1.Transcatheter Renal Arterial Embolization of a Polycystic Kidney for Control of Persistent Hemorrhage.
Min Kyoung KANG ; Mi Jung KANG ; Hyun Chul KIM ; Sung Bae PARK ; Hong KIM
Korean Journal of Nephrology 2001;20(5):922-925
We report a patient with autosomal dominant polycystic kidney disease(ADPKD) undergoing maintenance hemodialysis who underwent transcatheter arterial embolization(TAE) of the renal arteries to control the persistent renal hemorrhage. In 1991, the patient had been diagnosed as having ADPKD by computed tomography(CT) of abdomen. In 1997, the patient started hemodialysis. In October 2000, she was admitted to our hospital because of gross hematuria and both flank pain. Abdominal CT showed marked enlargement of the bilateral kidneys with numerous cysts. Renal angiography using the Seldinger technique showed stretched and deformed segmental renal arteries without active bleeding. Renal hemorrhage was continued despite of medical treatment. TAE with stainless steel coils was performed on both renal arteries. Renal bleeding was stopped immediately after TAE and anemia was improved and stabilized thereafter. Follow-up CT after five months later TAE showed the marked decrease in size of both kidneys, and patient's abdominal symptoms were disappeared too. This report shows that TAE is a safe and effective therapy for ADPKD patients with persistent renal bleeding refractory to medical therapy.
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2.Immunohistochemical Observation on the Plasma Cells Secreting Specific and Non-specific Anti-body to Parasite in Soft Tissue Cysticercosis.
Eon Sub PARK ; Suk Il KIM ; Kye Yong SONG
Korean Journal of Pathology 1988;22(4):367-374
In order to elucidate the possibility of diagnosis in soft tissue cysticercosis in case no parasite in it, immunohistochemical staining with antihuman IgG, IgM, and IgA and anticysticercus antibody in tissue section were carried out. Not only the differential counts of infiltrated plasma cells but also the parasite itself against to the anticysticercus antibody were observed. Materials stained immunohistochemically were consisted of 21 soft tissue cysticercosis with or without parasite. The results were as follows: 1) IgG producing plasma cells were most frequent (45.8+/-18.7) and followed by IgM (14.3+/-0.43) and (4.3+/-5.71). Number of IgG plasma cells were more frequently accompanied in the presence of cysticercus (55.9+/-17.7) than in the absence of parasite (39.7+/-17.1). 2) The mean+/-S.D. of plasma cells positive to the anticysticercus antibody were 28.2+/-18.7. And anticysticercus antibody producing plasma cells were more frequent in the presence of cysticercus (49.2+/-5.16) than in the absence of parasite (15.2+/-9.46). 3) Antigenicity of the cysticercus was strong in inner layer(#) followed by tegument(+) and fibrous layer(-). 4) Therefore, it could be suggested that antibody against to the cysticercus is mainly produced by IgG plasma cells and antigenicity of the worm is strong in the inner layer of cyst wall. In addition, there is a possibility of assisting the diagnosis of cysticercosis with anticysticercus antibody by immunohistochemically.
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3.Ciliated Foregut Cyst of the Liver: Report of a case.
Yun Kyung KANG ; Yong Il KIM ; Hyun Soon LEE ; Soong Duk LEE ; Kuk Jin CHOE
Korean Journal of Pathology 1991;25(3):278-280
We report a case of ciliated hepatic foregut cyst which was incidentally found in a 64 year-old man. The cyst, 6 cm in diameter, was unilocular, solitary and was located in the medial segment of left lobe, just below the Glisson's capsule. Microscopically, the cyst wall consisted of 4 layers; pseudostratified ciliated columnar epithelium, subepithelial loose connective tissue, smooth muscle bundles and an outermost fibrous capsule. Although cartilage or subepithelial sero-mucous glands were absent, the morphologic features of the cyst correspond with those of an incomplete form of brochogenic cyst.
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4.Gastric Duplication.
Hee Na KIM ; Chang Seok KANG ; Sang In SHIM ; Sun Moo KIM
Korean Journal of Pathology 1988;22(2):148-153
Gatric duplication is a rare congenital anomaly. Thus for about 90 cases of gastric duplication have been recorded in the literature. It is less frequent than small intestinal or eosphageal duplication, and accounts for only 3.8% of all gastrointestinal tract duplication. Most gastric duplications are seen during the first year of life. Palpable abdominal mass and gastric outlet obstruction in infancy are most common presentation. We experienced a case of non-communicating gastric duplication. A 12-year-old girl visited St. Mary's Hospital because of indigestion, intermittent vomiting, and left upper quandrant pain for about 40 days. She have had intemittent abdominal pain with concomitant increased level of amylase since 5 years old. Physical examination showed a hen's egg sized palpable mass on left upper quadrant of the abdomen. Upper GI series and barium enema revealed only indentation of duodenal C-loop, and sonogram and abdominal CT demonstrated isolated cystic mass along the greater curvature of gastric antrum. She had taken an operation under the impression of pancreatic pseudocyst. Operation revealed a cystic mass, located along the greater curvature. There was no pathologic change in the pancreas. Microscopic findings of the cyst wall revealed normal gastric mucosal lining and common muscle layer, shared with gastric antral muscle layer.
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5.Ruptured or Dissected Popliteal Cyst in Patients with Calf Symptoms.
Jun Ki MIN ; Seung Ki KWAK ; Zee A HAN ; Mi Sook SUNG
The Journal of the Korean Rheumatism Association 2008;15(3):212-221
No abstract available.
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6.Histologic Variations of Intramural Heterotopic Pancreas in Gastrointestinal Tract Analysis of 15 Cases.
Seung Sook LEE ; Yong Il KIM ; Woo Ho KIM ; Eun Sil YU
Korean Journal of Pathology 1991;25(6):520-527
We reviewed a total of 15 cases of heterotopic pancreatic tissue within the gastrointestinal wall(intramural type), and compared with 3 extramural ones. Intramural heterotopic pancreatic lesions were located in the antrum(33%), pylorus(20%), and body of stomach(7%), and the remainders in the duodenum(40%). Only two cases presented with chinical symptoms by their existence. Two of them were situated within the submucosa, 3 in the muscularis, 6 in submucosa-muscularis, 2 in the muscularis-subserosa, and 1 in the susbmucosa-subserosa. Intramural type was featured with their structural heterogeneity compared to the extramural ones; 10 cases showed participation of gastrointestinal mucosal elements, and some accompanied tissue elements that were indistinguishable from submucosal epithelial heterotopia or microduplication cyst of the stomach. Langerhans islets were found in 67%, and one developed islet cell tumor. The above results suggest that the initially engrafted heterotopic pancreatic tissue becomes modified and presents with heterogeneity of endodermal and mesodermal tissue-derived components by its intramural growth during the gastrointestinal organogenesis; failure of opening of its drainage system into the gastrointestinal lumen may result in the increase of intraductal pressure with subsequent atrophy of the acinar tissue and various metaplastic changes of ductal epithelium, aside from induction of smooth muscle coat around the heterotopic tissue.
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7.Congenital Cystic Disease of the Lung.
Korean Journal of Pathology 1986;20(2):215-221
Congenital cyst of the lung is a type of rare pulmonary disease. This lesion was initially introduced by Morgagni in 1769. Thereafter many other cases were reported. Etiology or developemental pathogenesis of this lesion is not certain, but abnormal developement of embryonic lung bud during the embryonal period is highly suspected. This lesion is two times more frequently located at the left lung, but both sides of the lung may be involved. This lesion is largely asymptomatic and found incidentally but can be evoked respiratory symptoms and also can be died due to only this lesion. So accurate diagnosis and treatment in the early period are very important. Therefore, 32 cases of congenital cyst of the lung reported at the department of pathology, seoul national university hospital from 1. 1986 to 12. 1984 were reviewed and classified with clinical, gross and microscopic findings based on the Buntain's classification. Among 32 cases of congenital cyst of the lung, 16 cases were bronchogenic cysts and were largest in number, 8 cases were pulmonary sequestration, 6 cases were congenital cystic adenomatoid malformation (CCAM) and 2 cases were pulmonary emphysema. In cases of bronchogenic cyst, involved age was variable from 7 months to 51 years and large cases were asymptomatic. Grossly, 15 cases were solitary cyst and only one case was multiple. Size was also variable from 3 cm to 11.5 cm. Microscopically, cyst wall was lined by pseudostratified ciliated columnar epithelium with gobet cells, mucous secreting glands, smooth muscle fibers and fibrous interstitial tissue. Three cases were also exhibit cartilage at the wall. In cases of CCAM, there were involved below the 7 months old boys and girls. Four cases were confirmed at the autopsy, other 2 cases were confirmed at the surgical specimens which were found incidentally or due to generalized cyanosis. Microscopic findings were similar in all cases showing relatively well demarcated multiple small cysts with adenomatous proliferation. Lining epithelial cells were tall columnar, pseudostratified ciliated columnar epithelium with occasional mucous secretion. Stroma also exhibit adenomatous proliferation lined by simple columnar or cuboidal epithelium. In cases of pulmonary sequestration, 7 cases were intrapulmonary, other one case was extrapulmonary sequestration. In five cases, systemic large vessel were confirmed. Microscopically it was composed of irregularly dilated bronchiolar structures lined by pseudostratified ciliated columnar epithelium.
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8.Congenital Cystic Adenomatoid Malformation of the Lung: Clinicopathologic analysis of 22 cases.
Young Lyun OH ; Yeon Lim SUH ; Je G CHI
Korean Journal of Pathology 1994;28(3):219-227
Congenital cystic adenomatoid malformation of the lung(CCAML) is a rare developmental anomaly characterized by an "adenomatoid" hyperplasia of terminal respiratory structures with formation of the cysts of varying sizes. CCAML is separated into three major types based on the gross and microscopic findings. We have analyzed 22 cases of CCAML, those consisted of 6 autopsy cases and 16 surgical specimens. Out of 22 cases, 5 cases were composed of large cysts(type I) and 9 cases had multiple small cysts(type II). Remaining one case revealed features of solid type(type III), and 7 cases were mixed form. There were 16 boys and 6 girls. All cases were below the age of 14 years. There was no clear-cut age difference between different types of CCAML. However, inflammation, fibrosis and pseudostratification of epithelium were often found in older age. All fetal autopsy cases of CCAML had hydrops fetalis and were associated with maternal hydramnios. One case of type III showed definite mucinogenic cells in the cysts unexpectedly, and one case of the mixed form(typeI+II+III) was found in a fetus of 22 weeks of gestational age. Above findings contradicted the classical description of the CCAML, and suggested that arbitrary classification into three types may not be the best way in understanding this condition.
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9.Treatment of Simple Renal Cysts by Percutaneous Aspiration and OK-432 Sclerotherapy.
Sung Jin PARK ; Won Sik HAM ; Won Tae KIM ; Dong Hoon LEE ; Soung Yong CHO ; Kang Su CHO ; Young Deuk CHOI
Korean Journal of Urology 2008;49(10):917-922
PURPOSE: Percutaneous aspiration with sclerotherapy has been widely used for the treatment of symptomatic or large simple renal cysts. Ethanol has been most commonly used as a sclerosing agent; however, a temporary percutaneous nephrostomy for multiple ethanol injections is necessary to achieve a low recurrence rate. Thus, we used OK-432 as a new sclerosing agent without a temporary percutaneous nephrostomy for multiple injections, and also compared our results with the results of previous studies. MATERIALS AND METHDOS: Between October 2005 and April 2006, 50 patients (63 simple renal cysts) who underwent percutaneous OK-432 sclerotherapy for simple renal cysts were evaluated. The simple renal cysts were aspirated under ultrasonography and fluoroscopy, after which OK-432 was injected into the cyst. Follow-up was performed with ultrasonography or CT scan after 3 months. Regression of the renal cyst or a >70% reduction in size with no symptoms was considered a treatment success. RESULTS: Among 63 renal cysts in 50 patients, complete regression occurred in 17(27.0%). Greater than a 90% reduction in size occurred in 8(12.7%), a 80-90% reduction in size occurred in 21(33.3%), and a 70-80% reduction in size occurred in 15(23.8%); a <70% reduction in size occurred in 2 (3%). The overall efficacies of success were 96.8%. After the procedure, there were only some minor complications, such as mild fever, local pain, and liver function test elevation that subsided with symptomatic treatment. CONCLUSIONS: Percutaneous OK-432 sclerotherapy is simple, safe, and effective and can be an alternative first-line therapy of simple renal cysts.
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10.Epidermoid Cyst of the Ovary: Two case reports.
Hyuni CHO ; Yu Hoon KIM ; Eun Suk NAM ; Insun KIM
Korean Journal of Pathology 1995;29(6):811-814
Two cases of epidertnoid cyst of the ovary are added to the ten reported in the literature. This rare lesion is usually an incidental finding. Its main interest is in its histogenesis, which includes metaplasia of the coelomic surface epithelium, monophyletic development of teratoma, and metaplasia of the rete ovarii. We investigated two cases of epidertnoid cyst. Histologic examination of the cysts showed a thin lining of mature keratinizing squamous epithelium rectum: unaccompanied by skin appendages or other teratomatous elements.
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