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갑상선암 환자에서 방사성요오드 치료 후 발생한 만성 골수성 백혈병 2예
박해열 ( Hae Yeul Park ),최성은 ( Sung-eun Choi ),유영훈 ( Young Hoon Ryu ),장항석 ( Hang Seok Change ),박정수 ( Cheong Soo Park ),이경화 ( Kyoung Hwa Lee ),김유리 ( Yu Ri Kim ) 대한내과학회 2016 대한내과학회지 Vol.91 No.1
저자는 갑상선암 환자에서 방사성요오드 치료 후 진단된만성 골수성 백혈병에서, 2세대 타이로신 키나제 억제제로 치료가 되는 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. The incidence of thyroid cancer has increased rapidly worldwide, although most patients can survive for a long time without developing symptoms. While most thyroid cancers are treated with thyroidectomy alone, some patients are given additional radioactive iodine (RAI) in the form of 131I to treat thyroid cancer metastasis. RAI is associated with acute and chronic complications. Secondary malignancies are the most important in long-term cancer survivors. While many studies have reported the occurrence of acute myeloid leukemia after high-dose RAI, there are few reports on chronic myeloid leukemia (CML) after low-dose RAI treatment. Moreover, previous cases of CML following thyroid cancer were reported before the tyrosine kinase inhibitor (TKI) era. Here, we describe two cases of CML following thyroid cancer that were successfully treated with second-generation TKIs. (Korean J Med 2016;91:70-74)
증 례 : 직장암 치료 중 진단된 만성호중구성백혈병 1예
김석형 ( Seok Hyung Kim ),박해열 ( Hae Yeul Park ),황창혁 ( Chang Hyeok Hwang ),정영학 ( Young Hak Jung ),이민주 ( Minjoo Lee ),최성은 ( Sung Eun Choi ),김유리 ( Yu Ri Kim ) 대한내과학회 2016 대한내과학회지 Vol.90 No.1
증례는 감염 및 악성종양과 동반되어 백혈병양 반응과의 감별이 어려웠고, 또한 악성종양의 전이와 유사하게 종괴를 형성하여 더욱 감별이 어려웠던 CNL 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative neoplasm characterized by sustained neutrophilia, splenomegaly, and hypercellular bone marrow without Philadelphia chromosome. Diagnosis of CNL requires exclusion of identifiable causes of reactive neutrophilia, such as infection and tumors. Our patient presented with general weakness and weight loss. Computed tomography (CT) showed a mass in the distal rectum, which was confirmed to be an adenocarcinoma by colonoscopic biopsy. Positron emission tomography-CT showed multiple liver, bone, and lymph node metastases. Liver and lymph node biopsies revealed neutrophilic infiltration with no evidence of adenocarcinoma. The pathological findings of the bone marrow were compatible with CNL. Cytogenetic analysis revealed a normal karyotype, and molecular analysis was negative for BCR/ABL. Here, we present a 73 year-old man diagnosed with concurrent CNL and rectal cancer. (Korean J Med 2016;90:59-62)
김석형,이지훈,박해열,송영구,황창혁,이민주 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.2
A 56-year-old woman with emphysematous pyelonephritis underwent an emergent left nephrectomy due to her religious creed. Postoperative hemoglobin level was decreased to 4.4 g/dL from preoperative value of 13.9 g/dL. The patient completely recovered without transfusion and was discharged on the 40th postoperative day without complication.