KCP 807 대한세포병리학회 2014 봄 학술대회 슬라이드 세미나 가톨릭대학교 서울성모병원 전공의 4년차 조의주
Papillary carcinoma, classic type *Lymph node metastasis *Total thyroidectomy Papillary carcinoma, classic type *Lymph node metastasis Present at delphian, right central, left perithyroidal LNs *pT3N1a Total thyroidectomy Papillary carcinoma, classic type -bilateral , three masses, up to 0.3 x 0.2 cm -extracapsular invasion -lymph node metastasis present delphian, right central, left perithyroidal Pathology staging T3N1a
Papillary thyroid carcinoma Radiofrequency ablation Patient History 74/ M 2013.3 Total thyroidectomy Papillary thyroid carcinoma Radioactive Iodine Tx 2013.11 Right level 4 LN meta FNA- PTC 2013.12 Radiofrequency ablation LN- sono F/U 3months
8 months later Rt level 4 LN
8 months later Rt level 4 LN
Radiofrequency ablation (고주파절제술) *1mm 바늘, 일정 주파수의 교류 전류, 90~100도 *일반적으로 양성종양, 2cm보다 크고 점점 커지거나 증상이 있는 경우 *일부 전이와 국소 재발 병변의 치료 Anaplastic change 와 감별?
9months later Radiofrequency ablation
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
12 months later Rt level 4 LN
Differential diagnosis Metastatic papillary thyroid carcinoma Metastatic anaplastic thyroid carcinoma Other metastatic carcinoma or benign tumor
Final cytologic diagnosis Metastatic papillary thyroid carcinoma
우리 몸에 여러 장기에 적용하고 있음. 간암, 심장 부정맥, 각종 종양.
Indications Recurrent thyroid cancer (operation bed and lymph nodes) Surgery – standard treatment Can be used in patients at high surgical risk and in patients who refuse to undergo repeated surgery Preprocedural check list Histocytologic diagnosis of recurrence by US-guided FNA
크기가 커지는 갑상선결절..치료 후 소실됨.
evaluation of efficacy after RFA Cytologic changes & evaluation of efficacy after RFA
이번 연구를 통해 gastric pit dysplasia는 gastric adenocarcinoma 의 중요한 candidate precursor이고, intestinal type의 gastric adenocarcinoma의 pathogenesis의 또다른 morphologic step을 대표할 것으로 제안한다.