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흉막에 발생한 고립 섬유성 종양의 세침흡인 세포학적 소견 - 폐의 선암종으로 오진한 1예 보고 -
최윤라,오영륜,이미숙,한정호,안긍환,Choi, Yoon-La,Oh, Young-Lyun,Lee, Mee-Sook,Han, Jung-Ho,Ahn, Geung-Hwan 대한세포병리학회 2001 대한세포병리학회지 Vol.12 No.2
Solitary fibrous tumor on the pleura is rare but should be included in the differential diagnosis on a peripheral pulmonary nodule. Cytologic features of solitary fibrous tumor of the pleura is not familar to the pathologist and may be misdiagnosed as malignancy. We report fine needle aspiration cytologic(FNAC) findings of a case of solitary fibrous tumor misdiagnosed as adenocarcinoma in a 48-year-old woman. The FNAC displayed a mixture of bland-looking spindle cells and clusters of epithelioid cells, which have hyperchromatic nuclei with prominent nucleoli. The helpful finding to distinguish It from other circumscribed benign and malignant lesions is the presence of fibromyxoid matrix admixed with blood vessels and thin collagen fibers. Familiarity with these features is essential to avoid misdiagnosis and overtreatment.
이유영 ( You Young Lee ),최윤라 ( Yoon La Choi ),김철중 ( Chul Jung Kim ),이선주 ( Sun Joo Lee ),이정원 ( Jeong Won Lee ),박창수 ( Chang Soo Park ),이제호 ( Je Ho Lee ),안긍환 ( Geung Hwan Ahn ),배덕수 ( Duk Soo Bae ),김병기 ( Byo 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.9
An extremely rare case of squamous cell carcinoma with sarcomatoid features of the vulva in a 43- year-old woman is reported. Squamous cell carcinoma with sarcomatoid features of the vulva is known as a rapidly growing tumor with poorer clinical outcomes
자궁경부암 환자의 근치적 방사선치료 시 VEGF 발현의 임상적 의의
박원(Won Park),최윤라(Yoon-La Choi),허승재(Seung Jae Huh),윤상민(Sang Min Yoon),박영제(Young Je Park),남희림(Hee Rim Nam),안용찬(Yong Chan Ahn),임도훈(Do Hoon Lim),박희철(Hee Chul Park) 대한방사선종양학회 2006 Radiation Oncology Journal Vol.24 No.1
Purpose: We wanted to determine the clinical characteristics and prognosis according to the VEGF expression in stage II cervical carcinoma patients treated with definitive radiotherapy. Materials and Methods: We enrolled 31 patients who were diagnosed with cervical cancer from 1995 to 2003 at Samsung Medical Center and their paraffin block tissue samples were available for study. The median age of the patients was 65 years. The mean tumor size was 4.1 cm (range: 1.2∼8.2 cm). Seven patients (22.6%) were suspected of having pelvic lymph node metastasis. An external beam irradiation dose of 45-56.4 Gy was administered to the whole pelvis with a 15 MV linear accelerator, and an additional 24 Gy was given to point A by HDR intracavitary brachytherapy. VEGF staining was defined as positive when more than 10% of the tumor cells were stained. The median follow-up duration was 58 months. Results: A positive VEGF expression was observed in 21 patients (67.7%). There was no significant correlation between the VEGF expression and pelvic lymph node metastasis, tumor size and the response of radiotherapy. During follow-up, 7 patients had recurrence. The complete response rate was not significant between the VEGF (-) and VEGF (+) tumors. However, the VEGF (+) tumors showed a significantly higher recurrence rate in comparison with the VEGF (-) tumors (p=0.040). The three year disease-free survival rates were 100% and 66.7%, respectively, for patients with VEGF (-) or VEGF (+) tumor (p=0.047). Conclusion: The VEGF expression was a significant factor for recurrence and disease-free survival. However, the significance of the VEGF expression is still controversial because of the various definitions of VEGF expression and the mismatches of the clinical data in the previous studies. 목 적: 종양 내 VEGF의 발현이 방사선저항성과 관련이 있고, 자궁경부암에서 VEGF 발현이 예후와 관련된다는 보고들이 있다. 본 연구에서는 자궁경부암 환자에서 근치적 방사선치료를 시행받은 환자를 대상으로 후향적으로 VEGF 발현에 따른 임상적 특성 및 환자 예후와 연관 관계를 알아보고자 하였다. 대상 및 방법: 1995년 9월부터 2003년 4월까지 삼성서울병원에서 자궁경부의 편평상피세포암 FIGO 병기 II로 진단받고 근치적 방사선치료가 시행된 환자 중 면역조직학 검사를 위한 파라핀 블록이 유용한 31명 환자를 대상으로 하였다. 대상환자들의 연령 분포는 38∼83세(중간값 65세)였다. 종양의 크기는 1.2∼8.2 cm (평균 4.1 cm)였고, 골반내 림프절 전이는 7예(22.6%)에서 있었다. 방사선치료는 15 MV 광자선으로 매일 1.8 Gy씩 주 5회, 전골반 내 조사가 시행되었는데 외부방사선치료 선량은 45∼56.4 Gy (중간값 50.4 Gy)였고, 강내치료는 point A에 1회 4 Gy씩 주2회, 총 24 Gy 조사되었다. 방사선치료 기간은 48∼67일(중간값 53일)이었다. VEGF 면역조직학 검사상 양성은 종양세포 중 VEGF 분포가 10% 이상인 경우로 정하였다. 대상환자들의 추적관찰기간은 12∼119개월(중간값 58개월)이었다. 결 과: VEGF 양성인 경우는 21예(67.7%)였다. VEGF 발현에 따른 골반 내 림프절 전이 유무, 종양 크기와 방사선 치료에 따른 관해 정도의 유의한 차이는 없었다. 전체 환자 중 7예에서 재발이 있었는데 국소재발, 원격전이, 국소 재발과 원격전이가 동반된 경우가 각각 3예, 3예, 1예였다. VEGF 음성과 양성인 경우에 방사선치료 후 완전관해율이 각각 90%와 81%로 의의있는 차이는 없었지만, 재발은 모두 VEGF 양성인 환자에서 발생하여 통계적으로 의의 있는 차이를 보였다(p=0.040). 3년 무병생존율은 77.4%였는데, VEGF 음성과 양성인 경우 각각 100%와 66.7%로 차이가 있었다(p=0.047). 결 론: 자궁경부암 FIGO 병기 2기 환자의 근치적 방사선치료 시 종양 내 VEGF 발현 유무는 재발률과 무병생존율에 영향을 주는 인자였다. 그러나 VEGF 과발현에 대한 각 문헌마다 정의가 다르고, 문헌에 보고되는 환자수가 많지 않아 향후 VEGF 발현이 자궁경부암 환자의 예후인자로 결정되기 위해서는 대규모 연구가 필요하겠다
설호준 ( Ho Jun Seol ),황승균 ( Sung Kyun Hwang ),최윤라 ( Yoon La Choi ),지제근 ( Je G Chi ),정희원 ( Hee Won Jung ) 대한뇌종양학회 2002 대한뇌종양학회지 Vol.1 No.2
Subependymoma is a rare, slow growing, rarely recurrent tumor. We report a case of recurrent subependymoma with subependymal seeding. An intraventricular tumor in the left temporal horn was detected in a 48-year-old female who presented with a 4-year history of dizziness and memory disturbance. Following near total surgical resection, a tumor diagnosis of subependymoma was confirmed by scattered clusters of isomorphic nuclei embedded in a dense fibrillary matrix of glial cell processes. Twenty six months after surgery, follow-up(F/U) magnetic resonance(MR) imaging revealed tumor recurrence in the previous site which necessitated linear accelerator radiosurgery(LINAC). A further 21 months later, F/U MR imaging showed recurrent, multiple, enhanced, nodular lesions in the enlarged left lateral ventricle for which the patient underwent reoperation. Radiological and operative findings revealed local relapse with subependymal seeding. The pathological finding was similar to that of the previous tumor and compatible with subependymoma. Immunohistochemical studies revealed that glial fibrillary acidic protein(GFAP) was positive and CD-99 was negative. The patient underwent radiation therapy for the residual tumor. This case history suggests that symptomatic residual tumors require close observation even though the clinical course of subependymoma is usually benign.
성상세포종과 수막종으로 오인된 유두상 상의세포종 -증례보고-
이승준 ( Seung Joon Lee ),김정은 ( Jeong Eun Kim ),황승균 ( Sung Kyun Hwang ),정희원 ( Hee Won Jung ),최윤라 ( Yoon La Choi ) 대한뇌종양학회 2003 대한뇌종양학회지 Vol.2 No.2
The authors report a case of papillary ependymoma, which is known to be rare and difficult to diagnose. A 35-year-old female, who had been previously diagnosed as having anaplastic astrocytoma at the other hospital, was admitted with headache, vomiting and decreased visual acuity. She had a multicystic tumor in the left parietal lobe on magnetic resonance image(MRI), and initial pathologic diagnosis after surgical resection was papillary meningioma. However, the electronmicroscopy( EM) examination showed findings of papillary ependymoma. In spite of adjuvant radiotherapy, postoperative 1-year follow-up MRI showed recurrence of tumor. The tissue obtained from the recurred tumor showed anaplastic features of dedifferentiated tumor cells with a proliferation index(Ki-67 index) of 10%. Supratentorial papillary ependymoma is difficult to be diagnosed only by typical light microscopy or immunohistochemistry. Therefore, ultrastructural study is necessary for diagnosis of papillary ependymoma.
조기 유방암 환자를 위한 다지표 예후 예측 검사 GenesWell<sup>TM</sup> BCT의 분석적 성능 시험
김지은 ( Jee-eun Kim ),강병일 ( Byeong-il Kang ),배승민 ( Seung-min Bae ),한새봄 ( Saebom Han ),전아름 ( Areum Jun ),한진일 ( Jinil Han ),조민아 ( Min-ah Cho ),최윤라 ( Yoon-la Choi ),이종흔 ( Jong-heun Lee ),문영호 ( Young-ho Moo 대한임상검사과학회 2017 대한임상검사과학회지(KJCLS) Vol.49 No.2
GenesWell<sup>TM</sup> BCT는 호르몬 수용체 양성, HER2 음성, 및 pN0 또는 1인 조기 유방암 환자의 10년내 타 장기 전이 재발 위험도를 제시하는 다지표 예후 예측 검사로, 예후에 대한 위험을 BCT Score로 제시한다. 본 연구에서는 GenesWell<sup>TM</sup> BCT의 분석적 성능을 검사하였다. 조기 유방암 환자의 FFPE 검체로 부터 추출한 RNA를 대상으로 GenesWell<sup>TM</sup> BCT 수행하여, 12개유전자의 발현값을 측정하였다. GenesWell<sup>TM</sup> BCT의 최소검출한계, 공란 한계 및 측정 범위는 단계 희석한 RNA 검체를 사용하여 평가하였으며, 분석적 정밀도 및 특이도 시험은 BCT Score에 따라 저위험군, 고위험군 그리고 경계선 주변으로 나누어진 3개의 RNA 검체를 이용하여 시험하였다. GenesWell<sup>TM</sup> BCT는 1 ng/μL 미만의 RNA 검체에서 RNA를 측정할 수 있었으며, 다기관에서 수행된 분석적 정밀도 시험에서 반복성 100% 및 재현성 98.3%의 결과를 확인할 수 있었다. 또한, 분석적 특이도 시험을 통해, 간섭 물질이 검체의 재발 위험성 판정에 영향을 미치지 않음을 확인할 수 있었다. 이들 결과는 GenesWell<sup>TM</sup>BCT가 95% 이상의 항상성을 나타내는 높은 분석적 성능을 가지고 있음을 제시한다. GenesWell<sup>TM</sup> BCT is a 12-gene test suggesting the prognostic risk score (BCT Score) for distant metastasis within the first 10 years in early breast cancer patients with hormone receptor-positive, HER2-negative, and pN0∼1 tumors. In this study, we validated the analytical performance of GenesWell<sup>TM</sup> BCT. Gene expression values were measured by a one-step, real-time qPCR, using RNA extracted from FFPE specimens of early breast cancer patients. Limit of Blank, Limit of Detection, and dynamic range for each of the 12 genes were assessed by serially diluted RNA pools. The analytical precision and specificity were evaluated by three different RNA samples representing low risk group, high risk group, and near-cutoff group in accordance with their BCT Scores. GenesWell<sup>TM</sup> BCT could detect gene expression of each of the 12 genes from less than 1 ng/μL of RNA. Repeatability and reproducibility across multiple testing sites resulted in 100% and 98.3% consistencies of risk classification, respectively. Moreover, it was confirmed that the potential interference substances does not affect the risk classification of the test. The findings demonstrate that GenesWell<sup>TM</sup> BCT have high analytical performance with over 95% consistency for risk classification.