담관 유두종증

구현령,유은실 대한간학회 2002 Clinical and Molecular Hepatology(대한간학회지) Vol.8 No.3

신장의 원발성 원시성 신경외배엽 종양 -2예 보고-

구현령,전선영,최진,노재윤,안한종,조경자 대한병리학회 2003 Journal of Pathology and Translational Medicine Vol.37 No.2

Primitive neuroectodermal tumor (PNET) is a small round cell neoplasm that mainly develops in the central nervous system and soft tissue of children. Primary occurrence in the kidney is rare and the identification of immunopositivity for CD99 and t(11;22)(q24;q12) is essential in differential diagnoses. We report two cases of PNET developed in a 21-year-old woman and a 44-year-old man. Resected tumors were composed of sheets of round or ovoid cells with hyperchromatic nuclei and minimal eosinophilic cytoplasm. Rosette formations, more prominent in the first case, were observed. The tumor cells of both cases were diffusely positive for CD99, vimentin, and neuron specific enolase, while they were negative for cytokeratin, desmin, and chromogranin. Synaptophysin was focally expressed only in the first case. The EWSFLI1 chimeric gene was identified by a reverse transcriptase-polymerase chain reaction in the first case. The first patient is alive with a recurrent tumor two years after the diagnosis, and has received combination chemotherapy. The second patient is alive with no evidence of recurrence or metastasis nineteen months after the diagnosis.

HIV 음성 환자에서 형질모세포종의 세침흡인 세포소견 - 1예 보고 -

이향임,구현령,한은미,공경엽,서철원,류민희,강윤구,박찬정,허주령,Lee, Hyang-Im,Koo, Hyun-Ryung,Han, Eun-Mee,Gong, Gyung-Yub,Suh, Chul-Won,Ryu, Min-Hee,Kang, Yoon-Goo,Park, Chan-Jeong,Huh, Joo-Ryung The Korean Society for Cytopathology 2005 대한세포병리학회지 Vol.16 No.1

Plasmablastic lymphoma (PBL) is a recently described aggressive B-cell neoplasm, which usually manifests as a localized disease of the oral mucosa in individuals infected with human immunodeficiency virus (HIV). Recently we encountered a case of plasmablastic lymphoma manifesting in the left maxillary sinus and cervical lymph node of a previously healthy HIV-negative man, 48 years of age. we conducted a fine-needle aspiration smear of the cervical lymph node, and this was found to be highly cellular with numerous large cells exhibiting eccentrically positioned nuclei, prominent nucleoli, and moderate quantities of basophilic cytoplasm. A biopsy of the mass in the maxillary sinus evidenced diffuse growth of similar plasmablastic cells. These tumor cells were negative for the leukocyte common antigens, CD20, CD3, CD30, and EMA. However, the cells tested positive for CD79a and CD138/syndecan-1. The tumor cells also exhibited L-light-chain restriction. The Ki-67 proliferation index was measured at almost 100%. The patient was diagnosed with plasmablastic lymphoma. After three cycles of combination chemotherapy and radiotherapy, the patient went into complete remission, and currently remains in this state.

A Case of Combined Hepatocellular and Cholangiocarcinoma withNeuroendocrine Differentiation and Sarcomatoid Transformation- A Case Report -

김미정,구현령,이승규,노재윤,유은실 대한병리학회 2005 Journal of Pathology and Translational Medicine Vol.39 No.2

We report here on a case of combined hepatocellular and cholangiocarcinoma (CHC) with neuroendocrine differentiation and sarcomatoid transformation. A 59-year-old male who had had HBV-associated chronic liver disease presented with hepatic masses. The explanted liver showed three small masses, two in the right lobe and one in the left lobe. The largest one in the right lobe was a 2.0 cm sized binodular mass,consisting of a yellowish tan nodule and an abutting reddish brown nodule. Microscopically, the reddish brown nodule was a cholangiocarcinoma (CC) showing neuroendocrine differentiation and sarcomatoid tranformation. The yellowish tan nodule and the remaining two masses were hepatocellular carcinoma (HCC)s. On immunohistochemistry, both the adenocarcinoma and spindle sarcomatoid cells were positive for pancytokeratin, but only the adenocarcinoma cells were positive for chromogranin and carcinoembryonic antigen (CEA). Mitotic and Ki67 labeling indices as well as p53 immunopositivity were significantly increased only in the CC component. We report here on the first case of CHC in which the CC displayed neuroendocrine differentiation and sarcomatoid transformation with high mitotic and Ki67-labeling indices, as well as having p53 overexpression.

신장의 다형 지방육종 - 1예 보고-

김미정,구현령,전선영,노재윤 대한병리학회 2003 Journal of Pathology and Translational Medicine Vol.37 No.3

Although the liposarcoma is a common malignant mesenchymal tumor of the retroperitoneum, its occurrence in the kidney is very rare. A few cases involving only the renal parenchyma have been reported. The histologic features of these cases are not different from those of other body sites. We report a case of pleomorphic liposarcoma arising in the kidney of a 36-year-old man. He had been suffering from pain in the right flank for two weeks. A computed tomographic scan demonstrated a large mass in the right kidney. He underwent a radical nephrectomy under the clinical impression of renal cell carcinoma. There was a 11 cm-sized well demarcated solid mass in the lower pole of the right kidney. Microscopically, the tumor consisted of pleomorphic spindle and epithelioid cells with focal areas showing distinct adipocytic differentiation and geographic necrosis. A few diagnostic lipoblasts were present. Despite extensive search on samples, no carcinomatous component was found. Immunohistochemically, all of the tumor cells were negative for cytokeratin but positive for vimentin. Lipoblasts were positive for S-100 protein as well as for vimentin. When the kidney tumor is exclusively sarcomatous, a generous sampling with proper immunohistochemical staining is recommended to differentiate a primary sarcoma of the kidney from a sarcomatoid carcinoma.

A Giant Colonic Hamartoma and Multiple Colonic Hamartomatous Polyps in a Middle-Aged Man

박인자,김희철,유장식,구현령,김정선,김진천 연세대학교의과대학 2006 Yonsei medical journal Vol.47 No.5

Colonic hamartomas are rare polypoid lesions. We report an unusual case of multiple colonic hamartomatous polyps, including a giant hamartoma, unrelated to hereditary or familial polyposis syndromes, in a 48-year-old man. The diameter of the largest polyp was 9.5cm, and endoscopy revealed that the lesion caused colonic obstruction. The clinical, endoscopic and histological aspects of this case are discussed.

선천성 낭선종성 기형이 의심되었던 환아에서 진단된 흉막폐모세포종 1례

우성일,김효빈,송준섭,구현령,임호준,홍수종 대한 소아알레르기 호흡기학회 2006 Allergy Asthma & Respiratory Disease Vol.16 No.2

Congenital cystic adenomatoid malformation(CCAM) is one of the most common congenital lung lesions. Clinical manifestations that show are neonatal respiratory distress, recurrent respiratory infection, pneumothorax, and hemothorax. But, there are patients who are asymptomatic until mid-childhood. The treatment of asymptomatic CCAM is controversial. There is a possibility to resolve it spontaneously, but late complications such as recurrent pulmonary infection, pneumothorax, hemothorax, and cancer, which includes bronchoalveolar carcinoma and rhabdomyocarcinoma, pleuropulmonary blastoma still remain. Some investigators advocate routine surgery for all cases of CCAM that are apparent at birth. A previously healthy 16- months-old girl who had suffered from a cough for 2 weeks was transferred to Asan Medical Center with CCAM. Due to a chest CT and fever, we first thought that she had CCAM with infection. After we treated her with antibiotics for one week, we performed surgery to confirm the diagnosis and to prevent further complication. But by surgical wedge resection, a pleuropulmonary blastoma was found. There were no evidence of metastasis and adjacent involvement. She started her chemotherapy with vincristine, actinomycin D and cyclophosphamide, and is now continuing maintenance chemotherapy with etoposide, vincristine, and Ifosfamide. We report pleuropulmonary blastoma that presented as CCAM. So we recommend surgical resection in asymptomatic CCAM to confirm the diagnosis and to prevent its malignant transformation, even not accompanied by symptoms. 저자들은 이전에 증상이 없던 16개월 여아에서 선천성 낭선종성 기형 의심하에 수술적 절제 후 병리학적 검사에서 흉막폐모세포종으로 진단된 증례를 경험하였기에 보고하는 바이며, 선천성 낭선종성 기형이 의심되는 경우 증상의 동반 여부와 관계없이 확진과 발생할 수 있는 합병증의 예방, 악성 종양 발생 가능성을 없애기 위해 수술적 절제가 필요할 것으로 생각한다.

하지근육에 국한된 증세로 발생한 결절다발동맥염의 2예

나성수,이창근,변대근,서욱장,강신광,구현령,유빈 대한내과학회 2005 대한내과학회지 Vol.68 No.3

선천성 낭선종성 기형이 의심되었던 환아에서 진단된 흉막폐모세포종 1례

우성일 ( Sung Il Woo ),김효빈 ( Hyo Bin Kim ),송준섭 ( Joon Sup Song ),구현령 ( Hyun Lyoung Koo ),임호준 ( Ho Jun Lim ),홍수종 ( Soo Jong Hong ) 대한소아알레르기호흡기학회 2006 소아알레르기 및 호흡기학회지 Vol.16 No.2

Congenital cystic adenomatoid malformation(CCAM) is one of the most common congenital lung lesions. Clinical manifestations that show are neonatal respiratory distress, recurrent respiratory infection, pneumothorax, and hemothorax. But, there are patients who are asymptomatic until mid-childhood. The treatment of asymptomatic CCAM is controversial. There is a possibility to resolve it spontaneously, but late complications such as recurrent pulmonary infection, pneumothorax, hemothorax, and cancer, which includes bronchoalveolar carcinoma and rhabdomyocarcinoma, pleuropulmonary blastoma still remain. Some investigators advocate routine surgery for all cases of CCAM that are apparent at birth. A previously healthy 16-months-old girl who had suffered from a cough for 2 weeks was transferred to Asan Medical Center with CCAM. Due to a chest CT and fever, we first thought that she had CCAM with infection. After we treated her with antibiotics for one week, we performed surgery to confirm the diagnosis and to prevent further complication. But by surgical wedge resection, a pleuropulmonary blastoma was found. There were no evidence of metastasis and adjacent involvement. She started her chemotherapy with vincristine, actinomycin D and cyclophosphamide, and is now continuing maintenance chemotherapy with etoposide, vincristine, and Ifosfamide. We report pleuropulmonary blastoma that presented as CCAM. So we recommend surgical resection in asymptomatic CCAM to confirm the diagnosis and to prevent its malignant transformation, even not accompanied by symptoms. [Pediatr Allergy Respir Dis(Korea) 2006;16:177-182]

두개저와 상부 경추를 침범한 고어햄씨병의 보존적 치료 및 방사선 치료에 대한 경험 -증례보고-

장인석 ( In Seok Jang ),박준범 ( Jun Bum Park ),나영신 ( Young Shin Ra ),김정훈 ( Jeong Hoon Kim ),구현령 ( Hyun Lyoung Koo ),강신광 ( Shin Kwang Khang ) 대한뇌종양학회 2007 대한뇌종양학회지 Vol.6 No.1

A 10-year-old boy was admitted at our institute with neck pain, limiting the neck movement and chin point deviation to the right. Which confirmed the suspected diagnosis of Gorham`s disease, the patient underwent biopsy on the 3rd cervical spine. Gorham`s disease was confidently diagnosed with the support of present clinical and radiographic findgings by a regional histopathologist. In order to diminish neck pain and ensure radiation field uniformity, a halo-vest was recommended. The patient received 4,000 cGy of radiation to the upper cervical osteolytic lesion. There has been no radiographic evidence of progression of the disease at the MR follow-up of post-radiotherapy 23 months. At present, the patient is remarkably doing well with no evidence of disease progression. The authors suggest that application of a halo-vest and early radiation therapy can be a good choice to management of Gorham`s disease involving skull base and upper cervical spine. However, long term follow-up will be essential to confirm the remission of disease.