부비동과 비의 미분화 암종 - 1예 보고 -

신미경,채양석,Shin, Mi-Kyung,Chae, Yang-Seok 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.1

Sinonasal undifferentiated carcinoma(SNUC) is a distinct, relatively rare neoplasm arising in the nasal cavity and paranasal sinuses composed of undifferentiated epithelial cells and clinically characterized by a fulminant course. We report a case of SNUC in a 56-year old man who have had bilateral neck masses since one month ago before coming to our hospital. The paranasal computed tomography showed soft mass density in the left maxillary sinus and the nasal cavity with bone destruction in the anterior medial and the inferior maxillary sinus wall. This mass was extruded into the left orbital wall. Biopsy of the nasal mass and fine needle aspiration(FNA) of the neck mass were done. FNA revealed medium-sized neoplastic cells forming clusters or individually dispersed. Nuclei were round to oval, slightly to moderately pleomorphic, and hyperchromatic. Chromatin was finely granular, but occasionally was coarsely granular. Nucleoli varied from large to inconspicuous and the cytoplasm was scanty.

귀밑샘의 형질세포와 호산성 조직구를 다량 함유한 림프절외 변연부 B-세포 림프종의 세침흡인 세포검사 소견 -1예 보고-

이영석,안정석,채양석,염범우,최종상,김철환,Lee, Young-Seok,An, Jung-Suk,Chae, Yang-Seok,Yeom, Bom-Woo,Choi, Jong-Sang,Kim, Chul-Hwan 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.2

The authors present the fine needle aspiration cytology (FNAC) cytologic findings of a case of extranodal marginal zone B cell lymphoma (MZBCL), which featured abundant plasma cells and eosinophilic histiocytes arising in both parotid glands. A 49-year-old female presented with palpable masses in both parotid glands. She had been suffering from systemic lupus erythematosus and rheumatoid arthritis. The lesions were evaluated by FNAC and smears showed a small number of clusters of oncocytic cells with abundant eosinophilic granular cytoplasm and small nuclei, intermixed with small to medium-sized lymphoid cells containing round to lobulated nuclei, which suggested Warthin's tumor. Some of lymphoid cells had a plasmacytoid appearance, and some scattered large cells contained a large amount of eosinophilic cytoplasm. Bilateral superficial parotidectomy was performed and a histopathologic study indicated MZBCL with abundant plasma cells, intermixed with eosinophilic histiocytes. The presence of oncocytic cells and a mixture of lymphoid and plasma cells indicates Warthin's tumor, but the cytologic features of a relatively monotonous small to medium-sized lymphoid infiltrate suggest the possibility of MZBCL in the clinical setting of an FNAC study performed on a patient suffering from a connective tissue disease.

당뇨병에 합병된 비안와형 ( Rhinoorbital ) 모균증 1 예

박명규(Myung Kyu Park),채양석(Yang Seok Chae),박승철(Seung Chull Park),김민자(Min Ja Kim),김우주(Woo Joo Kim),박희남(Hee Nam Park),이상화(Sang Hwa Lee),남용진(Yong Jin Nam),한승환(Seung Hwan Han) 대한내과학회 1994 대한내과학회지 Vol.47 No.4

Mucormycosis is a rare, rapidly progressive and often fatal opportunistic fungal infection, which occurs most commonly in patients with uncontrolled diabetes. We reported a case of rhinoorbital mucormycosis confirmed by nasal mucosal biopsy, which showed characteristic fungal hyphae and vascular invasion. The patient was a 41-year-old woman, who had diabetes mellitus for 5 years, presented with a 2-day history of redness and swelling in the left eyelid and maxillary area. On the admission, blood glucose was 412 mg/dl. Brain CT revealed pansinusitis, air-fluid level in the maxillary sinus, preorbital swelling and soft tissue density in the nasal cavity. But there was no demonstrable bony destruction. After aggressive surgical resection, systemic intravenous amphotericin B (1.0 mg/kg/day) was given for 7 weeks to a total dose of 2.0 g. On the 72th hospital day, she developed sudden, unexpected alteration of consciousness followed by coma. Two days later, the patient died and an autopsy was not performed.

위암에서 E-cadherin과 $\beta-catenin$ 발현과 유전자 돌연변이에 관한 연구

김광일,박성혜,한선애,채양석,김인선,Kim Kwang Il,Park Sung-Hye,Han Sun-Ae,Chae Yang-Seok,Kim Insun 대한위암학회 2001 대한위암학회지 Vol.1 No.4

Purpose: When cancer cels invade the stroma, they should be dissociated from the adjacent cells at first. E-cadherin and $\beta-catenin$ constitute an important protein complex associated with cellular adhesion, development, and differentiation, especially in epithelial cells. The role of E-cadherin and $\beta-catenin$ in gastric carcinogenesis were studied. Materials and Methods: The expression of E-cadherin and $\beta-catenin$ in gastric adenocarcinomas by using immunohistochemical staining and the mutation by using polymerase chain reaction- single stranded conformation polymorphism (PCR-SSCP) and sequencing were performed in 40 adenocarcinomas and 5 dysplasia of stomach. Thirteen cases, which had lymph node metastasis, were also included for immunohistochemical staining. Results: Inappropriate cytoplasmic and/or nuclear expression of a E-cadherin-$\beta-catenin$ complex was more frequent in poorly differentiated, diffuse type signet ring cell carcinomas than in well-differentiated, intestinal type adenocarcinomas (P<0.05). However, the expression was not related with clinical stage or lymph node metastasis. Mutation of E-cadherin was detected in 4 cases by using PCR-SSCP, whereas mutation of $\beta-catenin$ was detected in 2 cases. Conclusion: E-cadherin and $\beta-catenin$ seem to be important in gastric carcinogenesis, especially in poorly differentiated diffuse type.

소아에서 발생한 갑상선 수질암종 - 1예 보고 -

문정석,김혜선,조성진,채양석,염범우,Moon, Jeong-Seok,Kim, Hye-Sun,Cho, Seong-Jin,Chae, Yang-Seok,Yeom, Bom-Woo 대한세포병리학회 1996 대한세포병리학회지 Vol.7 No.2

Medullary carcinoma of the thyroid gland is a malignant neuroendocrine tumor arising from calcitonin producing-parafollicular cells. The tumor is clinically divided into sporadic and familial form, constituting about 80% and 20%, respectively. Recently, we experienced a case of unilateral and solitary sporadic medullary carcinoma of the left thyroid gland. The patient was a 9 year-old female, who presented with a palpable mass on the anterior lateral neck of 8 months duration without any familial and personal history of neuroendocrine disease. The cytopathologic findings showed spindle cells and plasmacytoid cells in the background of colloid-like materal. The nuclei were eccentrically located, mildly hyperchromatic and pleomorphic, showing speckled chromatin pattern without nuclear inclusion or prominent nucleoli. The cytoplasm was abundant and had a pale granular cyanophilic appearance. No amyloid materal could be identified.

뇨세포진 검사로 진단된 방광의 원발성 소세포암 - 1예 보고 -

김혜선,김애리,김철환,채양석,원남희,Kim, Hye-Sun,Kim, Aee-Ree,Kim, Chul-Hwan,Chae, Yang-Seok,Won, Nam-Hee 대한세포병리학회 1994 대한세포병리학회지 Vol.5 No.2

Small cell carcinoma of the urinary bladder is a rare tumor which occurs in about 0.48 % of all bladder tumors. We report cytologic features of small cell carcinoma of the urinary bladder in a 66-year-old man who had painless total gross hematuria, which was confirmed by partial cystectomy. In urine cytology, abundant tumor cells appeared in scattered and clustered forms in a bloody background. The tumor cells were small and uniform in size with a high nuclear/cytoplasmic ratio. The nuclei of the tumor cells were hyperchromatic, characteristically molded and showed inconspicuous nucleoli. The cytoplasms were scanty and pale blue.

다형선종 수술 후 발생한 이하선 점액표피양암종

정광윤(Kwang-Yoon Jung),채양석(Yang-Seok Chae),백승국(Seung-Kuk Baek),박민우(Min-Woo Park),유준혁(Joon-Hyuk Yoo) 대한두경부종양학회 2012 대한두경부 종양학회지 Vol.28 No.1

Mucoepidermoid carcinoma is most frequent malignant tumor of parotid gland. However, mucoepidermoid carcinoma arising from pleomorphic adenoma has been disputed and rarely reported. 54-year-old woman with pleomorphic adenoma underwent superficial parotidectomy. And 15 years later, she diagnosed mucoepider-moid carcinoma at the same side. We report the case with a review of literature.

위선암의 임상소견 및 Flow Cytometry 분석결과에 관한 연구

목영재(Young Jae Mok),채양석(Yang Seok Chae) 대한외과학회 1992 Annals of Surgical Treatment and Research Vol.43 No.5

원발성 시신경교차 주위 종양으로부터 전이한 비장의 생식세포종 - 1예 보고 -

신봉경,김민경,김한겸,채양석,원남희,김인선,Shin, Bong-Kyuug,Kim, Min-Kyung,Kim, Han-Kyeom,Chae, Yang-Seok,Won, Nam-Hee,Kim, In-Sun 대한세포병리학회 2001 대한세포병리학회지 Vol.12 No.1

A 20-year-old young man who had undergone treatment for a suprasellar/perichiasmal tumor 2 years before, was presented with a huge palpable splenic mass. A fine needle aspiration cytology from the splenic mass showed dissociated large pleomorphic tumor cells having irregular nuclear outline, coarse chromatin, and one or two macronucleoli, and scattered small lymphocytes in fine granular background. Above cytologic findings were regarded as the characteristics of germinoma. Differential diagnosis from the large cell lymphoma of spleen was emphasized.

위에 발생한 위장관 간질성 종양의 임상병리학적 특성과 치료성적

류제석,이성렬,최새별,박성수,이주한,김승주,김종석,채양석,목영재,Ryu Je-Seock,Lee Sung-Ryul,Choi Sae-Byeol,Park Sung-Soo,Lee Ju-Han,Kim Seung-Joo,Kim Chong-Suk,Chae Yang-Seok,Mok Young-Jae 대한위암학회 2005 대한위암학회지 Vol.5 No.1

배경: 위장관 간질성 종양(GISTs)은 위장관계에 발생하는 간엽성 종양이다. 위장관 간질성 종양은 면역조직화학 검사에서 c-kit 단백 발현의 양성을 나타내며 그 임상적 경과는 매우 다양하다. 저자들은 위장관 간질성 종양의 임상병리학적 특성을 고찰하고 예후 인자를 평가하기 위하여 후향적 연구를 시행하였다. 대상 및 방법: 본 연구는 고려대학교 의과대학 외과학교실에서 1996년부터 2003년까지 위장관 간질성 종양으로 수술적 절제를 시행한 40명의 환자를 대상으로 하였다. 종양의 크기와 핵분열 정도에 따라 저위험도 집단(23예), 고위험도 집단(17예)으로 분류하였으며 두 군간 임상병리학적 특성, 면역조직화학 검사 결과 및 예후를 비교 분석하였다. 결과: 환자의 평균 연령은 $61.3\pm11.1$세이었으며 남녀비는 1:1,1이었다. 임상병리학적 소견으로는 수술 전 임상 증상이 있었던 경우와 수술 전에 조직학적으로 진단이 되었던 경우, 종양의 크기가 클수록, 핵분열이 많을수록, 종양의 성상이 궤양을 동반하거나 괴사를 보일 때, 고위험군에 포함되는 빈도가 높았다. 단변량 분석 결과, 종양의 크기, 핵분열 정도, 궤양 및 괴사 소견 그리고 내시경적 초음파 이상소견이 통계학적으로 의미가 있는 인자들로 나타났으며, 다변량 분석을 시행한 결과 핵분열 정도가 생존율에 영향을 미치는 독립적인 예후 인자로 나타났다. 관찰 기간 중 8예에서 재발하였으며 STI-571(imatinib mesylate, $Gleeveo^{R}$)을 사용한 4예는 현재까지 생존하고 있으며 사용하지 않은 4예 중 2예는 질환이 진행하는 양상을 나타내었고, 나머지 2P는 사망하였다. 결론: 위에서 기원한 위장관 간질성 종양에서 종양의 크기, 궤양 및 괴사 소견은 생존율에 영향을 주는 임상병리학적 소견이며, 핵분열 정도는 유용한 예후 인자라고 할 수 있다. STI-571은 재발 혹은 전이 환자에 있어 치료 효과를 나타내므로 술후 치료에 적용하는 것이 예후 향상에 기여하리라 생각된다. Purpose: Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms of the gastrointestinal tract. GISTs are positive for the expression of c-Kit protein at immunohistochemistry, and their clinical presentations vary. This retrospective study was performed to evaluate the clincopathologic characteristics of GISTs and to define the prognostic factors. Materials and Methods: 40 patients who underwent a complete resection of a GIST during the period $1996\~2003$ at the Department of Surgery, Korea University College of Medicine, were studied. We divided them into low- and high-risk. groups by using tumor size and mitotic count: 23 cases were low risk, and 17 were high risk. Clinicopathologic features, immunohistochemical findings, and prognoses were compared between the low- and the high-risk groups. Results: The mean age of the 40 patients was $61.3\pm11.1$years, and the male-to-female ratio was 1:1.1. There was no significant difference in age and sex between the groups. A comparative analysis revealed tumor size, mitotic count, clinical symptoms, preoperative pathologic diagnosis, ulceration, and necrosis to be variables that had statistically significant differences between the high- and the low-risk groups. In the univariate analysis, tumor size, mitotic count, ulceration, necrosis, and abnormal endoscopic ultrasound findings were associated with disease-free survival, but in the multivariate analysis, mitotic activity was the only independent factor associated with disease-free survival. 8 patients had recurrences during the follow-up period, and four of them were treated with STI-571 (imatinib mesylate, $Gleevec^{(R)}$). The treated patients have survived until now; however, two of non-treated patients died from disease progression. Conclusion: Based on this study, tumor size, ulceration, and necrosis are significant factors affecting survival, and mitotic activity may be a useful prognostic marker. STI-571 may be used in an adjuvant setting because the drug has shown anticancer activity in patients with recurrence or metastasis.