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28 2019 43권 5호

구개에 발생한 가성림프종

저자 김민규, 박성민, 김문영

초록

Pseudolymphoma or benign lymphoid hyperplasia is an uncommon benign lymphoproliferative lesion that occurs very ralely in the oral mucosa, most commonly in the hard palate. It is important to differentiate between malignant lymphoma and pseudolymphoma with similar clinical and morphological symptoms. Clinically, pseudolymphoma is a firm, painless, nonulcerated, nonfluctuant, slowly growing mass or swelling on the one side of the palate. However, lymphoma at hard palate is unilateral, and some are hard, painful, or show evidence of bone destruction. The treatment of pseudolymphoma is local excision. Key words : Pseudolymphoma, benign lymphoid hyperplasia, Palate

27 2019 43권 5호

구강저와 하악골에 발생한 기저양 편평세포암종

저자 이준상, 김욱규, 황대석, 이준호, 최홍석, 최나래, 유미현, 김규천

초록

Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of squamous cell carcinoma arising in various anatomical sites. This article describes a case history of BSCC of the floor of mouth with mandibular involvement, and further discusses the appropriate management of such case with reference to the literature review. A 52-year-old male patient was referred to our clinic from another university hospital. Segmental mandibulectomy with supraomohyoid neck dissection and mandible reconstruction with left fibular free flap under general anesthesia was performed, followed by radiotherapy. Histopathological examination on the tumor lesion revealed features of squamous cell carcinoma with comedo-type necrosis. A diagnosis of BSCC was given by the oral pathology specialist. Basaloid squamous cell carcinoma (BSCC) is a biphasic variant of SCC with both basaloid and squamous cell histology. A recent report showed that there is no significant difference in the prognosis. Due to the lack of accumulated research, close follow-up and continuous research are deemed necessary. Treatment that focuses on the stage of the tumor is appropriate. A periodic follow-up observation is also very important due to the occurrence of distant metastasis to the lungs. Key words : Basaloid squamous cell carcinoma, Segmental mandibulectomy, Fibular free flap

26 2019 43권 5호

치은의 소아황색육아종

저자 김영관, 한다울, 양우익, 박진후, 조은애산드라, 김동욱

초록

Juvenile xanthogranuloma (JXG) is a benign histiocytosis that occurs in the pediatric population. Cutaneous JXG is the most common form, while extracutaneous lesions, including oral JXG, is extremely rare. Cutaneous JXG can occur as multiple lesions and may have systemic visceral involvement, but this is not seen in oral JXG. In this case, we report a solitary oral JXG at the gingiva in a 3-year old male. Key words : Juvenile xanthogranuloma, Oral cavity, Histiocytosis

25 2019 43권 5호

상악의 단발 림프종모양육아종증

저자 하태욱, 알파델 후세인 이브라힘, 한다울, 양우익, 김동욱, 조은애산드라

초록

Lymphomatoid granulomatosis (LYG) is an uncommon Epstein-Barr virus (EBV)-associated B-cell lymphoproliferative disorder distinct from lymphoma. LYG primarily occurs in the lung with or without accompanied lesions in the skin, central nervous system, kidney, gastrointestinal tract, nose, eyes, liver and oral cavity. Solitary extrapulmonary LYG is extremely rare, and whether solitary lesions progress onto pulmonary development and dysfunction is controversial. Herein, we report a case on a solitary LYG in the maxilla gingiva with bone exposure in a patient who had been taking methotrexate for rheumatoid arthritis. Key words : Lymphomatoid granulomatosis, Methotrexate, Maxilla, Epstein-Barr virus

24 2019 43권 5호

상하악골에 발생한 골내 골수지방종

저자 최재원, 팽준영, 안재명

초록

Myelolipoma is a benign tumor consists of mature adipocyte and hematopoietic elements. Mostly, this tumor locates in adrenal gland and it also can be found in extra-adrenal area. However, intraosseous myelolipoma is extremely rare. The etiology of this tumor is unclear but some hypothesis proposed that altered mesenchymal stem cell functioning and hormonal events act together in the pathogenesis of myelolipoma. With radiographic view, myelolipoma shows similar characteristics of other fat-containing tumors. The histopathologic examination is necessary for the definite diagnosis. This case report includes a patient with intraosseous myelolipoma of maxilla and mandible and literature review about the clinical, histopathologic, and radiologic features of myelolipoma. Key words : Myelolipoma, Radiographs, Histology

23 2019 43권 5호

치성기원에 의한 뇌농양

저자 장태환, 임대호

초록

Brain abscesses caused by odontogenic infection are a rare and life-threatening condition. When dental patients show neurological symptoms such as decreased consciousness, a brain abscess should be considered as a possible diagnosis. We reported that a 65-year-old man visited the emergency room because of left facial edema, high fever, limitation of mouth opening and decreased consciousness. CT, bone scan, and microbiologic examination revealed that the brain abscess originated from left mandibular osteomyelitis with an apical lesion in tooth #36. It was hard to diagnose the location of odontogenic infection. Because there were no evidence of submandibular abscess which is a common path of mandibular posterior infection, early diagnosis was difficult. MRI and radiographs such as facial CT and brain CT revealed procedure that inflammatory findings progressed through the coronoid process, the temporal space, into the subdural space. We compared the present case to previous cases, articles published after the year 2000 in Korea and abroad were investigated. The patient was treated successfully with extraction of causative teeth, drainage surgery, intravenous antibiotics by collaboration between the department of oral maxillofacial surgery and neurosurgery. It is difficult to diagnose brain abscess because central nervous system can be infected by various pathway. As shown in this case, patients with a brain abscess caused by a dental infection should be diagnosed and treated with a multidisciplinary approach. Key words : Brain abscess, Odontogenic infection, Osteomyelitis

22 2019 43권 5호

임플란트 식립 시 관찰된 하악의 방사선학적 골수 결손부위애 대한 감별진단

저자 송상진, 장희영, 유형근, 피성희

초록

Recently, a number of recent reports have reported cases of bone marrow defect (BMD) in the mandible. Among the diseases seen by BMD in radiographs, focal osteoporotic bone marrow defect(FOBMD) is asymptomatic, which is discovered incidentally and localized radiolucency. Because it varies in size, shape, trabeculae and border definition, it needs to biopsy to differential diagnose other intraosseous lesions that show radiological bone marrow defects. This cases report discusses the pre-operation considerations in patients planning to implant the mandible and suspected to have FOBMD in radiographs. The following 4 cases in Dental Hospital of Wonkwang University were taken in panoramic and Cone beam computed tomography(CBCT). In all cases, there were radiolucent lesion diagnosed with FOBMD under radiologic differential diagnosis. In three of cases the implant were placed without treatment plan change and one case changed the treatment plan with removable partial denture. BMD is anatomical state that can affect primary stability of implant fixture. During implant placement, it can lead to unexpected results that fixture is fallen into BMD and the nerve may be damaged after implant fixture removal to cause hyperesthesia. Preoperative diagnosis of these lesions by differential diagnosis with panoramic and CBCT can prevent the complications by changing the treatment plan or paying attention to the manipulation during surgery. Key words : Bone Marrow Diseases, Mandibular Prosthesis Implantation, Differential Diagnosis

21 2019 43권 4호

합성곱신경망 테스트 자료에 따른 파노라마 방사선 사진에서의 골다공증 판독의 차이

저자 임야곱, 이은주, 이재서, 강병철, 써얌 아다카리, 김형석, 윤숙자

초록

This study was conducted as part of a series of studies to introduce the Convolutional Neural Network(CNN) into the diagnostic field of osteoporosis. The purpose of this study was to compare the results when testing Digital Radiography(DR) and Computed Radiography(CR) panoramic radiographs by CNN that were trained by DR panoramic radiographs. The digital panoramic radiographs of females who visited for the purpose of diagnosis and treatment at Chonnam National University Dental Hospital were taken. Two Oral and Maxillofacial Radiologists were selected for the study to compare the panoramic radiographs with normal and osteoporosis images. Among them, 1068 panoramic radiographs of females{Mean [± standard deviation] age: 49.19 ± 21.91 years} obtained by DR method were used for training of CNN. 200 panoramic radiographs of females{Mean [± standard deviation] age: 63.95 ± 6.45 years} obtained by DR method and 202 panoramic radiographs of females{Mean [± standard deviation] age: 62.00 ± 6.86 years} obtained by CR method were used for testing of CNN. When the DR panoramic radiographs were tested, the Accuracy was 92.5%. When the CR panoramic radiographs were tested, the Accuracy was 76.2%. It can be seen that the CNN trained by DR panoramic radiographs is suitable to be tested with the same DR panoramic radiographs. Key words : CNN, Osteoporosis, DR panoramic radiographs, CR panoramic radiographs

20 2019 43권 4호

우측 경부 림프절에 발생한 키쿠치-후치모토씨 병

저자 정상환, 장한슬, 장성백, 권대근, 최소영

초록

Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease, KFD) is a benign self-limiting lesion that can self-heal when no severe symptoms are present. KFD resembles tuberculous lymphadenitis and malignant lymphoma. Thus, early differential diagnosis will minimize unnecessary evaluation and treatment. Histological examination of a lymph node biopsy or fine needle aspiration could be a reliable method for KFD diagnosis. This study reports a case of histiocytic necrotizing lymphadenitis of the right cervical lymph node in a 52-year-old female patient. According to the fine needle aspiration biopsy result, the patient was diagnosed with Kikuchi-Fujimoto disease and treated with prednisolone (15 mg/day). After treatment, there was no recurrence or adverse event. Key words : Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto disease, Fine needle aspiration biopsy, Prednisolone

19 2019 43권 4호

우측 상악골에 발생한 다방성 편평 치성 종양

저자 이원범, 김욱규, 박혜련, 유미현, 정연화, 황재준, 황대석

초록

Squamous odontogenic tumor (SOT) is a relatively rare, benign, small (rarely > 1.5 cm in diameter), but locally infiltrative and occasionally aggressive odontogenic epithelial lesion that appears to have harmatomous and neoplastic characteristics [1]. SOT is often asymptomatic, although it can present with mildly painful gingival swelling or tooth mobility. Radiographically, SOT is usually visualized as an irregularly or triangularly shaped unilocular radiolucency associated with the lateral roots of teeth. We report a case of the squamous odontogenic tumor occurring in a 60-year-old female in the right posterior maxilla with unusual radiographic and clinical appearances. Key words : Squamous odontogenic tumor, Maxilla, Radiolucency

18 2019 43권 4호

Sialadenoma popilliferum에 대한 사례보고와 문헌고찰

저자 김보현, HE YUZHU, SUN QIAOCHU, 김병국, 김옥수, 김영, 김옥준

초록

Sialadenoma papilliferum (SP) is a rare tumor that develops from salivary glands. First described by Abrams and Finck, the tumor shows a papillary form. The most frequent location of this tumor is the palate. In this case, we report a 63 year old man with a lesion located at the right retromolar of the mandible which might have caused bone resorption. Among with this case report, this paper discuss the feature of this rare tumor. The cases were searched from the pubmed website (https://www.ncbi.nlm.nih.gov/pubmed/) using the keyword ‘sialadenoma papilliferum’. Out of total 65 cases 41 patients were male and 19 patients were female. 4 patients were under the age of 20, 4 patients were between 21 and 40, 25 patients were between 41 and 60, 23 patients were between 61 and 80 and 4 patients were over 81 years old. The number of patients with the size of the lesion less than 1cm were 23, 16 patients had the size of 1cm to 2cm and 8 patients lesion were larger than 2cm. 22 lesions were located at the hard palate, 2 were at the soft palate, 6 were at the junction of hard and soft palate, 8 were at the buccal mucosa, 1 was at the upper lip mucosa, 3 were at the retromolar pad, 2 were at the tongue, 4 were at the parotid gland, 2 were at the floor of mouth, 1 was at the faucial pillar, 3 were at the bronchus, 1 was at the esophagus, 2 were at the nasopharynx, 1 was at the nasal septum, 1 was at the lung, 1was at the nasal cavity. In this case the lesion was found at an unusual location and although SP is known to be a benign tumor it may present bone resorption and have malignant characteristics. Key words : Sialadenoma papilliferum, Salivary glands

17 2019 43권 4호

우측 상악동에서 발생한 극세포형 법랑아세포종 유래 법랑아세포암종

저자 조극제, 김근환, 김호준, 신홍인, 권대근, 최소영

초록

Ameloblastoma is an odontogenic tumor characterized by various sites of metastasis, malignant transformation, and a high recurrence rate over time. Ameloblastic carcinoma(AC) is the term reserved for an ameloblastoma with histologic evidence of malignancy in the primary tumor. AC is classified into two types: most ACs occur de novo, and only few cases of malignant transformation of ameloblastoma become apparent. Here, we report a case of AC, arising from recurrent acanthomatous ameloblastoma on the maxillary sinus, in a 60-year-old male patient. The mass was first diagnosed as acanthomatous ameloblastoma; subsequently, surgical curettage was performed thrice while partial maxillectomy was performed twice. On the fifth recurrence, the tumor was identified as AC. Key words : Ameloblastic carcinoma, Metastasis, Acanthomatous ameloblastoma, Maxillary sinus

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