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위장의 점막 연관성 림프조직 림프종(MALT Lymphoma)의 임상적 고찰
백광열,노재형,허진석,손태성,최성호,조재원,김용일,Paik Kwang Yeol,Noh Jae Hyung,Heo Jin Seok,Sohn Tae Sung,Choi Seong Ho,Joh Jae Won,Kim Yong-Il 대한위암학회 2001 대한위암학회지 Vol.1 No.1
Purpose: The aim of this study was to analyze the clinical and the histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphomas in the stomach. Materials and Methods: We retrospectively reviewed the medical records of 22 patients who had been treated at Samsung Medical Center from Jan. 1995 to Sep. 2000 and who had been pathologically proven to have a MALT lymphoma. The factors we analyzed were operative procedure, tumor stage, and histopathological characteristics. Results: Of 3658 patients with a gastric malignancy, 22 patients proved to have a MALT lymphoma ($0.6\%$). There were 7 men and 15 women whose ages ranged from 25 years to 70 years (mean, 48.8 years). Forteen cases were located in the antrum, 4 ($18\%$) in the body and 4 ($18\%$) in the fundus or the high body. Nineteen of these patients were managed with total gastrectomy and splenectomy and 3 with radical subtotal gastrectomy. Histopathologically the tumor was limited to the mucosa in 3 patients ($1.36\%$), to the submucosa in 13 ($59.1\%$) and extended to the muscularis propria in 6 ($27.3\%$). Lymph node involvement was seen in 12 patients ($54.6\%$). There was no splenic or hepatic involvement. Bone marrow involvement was not seen in any patients. H. pylori was identified in 11 patients (50$\%$). During the mean follow-up period of 32.7 months, there were no reports of tumor recurrence or death. Conclusion: MALT lymphomas rarely disseminate by the time of diagnosis and rarely involve the bone marrow. Lymph node involvement is relatively high and a total gastrectomy is effective in managing patients with a MALT lymphoma.
백광열 ( Kwang Yeol Paik ) 대한소화기학회 2009 대한소화기학회지 Vol.54 No.6
Paraganglioma is a rare neuroendocrine tumor arising from the neural crest, which includes tissues such as the adrenal medulla, carotid and aortic body, organs of Zuckerkandl, and other unnamed paraganglia. The head, neck, and retroperitoneum are the most common sites for paraganglioma. However, paraganglioma of the pancreas is extremely rare. We report our experience of this rare disease. A 70-year old female patient admitted for a pancreas tail mass detected by computed tomography (CT) scan checked for vague left flank pain. CT with contrast enhancement showed a 4.2-cm heterogeneously enhanced lesion in the tail of the pancreas. A well defined ovoid shape mass in left adrenal gland was suggested adenoma. Distal pancreatectomy with left adrenalectomy was performed. Any lymph node enlargement was not found. Pancreas mass did not invade adjacent organ. Microscopic examination with pancreas and adrenal gland revealed that the cells were arranged in a characteristic Zellballen pattern. Immunohistochemical staining revealed positivity for neuron-specific enolase, chromogranin A, synaptophysin, and S-100 protein. On the basis of these findings, we diagnosed the tumor as a paraganglioma of the pancreas and adrenal gland. We report the first case of pancreas paraganglioma in Korea. (Korean J Gastroenterol 2009;54:409-412)
침윤성 췌관내 유두상 점액종양의 임상적 특징과 치료 결과
백광열(Kwang Yeol Paik),정준철(Jun Chul Jung),허진석(Jin Seok Heo),최성호(Seong Ho Choi),최동욱(Dong Wook Choi),김용일(Yong Il Kim) 대한외과학회 2007 Annals of Surgical Treatment and Research(ASRT) Vol.72 No.4
Purpose: Histologically, IPMN (intraductal papillary mucinous neoplasm) includes various grades of lesion, from hyperplasia and adenoma to adenocarcinoma. The prognosis is different for each histological grade. The malignant IPMN contain in-situ and invasive carcinoma. The purpose of this study was to investigate the clinicopathologic features and outcome of invasive IPMN. Methods: 18 patients with invasive IPMN underwent surgical treatment between October 1994 and December 2005 at Samsung Medical Center. The clinical, biochemical and pathologic features were retrospectively analyzed. Survival and the clinicopathologic features were compared between invasive IPMN and PDAC of the well differentiated type (wd, n=27) and carcinoma in-situ (CIS, n=10). Results: The preoperative CA19-9 level and total bilirubin level of invasive IPMN patients was statistically higher than those of the CIS patients. The tumor size of invasive IPMN was larger than that of PDAC (wd) (P=0.038). The median survival of patients with invasive IPMN was 31.0 month. The 5-year survival rates of patients with PDAC (wd) and invasive IPMN were 35.5% and 41.7%, respectively (P=0.237). Conclusion: there were no differences for invasive IPMN and PDAC (wd) except for tumor size. The survival in patients with surgical resected invasive IPMN was similar to that of the patients with surgical resected PDAC (wd).