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증례 : 혈액종양 ; 제1형 신경섬유종증 환자에서 발생한 다발성 암 1예: 위장관기질종양, 유방암 및 바터팽대부암
김효은 ( Hyoeun Kim ),조재용 ( Jae Yong Cho ),황창혁 ( Chang Hyeok Hwang ),양서연 ( Seo Yeon Yang ),천유진 ( You Jin Chun ),최성민 ( Sung Min Choi ),최성은 ( Sung Eun Choi ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2
저자는 제1형 신경섬유종증 환자에서 동반된 세 종류의 종양(위장관기질종양, 유방암 및 바터팽대부암) 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder with a prevalence of approximately 1 in 3,500 live births. NF-1 predisposes to various benign and malignant neoplasms. Neurological malignancies are most frequent, but the risks of non-nervous system tumors, such as of the esophagus, stomach, colon, liver, biliary tract, pancreas, lung, melanoma, thyroid gland, female breast and ovaries, are also increased. Malignant tumors are the most common cause of death in patients with NF-1. Cases with double primary tumors have been reported, but cases involving three or more primary cancers are rarely reported. Therefore, we present the case of a NF-1 patient diagnosed with gastrointestinal stromal tumor, breast cancer and ampulla of Vater cancer. (Korean J Med 2016;90:154-158)
증 례 : 직장암 치료 중 진단된 만성호중구성백혈병 1예
김석형 ( Seok Hyung Kim ),박해열 ( Hae Yeul Park ),황창혁 ( Chang Hyeok Hwang ),정영학 ( Young Hak Jung ),이민주 ( Minjoo Lee ),최성은 ( Sung Eun Choi ),김유리 ( Yu Ri Kim ) 대한내과학회 2016 대한내과학회지 Vol.90 No.1
증례는 감염 및 악성종양과 동반되어 백혈병양 반응과의 감별이 어려웠고, 또한 악성종양의 전이와 유사하게 종괴를 형성하여 더욱 감별이 어려웠던 CNL 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm characterized by sustained neutrophilia, splenomegaly, and hypercellular bone marrow without Philadelphia chromosome. Diagnosis of CNL requires exclusion of identifiable causes of reactive neutrophilia, such as infection and tumors. Our patient presented with general weakness and weight loss. Computed tomography (CT) showed a mass in the distal rectum, which was confirmed to be an adenocarcinoma by colonoscopic biopsy. Positron emission tomography-CT showed multiple liver, bone, and lymph node metastases. Liver and lymph node biopsies revealed neutrophilic infiltration with no evidence of adenocarcinoma. The pathological findings of the bone marrow were compatible with CNL. Cytogenetic analysis revealed a normal karyotype, and molecular analysis was negative for BCR/ABL. Here, we present a 73 year-old man diagnosed with concurrent CNL and rectal cancer. (Korean J Med 2016;90:59-62)