Hodgkin병의 세포학적 검색

고영혜,박찬필,이중달,Ko, Young-Hyeh,Park, Chan-Pil,Lee, Jung-Dal 대한세포병리학회 1991 대한세포병리학회지 Vol.2 No.1

Cytologic findings from five cases with variable types of Hodgkln's disease were reviewed with special emphasis on the Reed-Sternberg (R-S) cells and their variants. Typical R-S and Hodgkin's cells were mono- or binucleated, and nuclei had rounded smooth contour, Acidophilic prominent nucleoli with perinucleolar halo were conspicuous in comparison to typical Reed-Sternberg cells, L & H (lymphocytic and histiocytic) cells in the lymphocyte predominant type tended to show pop-corn like irregular nuclear contour and to lack the prominent nucleoli. Lacunar cells in the nodular sclerosis type had multilobated nuclei with prominent acidophilic nucleoli. There was no prominent perinucleolar halo in L & H and lacunar cells. In conjuction with the number of Reed-Sternberg cells and back ground findings observed on the smears, the characteristic features of R-S cells and their variants allowed to make typing of Hodgkin's disease.

원발미상암으로 오인된 이하선 림프상피암종

고영혜(Young-Hyeh Ko),정한신(Han-Sin Jeong),장전엽(Jeon Yeob Jang),박준오(Jun Oh Park) 대한두경부종양학회 2013 대한두경부 종양학회지 Vol.29 No.2

Neck mass is a common manifestation from head and neck malignancy, most of which come from mucosal squamous cell carcinomas in the upper aero-digestive tract. However, once aspiration cytology suggests atypical malignant cells in the neck mass rather than metastatic squamous cell carcinomas, it is confusing to decide the adequate diagnostic work-ups and treatment planning. Here, we report a 29-year-old woman presenting with a growing neck mass mimicking malignancy of unknown origin, which was finally diagnosed as primary lympho-epithelial carcinoma in the parotid gland with multiple metastases to the lymph nodes. The patient underwent comprehensive neck dissection and total parotidectomy and the adjuvant radiation treatment was given. Our re-port highlight that the primary salivary gland cancer should be considered as the potential tumor origin in case of malignancy of unknown origin in the head and neck region and neck mass suggestive of atypical carcinomas.

처음 진단된 두경부 선양낭성암종에서 18F-FDG PET/CT: 임상상 및 병리소견과의 상관성

이지영 ( Ji Young Lee ),최준영 ( Joon Young Choi ),고영혜 ( Young Hyeh Ko ),백정환 ( Chung Hwan Baek ),손영익 ( Young Ik Son ),조숙경 ( Suk Kyong Cho ),천미주 ( Mi Ju Cheon ),이경한 ( Kyung Han Lee ),김병태 ( Byung Tae Kim ) 대한핵의학회 2009 핵의학 분자영상 Vol.43 No.5

목적: 처음 진단된 두경부 선양낭성암종의 18F-FDG PET/CT의 영상소견을 선양낭성암종의 병리적 소견, 병기 결정, 가장 흔한 두경부암인 편평세포암종의 18F-FDG 섭취양상, 예후와 상관 지어 알아보았다. 대상 및 방법: 두경부 선양낭성암종으로 처음 진단되어 18F-FDG PET/CT를 시행한 16명의 환자가 대상이었다. PET/CT의 병기 결정 능력을 알아보고, 두경부 선양낭성암종의 SUVmax를 원발종양의 조직학적 아형(고형 대 관상형/사상형상), 병변의 크기와 일치하는 두경부 편평세포암종의 SUVmax, 무병생존율과 비교하였다. 결과: 16명의 환자들 중, 관상형 또는 사상형을 가진 군은 10명이었고 나머지 6명은 고형을 가진 군이었다. 고형 선양낭성암종의 SUVmax는 관상형 또는 사상형 선양낭성암종 보다 유의하게 높았다(6.7±3.2 vs. 4.2±0.9, p=0.03). 18F-FDG PET/CT로 기존 영상법에서 발견하지 못한 원격 전이를 18.7%의 환자에서 발견하여, 치료방침 변경에 기여하였다. 선양낭성암종의 SUVmax는 병변 크기가 같은 편평세포암종과 비교해 보았을 때 유의하게 낮았다(5.1±2.4 vs. 13.6±6.0, p<0.001). 조직학적 아형에 따른 무병생존율은 통계적으로 유의한 차이를 보이지 않았다. 반면에, 원발종양의 SUVmax가 6.0 이상인 환자들의 무병생존율은 SUVmax가 6.0 미만인 환자들보다 유의하게 낮았다(p=0.002). 결론: 두경부 선양낭성암종의 18F-FDG 섭취양상은 조직학적 아형과 무병생존율과 유의한 관계가 있다. 18F-FDG PET/CT는 기존 영상법에서 발견하지 못한 원격전이 진단에 유용한 것으로 보인다. 사상형상 또는 관상형 선양낭성암종의 18F-FDG 섭취는 낮을 수 있어, 선양낭성암종이 의심되지 않은 환자들의 PET 영상 판독에 주의가 필요하다. Purpose: We evaluated 18F-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis. Materials and Methods: The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment 18F-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), SUVmax of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the SUVmax of ACC of the head and neck. Results: Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The SUVmax were significantly higher in solid pattern group than in tubular/cribriform pattern group (6.7±3.2 vs. 4.2±0.9, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The SUVmax of ACC was significantly lower than that of size-matched SqCC (5.1±2.4 vs. 13.6±6.0, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high 18F-FDG uptake (SUVmax≥6.0) had significantly shorter DFS than those with low 18F-FDG uptake (SUVmax<6.0). Conclusion: 18F-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. 18F-FDG PET/CT may be useful for detecting unexpected metastasis. Since 18F-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC. (Nucl Med Mol Imaging 2009;43(5):395-401)

유방에 전이한 악성 흑색종의 세침흡인 세포학적 소견 - 1예 보고 -

오영륜,고영혜,Oh, Young-Lyun,Ko, Young-Hyeh 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.1

Although the characteristic cytologic features of melanoma have been well described the diagnosis of metastatic melanoma by fine needle aspiration cytology (FNAC) may be difficult in the case of amelanotic melanoma and in the absence of awareness of clinical history. Furthermore, when the breast is the site of initial presentation, it could simulate a primary breast carcinoma leading to misdiagnosis. The recognition of metastatic malignant melanoma in FNAC material is essential to avoid an unnecessary mastectomy and to ensure appropriate chemotherapy. We experienced a case of metastatic melanoma of breast which presented as solitary breast mass in a 56-year-old woman. She had a history of surgical excision of right foot for melanoma one year ago. The cytologic smears were composed of noncohesive epithelioid cells with round or eccentric nuclei, bi-or multi-nucleation, prominent nucleoli, fine chromatin, and intranuclear inclusions. The cytoplasm of tumor cells had scanty melanin pigment but were diffusely positive for S-100 protein.

Sequential Chemoradiotherapy for Stage I/II Nasal Natural Killer/T Cell Lymphoma

노영주(Young Joo Noh),안용찬(Yong Chan Ahn),김원석(Won Seog Kim),고영혜(Young Hyeh Ko) 대한방사선종양학회 2004 Radiation Oncology Journal Vol.22 No.3

목 적: 초기 병기 비강 natural killer/T-cell 림프종에 대한 CHOP 항암화학요법과 국소 방사선치료의 순차적 적용 결과를 보고하고자 한다. 대상 및 방법: 1995년 3월부터 1999년 12월 사이에 성균관의대 삼성서울병원 종양센타에 비강 I/II 병기natural killer/T-cell 림프종으로 등록된 17명의 환자들 중 14명의 환자들에 대하여 순차적 항암화학요법과 방사선치료를 적용하였고 이들에 대한 분석을 시행하였다. 치료방침은 우선 CHOP 항암화학요법을 3주 간격으로 3∼ 4회 시행한 후 5주간에 걸쳐 육안적 병변과 인접한 림프절 부위에 대한 국소 방사선치료를 추가하는 것이었다. 결 과: 방사선치료의 시작 전에 시행한 국소종양의 항암화학요법에 대한 반응평가는 50%의 환자들에서 양호한 반응(완전관해 5명+부분관해 2명)을 보였고 나머지 50%의 환자들에서는 병변이 진행하였다. 6명의 환자에서 국소재발이 나타났는데 이들 중 2명은 원격전이를 동반하였고, 영역 림프절 재발을 수반한 경우는 없었다. 3년 생존율과 무병생존율은 50.0%와 42.9%였으며, 모든 사망과 재발사례는 치료개시 후 13개월 이내에 발생하였다. 예후인자의 단변량 분석에서 ‘B’ 증상이 없는 경우, 항암화학요법과 전체 치료방침에 양호한 반응을 보인 경우, 국제예후지표상 저위험군 등이 양호한 생존율과 관련이 있었다. 결 론: 본 연구의 치료방침에 의한 결과는 과거의 방사선치료 단독 또는 방사선치료 후 항암화학요법 추가에 따르는 결과들과 비교해 볼 때 재발양상과 생존율의 측면에서 유리한 점이 없었다. 따라서 방사선치료와 항암화학요법을 새로운 병용방법에 관한 연구개발이 요망된다. Purpose: Authors would report the results of sequential CHOP chemotherapy (cyclophosphamide, adriamycin, vincristine, and prednisone) and involved field radiotherapy (IFRT) for early stage nasal natural killer/T-cell lymphoma (NKTCL). Materials and Methods: Fourteen among 17 patients, who were registered at the Samsung Medical Center tumor registry with stage I and II nasal NKTCL from March 1995 to December 1999 received this treatment protocol. Three to four cycles of CHOP chemotherapy were given at 3 weeks' interval, which was followed by local IFRT including the known tumor extent and the adjacent draining lymphatics. Results: Favorable responses after chemotherapy (before IFRT) were achievable only in seven patients (5CR's+2 PR's: 50%), while seven patients showed disease progression. There were six patients with local failures, two with distant relapses, and none with regional lymphatic failure. The actuarial overall survival and progression-free survival at 3 years were 50.0% and 42.9%. All the failures and deaths occurred within 13 months of the treatment start. The factors that correlated with the improved survival were the absence of‘B’ symptoms, the favorable response to chemotherapy and overall treatment, and the low risk by international prognostic index on univariate analyses. Conclusion: Compared with the historic treatment results by IFRT either alone or followed by chemotherapy, the current trial failed to demonstrate advantages with respect to the failure pattern and survival. Development of new treatment strategy in combining IFRT and chemotherapy is required for improving outcomes.

갑상선 여포성 종양 진단에 있어서 Flow Cytometry를 이용한 DNA분석의 가치

박영석(Young Seok Park),정파종(Pa Jong Jung),고영혜(Young Hyeh Ko) 대한외과학회 1992 Annals of Surgical Treatment and Research Vol.43 No.4

성인여성에서 발생한 유방의 분비성 암종의 세침흡인 세포학적 소견 - 1예 보고 -

김나래,고영혜,오영륜,Kim, Na-Rae,Ko, Young-Hyeh,Oh, Young-Lyun The Korean Society for Cytopathology 2000 대한세포병리학회지 Vol.11 No.1

유방의 분비성 암종은 관 기원으로 통상의 침윤성 관암종보다 예후가 좋은 드문 종양이다. 현재까지 분비성 암종에 대한 세침흡인 세포검사의 세포학적 소견에 대해 보고한 영문보고는 소수이며 국내에는 단 1예의 보고가 있다. 최근 저자들은 세침흡인 세포검사로 진단한 유방의 분비성 암종 1예를 경험하였기에 이를 보고한다. 세포학적 소견은 약호산성의 분비성 물질로 이루어진 배경에 종양세포들이 판상구조를 보이며 개개로 떨어지는 세포는 거의 없었다. 레이스양 세포질의 다공성 변화는 간혹 반지 양 모양을 이루기도 하여 분비성 암종에 합당하였다. 본 증례에서 알 수 있듯이 분비성 도말 배경과 점액으로 채워진 소낭성 공간 및 간혹 관찰할 수 있는 관상피세포의 이형성은 유방의 드문 종양인 분비성 암종의 정확한 세포학적 진단에 매우 유용한 소견이다. Secretory carcinoma of the breast is a rare tumor of the ductal origin with a more favorable prognosis than the conventional ductal carcinoma. To the best of our knowledge, there are a few reports on fine needle aspiration cytology (FNAC) of secretory carcinoma in the English literature and one in the Korean literature. Recently, we experienced a case of secretory carcinoma of the breast performed by FNAC. The cytologic smears revealed several clusters and sheets of cohesive neoplastic cells in eosinophilic secretory background. Individually scattered cells were rarely found. Intracytoplasmic vacuolization and occasional signet rung cells with lacy cytoplasm were detected. To make the diagnosis and differentiation of this rare, tumor, an identification of the secretory background and microcystic spaces filled with bluish mucin and occasional nuclear atypism of tumor cells is crucial.

악성 침샘종양의 세침흡인 세포검사의 정도관리

오영륜,고영혜,Oh, Young-Lyun,Ko, Young-Hyeh 대한세포병리학회 2004 대한세포병리학회지 Vol.15 No.1

To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.

Cytologic Features of Langerhans' Cell Histiocytosis

류근신,고영혜,박문향,이중달,Lyu, Geun-Shin,Ko, Young-Hyeh,Park, Moon-Hyang,Lee, Jung-Dal The Korean Society for Cytopathology 1991 대한세포병리학회지 Vol.2 No.2

저자들은 세포학적 검사로 진단이 가능하였던 2예의 Langerhans 세포 조직구증의 세포학적 소견을 기술하였다. 한 예는 3개월된 남아의 구진성 피부병소로 부터 얻은 찰과 도말 표본에서, 다른 예는 3세된 남아의 종창된 경부림프절의 세침천자 세포학적 표본에서 각각 특징적인 조직구의 도말배경을 관찰함으로써 진단이 가능하였다. 진단적인 세포학적 표본의 검색에서 도말된 세포성분은 풍부하고, 도말배경은 깨끗하였다. 특징적인 조직구는 길죽한 핵의 한쪽이 약간 함몰되고, 긴 구열을 가지며, 핵막은 얇고, 염색질은 섬세하며, 핵소체는 인정되지 않았다. 호산성의 세포질은 풍부하고, 활동적인 탐식작용의 증거는 관찰되지 아니하였다. 특징적인 조직구와 더불어 림프구와 드물게 호산구가 도말배경을 이루고 있었다. Langerhans' cell histiocytosis (LCH), known for histiocytosis X, is a clinicopathologic entity characterized by proliferation of Langerhans' cells (LCs) throughout the body including the reticuloendothelial system, bone, and skin. LCs is currently considered as a distinct type of histlocytic cells, not primarily phagocytic in nature. Recently, we could make the diagnosis on cytologic specimen in a 3 month-old-boy and a 3 year-old-boy. The cases were diagnosed on scraping smear from the skin and fine needle aspiration cytology from the lymph node, respectively. The characteristic cytologic features of Langerhans' cells were noted in the nuclei, namely eccentric, indented, elongated, and grooved nuclei. The cells also had abundant and acidophilic cytoplasm. The cytologic diagnoses were confirmed on the biopsies from the skin and lymph node, respectively.

세침흡인 세포검사로 진단한 폐의 포상 연부육종 - 1예 보고 -

김대수,오영륜,고영혜,Kim, Dae-Su,Oh, Young-Lyun,Ko, Young-Hyeh 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.2

Alveolar soft part sarcoma(ASPS) is a rare malignant neoplasm with a distinct clinicopathologic entity of which fine needle aspiration(FNA) cytologic findings have been described in only a few reports. Although patients usually present with an isolated soft-tissue mass in the extremity, metastasis can occur in about 13 % of total cases and the most frequent metastatic site is the lung. We have recently experienced a FNA cytologic case of ASPS in the lung. A 23-year-old female patient was admitted to this hospital due to 2-month-history of cough She had been good in health before the visit. Chest computed tomography revealed multiple, variable sized, bilateral pulmonary nodules. Physical examination and other staging work up revealed no other lesions except for pulmonary nodules. A percutaneous transthoracic FNA was performed from the pulmonary nodules. The smear was cellular and most cells were arranged singly. In addition, a few clusters lined by thin-walled vasculature with a pseudoalveolar pattern were present. Some of the tumor cells were large and polygonal lo oval with abundant granular or vacuolated cytoplasm. Most cells were naked nuclei showing finely granular chromatin pattern with prominent central nucleoli.