대퇴골에 발생한 Bizarre Parosteal Osteochondromatous Proliferation of the Femur (Nora 병변) - 증례 보고 -

신봉경,조현득,염범우,최종상,김철환,Shin, Bong-Kyung,Cho, Hyun-Deuk,Yum, Bum-Woo,Choi, Jong-Sang,Kim, Chul-Hwan The Korean Musculoskeletal Tumor Society 1999 대한골관절종양학회지 Vol.5 No.3

저자들은 18세 남자 환자의 우측 대퇴골에 발생한 bizarre parosteal osteochondromatous proliferation (Nora 병변) 1례를 보고하고자 한다. 방사선 소견상 비교적 경계가 좋은 석회화 병변이 하부 대퇴골의 피질 표면에 붙어 있었으며 병변은 넓은 기저면을 갖고 있었다. 대퇴골의 변형은 없었고, 병변과 대퇴골간의 골수강의 연결은 관찰되지 않았다. 조직학적으로 병변은 연골, 골 및 섬유조직으로 구성되어 있었고 연골은 세포밀도가 증가되어 있었으나, 과염색증이나 다형성세포는 없었다. 불규칙한 골과 연골간의 경계와 연골내 골화를 보였다. 골소주는 불규칙한 형태를 보이고 배경 기질에서 방추형 세포들을 관찰할 수 있었다. 세포학적 비정형은 관찰되지 않았다. 본 병변은 일종의 이소성 골화로써 반응성 병변으로 간주되며, 임상적으로나 병리학적으로 골육종이나 연골육종과 같은 악성 병변과 혼동하지 않는 것이 중요하다. We report a case of bizarre parosteal osteochondromatous proliferation of the right femur in an 18-year-old man. Roentgenograms showed a calcific mass attached to the underlying cortex with a broad base. Histologically, the lesion showed hypercellular cartilaginous tissue with maturation into trabecular bone, which contained spindle cells and lymphocytes in the intertrabecular spaces. Bizarre parosteal osteochondromatous proliferations are a form of heterotopic ossification and should not be mistaken for osteosarcoma or chondrosarcoma.

비골 원위부 골아세포종 - 증례보고 -

박혜림,민수기,조현득,고성혜,권봉철,박용구,Park, Hye-Rim,Min, Soo-Kee,Cho, Hyun-Deuk,Koh, Sung-Hye,Kwon, Bong-Chul,Park, Yong-Koo The Korean Musculoskeletal Tumor Society 2004 대한골관절종양학회지 Vol.10 No.1

저자들은 32세 남자에서 비교적 드문 부위인 비골 원위부에서 발생한 골아세포종을 보고하고자 한다. 단순 방사선 소견상 내부 육주현상(trabeculation을) 동반한 풍선양 확대 병변으로 관찰되었다. 자기공명영상촬영 검사상 불균질성 저신호 강도의 중심부를 갖는 소엽상 팽창성 병변이 관찰되고 이는 조영 증강이 되었다. 소파술 시행 결과 석회화를 동반하지 않은 풍부한 분홍색의 유골로 구성되었고 유골 봉합선(seam)은 통통한 골아세포 및 소수의 거대 세포로 피복되어 있었다. 국소적으로 레이스 모양의 석회화되지 않은 유골이 관찰되었다. We report an unusual case of osteoblastoma in the distal fibula in a 32-year-old man. Radiographs showed a ballooning lesion with internal trabeculation. MR images demonstrated a lobulated expanding lesion of central heterogeneous low signal intensity with enhancement. Curettage specimen was composed of abundant thick, pink osteoid without mineralization. The osteoid seams were lined by plump osteoblasts and a few giant cells. Focally, a fine unmineralized lace-like osteoid was seen.

마졸린씨 궤양에서 발생한 암육종의 증례 보고

문유진,김준혁,이영만,오미혜,조현득,Moon, Yoo-Jin,Kim, Jun-Hyuk,Lee, Young-Man,Oh, Mee-Hye,Cho, Hyun-Deuk 대한성형외과학회 2010 Archives of Plastic Surgery Vol.37 No.1

Purpose: Carcinosarcomas are rare neoplasms in which both malignant epithelial and mesenchymal elements are identified. We have found only twenty one cases of primary cutaneous carcinosarcoma in the English language literature. Therefore it has been difficult to diagnosis because its unclear etiology and low frequency. Methods: A 31-year-old young man with a protruding mass on his ankle dorsum was examined. The tumor was $7{\times}6{\times}3\;cm$ sized and arose from a burn scar. The mass was wide excised and applied split thickness skin graft. Characteristic pathologic finding was a mixture of squamous cell carcinoma and malignant fibrous histiocytoma. Results: Three months after the operation, the patient died of multiple metastasis to the liver, lung and finally of sepsis despite adjuvant chemotherapy and adjuvant radiotherapy. Conclusion: If a metastatic cutaneous carcinosarcoma is diagnosed, wide excision is required. There should be more aggressive management to minimize the risk of recurrence. Further research into the etiology and pathophysiology of the disease and a more careful differential diagnosis may allow improvement in treatment.

대장 림프양 증식증의 내시경 소견과 임상적 특징

김인호(In Ho Kim),김영훈(Young Hoon Kim),정일권(Il Kwun Chung),조현득(Hyun Deuk Cho),김홍수(Hong Soo Kim),박상흠(Sang Heum Park),이문호(Moon Ho Lee),김선주(Sun Joo Kim) 대한내과학회 2002 대한내과학회지 Vol.62 No.6

목적 : 대장 림프양 증식증에 대한 내시경적 연구는 매우 드물다. 따라서 저자들은 대장내시경 조직검사를 통해 확인된 림프양 증식증의 내시경 소견을 분류하고, 이와 연관된 임상 양상 및 병리학적인 의미를 알아보고자 하였다. 대상 및 방법 : 35예의 대장 림프양 증식증에 대하여 내시경 사진을 통한 병변의 육안적 분류와 병리조직검사 및 의무기록을 통한 임상병리학적 분석을 시행하였다. 병리조직학적으로는 분류 1등급은 정상 림프 여포 1개와 소수의 림프구의 간질조직 침윤을 보인 경우, 2등급은 정상 림프 여포 1개와 다수의 림프구의 간질 조직 침윤이거나, 정상 림프 여포가 2개 보이는 경우, 3등급은 정상 림프 여포가 3개 이상, 다발성 또는 림프구 간질조직 침윤이 매우 심한 상태인 경우로 분류되었다. 결과 : 환자의 성별은 남자 20예, 여자 15예, 평균 나이는 45.2±5세이고, 주증상은 하복부 복통과 불쾌감 18예 (51.4%), 설사 8예 (22.9%), 혈변 및 기타 (25.7%) 등의 순이었다. 내시경 소견으로서 모양은 용종 18예 (52%), 표적 병변 7예 (20%), 사마귀상 병변 5예 (14%), 미란 5예 (14%), 종괴로 관찰되는 경우는 없었다. 크기는 5 mm 이하가 10예 (29%), 5∼10 mm가 11예 (31%), 10 mm 이상이 14예 (40%)였고, 갯수는 3개 이하가 22예 (63%), 3∼5개가 10예 (29%), 5개 이상이 3예 (8%)였다. 발생 부위별 빈도는 말단 회장 2예 (6%), 회맹부와 맹장 6예 (17%), 상행결장 3예 (8%), 횡행결장 3예 (8%), 하행결장 0예, S상 결장 5예 (14%), 직장 1예 (46%)가 관찰되었다. 이상의 결과로 대장 림프양 증식증은 용종의 모양이 가장 많았으나, 표적 병변의 경우도 다수 관찰되었다. 호발 부위는 맹장 및 직장이 많았고, 내시경적 모양에 따른 발생 부위에서 용종 및 표적 병변이 맹장 및 직장 부위에서 다수 관찰되었다. 병리조직학적으로는 분류 1등급은 19예 (54.3%), 2등급은 13예 (37.1%), 3등급은 3예 (8.6%)로 분류되었다. 조직학적 중등도는 연령, 병변의 크기, 발생부위, 병변의 개수 등과 관련이 없었다. 사마귀양 및 미란 형태의 소견을 보이는 경우에는 조직학적 중등도가 높은 경향이 있었으나, (p=0.105) 추적 검사상 기질적 질환으로 변환 및 악성화한 경우는 없었다. 결론 : 대장 림프양 증식증의 내시경적 소견은 용종, 표적 병변이 대부분이지만 미란이나 사마귀양 병변 등의 다양한 소견을 보였다. 그러나 사마귀양 병변이나 미란 소견에서 조직학적 중등도가 높은 경향을 보여 (p=0.105) 대장 내시경을 통한 추적 검사시 더 많은 관심과 주의가 필요하리라 생각된다. 이러한 대장 림프양 증식증의 내시경 소견 및 임상 양상과의 정확한 임상적 의의를 찾기 위해서는 더 많은 환자를 대상으로 한 연구 및 장기적 추적 관찰이 필요하리라 사료된다. Background : There have been known a few endoscopic studies of colonic lymphoid hyperplasia. The various findings of colonic lymphoid nodules may nevertheless cause confusion with other endoscopic diagnosis and their clinicopathologic significance have not been well known until now. The aims of this study were to classify the colonic lymphoid hyperplasia accordings to the colonoscopic findings and to reveal the clinicopathological relationship. Methods : From January 1998 to December 2000, 35 cases of colon lymphoid hyperplasia were selected in this study, the patients who had any other colon diseases were excluded in initial study group. We evaluated the endoscopic features of colonic lymphoid hyperplasia and analyzed their clinicopathologic relationships. Results : Colonic lymphoid hyperplasia was endoscopically classified as follows: 18 Polyps, 7 Target lesions, 5 Verrucous lesions, 5 Erosions. The rectum and cecum were most frequently involved. The histological grades of colonic lymphoid hyperplasia were divided into grade I (19 cases), grade II (13 cases), graded III (3 cases) according to degree of lymphatic follicle and lymphocyte infiltration to interstitial tissue. The severity of histologic grades had a tendency to increment in verrucous or erosive lesion comparing with polyp or target lesion, but they had no significant relation with other endoscopic or clinical features. Conclusion : Colonic lymphoid hyperplasia can be classified endoscopically into four types. Verrucous or erosive lesion might be considered as more severe colonic lymphoid hyperplasia. Further prospective and long-term studies are needed to confirm clinicopathologic significance of various endoscopic features.(Korean J Med 62:625-632, 2002)

담도 협착에서 종양 특성과 솔질세포검사 순서에 따른 진단 정확도

조영걸 ( Yeong Geol Jo ),이태훈 ( Tae Hoon Lee ),조현득 ( Hyun Deuk Cho ),박상흠 ( Sang Heum Park ),박재만 ( Jae Man Park ),조영신 ( Young Sin Cho ),정윤호 ( Yunho Jung ),정일권 ( Il Kwun Chung ),최현종 ( Hyun Jong Choi ),문종호 ( 대한소화기학회 2014 대한소화기학회지 Vol.63 No.4

Background/Aims: There are few data supporting the diagnostic yield of brush cytology depending on the order of cytologic reparation method or the location or shape of tumors in biliary strictures. We investigated diagnostic yields and variations n brush cytology with direct smear and cell-block preparations according to sampling preparation sequence and tumor location nd shape in biliary strictures. ethods: Patients who had undergone ERCP with tissue sampling between August 2009 and April 2013 were analyzed etrospectively. Group A was examined using brush cytology with direct smear followed by cell-block with or without biopsy, hile the reverse order was performed for group B. esults: Among 138 enrolled patients, 92 patients (A: 36, B: 56) underwent both brush cytology with direct smear and cell-block reparations. No differences in sensitivity, specificity, or accuracy were observed according to the sampling preparation method nd the location or shape of tumors in biliary strictures. The cellularity observed from brush cytology with direct smear was etter than that from cell-block according to the location of the tumor (p<0.01). The diagnostic yield was increased in both roups with addition of an endobiliary biopsy. onclusions: No difference in diagnostic accuracy was observed between the sequences of preparation for brush cytology ith direct smear and cell-block techniques. Brush cytology showed better cellularity for diagnosis.

월경성 기흉을 유발한 횡격막의 자궁내막증

문가을 ( Ga Ui Mun ),전혜지 ( Hye Ji Jeon ),조은규 ( Eun Kyu Cho ),김윤숙 ( Yun Sook Kim ),배동한 ( Dong Han Bae ),이석열 ( Seok Yul Lee ),조현득 ( Hyun Deuk Cho ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.7

Endometriosis is a relatively common gynecologic disease. Thoracic endometriosis syndrome occupies half of various types of external endometriosis, however it is very rare condition, We experienced a case of 40-year-old woman who presented with recurrent episodes of spontaneous right-sided pneumothorax that occurred during her menstrual periods. After the localization of the disease site by means of chest radiography and high resolution computed tomography of the thorax, thoracoscopic assisted diaphragm endometriosis resection and suture were performed. After pathologic diagnosis, a hormonal treatment with gonadotropin-releasing hormone agonist was also conducted. We report this case with a brief review of the concerned literatures.

캐슬만병에서 기원하여 무증상 복강 내 종양으로 발현된 여포성 수상돌기 세포육종

황순오 ( Soon Oh Hwang ),이태훈 ( Ae Hoon Lee ),배상호 ( Sang Ho Bae ),조현득 ( Hyun Deuk Cho ),최강혁 ( Kang Hyug Choi ),박상흠 ( Sang Heum Park ),김창호 ( Chang Ho Kim ),김선주 ( Sun Joo Kim ) 대한소화기학회 2013 대한소화기학회지 Vol.62 No.2

Follicular dendritic cell (FDC) sarcoma is an extremely rare malignant neoplasm arising from FDCs. The exact origin of FDCs remains unclear; both a hematopoietic lineage origin and a stromal cell derivation have been proposed. Proliferation of FDCs can lead to benign reactive lesions or generate neoplastic conditions. The lesions are most commonly found in lymph nodes and usually involve the head and neck area. Castleman`s disease is a rare non-neoplasitic lymphoproliferative disorder. Rare cases of hyaline-vascular Castleman`s disease have been associated with FDC sarcoma, but a clonal relationship has not been convincingly demonstrated. A pathway toward tumor evolution, beginning with hyperplasia and dysplasia of FDCs, has been proposed. Despite this known association between Castleman`s disease and FDC sarcoma, there have only been few reported cases of sarcoma arising as a complication of pre-existing Castleman`s disease, especially in abdominal lesions. We describe here a 51-year-old female with an FDC sarcoma arising from unicentric, hyaline-vascular type Castleman s disease in an intra-abdominal mass. Pathologically, the lesion showed a series of changes during the process of transformation from Castleman`s disease to FDC sarcoma. (Korean J Gastroenterol 2013; 62:131-134)

충청남도 지역에서 진단된 광선 각화증에 대한 임상 및 병리조직학적 고찰

김성근 ( Sung Keun Kim ),신정웅 ( Jung Woong Shin ),이성열 ( Sung Yul Lee ),이상훈 ( Sang Hoon Lee ),조문균 ( Moon Kyun Cho ),황규왕 ( Kyu Uang Whang ),박영립 ( Young Lip Park ),남두현 ( Doo Hyun Nam ),조현득 ( Hyun Deuk Cho ) 대한피부과학회 2010 大韓皮膚科學會誌 Vol.48 No.1

Background: Actinic keratoses (AK) have been recognized as precancerous lesions, they have been recently considered to be an early in situ squamous cell carcinoma (SCC). However, there have been few studies to determine the clinical and histopathological characteristics of AK, and especially in the Province of Chungcheongnam-do. Objective: The purpose of this study was to evaluate the clinicopathological characteristics of 80 cases of AK in the province of Chungcheongnam-do. Methods: The authors evaluated the clinical and histopathological features of 80 patients with AK at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. Results: The ratio of male to female patients was 1:4.7. The age distribution ranged from 42 to 93 years old. Single lesions are more common than multiple lesions. The duration of lesions was variable with a mean duration of 25.1 months. The most commonly involved sites were the face and especially the cheek. The color was erythematous in 63.3% of the cases, brownish in 24.5%, dark-brownish in 9.5% and gray in 2.7%. Crust and scale were noted in 37.4% and 22.4% of the cases, respectively. SCC was associated with AK in 6.3% of the cases, basal cell carcinoma was associated with AK in 1.3%, and keratoacanthoma in 1.3%. The most common histopathological types of AK were atrophic types in 20.6%, and this was followed by the hypertrophic types in 18.6% of the cases and the hypertrophic and atrophic types in 14.7% of the cases. Conclusion: Our results are similar to those of the previous reports. In addition, we observed a consistently higher incidence in females than males in the Korean reports and a more frequent incidence of single lesions than multiple lesions in the Asian reports. We found that AK is not easily distinguishable from SCC both clinically and cytologically. Thus, we suggest that biopsies and active treatments should be performed on AK lesions. (Korean J Dermatol 2010;48(1):1∼7)

이차성 유아구성 외투 세포림프종 1예

신정웅 ( Jung Woong Shin ),양정훈 ( Jung Hoon Yang ),이성열 ( Sung Yul Lee ),이종석 ( Jong Suk Lee ),박영립 ( Young Lip Park ),조문균 ( Moon Kyun Cho ),조현득 ( Hyun Deuk Cho ) 대한피부과학회 2010 大韓皮膚科學會誌 Vol.48 No.8

Mantle cell lymphoma (MCL) is a low-grade malignant lymphoma derived from a subset of B-cells localized in the mantle zone of the lymphoid follicle. MCL commonly involves extranodal sites, usually as a manifestation of disseminated disease. The immunophenotype of MCL is characterized as CD20+, CD5+ and Cyclin D1+. Blastoid mantle cell lymphoma (BV-MCL) is a rare variant and has a more aggressive clinical course. In the blastoid variant, the genetic profile is often more complex and includes tetraploid chromosomes, CCND1 amplification, a higher incidence of p53 gene mutations, and p16(INK4a) deletions. We report a case of a 62-year-old male patient who presented with erythematous subcutaneous nodules on the lower back. He had been treated for BV-MCL of the testis which had occurred 1 year ago. The analysis of histopathological and immunohistochemical examinations of the skin lesions also revealed a BV-MCL. (Korean J Dermatol 2010;48(8):684~688)

충청남도 지역에서 진단된 표피낭종에 대한 임상 및 병리조직학적 고찰

김성근 ( Sung Keun Kim ),권혁 ( Hyuk Kwon ),이성열 ( Sung Yul Lee ),이종석 ( Jong Suk Lee ),황규왕 ( Kyu Uang Whang ),박영립 ( Young Lip Park ),김준혁 ( Jun Hyuk Kim ),조현득 ( Hyun Deuk Cho ) 대한피부과학회 2009 大韓皮膚科學會誌 Vol.47 No.5

Background: Epidermal cysts are the most common type of epithelial cysts of the skin. There have been a few studies to determine the clinical and histopathological characteristics of epidermal cysts. Objective: The purpose of this study was to evaluate the clinicopathological characteristics of 243 cases of epidermal cysts in the province of Chungcheongnam-do. Methods: We retrospectively evaluated the clinical and histopathological features of 243 cases of epidermal cysts at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. Results: The ratio of male to female patients was 1.7:1. The age distribution of subjects at the first visit ranged from 11 months to 83 years. The most common site of occurrence was the face. The most common histopathological change of the cystic wall was atrophy. Cystic contents such as calcifications, parakeratotic cells, red blood cells as well as keratinous material were observed. We found stromal changes such as foreign body reactions, fibrosis and granulation tissue. Forty-seven cases were clinically misdiagnosed as other diseases, but subsequent histopathological findings demonstrated the presence of epidermal cysts. No particular relationship was found among duration, size, atrophy of the cyst wall and calcification of keratin material. Conclusion: We reaffirmed contiguity with previous reports. In addition, we found some cases could have been clinically misdiagnosed as other diseases. In addition, there was a poor relationship between the duration of the lesion and other variables such as the size of the lesion, the degree of atrophy of the cyst wall and calcification of keratin material. (Korean J Dermatol 2009;47(5):516~523)