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신장이식 환자에서 발생한 Paecilomyces lilacinus에 의한 피부농양 1예
신상부,이혜남,김성욱,박건수,조백기,김희정 대한의진균학회 1998 대한의진균학회지 Vol.3 No.2
Paecilomyces lilacinus is an ubiquitous saprophytic fungus and very rarely pathogenic to the human. Although it has been reported to cause endophthalmitis, orbital cellulitis, prosthetic velve endocarditis, and pulmonary infection, cutaneous infection caused by Paecilomyces lilacinus has been rarely reported. A 46-year-old Korean man had asymptomatic slowly growing multiple cutaneous nodules on the left arm and wrist for 8 months. He received a renal transplantation in 1991 because of end-stage renal disease. Postoperatively, he has taken cyclosporin and deflazacort for immunosuppression. Physical examination revealed that the lesions were discrete or confluent, firm, elevated, well defined fluctuating nodules. Histologic section showed multiple well-encapsulated intradermal abscesses with some foci of chronic granulomatous changes composed of Iymphocytes histiocytes and giant cells. PAS positive fungal hyphae and spores were also found. On the Sabouraud's dextrose agar media, the organism grew rapidly to form velvety lilac-colored colonies with shallow radiating furrows. Slide culture showed brush-like conidiophores ending in flask-shaped phialides carrying chain of conidia. Because of the poor response to the oral antifungal drug for 2 months, all the lesions were completely excised.
피부 백혈병과 과립구성 육종이 발생한 급성 골수구성 백혈병 1 예
이준영,이동원,신상부,조백기 대한피부과학회 2000 大韓皮膚科學會誌 Vol.38 No.7
Cutaneous granulocytic sarcoma are rare extramedullary tumor composed of immature leukemic cells of the myeloid series. It has a characteristic greenish color caused by myeloperoxidase in the granulocytic cells. 58-year-old female patient who had been diagnosed as acute myelocytic leukemia presented multiple, variable sized, tender brown-pigmented nodules, papules and plaques on the abdomen and both upper extremities for about 4 weeks. An incision biopsy of the large subcutaneous nodule on her abdomen showed a dense dermal infiltrate of immature myeloblastic cells with pleomorphic hyperchromatic vesicular nuclei and conspicuous nucleoli. A punch biopsy of the other small papule on her abdomen showed an infiltrate of granulocytic cells with round hyperchromic nuclei and granular acidophilic cytoplasm, between the dermal collagen bundles. We present a case of the cutaneous granulocytic sarcoma (chloroma) with coexistent leukemia cutis in acute myelocytic leukemia developed from myelodysplastic syndrome.
이형성 모반의 임상 및 병리조직학적 고찰 : Review of 15 Cases 15 예에 대한 고찰
이준영,이동원,신상부,조백기 대한피부과학회 2000 대한피부과학회지 Vol.38 No.8
Background: The dysplastic nevus is a rare form of melanocytic nevus, but the clinical criteria and histopathologic finding are still debated. There are no studies of dysplastic nevus in korea except a few case reports. Objective : This study was aimed to evaluate the clinical and histopathological characteristics of dysplastic nevus developed in korean. Methods: We reviewed the clinical and histopathologic finding of 15 patients diagnosed as dysplastic nevus on the biopsy. Results : The result were as follows; 1. The incidence of dysplastic nevus in our study was 9.9 cases/100,000 population 2. The subjects consisted of 9 males and 6 females. 3. The common onset of age was 11-20. 4. The common site of dysplastic nevus was the trunk. 5. The common pattern of lesional change was asymmetry and color variegation. 6. The common clinical findings of the dysplastic nevus was multiple, 5-12mm size, multipapular surface, ill-demarcated margin and brown/black color. 7. The pathologic findings including shoulder phenomenon, melanocytic nest, patchy lymphohistiocytic infiltration, melanophage, scattered atypical epitheloid cell, random atypia, anisokaryosis and no mitosis was shown in all the patients, but eosinophilic hyperplasia was shown in 13 patients. 8. The mild atypia in the Duke grading system was the most common. There was significant positive correlation between architectural and cytologic scores(Pearson correlation test, P$lt;0.05, r=0.97). Conclusion : Although the incidence of the dysplastic nevus in our study was much lower than that of the west, the clinicopathologic findings were not different.