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장리라,최영식,박요한,문대성,김자경,김성은,최인수,유찬희,남성진 고신대학교 의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.3
Metastasis to the thyroid gland is usually considered uncommon. The most frequent sites of the primary tumor include the kidney, breast and lung. Its presence often indicates poor prognosis. Metastases represent the advanced stage of the tumors and fine needle aspiration cytology is and important way of diagnosis in thyroid metastasis. we experienced a case of Metastatic Small cell Lung Carcinoma to the Thyroid Gland. A 58-year-old man with Graves' disease diagnosed pulmonary nodule in the left upper lung field on his chest X-ray film. The patient's thyroid gland was diffusely swollen, and elastic to hard. A thyroid ultrasonography showed 1cm sized hypodense nodule on the left thyroid gland. The patient underwent a ultrasonography guided fine needle aspiration cytology of the mass. Cytological diagnosis was a metastatic small cell carcinoma. Then Chemotherapy was administered to the patient. The authors report this rare case of metastatic small cell lung carcinoma to the thyroid with literature review.
Factors Related to Diagnostic Yield of Lung Biopsy Using both Radial EBUS and Fluoroscopy
( Seung Hyun Yong ),( Soojoung Yu ),( Young Mok Park ),( A La Woo ),( Ah Young Leem ),( Su Hwan Lee ),( Sang Hoon Lee ),( Kyung Soo Chung ),( Song Yee Kim ),( Eun Young Kim ),( Ji Ye Jung ),( Young Ae 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background Transbronchial lung biopsy (TBLB) is a key modality in the diagnosis of peripheral lung lesions. Radial EBUS is new diagnostic technology which can apply to enhance the accuracy of peripheral lung biopsy during bronchoscopy. The purpose of this study was to investigate factors related to diagnostic yield of TBLB with radial EBUS Method A retrospective analysis on the diagnostic yield of TBLB under fluoroscopy consist with radial EBUS, with or without guide sheath (GS) was conducted. Data included TBB that was performed from 2020 to 2021 at a single center by a single operator Results 294 patients with confirmed final diagnoses were included in this study. Definitive diagnosis was established by TBLB in 117/155 (75.48%) patients using radial EBUS without GS, 55/69 (79.71%) patients using EBUS with GS, and 54/70 (77.14%) patients whose tissues were obtained partly without GS and partly with GS. We compared diagnostic yield by type pulmonary lesion which was inconsistent between the diagnostic modalities, but overall, solid lesions had highest diagnostic yield (77.05%) compared to pure ground glass opacities (75%) and part-solid lesions (76.09%). Lung cancer patients that underwent rebiopsy were analyzed in this study which showed diagnostic yield of 68.29%. Diagnostic yield showed improvement over time in radial EBUS assisted TBLB cases that did not use GS with yield of 59.62% in 2020 and 83.5% in 2021. Conclusion For many decades there has not been another diagnostic method to enhance the TBLB in diagnosis of peripheral pulmonary lesions until radial EBUS is introduced. This investigation reviewed current diagnostic usage of TBLB accompanied by radial EBUS and compared diagnostic yields not only by size and targeting, but solid components and exam period as well. Further studies on re-biopsy by TBLB will be needed to learn more about its significance in clinical application.
( Ji Yeon Choi ),( Song Lee Kim ),( Sang Hoon Lee ),( A La Woo ),( Young Mok Park ),( Seung Hyun Young ),( Ah Young Leem ),( Su Hwan Lee ),( Eun Young Kim ),( Kyung Soo Chung ),( Ji Ye Jung ),( Young 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Background Survival after lung transplantation (LT) has steadily improved but its prognosis is still lower than other solid organ transplantation. It is important to predict prognosis in patients who underwent LT but currently there is no specific tool for prediction. Methods In the single-center retrospective study, we reviewed data from patients who underwent LT at Severance Hospital in South Korea from October 2012 to September 2020. Patients who underwent multi-organ transplantation (n=5), re-transplantation (n=5), age ≤18 years old (n=4) and early acute-phase patients within 3 months after LT (n=31) were excluded. A total of 249 LT patients were included for constructing the prediction model for prognosis called the Composite Biologic Scoring (CBS), using the numeric biologic markers around 3 months as a reference which were highest among observation period. Cox proportional hazards model was used to calculate the weight of each criterion included in the CBS, and the predictive accuracy and discriminative ability were measured by concordance index (C-index) and Kaplan Meier survival curve. Results Among 249 patients, mean age was 54.5±11.6 years, and 161 (64.7%) were men. Eight independent prognostic factors were identified and points were assigned to each variable based on Cox proportional hazards regression analysis including white blood cells, hemoglobin, platelet, ferritin, fibrinogen, aspartate aminotransferase, triglyceride, and lactate dehydrogenase (Fig. 1). The C-index for cox proportional hazards model was 0.809 and the calibration curves for the probability of 2, 3, and 5-year overall survival showed close approximation between nomogram prediction and actual observation. Three stratified risk groups according to CBS in post LT patients demonstrated significant distinction between Kaplan-Meier survival curves (Fig. 2 & 3; p-value<0.001). Conclusion The CBS is a useful prediction model for long-term prognosis of LT patients. Further validation study is needed to confirm.
Lee, Soo Hyun,Jang, Mi Jung,Kim, Sun Mi,Yun, Bo La,Rim, Jiwon,Chang, Jung Min,Kim, Bohyoung,Choi, Hye Young The Korean Society of Radiology 2019 KOREAN JOURNAL OF RADIOLOGY Vol.20 No.1
<P><B>Objective</B></P><P>To compare digital breast tomosynthesis (DBT) and conventional full-field digital mammography (FFDM) in the detectability of breast cancers in patients with dense breast tissue, and to determine the influencing factors in the detection of breast cancers using the two techniques.</P><P><B>Materials and Methods</B></P><P>Three blinded radiologists independently graded cancer detectability of 300 breast cancers (288 women with dense breasts) on DBT and conventional FFDM images, retrospectively. Hormone status, histologic grade, T stage, and breast cancer subtype were recorded to identify factors affecting cancer detectability. The Wilcoxon signed-rank test was used to compare cancer detectability by DBT and conventional FFDM. Fisher's exact tests were used to determine differences in cancer characteristics between detectability groups. Kruskal-Wallis tests were used to determine whether the detectability score differed according to cancer characteristics.</P><P><B>Results</B></P><P>Forty breast cancers (13.3%) were detectable only with DBT; 191 (63.7%) breast cancers were detected with both FFDM and DBT, and 69 (23%) were not detected with either. Cancer detectability scores were significantly higher for DBT than for conventional FFDM (median score, 6; range, 0–6; <I>p</I> < 0.001). The DBT-only cancer group had more invasive lobular-type breast cancers (22.5%) than the other two groups (i.e., cancer detected on both types of image [both-detected group], 5.2%; cancer not detected on either type of image [both-non-detected group], 7.3%), and less detectability of ductal carcinoma <I>in situ</I> (5% vs. 16.8% [both-detected group] vs. 27.5% [both-non-detected group]). Low-grade cancers were more often detected in the DBT-only group than in the both-detected group (22.5% vs. 10%, <I>p</I> = 0.026). Human epidermal growth factor receptor-2 (HER-2)-negative cancers were more often detected in the DBT-only group than in the both-detected group (92.3% vs. 70.5%, <I>p</I> = 0.004). Cancers surrounded by mostly glandular tissue were detected less often in the DBT only group than in the both-non-detected group (10% vs. 31.9%, <I>p</I> = 0.016). DBT cancer detectability scores were significantly associated with cancer type (<I>p</I> = 0.012), histologic grade (<I>p</I> = 0.013), T and N stage (<I>p</I> = 0.001, <I>p</I> = 0.024), proportion of glandular tissue surrounding lesions (<I>p</I> = 0.013), and lesion type (<I>p</I> < 0.001).</P><P><B>Conclusion</B></P><P>Invasive lobular, low-grade, or HER-2-negative cancer is more detectable with DBT than with conventional FFDM in patients with dense breasts, but cancers surrounded by mostly glandular tissue might be missed with both techniques.</P>