연부조직종괴로 오인된 늑골의 동맥류성 골낭종 - 증례 보고 -

이아원,이연수,조건현,이중달,김병기,Lee, Ah-Won,Lee, Youn-Soo,Jo, Gun-Huyn,Lee, Jung-Dal,Kim, Byung-Kee 대한근골격종양학회 2000 대한골관절종양학회지 Vol.6 No.4

동맥류성 골낭종(aneurysmal bone cyst)은 비종양성 팽륜성 골 병변으로 정확한 병인은 밝혀지지 않았지만 반응성 현상으로 생각되며, 다른 골 병변과 동반되거나 원발성으로 발생한다. 동맥류성 골낭종은 주로 장골과 척추골에 발생하며, 늑골에서 발생하는 경우는 드물다. 저자들은 좌측 첫번째 늑골에서 발생하였으며, 연부조직 악성 종양으로 오인되었던 동맥류성 골낭종 1예를 경험하였기에 보고하는 바이다. 19세 여자 환자가 좌측 견갑부에서 촉진되는 종괴를 주소로 내원하였다. 방사선학적 검사상, 광범위한 연부조직 병소이며 낭성구조로 이루어진 불균일한 양상이었고, 인접한 좌측 첫번째 늑골의 부분적 골소실이 있어, 연부조직에서 발생한 악성 종양 의진하에 절제술을 시행하였다. 절제된 종괴의 육안 소견상, 종괴 변연부를 달걀 껍질같이 얇은 한층의 골조직이 싸고 있는 것이 관찰되어 늑골 기원의 병변이라는 것을 알 수 있었다. 광학 현미경 검사상, 종괴는 큰 동맥류성 공간으로 이루어져 있었고 혈액으로 차 있었다. 동맥류성 공간사이를 피복세포가 없이 섬유성 격이 나누고 있으면서 여기에는 파골세포와 유사한 다핵 거대세포, 단핵세포, 유골과 섬유점액성조직이 관찰되었다. 병리 소견에 따라 재검한 MRI에서, 늑골에서 종괴의 변연부로 이어지는 얇은 골구조가 관찰되어 늑골에서 발생한 동맥류성 골낭종이 연부조직 쪽으로 광범위하게 돌출해 나온 것임을 알 수 있었다. Aneurysmal bone cyst(ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. We reported a case of ABC originating in the left first rib. The patient was a 19-year-old woman and presented with palpable mass on the shoulder. Chest X ray and MRI showed a large expansile mass, with multiple cystic areas, arising from the left first rib and bulging out into retroclavicular and paravertebral soft tissue, so the lesion was initially misdiagnosed as a soft tissue malignant tumor destructing adjacent rib. On histological examination, the mass, which was surrounded by a peripheral band of mature trabecular bone, consisted of multiple anastomosing cavernous blood channels separated by fibrous septa that containing osteoid, myxochondroid material and osteoclast-type giant cells.

유방의 낭내 유두상 암종의 세침흡인 세포학적 소견 - 1예 보고 -

이아원,최영진,이교영,김병기,김선무,심상인,Lee, Ah-Won,Choi, Yeong-Jin,Lee, Kyo-Young,Kim, Byung-Kee,Kim, Sun-Moo,Shim, Sang-In 대한세포병리학회 1997 대한세포병리학회지 Vol.8 No.2

Intracystic papillary carcinoma(IPC) of the breast is a distinctive and very rare variant of intrductal carcinoma. The cytologic features of IPC have been rarely reported, and there are difficulties in distinguishing between benign and malignant papillary breast lesions. Herein we report a IPC of the breast in a 80 year-old female. Fine needle aspiration cytology revealed monotonous cuboidal epithelial cells in small clusters and individually scattered on bloody background. The tumor cells did not show overt cytologic atypia. With the histologic features of this case and review of the literature, the cytologic differential points are discussed.

타액선 유두상-낭성 선방세포암종의 세침흡인 세포학적 소견 - 1예 보고 -

이아원,유진영,김병기,강석진,Lee, Ah-Won,Yoo, Jin-Young,Kim, Byung-Kee,Kang, Seok-Jin 대한세포병리학회 2001 대한세포병리학회지 Vol.12 No.1

Acinic cell carcinoma(ACC) is the third common malignancy in major salivary gland. Fine needle aspiration cytology is a useful tool for the diagnosis of salivary gland lesions. However, some low grade malignancies, such as ACC and mucoepidermoid carcinoma show relatively high false negative rate, mainly due to deceptively benign cytomorphologic appearance. We experienced a papillary-cystic variant of ACC, having different cytopathologic features compared with those of classic ACC. Our case showed monolayered sheets and papillary clusters without any acinic structures or naked nuclei of the tumor cells. Foamy proteinaceous material was seen in the background. The tumor cells had a large amount of granular cytoplasm and eccentric nuclei. Many vacuolated or clear cells were also noted.

혼합형 신경초 점액종

정소희 ( So Hee Jeong ),이동원 ( Dong Won Lee ),이준영 ( Jun Young Lee ),조백기 ( Baik Kee Cho ),박경신 ( Gyeong Sin Park ),이아원 ( A Won Lee ),이교영 ( Kyo Young Lee ),강창석 ( Chang Suck Kang ) 대한피부과학회 1998 대한피부과학회지 Vol.36 No.2

Nerve sheath myxoma or neurothekeoma, a rare cutaneous neoplasm probably originating from the nerve sheath, is classified into three groups as classical, cellular, and mixed types based on cellularity, mucin content and growth patterns. Only two cases of nerve sheath myxoma have been reported in the Korean literatures. We report a case of nerve sheath myxoma occurring on the scalp of a 29 year-old woman. It was identified as the mixed type by histopathological, immunohistochemical and electronmicroscopic findings. (Korean J Dermatol 1998;36(2): 367-371)

자궁경부 상피내병변에서 사람유두종바이러스 제자리부합법 및 L1 피각단백 면역조직화학염색의 임상적 유용성

정은선 ( Eun Sun Jung ),신정하 ( Jung Ha Shin ),이경지 ( Kyung Ji Lee ),김동철 ( Dong Chul Kim ),이아원 ( Ah Won Lee ),최영진 ( Yeong Jin Choi ),박종섭 ( Jong Sup Park ),이원철 ( Won Chul Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.12

목적: 자궁경부 상피내 병변 (CIN)에서 사람유두종바이러스 (Human papillomavirus, HPV) DNA의 숙주 유전체로의 통합은 중요한 자궁경부암화 단계이다. 사람유두종바이러스 제자리부합법 (HPV In Situ Hybridization)은 HPV 감염 여부와 더불어 HPV통합여부 (핵내 미만성 염색 양상, 부체성 (episomal); 반점상, 통합 (integrated))를 확인할 수 있다. 또한 HPV 통합이 일어나면 L1 피각단백은 발현이 중지되므로 L1 피각단백 면역염색은 HPV 통합의 간접적 증거로 간주된다. 이에 자궁경부 상피내병변에서 HPV ISH 및 L1 피각단백 면역조직화학염색을 시행하여 각각의 유용성을 살펴보고자 하였다. 연구 방법: 자궁경부 세포진검사와 조직검사를 통하여 CIN이 진단된 26명의 환자 및 평활근종 환자 19명에서 HPV ISH 및 L1 피각단백 면역조직화학염색을 시행하였다. 결과: HPV ISH는 80.8% (21/26)에서 양성이었으며 (미만성 34.6%, 미만성+반점상 46.2%) L1 피각단백은 세포검체에서 65.4%(17/26) 조직에서 15.4% (4/26)에서 양성이었다. CIN 등급이 높아질수록 HPV ISH 염색상 반점상 염색양상이 흔하게 관찰되었고 이는 통계적으로 유의하였으며 (P=0.007) L1 피각단백 발현 상태와 CIN 등급간 연관성은 확인 할 수 없었다. 결론: HPV ISH는 조직에서 HPV 감염 여부와 HPV 통합여부를 확인할 수 있는 좋은 검사법으로, CIN이 진행할수록 HPV 통합이 더 흔하게 관찰되었다. L1 capsid protein 염색법은 조직에서보다 세포 검체에 적합한 검사법이다. Objective: HPV in situ hybridization (ISH) is able to detect HPV DNA and identify integrated HPV DNA by punctuate staining and episomal HPV by diffuse staining in the nuclei. Because the expression of L1 capsid protein disappears after integration of HPV DNA, immunohistochemistry (IHC) of L1 capsid protein can be used as a indirect evidence of integration. Therefore, we tried to evaluate the usefulness of HPV ISH and IHC of L1 capsid protein in Cervical intraepithelial neoplasia (CIN). Methods: Twenty six cervical lesions from patients with CIN and 19 normal cervical epithelium from patients with leiomyoma were evaluated with HPV ISH and IHC of L1 capsid protein. Results: HPV ISH was positive in 80.8% (21/26) in CIN. Among 21 positive cases, diffuse staining was observed in 42.9% and punctuated and diffuse staining in 57.1%. L1 capsid protein was positive in 65.4% (17/26) of cervical tissue sections and 15.4% (4/26) of cervical smears. The punctuated staining of HPV ISH was correlated with high grade CIN (P=0.007) but expression of L1 capsid protein was not associated with grade of CIN (P>0.05). Conclusion: HPV ISH is a useful tool to identify integrated HPV DNA in paraffin-embedded, formalin-fixed cervical tissue. HPV integration confirmed by HPV ISH was associated with high-grade CIN. IHC of L1 capsid protein showed better result using cytology smears than tissue sections.

편평세포암종으로 오인된 와르틴 종양의 세침흡인 세포소견 -증례 보고-

이경지,정찬권,이아원,강창석,이교영,Lee, Kyung-Ji,Jung, Chan-Kwon,Lee, Ah-Won,Kang, Chang-Suk,Lee, Kyo-Young 대한세포병리학회 2005 대한세포병리학회지 Vol.16 No.2

We report a case of Warthin's tumor of the parotid gland in a 53 year old man, which is incorrectly diagnosed as squamous cell carcinoma. Fine needle aspiration cytology(FNAC) smear obtained from the right parotid gland revealed scattered epithelial cell clusters or nests in a diffuse inflammatory and necrotic background. Some epithelial cells had squamoid appearance showing variable sized bizarre shaped nuclei. They had abundant of dense eosinophilic keratinized cytoplasm. Occasionally, parakeratotic cells were also present. These cytologic findings with significant atypia and necrotic background made diagnosis as squamous cell carcinoma. But, the resection specimen from this patient showed classic Warthin's tumor in addition to abundant areas of inflammation and squamous metaplasia. Metaplastic or infarcted Warthin's tumor in the salivary gland may be confused with false positive diagnosis of malignancy on FNAC. Therefore, cytopathologist should have adequate awareness of potential of erroneous diagnosis in FNAC of Warthin's tumor.

신장의 투명세포 육종 1예

박재현,정재희,이아원,송영택,Park, Jae-Hyun,Jung, Jae-Hee,Lee, Ah-Won,Song, Young-Tack 대한소아외과학회 2001 소아외과 Vol.7 No.2

Clear Cell Sarcoma of the Kidney(CCSK) is a rare malignant childhood tumor with frequent metastasis to the bone. We report a case of right sided in a 5 month-old girl. A radical nephrectomy was performed. It was clinical stage III with renal capsular invasion and lymph node metastasis by the classification of NWTS-5. Histologic examination revealed the classic pattern of CCSK. Postoperative adjuvant chemotherapy with doxorubicin and radiotheraphy were applied.

질 확대경상 비정상 소견을 보인 환자에서 HPV DNA chip과 Hybrid-Capture II assay의 임상적 유용성 비교

김태정,정찬권,이아원,정은선,최영진,이교영,박종섭,Kim, Tae-Jung,Jung, Chan-Kwon,Lee, Ah-Won,Jung, Eun-Sun,Choi, Young-Jin,Lee, Kyo-Young,Park, Jong-Sup 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2

This study was performed to compare the efficacy between a DNA chip method and a Hybrid-Capture II assay (HC-II) for detecting human papillomavirus in patients with intraepithelial lesions of the uterine cervix. From May, 2005, to June, 2006, 192 patients with abnormal colposcopic findings received cervical cytology, HC-II and HPV DNA chip tests, and colposcopic biopsy or conization. We compared the results of HC-II and HPV DNA chip in conjunction with liquid based cervical cytology (LBCC) and confirmed the results of biopsy or conization. The sensitivity of the HPV DNA chip test was higher than HC-II or LBCC. The HPV DNA chip in conjunction with LBCC showed higher sensitivity than any single method and higher sensitivity than HC-II with LBCC. We confirmed that the HPV DNA chip test was more sensitive for detecting HPV in cervical lesions than HC-II, and that it would provide more useful clinical information about HPV type and its multiple infections.

소포성 갑상샘 유두암종의 세침흡인 세포검사의 정확도와 Galectin-3 면역염색의 유용성

정찬권,신정하,이현승,이아원,정은선,최영진,이교영,Jung, Chan-Kwon,Shin, Jung-Ha,Lee, Hyun-Seung,Lee, Ah-Won,Jung, Eun-Sun,Choi, Yeong-Jin,Lee, Kyo-Young 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2

The cytologic diagnosis of the follicular variant of papillary thyroid carcinoma (FVPTC) has become one of the common causes of false negative diagnoses when performing fine needle aspiration cytology (FNAC) of the thyroid gland. We retrospectively reviewed all the aspirates for which a diagnosis of FVPTC had been made based on the surgically excised specimens, regardless of the cytologic diagnosis. 145 FNACs was performed in 135 patients. The cytologic diagnoses were categorized as 2 unsatisfactory specimens (1.4%), 16 benign (11.0%), 49 atypical (33.8%) and 78 malignant lesions (53.8%). The tumor cells consistently showed significant nuclear overlapping, irregular nuclei and fine chromatin in all cases; however, nuclear grooves and inclusions were scarce. Galectin-3 immunostaining was performed on the cell blocks of 65 cases and this was positive for 45 cases (69.2%). The results of our study demonstrate that the determination of minimal cytologic criteria is needed to raise the sensitivity of detecting FVPTC by FNAC, and galectin-3 immunostaining is useful to make decisions on the surgical treatment of cytologically atypical thyroid nodules.

Role of MRI and Plain Radiograph to Diagnose Fibrous Dysplasia Mimicking Metastasis on PET/CT in a Patient with Breast Cancer

조송미,지원희,유이령,이아원,정양국,Cho, Song-Mee,Jee, Won-Hee,Yoo, Ie-Ryung,Lee, Ah-Won,Chung, Yang-Guk The Korean Musculoskeletal Tumor Society 2010 대한골관절종양학회지 Vol.16 No.1

Fibrous dysplasia is a common benign disorder of bone in which normal bone marrow is replaced with fibro-osseous tissue. As PET/CT is increasingly used for the staging of different malignant disease, incidentally found fibrous dysplasia with increased FDG uptake may mimic metastasis. We report on a 46-year-old woman with fibrous dysplasia who underwent PET/CT because of suspected recurrence of breast cancer and was misdiagnosed as a bony metastasis with a focal FDG uptake on left proximal femur. This lesion was interpreted as fibrous dysplasia based on MRI in addition to the plain radiographs. We conclude that MRI in addition to radiography may help to differentiate fibrous dysplasia mimicking metastasis on PET/CT in the patients with malignancy. 섬유형성이상은 골수가 섬유-골성 조직으로 치환되는 흔한 양성 골 질환이다. 암환자에서 병기의 결정과 추적 검사 시 암 전이의 발견에 PET/CT의 역할이 증가됨에 따라 우연히 발견된 FDG 섭취 증가를 보이는 섬유형성이상에서 암 전이와의 감별이 중요하다. PET/CT를 시행한 46세의 유방암 환자에서 좌측 대퇴골에 국소 FDG 섭취를 보여 암 전이로 의심되었으나 단순촬영과 자기공명 영상 소견에서 섬유형성이상으로 진단한 환자의 증례를 보고하고자 한다. 이 환자에서 단순활영과 자기공명영상 소견은 PET/CT에서 유방암 전이로 오인된 섬유형성이상의 감별에 도움이 되었다.