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중심성 폐암 발견에 있어 협대역 내시경의 임상적 유용성
박진경 ( Jin Kyeong Park ),조영선 ( Young Sun Jo ),장세진 ( Sae Jin Jang ),박영수 ( Young Soo Park ),최창민 ( Chang Min Choi ) 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.1
Background: Lung cancer is usually diagnosed at an advanced stage, resulting in a poor prognosis. The detection of these lesions at an earlier stage would be a clear benefit to patients. However, it is extremely difficult to detect carcinomatous lesions in the bronchial mucosal sites during a routine bronchoscopy. Methods: This study employed a novel optical technique, known as narrowband imaging (NBI), which allows noninvasive visualization of the microvascular structure of an organ`s surface using reflected light. Results: Narrow band imaging was performed on 10 patients who were radiologically suspicious or had a high risk of lung cancer. The median age of the patients was 57.5 years (range, 44∼81 years), and 80% of the patients were male. All lesions showed a microvascular proliferation pattern (dotted, tortuous and abruptly ending vessel) on the magnified NBI. Two lesions were confirmed histologically to be adenocarcinoma and the remaining lesions were squamous cell carcinomas. Two lesions were confirmed histologically to be a carcinoma in situ. Conclusion: NBI is a promising and potentially powerful tool for identifying carcinomas at an earlier stage or a central lesion during a routine bronchoscopy examination.
재발성 췌장염으로 발현한 췌장 상피내 종양(PanIN-3) 1예
손병석 ( Byeong Seok Sohn ),이성구 ( Sung Koo Lee ),김명환 ( Myung Hwan Kim ),서동완 ( Dong Wan Seo ),이상수 ( Sang Soo Lee ),김송철 ( Song Cheol Kim ),장세진 ( Sae Jin Jang ) 대한내과학회 2008 대한내과학회지 Vol.74 No.3
췌장 상피내 종양은 전암성 병변으로, 췌장암의 조기 진단 가능성 및 치료에 대한 기대로 인해 관심을 받고 있다. 췌장 상피내 종양은 원칙적으로 현미경 소견 이외에는 확인할 방법이 없으나, 최근 췌장 상피내 종양이 흔히 췌관 협착을 동반한 섬유화와 함께 발견되는 예가 보고되고 있어 이를 통한 조기 진단에 기대를 모으고 있다. 본례에서는 췌장 체부에 국소 만성 췌장염에 의한 섬유화 종괴의 발생과 이 종괴에 의한 재발성 췌장염 증상으로 내원하여 수술적 치료 시행하고, 병리 소견에서 섬유화 종괴 내에서 췌장 상피내 종양(PanIN-III)을 확인한 1예를 보고한다. Acute recurrent pancreatitis has a variety of etiologies. We experienced a case of a tumor-forming pancreatitis in a 49 year old Korean woman who also had pancreatic intraepithelial neoplasm III (PanIN-III), and this manifested just like recurrent pancreatitis. She had a history of recurrent pancreatitis. She was found to have an early stage of pancreatic cancer via computed tomography and magnetic resonance cholangiopancreatography. EUS guided fine needle aspiration (FNA) showed only many acinar cells of the pancreas. But due to the possibility of her having pancreatic carcinoma, she underwent distal pancreatectomy and splenectomy with lymph node dissection. Pathologically, the tumor of the pancreatic body showed secondary changes with focal fibrosis from the localized chronic pancreatitis. PanIN-III was observed in the pancreatic duct within the tumor, and there were no cancerous findings in the 13 dissected lymph nodes. (Korean J Med 74:310-314, 2008)