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박성범 ( Sung Bum Park ),박실비아 ( Silvia Park ),방선하 ( Sun Ha Bang ),김은경 ( Eun Kyung Kim ),전경만 ( Kyeong Man Jeon ),고원중 ( Won Jung Koh ),서지영 ( Gee Young Suh ),정만표 ( Man Pyo Chung ),김호중 ( Ho Joong Kim ),권오정 ( 대한결핵 및 호흡기학회 2011 Tuberculosis and Respiratory Diseases Vol.70 No.2
Pheochromocytomas are neuroendocrine tumors of chromaffin cell that originate in the paraganglia of the adrenal medulla. Approximately 10% of pheochromocytomas are found in the extra-adrenal paraganglia and are called paragangliomas. However, cases of middle mediastinal paragangliomas are very rare. In this case, the patient presented with a voice change and a headache. A middle mediastinal soft tissue mass with marked enhancement was detected on computed tomography of the chest. The 24-hour urine catecholamine level was markedly elevated. The middle mediastinal mass was biopsied via mediastinoscopy and the resulting immunohistochemical staining was compatible with a diagnosis of middle mediastinal paraganglioma. The mass was resected surgically and the symptoms were relieved.
증례 : 혈액종양 ; 단독 골수 외 심장 종괴로 재발한 만성 골수성 백혈병 1예
변성규 ( Seong Gyu Byeon ),김희경 ( Hee Kyung Kim ),문지훈 ( Ji Hoon Moon ),문성미 ( Seong Mi Moon ),박지은 ( Jee Eun Park ),박실비아 ( Silvia Park ),정철원 ( Chul Won Jung ) 대한내과학회 2016 대한내과학회지 Vol.90 No.2
저자들은 만성 골수성 백혈병으로 동종 조혈모세포 이식을 받은 후 심장 종괴의 형태로 단독 골수 외 재발을 하였으나, 2년 이상 질병의 진행과 골수 재발을 보이지 않은 증례가 있어 보고하였다. 일반적으로 만성 골수성 백혈병 골수 외 재발의 경우 그 예후가 불량하고 혈액학적 재발이 뒤따르는 경우가 많으나, 본 증례는 만성 골수성 백혈병 일부 클론이 재발하더라도 수년간 양성경과를 보이는 휴지기 골수 외 재발을 일으킬 수 있다는 것을 보여준다. 그러므로 이전에 골수성 백혈병을 진단받은 적이 있는 환자에서 골수 육종이 의심되는 소견을 보일 경우, 혈액학적 재발의 증거가 없더라도 적극적인 조직검사 및 분자생물학적 검사를 고려해야 할 것이다. Allogeneic hematopoietic stem cell transplantation is the only option for chemotherapy-refractory chronic myeloid leukemia (CML). Extramedullary relapse after transplantation is rare and usually accompanies marrow relapse. Generally, the prognosis of extramedullary relapse is poor. Here, we report a man with extramedullary relapsed CML after stem cell transplantation that presented as an isolated cardiac mass, which has shown an indolent course for more than 2 years, without evolving to medullary relapse during that period. This case implies that the CML clone might contribute to the development of quiescent extramedullary relapse with a benign course. (Korean J Med 2016;90:159-162)
증례 : 혈액종양 ; 종격종 자세포종양 항암 치료 2개월 후 발생한 골수형성이상증후군
양범희 ( Bum Hee Yang ),신선혜 ( Sun Hye Shin ),김지혜 ( Ji Hye Kim ),김민선 ( Min Sun Kim ),박실비아 ( Silvia Park ),장준호 ( Jun Ho Jang ),정철원 ( Chul Won Jung ) 대한내과학회 2016 대한내과학회지 Vol.90 No.5
Here, we report on a 20-year-old patient with a primary nonseminomatous mediastinal germ cell tumor (MGCT) who developed myelodysplastic syndrome (MDS) 2 months following chemotherapy with cisplatin, etoposide, ifosfamide, and paclitaxel. Bone marrow examinations revealed that the MDS was a refractory anemia with excess type II blasts and complex chromosomal abnormalities. With the onset of MDS occurring rapidly following chemotherapy, it is unlikely to have been caused by the therapy. We discuss the association between primary nonseminomatous MGCTs and hematological malignancies, including the possibility of a common clonal origin. (Korean J Med 2016;90:460-463)