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정동해 ( Dong Hae Chung ),이승호 ( Seung Ho Lee ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.6
Primary retroperitoneal mucinous cystadenocarcinoma is an extremely rare tumor. Preoperative diagnosis is very difficult and the treatment remains controversial. A 37-year-old Korean woman (gravida0) presented with a huge abdominal mass. Computed tomography scan revealed an 18 × 11 cm sized unilocular cyst with irregular wall thickening and solid component at right adnexa. Serum CA 19-9 was slightly elevated (37.05U/mL). At laparotomy, a huge right retroperitoneal cystic tumor originating from right paracolic gutter was found. Frozen section of the cystic tumor revealed a mucinous cystadenocarcinoma. Because the patient wished to remain fertile, fertility sparing surgery was performed. Microscopically, no evidence of metastasis was found and no further treatment was given. Six months after surgery, she has no evidence of recurrence. Fertility-sparing surgery should be considered for women with primary retroperitoneal mucinous cystadenocarcinoma, who wish to remain fertile.
김동규 ( Dong Kyu Kim ),권오상 ( Oh Sang Kwon ),김주현 ( Ju Hyun Kim ),김형식 ( Hyung Sik Kim ),김연수 ( Yun Soo Kim ),정동해 ( Dong Hae Chung ),정영걸 ( Young Kul Jung ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
Granular cell tumors are rare benign tumors that arise from Schwann cells. They are especially rare in the gallbladder; indeed, only four cases have been reported in the English-language literature. This paper reports a granular cell tumor in the gallbladder and is the first such report in a Korean woman. She was admitted to the hospital with jaundice and fever and was diagnosed with acute hepatitis A. While hospitalized, a well-demarcated round mass was incidentally found in her gallbladder. The acute hepatitis A improved with conservative care, but the mass did not change in size after 4 months. The tumor was resected with the gallbladder during laparoscopic surgery, and was found to be a granular cell tumor. The tumor was composed of sheets or irregular fascicles of large polygonal or spindle cells with plump eosinophilic granular cytoplasm that was immunohistochemically positive for S-100 and neuron-specific enolase and negative for neurofilament. (Korean J Med 2012;83:624-628)
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.
소아에서 대장 림프결절증식의 임상적 및 병리조직학적 소견
남유니,이승현,정동해,심소연,은병욱,최덕영,선용한,조강호,류일,손동우,전인상,차한,Nam, Yoo-Nee,Lee, Seung-Hyeon,Chung, Dong-Hae,Sim, So-Yeon,Eun, Byung-Wook,Choi, Deok-Young,Sun, Yong-Han,Cho, Kang-Ho,Ryoo, Eell,Son, Dong-Woo,Jeon, In-S 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.1
목 적: 소아에서 대장의 림프 결절 증식은 비교적 드물다고 알려져 있으며 몇 예의 증례 또는 소규모 그룹에 대한 연구만 보고 되어 왔고 임상적인 의의가 아직 확립되어 있지 않다. 본 연구에서는 대장에 림프 결절증식 소견을 보였던 환아들의 임상적 특징, 검사 소견 및 조직학적 소견 등을 분석하여 이 소견에 대한 임상적 의의에 대하여 알아보고자 하였다. 방 법: 2003년 5월부터 2008년 10월까지 가천의대 길병원 소아청소년과에서 하부 소화관 내시경 검사를 시행 받은 환아들 중 검사 당시 육안적으로 대장의 림프결절 증식 소견을 보였던 38명을 대상으로 하였다. 내시경 검사를 받을 당시 성별, 연령, 출생력, 과거력 및 가족력을 조사하였으며 주 호소와 동반 증상, 식이 방법과 주요 신체 진찰 소견을 확인하였다. 혈액 검사, 대변 검사, 영상학적 검사를 시행하였으며 내시경 검사시 모든 환아에서 조직검사를 시행하여 이를 분석하였다. 내시경 검사 후 단기 및 장기 추적을 통해 증상의 경과를 관찰하였다. 결 과: 총 38명의 환아 중 남아가 24명(63.1%), 여아가 14명(36.9%)이었고 내원 당시 나이는 평균 12.5${\pm}$14.4개월이었으며 12개월 이하의 영아가 28명(73.6%), 13개월 이상의 소아는 10명(26.4%)이었다. 38명 모두 혈변을 주소로 내원하였다. 전체 환아 중 설사가 17명 (44.3%)으로 가장 많이 동반되었으며 점액성 변, 구토, 복통, 경구 섭취 부족, 발열, 변비 등의 동반 증상을 보였다. 모든 환아는 신체 진찰 상 비교적 건강해 보였다. 혈액 검사 상 헤모글로빈, 혈청 알부민, 혈액 응고 검사수치 등은 1예를 제외하고 모두 정상 범위였다. 대변세균 배양 검사, 영상학적 검사상 다른 출혈의 원인은 찾을 수 없었다. 조직검사 상 36예(94.7%)에서 림프 소절이 확인되었으며 34예(84.5%)에서 알레르기성 대장염의 조직학적 기준을 만족하였다. 단기 경과 추적이 가능했던 25명 중 20명에서 증상이 소실되었으며 장기경과 추적이 가능했던 33명 모두에서 증상이 호전되고 재발하지 않았다. 결 론: 대장의 림프 결절 증식 소견은 알레르기성 대장염과 관련하여 영아에서 더 흔하지만 소아 전 연령대에서 나타날 수 있다. 특히 비교적 건강한 소아에서 다른 하부 위장관 출혈의 원인을 찾을 수 없고 내시경상 LNHC를 보이면 이를 하나의 진단으로 간주할 수 있을 것이다. 증상은 식이 변경과 상관 없이 소실되었고 장기간 추적 관찰에서 재발하지 않아 양성 질환임을 확인할 수 있었다. Purpose: Lymphonodular hyperplasia of the colon (LNHC) is a rare finding in children and its significance as a pathologic finding is unclear. The aim of this study was to investigate the clinical significance of LNHC by analyzing clinical and histopathologic findings in children with LNHC. Methods: We analyzed data from 38 patients who were confirmed to have LNHC by colonoscopy. We checked age, birth history, past history, family history, and clinical symptoms. A hematologic exam, stool exam, and image studies were performed and biopsy specimens were examined by a pathologist. All patients were asked to have short- and long-term follow-up. Results: The mean age of the patients was 12.5${\pm}$14.4 months. All patients presented with complaints of bloody stool. They appeared healthy and the hematologic findings were within a normal range, with the exception of one case. There was no other identified source of bleeding. On histologic exam, 36 patients (94.7%) had lymphoid follicles and 34 patients (84.5%) fulfilled the criteria of allergic colitis. Regardless of diet modification and presence of residual symptom, there was no recurrence of bloody stool through long-term follow-up in all patients. Conclusion: LNHC is more common in infants who are affected by allergic colitis, but it can appear even after infancy. LNHC should be regarded as the etiology when there are any other causes of rectal bleeding, especially in healthy children. We suggest that LNHC has a benign course regardless of diet modification and it might not require excessive concerns.
박재홍,하승연,조현이,정동해,김나래,박상희,Park, Jae-Hong,Ha, Seung-Yeon,Cho, Hyun-Yee,Chung, Dong-Hae,Kim, Na-Rae,Park, Sang-Hui 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.2
We evaluated the usefulness of cervicovaginal cytology as a primary screening test by analyzing the cytologic and histological diagnoses of 2,254 women. Cervicovaginal cytology had 93.0% sensitivity, 86.1% specificity, 88.2% positive predictive value, and 91.7% of negative predictive value. Cervicovaginal cytology as a primary screening test showed much higher specificity but slightly lower sensitivity than HPV DNA testing. However, the sensitivity of cervicovaginal cytology will be improved continuously due to the development of liquid-based cytology. We regard cervicovaginal cytology as a good primary screening test for cervical intraepithelial neoplasia or carcinoma.
림프절에 발생한 랑게르한스 세포 조직구증의 세침흡인 세포소견 -1예 보고-
김민정,김교영,조현이,정동해,김나래,하승연,Kim, Min-Jung,Kim, Gou-Young,Cho, Hyun-Yee,Chung, Dong-Hae,Kim, Na-Rae,Ha, Seung-Yeon 대한세포병리학회 2007 대한세포병리학회지 Vol.18 No.1
Langerhans cell histiocytosis (LCH) is a pleomorphic disease entity characterized by local or disseminated atypical Langerhans cells (LCs) found most commonly in bone, lungs, mucocutaneous structures and endocrine organs. Among different sites, unifocal disease confined to a lymph node (LN) is rare. We report a case of LCH confined to a LN in a 38-year-old male who presented with a 2 cm-sized cervical mass. The fine needle aspiration (FNA) smears of cervical LN showed high cellularity having isolated LCs with contorted nuclei and nuclear grooves mixed in multinucleated giant cells, small lymphocytes and eosinophils. Charcot-Leyden crystals were also seen, as were a few dendritic-like cells and intranuclear inclusions. Confirmation of LCH was made by histopathologic studies, positive reactions for S-100 protein and CD1a immunohistochemical staining and by the demonstration of Birbeck granules on electron microscopy. The differentials to be considered include dermatopathic lymphadenitis, sinus histiocytosis with massive lymphadenopathy, Hodgkin's lymphoma and malignant histiocytosis. The characteristic cytomorphologic pattern of LCH in a LN FNA smear plays an important role in suggesting the diagnosis of LCH.
김나래 ( Na Rae Kim ),정동해 ( Dong Hae Chung ),백정흠 ( Jeong Heum Baek ),박연호 ( Yeon Ho Park ),경희은 ( Hee Eun Kyung ),노미숙 ( Mi Sook Roh ),하승연 ( Seung Yeon Ha ) 대한장연구학회 2010 Intestinal Research Vol.8 No.2
Squamous cell carcinoma of the rectum is extremely rare. Herein we report two cases of rectal squamous cell carcinoma. Case 1 was a 44-year-old Korean female presenting with abdominal pain and rectal bleeding for 3 months before her hospital visit. A colonoscopic examination revealed an ulcerated rectal mass 8 cm proximal to the anal verge. Chemoradiotherapy was administered following Hartmann``s procedure in case 1. The patient remained alive during 19 months of follow up. Case 2 was a 43-year-old Korean female who had severe constipation for 2 months. A barium enema and computed tomography of the pelvis showed a rectal mass adherent to the sacrum. Based on the results of a colonoscopic biopsy, a diverting colostomy was performed in case 2, with no further treatment. The pathologic findings showed that both tumors were composed of oval-shaped cells with abundant eosinophilic cytoplasm and intercellular bridges with keratin pearls, and thus were diagnosed as well-differentiated squamous cell carcinoma. Neither of the cases showed evidence of HPV infection. The pathogenesis of rectal squamous cell carcinoma has not been clarified. Herein we report two cases of rectal squamous cell carcinoma and briefly discuss the possible histogenesis. (Intest Res 2010;8:172-176)