated by esophageal eareinoma repoted in near future in this Country.

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Upfront Stereotactic Radiosurgery for Pineal Parenchymal Tumors in Adults

  • Park, Jong Hoon;Kim, Jeong Hoon;Kwon, Do Hoon;Kim, Chang Jin;Khang, Shin Kwang;Cho, Young Hyun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.334-340
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    • 2015
  • Objective : Pineal parenchymal tumors (PPTs) in adults are rare, and knowledge regarding their optimal management and treatment outcome is limited. Herein, we present the clinical results of our series of PPTs other than pineoblastomas managed by stereotactic radiosurgery (SRS) at upfront setting. Methods : Between 1997 and 2014, nine consecutive adult patients with the diagnosis of PPTs, either pineocytoma or pineal parenchymal tumor of intermediate differentiation, were treated with SRS. There were 6 men and 3 women. The median age was 39 years (range, 31-53 years). All of the patients presented with symptoms of hydrocephalus. Endoscopic third ventriculostomy and biopsy was done for initial management. After histologic diagnosis, patients were treated with Gamma Knife with the mean dose of 13.3 Gy (n=3) or fractionated Cyberknife with 32 Gy (n=6). Results : After a mean follow-up of 78.6 months (range, 14-223 months), all patients were alive and all of their tumors were locally controlled except for one instance of cerebrospinal fluid seeding metastasis. On magnetic resonance images, tumor size decreased in all patients, resulting in complete response in 3 patients and partial response in 6. One patient had experienced temporary memory impairment after SRS, which improved spontaneously. Conclusion : SRS is effective and safe for PPTs in adults and can be considered as a useful alternative to surgical resection at upfront setting.

Clinical Review of Acute Gastric Anisakiasis (Anisakiasis에 대한 임상적 고찰)

  • Kim, Pill-Young;Chung, Moon-Kwan;Lee, Heon-Ju;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.4 no.1
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    • pp.43-47
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    • 1987
  • 7 cases of Acute Gastric Anisakiasis have been reviewed at the Department of Internal Medicine. Yeungnam University Hospital from March, 1983 to December 1986. 1. Of 7 cases, the ratio of male and female was 3:4 and the age 30s occupied most (5 cases) the 50s' followed (2 cases). 2. Chief complains were in order of epigastric pain (6 cases), vomiting (3 cases), Nause (2 cases), Ulticaria (1 case) & epigastric fulling sensation (1 case). 3. In all 7 cases, the causative fish is Astroconcer myriaster. 4. The onset of symptoms was observed within 5 to 7 hours after eating the causative raw fish. 5. Gastrofiberscopic exam was undergo within 18 hours since onset of symptoms. 6. The gastrofiberscopic findings were gastric mucosal edema and redness in all 7 cases. One case also had mucosal erosion. The involved sites of the stomach were in frequency of order, the body (5 cases), the antrum (2 cases). 7. The symptoms of the patients relieved spontaneously without medical treatment after the extraction of the larva with biopsy forcep during gastrofiberscopy. 8. In Korea, many people take raw fish and there may be many patients of Anisakiasis so if much concern and careful observation are paid to whom, with severe cramping epigastric pain after taking of raw marine fish in about 10 hours, we could find out and confirm more patients suffering from Anisakiasis by immediate endoscopic gastrofiberscopy.

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Variation in Contour and Cancer of Stomach (위 형태와 위암과의 상호연관성에 관한 연구)

  • Lee, Won-Hong;Hwang, Seon-Moon;Yoon, Kwon-Ha
    • Journal of radiological science and technology
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    • v.22 no.2
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    • pp.17-21
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    • 1999
  • There were four types of stomach contour included eutonic, hypotonic, steerhorn, and cascade. The aim of this study is to clarify relationship between incidence of stomach cancer and contour variation of the stomach. Double-contrast upper gastrointestinal study was performed in 1,546 patients, who had dyspepsia or other gastrointestinal tract symptoms. The radiographs were classified into the four types including eutonic, hypotonic, steerhorn, and cascade according to stomach contour in relation to body build. We also reviewed pathologic reports on endoscopic biopsy or surgical specimen. We studied the presence of relationship between incidence of stomach cancer and variation of stomach contour. We also examined the incidence of gastritis and gastric ulcer to the stomach contour variation. Of total 1,546 patients, eutonic stomach were 438(28.3%), hypotonic 911(58.9%), steerhorn 102(6.5%) and cascade 95(6.2%). Stomach cancer was found in 139(31.7%) of 438 eutonic stomachs, in 135(14.8%) of 911 hypotonic, in 42(41.2%) of 102 steerhorn, and in 24(36.9%) of 95 cascade (p=0.001). In hypotonic stomach, the incidence of stomach cancer was lower compared to the other three types significantly (p<0.05). Gastritis or gastric ulcer was found in 146(33.3%) of eutonic stomach, in 293(32,1%) of hypotonic, in 36(35.2%) of steerhorn, and in 26(27.3%) of cascade (p=0.640). In conclusion, gastric contour variation seems to be a factor affecting development of stomach cancer. The patients with hypotonic stomach may have lower incidence of stomach cancer than that of the other types. There was no relationship between the contour and gastritis or gastric ulcer.

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A Case of Trousseau's Syndrome with Catastrophic Course Triggered by an Intravenous Injection (한번의 말초정맥주사로 유발되어 파국적으로 진행된 Trousseau증후군 1예)

  • Moon, Ji-Yong;Kim, Sa-Il;Kwak, Hyun-Jung;Song, Soon-Young;Kim, In-Soon;Kim, Sang-Heon;Kim, Tae-Hyung;Sohn, Jang-Won;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.2
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    • pp.134-138
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    • 2011
  • Trousseau's syndrome is an unexplained thrombotic event that precedes the diagnosis of an occult visceral malignancy or appears concomitantly with the tumor. Upper extremity deep vein thrombosis is prevalent in patients with a central venous catheter. Furthermore, a peripheral intravenous injection may cause upper extremity deep vein thrombosis as well. However, a deep vein thrombosis has not been reported in the form of Trousseau's syndrome with a catastrophic clinical course triggered by a single peripheral intravenous injection. A 48-year-old man presented with a swollen left arm on which he was given intravenous fluid at a local clinic due to flu symptoms. Contrast computed tomgraphy scans showed thromboses from the left distal brachial to the innominate vein. The patient developed multiple cerebral infarctions despite anticoagulation treatment. He was diagnosed with stomach cancer by endoscopic biopsy to evaluate melena and had a persistently positive lupus anticoagulant. After recurrent and multiple thromboembolic events occurred with treatment, he died on day 20.

Primary Gastric Malignant Melanoma Mimicking Adenocarcinoma

  • Cho, Jun-Min;Lee, Chang Min;Jang, You-Jin;Park, Sung-Soo;Park, Seong-Heum;Kim, Seung-Joo;Mok, Young-Jae;Kim, Chong-Suk;Lee, Ju-Han;Kim, Jong-Han
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.279-283
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    • 2014
  • We report a case of primary gastric malignant melanoma that was diagnosed after curative resection but initially misdiagnosed as adenocarcinoma. A 68-year-old woman was referred to our department for surgery for gastric adenocarcinoma presenting as a polypoid lesion with central ulceration located in the upper body of the stomach. The preoperative diagnosis was confirmed by endoscopic biopsy. We performed laparoscopic total gastrectomy, and the final pathologic evaluation led to the diagnosis of primary gastric malignant melanoma without a primary lesion detected in the body. To the best of our knowledge, primary gastric malignant melanoma is extremely rare, and this is the first case reported in our country. According to the literature, it has aggressive biologic activity compared with adenocarcinoma, and curative resection is the only promising treatment strategy. In our case, the patient received an early diagnosis and underwent curative gastrectomy with radical lymphadenectomy, and no recurrence was noted for about two years.

Clonality Assay of Dysplastic Epithelial Lesions of the Stomach (위 이형성 상피 병변의 클론성에 대한 분자병리학적 연구)

  • Choi Ho Soo;Kim Mi Sook;Park Jae Woo;Park Chang Soo;Kim Young-Jin;Juhng Sang-Woo
    • Journal of Gastric Cancer
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    • v.1 no.3
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    • pp.129-135
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    • 2001
  • Purpose: Dysplasia or flat adenoma of the stomach is regarded as a precancerous lesion. However, the frequency and the evolutionary process of malignant transformation of gastric dysplasia are still debated. In order to see whether the lesion was a monoclonal or a polyclonal proliferation, clonality was assayed by X-linked HUMARA polymorphism. Materials and Methods: DNA was extracted from the paraffin-embedded tissue of 16 consecutive cases of endoscopic biopsy, eight of which supplied both dysplastic and nondysplastic tissue for comparison. HUMARA was amplified by PCR with or without pretreatment with methylationsensitive restriction enzyme, HpaII. The amplification products were electrophoresed on polyacrylamide gel and silver-stained. Results: Among the 16 cases, 13 cases were informative and 3 cases noninformative. Of the 13 cases, one case showed skewed lyonization, rendering 12 cases to be analyzed further. A monoclonal band pattern was noted in 2 cases, and a polyclonal band pattern in 10 cases. A review of the histopathologies of the monoclonal and the polyclonal cases did not reveal features discriminating the two groups. Conclusion: These results suggest that gastric dysplasia is a disease entity heterogeneous in the genetic level, and many cases may be non-neoplastic.

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A case of Bilateral Near Blindness Secondary to Isolated Sphenoid Sinus Aspergillosis with Headache (양측성 실명을 동반한 접형동 아스페르길루스증 1 예)

  • Yoon, Jun-Pil;Lee, Se-Jin;Lee, Jun;Kim, Ju-Hyun;Noh, Hyun-Doo
    • Journal of Yeungnam Medical Science
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    • v.24 no.1
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    • pp.79-84
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    • 2007
  • Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.

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