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강명진 ( Myung Jin Kang ),남궁경영 ( Kyung Young Namgung ),김미성 ( Mi Sung Kim ),고병성 ( Byung Sung Ko ),한창순 ( Chang Soon Han ),안현택 ( Hyun Taek Ahn ),신향미 ( Hyang Mi Shin ) 대한소화기학회 2004 대한소화기학회지 Vol.43 No.5
Kaposi`s sarcoma is a rare and slowly progressive disease that primarily affects the skin but has an associated visceral involvement. It can occur in the HIV-positive patients or patients treated with immunosuppressants. However, it is extremely rare in the patients receiving the treatment for inflammatory bowel disease. We used corticosteroid for the treatment of ulcerative colitis in 60-year-old woman. Then, Kaposis`s sarcoma occured in the skin and colon of the patient. Since she was HIV-negative, we believed that it was developed from the condition of corticosteroid-induced immunosuppression. We present a case of skin and colonic Kaposi`s sarcoma in a HIV-negative woman following treatment with corticosteroid for ulcerative colitis. (Korean J Gastroenterol 2004;43:316-319)
담낭의 대세포 신경내분비암종에 의한 화농성 간농양 1예
강명진,남궁경영,임홍목,고병성,안현택,이종률,김종옥 대한내과학회 2004 대한내과학회지 Vol.66 No.2
저자들은 화농성 간농양을 항생제와 경피적 배액술로 치료 중 임상적 호전이 없고, 복부 전산화 단층촬영에서 담낭에 담석과 담낭벽의 비후가 관찰되어 담낭절제술과 배농을 위하여 외과적 수술을 시행한 바 담낭의 대새포 신경내분비세포암종을 조직학적 검사와 면역조직화학검사로 진단할 수 있었던 1예를 경험하여 문헌고찰과 함께 보고하는 바이다. Pyogenic liver abscess is a rare but highly lethal disease. The diagnosis and treatment of pyogenic liver abscess has been evolving owing to specific antibiotic therapy, ultrasonography, abdominal computed tomography with improved percutaneous and operative techniques. However, pyogenic liver abscess may present as a rapidly fatal outcome. These unfavorable results are mainly attributed to the increasing numbers of patients with malignant disease and biliary tract disease. Carcinoma of the gallbladder has remained an uniformly fatal neoplasm characterized by early metastasis and rapid fatal course. In early stage, the symptom is nonspecific and often mimics benign biliary tract disease. We experienced a case of the gallbladder carcinoma presenting with pyogenic liver abscess in a 78-year-old female patient. Surgical drainage and cholecystectomy were done. The microscopic finding of resected gallbladder revealed large cell neuroendocrine carcinoma of gallbladder.
췌장 미부에 발생한 췌장 내분비종양에 의한 위정맥류 출혈 1예
임홍목,강명진,남궁경영,고병성,안현택,이종률,한은미 대한내과학회 2003 대한내과학회지 Vol.65 No.4
저자들은 혈변, 흑색변을 주소로 내원한 27세 남자 환자에서 위내시경으로 고립성 위분문부정맥류에 의한 출혈이 있어 원인 질환 평가 등으로 췌장 종양에 의한 비정맥폐쇄에 의한다고 생각되어 외과적수술을 시행하여 비기능성 췌장 내분비종양에 의함을 확인한 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Isolated obstruction of the splenic vein leads to segmental portal hypertension, which is mainly originated from pancreatic disease, such as chronic pancreatitis, pancreatic pseudocyst, pancreatic cancer. The clinical manifestation are devoid of ascites and encephalopathy, but presented with gastric variceal bleeding. We experienced 27-year-old male patient who complained or hematochezia and melena. After work-up with CT and angiography, we performed operation with the impression of pancreatic tumor associated with splenic vein occlusion. It resulted nonfunctioning pancreatic endocrine tumor. Ofter called islet cell tumor, pancreatic endocrine tumor has various names according to secreted hormones, such as inculinoma, Zollinger-Ellison syndrome and glucagonoma. It was classified as nonfunctioning tumor if there were any evidence of hormone secretin by radioimmunoassay and immunogistochemistry. Surgical excision and adjuvant medical therapy is the mainstay of therapy. We performed tumor resection and splenectomy for control of gastric variceal bleeding due to splenic vein occlusion.