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갑상선의 미만성 경화성 변종 유두상 암종의 세침흡인 세포학적 소견 - 1예 보고 -
김준미,민수기,주영채,김미림,김경래,Kim, Joon-Mee,Min, Soo-Kee,Chu, Young-Chae,Kim, Mi-Rim,Kim, Kyung-Rae 대한세포병리학회 2000 대한세포병리학회지 Vol.11 No.1
Diffuse sclerosing papillary carcinoma(DSPC), a variant of papillary carcinoma of the thyroid, is characterized by diffuse involvement of one or both thyroid lobes, and histologic features such as prominent sclerosis, intense lymphocytic infiltrate, numerous psammoma bodies, and squamous metaplasia together with the characteristic cytoarchitectural pattern of classical papillary carcinoma. We experienced a case of fine needle aspiration cytologic(FNAC) findings of DSPC, which was confirmed by histologic examination of the thyroidectomy specimens. The patient was 26 years old female who presented with diffuse firm enlargement of the thyroid gland with enlargement of many cervical lymph nodes. FNAC smears showed numerous psammoma bodies, many lymphocytes, metaplastic squamous cells, absence of stringy colloid, and epithelial cells showing classical features of papillary carcinoma, such as nuclear grooves, intranuclear unclusions, and ground glass chromatin pattern.
부신경절종의 세침 흡인 세포학적 소견 - 1례 보고 -
김준미,조영채,Kim, Joon-Mee,Chu, Young-Chae The Korean Society for Cytopathology 1993 대한세포병리학회지 Vol.4 No.1
부신경종은 주로 두경부에 발생하는 종양으로서 그 조직학적 소견은 잘 알려져 있으나 세포학적 고찰은 드문 편이다. 저자들은 30세 여자 환자의 경동맥체에 발생한 부신경절종 1례의 세침 흡인 세포학적 소견을 보고하고자 한다. 환자는 3년간 지속된 직경 3cm의 좌측 경부 종괴를 호소하였으며 본 종괴에서 세침 흡인 세포학적 검사를 시행하였다. 종양세포는 집단이나 낱개로 흩어져서 관찰되었는데 중등도의 세포질을 가졌으며 세포경계는 불분명하였다. 핵은 둥글거나 난원형으로서 간혹 거대핵의 관찰되었다. 핵질은 미세한 응집을 보였고 때로 핵소체가 존재하였다. 본 종양은 발생위치와 세포학적 소견이 갑상선에서 전이한 여포암종과 유사하였으며 기타두경부에 발생하는 원발성 및 전이성 병변과의 감별이 요구된다. Paraganglioma is a benign tumor arising in the paraganglion system scattered throughout the body, but its cytopathologic findings arenot well known. We experienced a case of paraganglioma of carotid body diagnosed by fine needle aspiration. The patient was a 30 year-old female who suffered from the left neck mass for 3 years. The mass was $3\times3cm$ in size without pulsation or bruit. Cytologically, the smear revealed aggregated and singly scattered tumor cells haying abundant pale cytoplasm and indistinct cell borders. Their nuclei were round to oval, but enlarged nuclei were occasionally observed. The nuclear membrane was smooth with fine clumping of chromatin. Differentiation from metastatic follicular carcinoma of the thyroid gland was difficult.
기관지암종 진단에 있어서 객담과 기관지 세척액 검사의 유용성 - 기관지경 검사를 통해 확진된 예를 대신으로 -
김준미,민수기,주영채,조철호,Kim, Joon-Mee,Min, Soo-Kee,Chu, Young-Chae,Cho, Chul-Ho 대한세포병리학회 2001 대한세포병리학회지 Vol.12 No.1
To evaluate the role of sputum and bronchial washing for the diagnosis of lung carcinoma, we studied the sensitivity of both cytologic techniques using the biopsy confirmed cases from 228 patients. Among them, 123 cases were squamous cell carcinomas, 42 cases were adenocarcinomas, 48 cases were small cell carcinomas, one case was large cell carcinoma, and 14 cases were other types of carcinoma including poorly differentiated carcinomas. Three hundreds and ninety two sputa and 173 sputa were obtained in the pre- and post-bronchoscopic periods. Bronchial washing had been taken once in each patient. The overall sensitivity of the sputum cytology was 0.52 and that of the bronchial washing 0.63, while it increased to 0.83 when a combination of both techniques. Squamous cell carcinomas were diagnosed to the great extent in which sensitivities were 0.59 and 0.74, in sputum and bronchial washing, respectively. The post-bronchoscopic sputa showed higher sensitivity (0.44) than pre-bronchoscopic sputa (0.30). The sensitivity on sputa increased from 0.34 to 0.49 when three samples were examined compared to the single examination. The accuracy of cell typing was 94.0% in sputa and 93.8% In bronchial washing. Repeated sputum examination including post-bronchoscopic sputa is warranted to Improve sensitivity and a complementary role of both cytologlc techniques can be postulated by these data.
김준미 ( Joon Mee Kim ) 대한간학회 2006 간학회 싱글토픽 심포지움 Vol.12 No.4
Hepatic fibrosis is the wound healing response of the liver, in which scar or extracellular matrix accumulates in response to injury from multiple causes. Stellate cells are activated during liver injury and they play the main roles in the synthesis and secretion of a large number of matrix proteins. Hypertrophied stellate cells can be recognized by the clusters of fat vacuoles and the stellate cells have been transformed into myofibroblasts. For demonstrating and quantifying hepatic fibrosis, several special stains and scoring systems have been extensively used, particularly for trials of therapeutic regimens to treat chronic hepatitis. Fibrosis throughout the liver leads to architectural reorganization and cirrhosis. Yet cirrhotic livers can be classified into various types according to the size of the nodules, the patterns of fibrosis and the etiologies.
성인에서 반복적인 복부통증을 유발한 Meckel 게실염에 의한 복막유착
김영수(Young Soo Kim),신용운(Yong Woon shin),문희용(Hee Yong Moon),김명식(Myong Sik Kim),권계숙(Kye Sook Kwon),방제소(Jei So Bang),조현근(Hyeon Geun Cho),김범수(Pum Soo Kim),김준미(Joon Mee Kim) 대한소화기학회 1997 대한소화기학회지 Vol.30 No.6
Meckel,s diverticulum is generally acknowledged to be the most prevalent congenital anomaly of the gastrointestinal tract. In the autopsy series, the incidence ranged from 0.5 to 2 percent. The preoperative diagnosis of Meckels divemiculum is difficult, especially in the adult, because of the lesions ability to masquerade as one of a variety of much more common abdominal pathologies. The diagnostic accuracy may be affected by the age of the patient and by complications of diverticulum. The complications that may result include ulcer bleeding, intestinal obstruction, perforation, diverticulitis, stone, and neoplasm. The ways a Meckels diverticulum can cause bowel obstruction are different. Recently we experienced a case of Meckels diverticulitis causing intlammatory reaction and adhesion with the abdominal wall and causing recurrent abdominal pain and obstruction in a 22-year-old woman. Therefore, we present this case with a brief review of the related literature. (Korean J Gastroenterol 1997; 30:826-830)
Peripheral Neuroblastoma of the Ulnar Nerve : Diagnosis by Fine Needle Aspiration Cytology
주영채,김준미,Chu, Young-Chae,Kim, Joon-Mee The Korean Society for Cytopathology 1993 대한세포병리학회지 Vol.4 No.1
A 30-year-old woman who was diagnosed as peripheral neuroblastoma by fine needle aspiration of a soft mass of the right upper arm is described. She presented a slowly growing, soft mass of the right upper arm for 1 month. The right humerus revealed no abnormal finding on X-ray. Ultrasonogram of the right upper arm revealed a well demarcated, smooth marginated solid mass without invasion of adjacent structures. Fine needle aspiration was done under the impression of soft tissue tumor with undetermined biologic behavior. The aspirates were highly cellular and the tumor cells were dispersed both singly and in clusters of varying size. The clusters occasionally showed a central capillary core and rosette-like structures. The tumor cells were small in size and had a small to medium amount of cytoplasm. Some of them revealed slender cytoplasmic processes. The nuclei showed distinct nuclear membranes, finely clumped chromatin and small conspicuous nucleoli. Cellular pleomorphism or mitotic figure was not definite. These cytologic findings were interpreted as a malignant, non-lymphomatous small round cell tumor, most likely representing peripheral neuroblastoma or Ewing's sarcoma. Final diagnosis was confirmed by simple excision as peripheral neuroblastoma. 말초성 신경아세포종은 예후가 나쁘고 희귀한 종양으로 이 종양의 세침흡인 세포학적 소견에 관한 보고는 세계 문헌상 1988년 Neuhold에 의해 처음 기술된 1례가 있을 따름이다. 최근 저자들은 30세 여자의 우측 상박의 연부조직 종괴로 부터 세침흡인 세포 검사를 시행하여 진단된 말초성 신경아세포종을 경험하여 그 세침흡인 세포학적 소견을 기술하는 바이다. 환자는 1개월전 부터 우측 상박에 서서히 자라는 종괴를 주소로 내원하였다. 우측 상박 X-선 및 초음파 촬영술에서 주위와 잘 경계지어진 방추형의 연부조직 종괴가 관찰되었고 주변조직으로 침윤하는 소견은 관찰할 수 없었으며 상완골은 정상이었다. 종괴의 세침흡인 도말은 세포밀도가 매우 높았고 작고 둥근 세포들이 뭉쳐있거나 산재되어 있었다. 세포간의 크기나 모양의 차이는 아주 미약하였고 유사분열은 거의 관찰되지 않았다. 종양세포들의 집단은 간혹 모세혈관을 중심으로 뭉치거나, 로제트 형태를 보이며 그 세포질은 가늘고 긴 돌기를 보였다. 핵은 뚜렷한 핵막과 미세하게 뭉친 염색질 및 작고 뚜렷한 핵 소체를 갖고 있었다. 이상의 소견은 작고 둥근 세포로 된 악성 종양 중 말초성 신경아세포종에 매우 합당하였으나 골외 Ewing 육종과의 감별은 불가능하였다. 단순 절제술이 시행되었고 종양은 조직학적으로 말초성 신경아세포종임이 확인되었다.
유방에 발생한 화생성 암종의 세침흡인 세포학적 소견 - 1증례 보고 -
민수기,차희정,김준미,주영채,Min, Soo-Kee,Cha, Hee-Jeung,Kim, Joon-Mee,Chu, Young-Chae 대한세포병리학회 1996 대한세포병리학회지 Vol.7 No.2
Metaplastic carcinoma of the breast is a morphologically heterogenous group of neoplasms characterized by ductal adenocarcinoma with extensive squamous differentiation, a spindle-cell pattern of growth, and/or heterologous mesenchymal elements. We experienced a case of metaplastic carcinoma diagnosed by fine needle aspiration(FNA) and confirmed by radical mastectomy in a 46 year-old woman. The FNA cytologic findings included atypical squamous cells with kertinization tying singly and in clusters in a necrotic background. In addition, scattered spindle cells with pleomorphic large nuclei and prominent nucleoli were present in a hemorrhagic and necrotic background. The histopathologic findings showed moderately differentiated squamous cell carcinoma and highly pleomorphic sarcoma with chondroid component. The immunohistochemical stain revealed focal positive reaction for cytokeratin as well as diffuse reactivity for vimentin in the sarcomatous area.
흉막강액에서 진단된 류마티스성 흉막염 - 세포학적 소견 1예 보고 -
차희정,민수기,김준미,주영채,Cha, Hee-Jeung,Min, Soo-Kee,Kim, Joon-Mee,Chu, Young-Chae 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.1
Patients with rheumatoid arthritis of any degree of severity or duration may develop necrotizing granulomatous pleuritis, a morphologic replica of the inflammatory reaction characteristic of rheumatoid synovitis and rheumatoid nodules. The principal feature is the background composed of granular, amorphous, particulate material or debris of various hues. The material is sometimes eosinophilic sometimes more cyanophilic, or even green in the Papanicolaou stain. Within this background are elongated, fibroblast-like epithelioid cells, numerous multinucleated giant cells and degenerating leukocytes. The combination of the debris, spindle epithelioid ceils, and multinucleated giant cells in fluid is pathognomonic for rheumatoid pleuritis. We experienced a hcase of rheumatoid pleuritis showing these characteristic cytologic findings. The patient was a 63 year-old man with positive rheumatoid factor. The pleual fluid specimen revealed elongated epithelioid cells and multinucleated giant cells on a background of amorphous granular material.