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경부 림프절에 전이한 정상피종의 세침흡인 세포학적 소견 - 1예 보고 -
장기택,박혜림,안진석,Jang, Kee-Taek,Park, Hye-Rim,Ahn, Jin-Seok 대한세포병리학회 2001 대한세포병리학회지 Vol.12 No.1
Fine needle aspiration cytology of the cervical lymph node was performed in a 63-year-old man who had had an orchiectomy for seminoma one year ago. The tumor cells were arranged in loose clusters, occasional sheets, or single cells. The nuclei were round to ovoid with fine or reticular chromatin, and had one or more prominent nucleoli. These cells were intermingled with lymphocytes in a characteristic foamy, lacelike background. Documented reports of the cytologic appearance of the seminoma are rare, especially in the metastatic lesion. The diagnosis of primary gonadal seminoma by fine needle aspiration cytology is probably not indicated since the treatment of primary gonadal tumor requires surgical resection. Because of the characteristic cytologic features, fine needle aspiration cytology may be helpful in evaluation of the extent of tumor spread in the patients with testicular tumors.
장기택 ( Kee Taek Jang ) 대한췌장담도학회 2014 대한췌담도학회지 Vol.19 No.3
Ampulla of Vater (AoV) is a small dilated duct less than 1.5 cm long, formed by the union of pancreatic duct and common bile duct. AoV has also anatomic layer of mucosa, sphincter of Oddi, perisphincteric or duodenal submucosa, and duodenal proper muscle, which corresponds to mucosa, muscularis mucosa, submucosa, and proper muscle layer of other gastrointestinal tract organs, respectively. Because of its small compact size and variation of anatomic structure, it is sometimes difficult to identify layering architecture of AoV. This anatomic difficulty may cause some problem in T classification of ampullary carcinoma (AC). The most confusing point in T classification is the vague definition of T2, “Tumor invades duodenal wall”. It seems that duodenal wall includes duodenal mucosa, submucosa, and proper muscle layer. However there is no precise description or definition about duodenal wall that might lead personal variation in T classification of AC staging. We found that clinical course of AC with perisphincteric and/or duodenal submucosal invasion is more close to AC with T2 than T1. Although it is described as T1b according to T classification scheme of ordinary gastrointestinal tract cancer, we thought AC with T1b may have more high-grade malignant potential than those of other gastrointestinal (GI) tract malignancy. AC showed various clinicopatholgic findings that represent heterogeneous tumor groups within category of AC. Recently sitespecific classification of AC was introduced, and it showed relatively well-categorized clinical prognosis. It may be reasonable to understand site-specific tumorigenesis in AC. The standard gross protocol is needed to evaluate pathologic T classification of AC. In conclusion, ampullary neoplasm is composed of various subtypes, which require a separate approach according to anatomic epicenter of ampullary neoplasm. Although submucosal invasion in AC was classified into pT1b, its` biologic behavior is more close to pT2.
Von Recklinghausen’s Disease 환자의 십이지장에 발생한 비기능성 Somatostatinoma 1예
김강재(Kang Jae Kim),장기택(Kee Taek Jang),김우석(Woo Seok Kim),최동욱(Dong Wook Choi) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.4
Somatostatinoma is a rare endocrine tumor that comprises around 1% of all gastroenteropancreatic endocrine neoplasm. The estimated annual incidence is 1 in 40 million. This tumor may be associated with von Recklinghausen’s disease. We present here a rare case of a 51-year-old female patient with a duodenal nonfunctioning somatostatinoma combined with von Recklinghausen’s disease. Whipple’ procedure was performed. The postoperative course was uneventful and the histopathologic findings were consistent with malignant nonfunctioning somatostatinoma with lymph node metastases. The patient is alive, healthy and without tumor recurrence 10 months after surgery.
김갑현 ( Kap Hyun Kim ),이규택 ( Kyu Taek Lee ),정현욱 ( Hyun Wook Jung ),박성현 ( Sung Hyun Park ),김종규 ( Jong Kyu Kim ),이광혁 ( Kwang Hyuck Lee ),이종균 ( Jong Kyun Lee ),장기택 ( Kee Taek Jang ) 대한소화기학회 2009 대한소화기학회지 Vol.53 No.4
The clinical manifestations of autoimmune pancreatitis (AIP) are diffuse pancreatic swelling, diffuse irregular narrowing of the main pancreatic duct, and increased serum IgG or positive serum autoantibody. Clinically, AIP can be improved dramatically with oral steroid therapy. In this report, we describe a 62-year-old woman diagnosed as autoimmune pancreatitis six years after onset of jaundice, who presented with uncontrolled blood glucose levels. The laboratory tests revealed obstructive jaundice, and the computed tomography of the pancreas showed pancreatic swelling. After six years of onset, she was diagnosed with AIP and successfully treated with steroid treatment. (Korean J Gastroenterol 2009;53:257-260)
바터팽대부암에 대한 근치적 수술 후 발생한 원격성 재발과 Ki-67, ㎚23-H1, VEGF 발현 및 임상병리학적 요인들과의 관련성
조성호(Sungho Jo),허진석(Jin Seok Heo),최성호(Seong Ho Choi),장기택(Kee-Taek Jang),오미정(Mi Jung Oh),최동욱(Dong Wook Choi),정준철(Jun Chul Chung),이승규(Sung Gyu Lee),김용일(Yong Il Kim) 대한외과학회 2006 Annals of Surgical Treatment and Research(ASRT) Vol.71 No.2
증례 : 소화기; 췌관내 유두상 점액종양을 동반한 국소종괴형 자가면역성 췌장염 1예
김효진 ( Hyo Jin Kim ),방희진 ( Hee Jin Bang ),장기택 ( Kee Taek Jang ),김정희 ( Jung Hee Kim ),장은영 ( Eun Young Jang ),최규 ( Kyu Choi ),이광혁 ( Kwang Hyuck Lee ) 대한내과학회 2014 대한내과학회지 Vol.86 No.4
자가면역성 췌장염에 대한 이해가 넓어짐에 따라 대부분의 경우에 수술적 절제 없이 진단되고 있다. 최근에 수술 후진단된 자가면역성 췌장염은 거의 모두 수술 전 검사에서췌장의 일부에만 이상 소견을 보이는 국소형으로 영상 검사에서 췌장암으로 오인되었던 경우이다. 저자들은 췌관내 유두상 점액종양과 그 주위로 국소 종괴를 형성하는 자가면역성 췌장염을 수술 전에 낭성 종양에서 발생한 췌장암으로 진단하고 수술한 증례를 경험하여 췌관내 유두상 점액종양과 병발한 자가면역성 췌장염을 국내 최초로 보고한다. 본증례는 췌장에 국소 종괴형으로 발생한 자가면역성 췌장염이 췌관내 유두상 점액종양 주위로 특히 심한 국소적인 림프형질세포의 침윤 및 섬유화를 일으켜 수술 전 영상 검사에서 낭성 종양을 동반한 췌장암과 감별이 어려운 증례였다. Autoimmune pancreatitis (AIP) has been increasingly recognized in recent years, and most cases are diagnosed without surgery. However, focal-type mass-forming AIP is difficult to differentiate from pancreatic cancer without surgical resection. A 61-year-oldmale patient with a clinical impression of pancreatic cancer underwent surgery. A postoperative pathologic examination showed lo-cally dense lymphoplasma cell infiltration and numerous lymphoid follicles with fibrosis and a low-grade intraductal papillary mu-cinous neoplasm (IPMN). Here, we report the first case of localized mass-forming AIP combined with a low-grade IPMN, which mimicked pancreatic cancer, in Korea. (Korean J Med 2014;86:466-471)