급성 췌장염은 췌장의 염증성 질환으로 췌장성 복수 및 가 성 낭종과 같은 합병증을 일으킬 수 있다. 이러한 합병증은 심할 경우 결장, 복막 및 장간막의 이차성 변화를 일으켜 복막암 종과 구별하기 어려울 수 있다. 본 증례의 환자는 타 병원에 서 급성 췌장염 및 합병증으로 발생한 가성 낭종을 치료하는 도중 복막암의 가능성이 있어 추가 평가를 위하여 본원으로 전원되었다. 복막암의 가능성을 배제하기 위한 복막 조직검사 없이 순차적인 시술적 접근을 통하여 췌관의 손상으로 발생한 췌장성 복수와 가성 낭종으로 진단할 수 있었다.

Acinic cell carcinoma is a well-differentiated, low-grade tumor that accounts for 1-3% of salivary gland tumors. Among the variant of acinic cell carcinoma, papillary cystic variant of acinic cell carcinoma is much more rare and it is known to be difficult to diagnose and has a poor prognosis. In this paper, we report a case of 58 - year - old man diagnosed as papillary cystic variant of acinic cell carcinoma and the characteristics of the lesion by integrating the recent cases of papillary cystic variant of acinic cell carcinoma. This study emphasizes the need for long-term studies and further investigation of papillary cystic variants of acinic cell carcinoma.

급성 췌장염 중에 1차 검사에서 원인이 불명확한 경우 급성 특발성 췌장염이라고 하며 그 중 종양에 의한 것은 비교 적 드물지만 진단이 늦어질 경우 예후가 좋지 않아 먼저 의심하는 것이 매우 중요하다. 본 증례는 급성 특발성 췌장염 환자에서 악성종양을 의심하고 적극적으로 추적관찰하던 과정에서 초음파내시경상 이상소견이 확인되었고, 적절한 시기에 수술을 결정하여 췌관내유두상점액종양 관련 침습 암을 진단한 경우이다. 따라서 원인이 불분명한 췌장염에 대해 악성종양을 의심하는 것이 필요함을 강조함과 동시에 초음파내시경의 추적관찰이 진단에 도움이 된 실제 사례를 보고함으로써 앞으로의 진료 및 의사결정에 유익할 것으로 보여 문헌과 함께 보고하는 바이다.

The purpose of this study is to evaluate which clinicopathologic factors are associated with central lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC). A total of 402 cases of PTC were divided into two groups: CNLM (+) and CLNM (-). In univariate analysis, CLNM showed correlation with sex, tumor size, multifocality, bilaterality, extrathyroid extension, and distance from the capsule. In multivariate analysis, male gender, >1 cm of tumor size, multifocallity and extrathyroid extension were significant risk factors for CLNM. Findings of this study suggest that clinicians should pay attention to the above mentioned significant risk factors when examining lymph node (LN) for deciding LN dissection.

Macrofollicular variant of papillary thyroid carcinoma (MFV-PTC) is a rare variant of papillary carcinoma. The tumors are easily misdiagnosed as benign due to their macrofollicular structures with bland-looking cytologic findings. The author experienced a rare case of MFV-PTC with pelvic bone metastasis 10 years after initial surgery. The patient was a 55-year-old female with a history of right thyroid lobectomy. The encapsulated nodule consisted of variable sized follicles with no nuclear atypia. The initial diagnosis was a nodular hyperplasia. She had recently suffered from pelvic discomfort due to metastasizing thyroid carcinoma. The thyroid was reevaluated and revised as MFV-PTC.

Marked neutrophilia associated with neoplasia is a relatively rare finding and has been considered as a paraneoplastic manifestation. Thyroid cancer seldom presents with paraneoplastic leukocytosis. We report on a case of a 69-year-old man who presented with paraneoplastic leukocytosis seven months after undergoing total thyroidectomy and I-131 therapy for treatment of papillary thyroidcarcinoma. We found neither bone marrow involvement of malignant cells nor hematologic malignancy. Based on elevated levels of serum granulocyte colony-stimulating factor, we concluded that the cause was paraneoplastic leukocytosis. Another interesting point was the anaplastic transformation in the pleural metastatic site. It usually occurs in the intrathyroid or regional lymph node.