림프절의 염증성 가성 종양 - 세침흡인 세포학적 소견 1예 보고 -

박소영,공경엽,허주령,유은실,이인철,김온자,Park, So-Young,Gong, Gyung-Yub,Huh, Joo-Ryung,Yu, Eun-Sil,Lee, In-Chul,Kim, On-Ja 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.1

Reports on the cytologic or histopathologic findings of inflammatory pseudotumors are relatively infrequent and most of them have dealt with those involving the lung, liver, genitourinary tract, alimentary tract, spleen, mediastinum, retroperitoneum, etc. Moreover there have not been any cytologic studios of those involving lymph nodes. We present fine needle aspiration cytologic features of inflammatory pseudotumor occurring in a lymph node in a 64 year-old man. The aspirate consisted of proliferating spindle cells and admixed histiocytes, fibroblasts, lymphocytes, and plasma cells. Histiocytes were present either singly or in loosely cohesive small clusters. A few multinucleated giant cells were present as well. However, tuberculosis could be excluded by the absence of typical granuloma, caseation necrosis, or characteristic mixed spindle and inflammatory cell components. Other benign and malignant lymphadenopathies could also be differentiated based on cytologic findings.

갑상선의 호산성 유두상 암종의 세침흡인 세포학적 소견

김영민,공경엽,김온자,Kim, Young-Min,Gong, Gyung-Yub,Kim, On-Ja 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.1

Oxyphilic (Hurthle) cells have abundant eosinophilic granular cytoplasms and occur in both benign and malignant neoplasms of the thyroid gland. Most published studies described mainly oxyphilic tumors of follicular type, and reports on oxyphilic papillary thyroid carcinomas are rare. The oxyphilic variant of papillary carcinoma differs from the classic papillary carcinoma in its more aggressive biological behavior. We report a case of oxyphilic papillary carcinoma exhibiting exclusively oxyphilic cells in a follicular pattern without papillary structures. The pattern of papillary carcinoma was confirmed by fine needle aspiration material and lymph nodal metastasis, both of which revealed typicaled papillary structures with characteristic nuclear features, psammoma bodies, and oxyphilic cytoplasm.

구강내 병변의 세침흡인 세포학적 소견

이호정,공경엽,정동해,허주령,김온자,Lee, Ho-Jung,Gong, Gyung-Yub,Chung, Dong-Hae,Huh, Joo-Ryung,Kim, On-Ja 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.2

Fine needle aspiration cytology(FNAC) has become a popular method for the diagnosis of a wide variety of both superficial and deep-seated lesions. However, there are few reports about the potential of FNAC for the diagnosis of intraoral lesions. We experienced 44 FNACS from intraoral lesions at Asan Medical Center: 22 from the palate, 6 from the tongue, 5 from the parapharyngeal space, 5 from the lip, 2 from the floor of mouth, 1 from the buccal mucosa, and 3 from other intraoral sites. Histological confirmation was obtained in 32 cases and we analyzed 27 cases excluding 5 cases of inadequate aspirates. Diagnosis was specifically made in 19 of 27 cases(70%) including 1 mucoepidermoid carcinoma, 1 undifferentiated carcinoma, 1 chordoma, 9 pleomorphic adenomas, 1 neurofibroma, and 6 benign lesions. There were three false negative cases(sensitivity, 62.5%) and no false positive cases(specificity, 100%): Two cases diagnosed as "cystic lesion" were confirmed to be mucoepidermoid carcinomas and a case diagnosed as pleomorphic adenoma was proved to be adenoid cystic carcinoma. The results of our study suggest that FNAC is a useful technique in the diagnosis of intraoral lesion.

공장에 단독으로 생긴 결절성 다발성 동맥염

김창남(Chang Nam Kim),유창식(Chang Sik Yu),한명식(Myoung Sik Han),이한일(Han Il Lee),조영미(Young Mee Cho),김온자(On Ja Kim),유빈(Bin Yoo),김진천(Jin Cheon Kim) 대한소화기학회 1998 대한소화기학회지 Vol.30 No.3

Polyarteritis nodosa(PAN) is a systemic vasculitis affecting mainly small and medium sized arteries. Over 50% of the cases, PAN may cause gastrointestinal symptoms. Main gastrointestinal symptoms are abdominal pain, vomiting, nausea, diarrhea and melena. A very rare case of isolated PAN affecting the jejunum, manifested as stricture, is reported. A 55-year-old woman with prior history of hypertension presented herself complaining of abdominal pain and weight loss. Radiologic studies showed a segmental narrowing of the jejunum. At the time of surgery, 3cm length narrowed, thickened fibrotic intestinal wall was found at 110cm distal to the Treitz ligament. Pathological finding showed acute necrotizing vasculitis of a medium sized artery. (Korean J Gastroenterol 1997; 30:411-414)

우측 경동맥에서 발생한 염증성 가성종양 1예

김건언(Geun-Eun Kim),조용필(Yong-Pil Cho),권태원(Tae-Won Kwon),정동해(Dong-Hae Chung),김온자(On-Ja Kim) 대한외과학회 1998 Annals of Surgical Treatment and Research Vol.54 No.6

유방의 양성 엽상종양 및 섬유선종에 대한 세포학적 비교 검색

서재희,공경엽,박정미,안세현,김온자,Suh, Jae-Hee,Gong, Gyung-Yub,Park, Jeong-Mi,Ahn, Sei-Hyun,Kim, On-Ja 대한세포병리학회 1996 대한세포병리학회지 Vol.7 No.2

Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings. In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA) smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters. Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA. The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.

뇌척수액에서 진단된 악성 종양세포의 세포학적 분석

서재희,공경엽,강신광,김온자,Suh, Jae-Hee,Gong, Gyung-Yub,Khang, Shin-Kwang,Kim, On-Ja 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.1

Cytologic evaluation of cerebrospinal fluid(CSF) is an effective tool in diagnosing many disorders involving the central nervous system(CNS). CSF examination has been found to be of particular value in the diagnosis of metastatic carcinoma, lymphomatous or leukemic involvement of CNS and certain primary CNS tumors. As a survey of metastatic tumors to CSF and an evaluation of the preparation techniques increasing cellular yield in our laboratory, 713 CSF specimens examined between July 1995 and April 1997(1 year 10 months), were reviewed. There were 75 positive and 5 suspicious cases, the latter have had no evidence of tumors clinically. Primary tumors of 75 positive cases were classified as follows; 4(5.3%) as primary brain tumors, 40(53.3%) as secondary carcinomas, 13(17.3%) as leukemias, and 18 (24.0%) as lymphomas. The most common primary site of metastatic carcinomas was the lung in 17 cases(42.5%) followed by the stomach in 13(32.5%), breast in 8 (20.0%), and unknown primary in 2(5.0%). Four primary brain tumors were 3 cerebellar medulloblastomas and a supratentorial primitive neuroectodermal tumor (PNET). All 40 metastatic carcinomas were adenocarcinoma presented as single cells or cell clusters. Although signet ring cells were frequent in the cases of gastric primary cancers, no significant cytologic differences according to the primary site were observed. The cytologic features of leukemia and lymphoma were characterized by hypercellular smears presenting as individual atypical cells with increased N/C ratio, presence of nucleoli, and nuclear protrusions. In medulloblastomas and PNET, the principal cytologic findings were small undifferentiated cells arranged singly or in loose clusters with occasional rosettoid features. This study suggests that the CSF cytology is useful in the diagnosis of malignancy, especially metastatic extracranial tumors and the diagnostic accuracy can be improved by increasing cellular yield using cytocentrifuge.

폐종양의 세포학적 진단에서 경기관지세침흡인검사의 유용성

김태엽,공경엽,김원동,김온자,Kim, Tae-Yub,Gong, Gyung-Yub,Kim, Won-Dong,Kim, On-Ja 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.2

Transbronchial fine needle aspiration(TBNA) is one of the cytologic methods in diagnosing lung cancers. TBNA can be used in cases of hilar, mediastinal or lung masses adjacent to the bronchi. We analyzed and compaired the findings of 27 cases of TBNA and bronchial washing and brushing(BW/BB) in lung cancers confirmed by either biopsy or surgical resection between Jun, 1996 and May, 1997 in Asan Medical Center. They were 18 cases of non-small cell carcinomas(eight squamous cell carcinomas, nine adenocarcinomas, and one large cell undifferentiated carcinoma), eight cases of small cell carcinomas, and one case of metastatic hepatocellular carcinoma. The sensitivity of TBNA was 37%(10/27) and false negative was 63%(17/27). Although the sensitivity of BW/BB w3s 56%(15/27), it was not different statistically from that of TBNA(Chi square, p=0.38). Overall sensitivity of TBNA and BW/BB in this series was 70%(19/27). Forty-seven percent of false negative TBNA(8/17) were positive in BW/BB. The findings suggest that the addition of TBNA to the standard BW/BB increases diagnostic yield in cytologic diagnosis of lung cancer.

자궁경부질 도말 검사 정도 관리과정으로서의 세포 및 조직진단의 비교 분석과 10% 무작위 재선별과의 비교 분석

윤길숙,허주령,손경희,김온자,공경엽,Yoon, Ghil-Suk,Huh, Joo-Ryung,Son, Kyung-Hee,Kim, On-Ja,Gong, Gyung-Yub 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.2

Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists $2{\sim}5%$ of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8) whereas six cases were screening errors(categories B:2 and C:4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytotechnologists reviewed 3,196 of 30,922 smears during the same period, There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and qualify assurance(cytologic/histologic correlation) programs.

유방의 점액성 암종의 진단시 세침흡인 검사의 의의

김윤정,공경엽,허주령,박정미,안세현,김온자,Kim, Yoon-Jung,Gong, Gyung-Yub,Huh, Joo-Ryung,Park, Jeong-Mi,Ahn, Sei-Hyun,Kim, On-Ja 대한세포병리학회 1996 대한세포병리학회지 Vol.7 No.2

Fine needle aspiration(FNA) is an effective tool in diagnosing mammary carcinoma. We experienced 7 cases of histologically confirmed mammary mucinous carcinoma among 3,052 aspirated cases of breast from 1992 to 1996 in Asan Medical Center. The average age of the patient was 48(33-64) years. The mean size of the lesions was $1.6(0.7{\sim}3)cm$, and they were palpated as well-defined, firm to hard masses. The cytologic features that may be useful in making a FNA diagnosis of mucinous carcinoma of the breast were analysed. Mucinous background and tumor cell clusters with occasional single cells were observed in all cases. Among them, two cases showed abundant scattered single cells, whereas only few single cells were seen in the other two cases. Tumor cells exhibited mild pleomorphism in four cases and moderate pleomorphism in three cases. Nucleoli tended to be not prominent and are observed in three cases, rarely noted in other three cases and not seen in one. There was microcalcification in four cases(57%). In conclusion, mucinous background and clustered tumor cells showing mild to moderate pleomorphism with characteristic clinical findings allow us to diagnose mucinous carcinoma of the breast.