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갑상샘 세침흡인 세포검사와 조직검사의 진단 일치율 및 정확도 분석 -조직학적으로 확진된 322 예에 대한 분석-
구자승,정우희,양석우,홍순원,Koo, Ja-Seung,Jung, Woo-Hee,Yang, Seok-Woo,Hong, Soon-Won 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2
Fine needle aspiration (FNA) cytology is the decisive test in the pre-operative diagnostics of thyroid nodules. Here we share our institutional experience about thyroid aspiration and give suggestions for suspicious cytology results. Three hundred twenty-two cases in 270 patients (mean age 47.4 years, 243 women and 27 men) who underwent thyroidectomy were reviewed. Among the 322 cases, the FNA diagnosis of "positive for malignancy" was 87 cases (27.0%), "suggestive of malignancy" 30 cases (9.3%), "suspicious for malignancy" 61 cases (18.9%), "negative for malignancy" 102 cases (31.7%), and "unsatisfactory smear" 42 cases (13.0%). Eighty seven cases (100%) out of "positive for malignancy", 29 cases (96.7%) out of "suggestive of malignancy", and 39 cases (64.0%) out of "suspicious for malignancy" were papillary carcinoma (148 cases, 95.5%), or follicular carcinoma (2 cases, 1.3%), or metastatic carcinoma (1 case, 0.6%). Seventeen patients who had only negative or unsatisfactory cytology underwent thyroidectomy and nine cases (52.9%) were papillary carcinoma. We suggest that: the cytology diagnosis of "suggestive of malignancy" could be regarded as "positive for malignancy", the cytology diagnosis of "suspicious of malignancy" should be carefully correlated with clinico-radiologic manifestation, and even a negative or unsatisfactory smear should be carefully followed up.
Seho Park(박세호),Young Sin Ko(고영신),Ja Seung Koo(구자승),Joohyuk Sohn(손주혁),Seung Il Kim(김승일),Byeong-Woo Park(박병우) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.1
Purpose: This study aimed to compare expression of human epidermal growth factor receptor (HER) family and insulin-like growth factor- 1 receptor (IGF-1R) before and after targeted therapy in HER-2 positive breast cancers. Methods: Epidermal growth factor receptor (EGFR), HER-3, HER-4, and IGF-1R were immunohistochemically determined using pairwise archives tumor blocks of 28 patients received chemotherapy and HER-2 directed therapy between January 2007 and December 2011. Of them, 5 good responders achieved a pathologic complete response after neoadjuvant therapy and 23 poor responders experienced disease progression or metastasis even HER-2 targeted therapy. Expression of biomarkers was compared using chi-square test. Results: Stage II, III, and IV was 14 (50.0%), 11 (39.3%), and 3 (10.7%) patients, respectively. Hormone receptors-positive tumors were 15 (53.6%) patients and 9 (32.1%) patients received tyrosine kinase inhibitors with or without trastuzumab. Positive expression of initial EGFR, HER-3, HER-4, and IGF-1R was determined in 15 (53.6%), 11 (39.3%), 22 (78.6%), and 14 (50.0%) patients, respectively. Although there was no statistical significance, good responders showed a higher proportion of positive HER-3 expression. Among 23 poor responders, growth factor receptors family expression showed a trend of concordant results, however, unpredictively certain patients demonstrated discordant results between before and after targeted therapy. Conclusion: Unpredicted correlation of growth factor receptors family expression suggested that complex and personalized resistance mechanisms may be involved to HER-2 directed therapy. However, HER-3 expression might be associated with responsiveness to HER-2 targeted therapy. It would be important to develop diagnostic and therapeutic strategies for overcoming resistance to HER-2 targeted therapy.
박세호 ( Se Ho Park ),김승일 ( Seung Il Kim ),박병우 ( Byeong Woo Park ),박형석 ( Hyung Seok Park ),이준상 ( Jun Sang Lee ),이종석 ( Jong Seok Lee ),노송미 ( Song Mi Noh ),구자승 ( Ja Seung Koo ),김민정 ( Min Jung Kim ),김은경 ( E 대한임상종양학회 2010 Korean Journal of Clinical Oncology Vol.6 No.2
유방의 과립세포 종양은 드물게 발생하는 양성 종양으로 말초 신경의 신경섬유초 세포에서 기원하는 것으로 알려져 있다. 과립세포종양의 임상적, 영상의학적 소견은 유방의 악성 종양 소견과 유사하여 양성 종양임에도 불구하고 악성 종양으로 오인되기 쉽다. 저자들은 갑상선 기능 항진증으로 추적 관찰 중인 54세 여자의 우측 유방에서 중심 침생검과 면역조직화학 염색으로 진단된 과립세포종양 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Granular cell tumor (GCT) of the breast is an uncommon, usually benign tumor originating from Schwann cells of peripheral nerves. Clinical and radiological findings of GCTs are similar to those of malignant tumors, and GCTs of the breast are often confused with breast cancer clinically or radiologically. We experienced 1 case of GCT diagnosed by core needle biopsy and immunohistochemical staining in the right breast of 54-year-old woman with Graves`s disease and report the case with a review of the literature.
강호정(Ho-Jung Kang),황보현(Bo-Hyun Hwang),정민(Min Jung),구자승(Ja-Seung Koo),신규호(Kyoo-Ho Shin),한수봉(Soo-Bong Hahn),김성재(Sung-Jae Kim) 대한견주관절의학회 2009 대한견주관절학회지 Vol.12 No.1
목적: 동면종은 혈관분포가 풍부한 갈색지방조직으로 이루어진 매우 희귀한 양성 연부조직 종양이다. 대상 및 방법: 조직학적으로 악성의 성향을 보이지는 않으나, 진단 방법에 있어서 자기 공명 영상이나 조영 증강 컴퓨터 단층 촬영상에서 지방육종 등의 악성 종양과 구별되지 않는 특징을 갖기 때문에, 수술적 방법을 통한 조직 생검이 치료 방법이다. 결과: 조직병리학적으로 갈색지방세포로 이루어져 있기 때문에, 백색지방세포 조직과 달리 구성 세포들은 다각형 모습의 다공포성이며, 핵이 중앙부에 위치하고 과립성의 세포질을 갖고 있다. 결론: 본 증례에서는 조직학적으로 확인된 우측 견관절의 동면종에 대해서 보고하고자 한다. Purpose: Hibernoma is a very rare benign soft tissue tumor of the hypervascularized brown fat tissue with no malignant potential. Materials and Methods: However, it is difficult to differentiate a hibernoma from other malignant tumors, such as liposarcoma using computed tomography and magnetic resonance imaging, and a surgical resection with histological confirmation is the treatment of choice. Results: Histopathologically, hibernoma is composed of brown adipose cells that are polygonal and multivacuolated with a centrally located nucleus and granular cytoplasm, unlike white adipose cells. Conclusion: This article describes a patient with a histologically-confirmed hibernoma of the right shoulder.
권기환(Ki Hwan Kwon),윤종호(Jong Ho Yoon),홍순원(Soon Won Hong),구자승(Ja Seung Koo),정웅윤(Woung Youn Chung),박정수(Cheong Soo Park) 대한두경부종양학회 2004 대한두경부 종양학회지 Vol.20 No.1
Papillary carcinoma of thyroid is the most common thyroid carcinoma carrying better prognosis than the other thyroid carcinoma. Among the variants in the papillary thyroid carcinoma, the tall cell variant and diffuse sclerosing variants have more aggressive behavior than the classic papillary carcinoma. Recently, a new variant of papillary carcinoma has been reported which was named warthin-like tumor of the thyroid because of its close histologic resemblance to a tumor encountered in the salivary gland, carrying favorable prognosis. Since then, in English literature, a few cases have been reported, but in Korea have not been reported yet. We report a case of warthin-like tumor of the thyroid. A 38 year-old woman who had neck mass, was administered for thyroid surgery due to suspicious thyroid cytology. Right total thyroidectomy and left subtotal thyroidectomy with central compartment node dissection was performed. Histologic diagnosis was made as a Warthin-like tumor of the thyroid.
비분절형 백반증 환자의 노출부위 탈색소반에서 발생한 다발성 광선각화증
신재용 ( Jaeyong Shin ),김도영 ( Do Young Kim ),박수진 ( Sujin Park ),구자승 ( Ja Seung Koo ),한승경 ( Seung Kyung Hann ),오상호 ( Sang Ho Oh ) 대한피부과학회 2020 大韓皮膚科學會誌 Vol.58 No.1
A 74-year-old man visited our department with complaints of multiple asymptomatic erythematous scaly crusted patches on the scalp. He had non-segmental vitiligo with the extent of over 20% of the body surface area for 30 years. Biopsies showed hyperkeratosis, foci of atypical, pleomorphic keratinocytes along the basal cell layer, and marked solar elastosis, consistent with actinic keratosis (AK). Melan-A and Fontana-Masson staining showed absence of melanin and melanocytes. Despite conflicting data on the prevalence of skin cancers in patients with vitiligo, it is known that vitiligo does not increase nor decrease the risk of skin cancer. Recent studies have reported that patients with vitiligo lesions show increased epidermal expression of wild-type p53 protein than healthy controls. However, a few cases of skin cancer have been reported in patients with vitiligo. Here, we report a case of AK developing in vitiligo lesions. Dermatologists should not overlook the possible occurrence of AK or skin cancers in sun-exposed vitiliginous skin. (Korean J Dermatol 2020;58(1):39∼42)
허호(Ho Hur),안영재(Young Jai Ahn),박세호(Seho Park),김주희(Joo-Hee Kim),구자승(Ja Seung Koo),박병우(Byeong Woo Park) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.1
Purpose: Apocrine carcinoma is a rare type of breast carcinoma, which has not been fully investigated. The aim of this study was to review clinicopathological features of apocrine carcinoma of the breast and to determine if there are some characteristics different from invasive ductal carcinoma. Methods: There were 4,064 breast cancer patients who had been managed in the Department of Surgery of Yonsei University College of Medicine from January 1997 to January 2008. Out of the patients, 16 patients with apocrine carcinoma and 2,997 patients with invasive ductal carcinoma were analyzed retrospectively. Results: The incidence of apocrine carcinoma was 0.4%. Most of the clinicopathologic features of apocrine carcinoma were similar to those of invasive ductal carcinoma. The percentage of estrogen receptor (ER) positivity and progesterone receptor (PR) positivity of apocrine carcinoma were all 12.5%. And the percentage of ER positivity and PR positivity of invasive ductal carcinoma were 64.2% and 55.2% respectively. Androgen receptor was only examined for eleven patients out of the 16 patients with apocrine carcinoma and the result were all positive. Conclusion: Apocrine carcinoma is also a rare disease in Korea. When compared with invasive ductal carcinoma, the disease did not appear to show any other significant difference in clinicopathologic characteristics but the percentages of ER and PR positivity of apocrine carcinoma seemed lower than those of invasive ductal carcinoma.
이진우 ( Jin Woo Lee ),김세광 ( Sei Kwang Kim ),조재성 ( Jae Sung Cho ),전명재 ( Myung Jae Jeon ),노진래 ( Jin Lae Roh ),이현정 ( Hyun Jung Lee ),박기현 ( Ki Hyun Park ),구자승 ( Ja Seung Koo ),조상호 ( Sang Ho Cho ),한석주 ( Seok 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.9
Persistent cloaca is a very rare congenital anomaly with a single common perineal opening for the genital, urinary and gastrointestinal tracts, which arises from defects in the embryonal process of descent of urorectal septum or fusion to cloacal membrane. Anomalies associated with persistent cloaca are found in the upper urinary tract, gastrointestinal tract, cardiovascular system, central nervous system and respiratory system, which are not easily detected through ultrasound during pregnancy. It has been reported that if those anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with hydrocolpos confirmed by autopsy after emergency cesarean section which was initially presented as a huge abdominal cystic mass and bilateral hydronephrosis by ultrasound at 34 weeks of gestation.
이용규 ( Yong Kyu Lee ),유정선 ( Jeong Seon Yoo ),한정우 ( Jung Woo Han ),진성준 ( Sung-joon Jin ),박종숙 ( Jong Suk Park ),구자승 ( Ja Seung Koo ),윤동섭 ( Dong-sup Yoon ) 대한내과학회 2017 대한내과학회지 Vol.92 No.4
저자들은 10 cm 크기의 부신 우연종을 수술한 후, 조직병리 결과 후복막 신경초종이 진단된 1 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. A schwannoma is a benign neoplasm originating from the Schwann cells of the neural sheath. The most common type of benign schwannomas is the acoustic neuroma presenting with deafness. We report a rare case of schwannoma mimicking an adrenal mass. A 66-year-old woman was diagnosed with an adrenal incidentaloma measuring 10 cm in length on a health checkup. The hormonal study revealed that the adrenal mass was non-functioning. Due to a high risk of adrenal malignancy, a retroperitoneal mass excision, distal pancreatectomy, splenectomy, wedge resection of stomach, and left adrenalectomy were conducted. The subsequent histo-pathologic examination revealed it to be a benign schwannoma. (Korean J Med 2017;92:411-414)