Depressed-Type of Early Colon Cancer with Extensive Lymph Node Metastasis

Early colorectal cancer (ECC) is defined as invasive tumor limited to the colonic and rectal mucosa or submucosa, regardless of the presence or absence of lymph node metastasis. The incidence of lymph node metastasis in ECC ranges from 0 to 15.4%, and risk factors include depth of submucosal invasion, growth patterns (polypoid or non-polypoid), histologic subclassification, and lymphatic invasion. Of non-polypoid growth patterns, the depressed types of colorectal cancer have higher malignant potential than polypoid types, even for small sizes. Unfortunately, this type is also difficult to detect on colonoscopic examination. In this report, we describe a case of depressed type ECC with extensive lymph node metastasis without regional lymph node involvement.

A Case of Bronchiolitis Obliterans Organizing Pneumonia Following CHOP Chemotherapy and Filgrastim Use in a Patient with Diffuse Large B-cell Lymphoma / 결핵및호흡기질환

Bronchiolitis obliterans organizing pneumonia (BOOP) is often diagnosed in patients with pneumonia who respond poorly to antibiotics. BOOP is often idiopathic, and the etiology of the remaining cases has been attributed to a wide range of agents or medical conditions. When a patient develops the clinical symptoms characteristic of BOOP, the medical team must endeavor to determine the etiology of this disease because it can be treated with glucocorticoid and avoidance of the causative agent. In particular, if BOOP is diagnosed during or after chemotherapy for a malignancy, the possible culprit agent can be the anti cancer drugs but other drugs used for supportive care must be also be considered. We report a case of BOOP that arose after CHOP chemotherapy and a filgrastim injection in a patient with a diffuse large B-cell lymphoma.

Recurrent Secondary Pneumothorax Caused by Bronchiolitis Obliterans Due to Chronic Graft Versus Host Disease in a Patient with Chronic Myelogenous Leukemia after Allogenic Bone Marrow Transplantation / 결핵및호흡기질환

Bronchiolitis obliterans (BO) is a nonspecific inflammatory injury affecting primarily the small airways. Its inflammatory process is characterized by fibrotic obliteration of the lumen of bronchioles. BO can be idiopathic or associated with connective tissue disease, inhaled toxins, infections, drugs, and chronic graft-versus-host-disease (GVHD). Pulmonary complications occur in 40~60% of patients who undergo allogeneic bone marrow transplantation (BMT), causing 10~40% of transplant-related deaths. BO is a characteristic pulmonary complication which occurs usually within a few years after BMT. Documented complications of BO include air-leak syndromes such as pneumomediastinum, subcutaneous emphysema and pneumothorax. We report a case of a 30-year-old male patient with BO due to chronic GVHD after allogenic BMT who presented with recurrent bilateral pneumothoraces.