Calcification of gastric carcinoma is unusual and most of the reported cases were of the mucinous type. This report describes two cases of papillo-tubular adenocarcinoma of the stomach with psammomatous calcification confined only to the papillary portion. Calcification was so heavy that specimen X-ray was able to clearly delineate its distribution. Microscopically, the calcification was confined to the papillary carcinoma area and was not found in the area of the tubular adenocarcinoma. Polymorphic calcific bodies were found in the supportive stroma of papillae and extrapapillary spaces as concentrically laminated psammoma bodies. They were also found in tumor cells as minute corpuscles. The mechanism of neoplastic mineralization in these cases seemed different from ontogenic calcification of mucinous gastric carcinoma and we postulated the mechanism of psammomatous calcification which is referred as intracellular calcification.
Adenocarcinoma, Papillary/surgery ; Adenocarcinoma, Papillary/pathology* ; Case Report ; Human ; Male ; Middle Age ; Stomach Neoplasms/surgery ; Stomach Neoplasms/pathology*

Adenocarcinoma, Follicular ; classification ; diagnosis ; pathology ; Carcinoma, Papillary ; diagnosis ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Thyroid Neoplasms ; diagnosis ; pathology ; surgery

Humans ; Female ; Carcinoma, Intraductal, Noninfiltrating/surgery* ; Thoracic Wall/pathology* ; Adenocarcinoma, Papillary ; Breast Neoplasms/surgery* ; Carcinoma, Ductal, Breast/pathology*

OBJECTIVETo evaluate the prognostic significance of micropapillary pattern (MPP) in adenocarcinoma of lung.

METHODSNinety-one consecutively excised cases of pulmonary adenocarcinoma, including follow-up data, were retrospectively studied. These tumors were divided into 2 major groups: those with MPP and those without MPP. The former was further subdivided according to extent of the micropapillary component, as follows: MPP + (constituting 1% to 10% of the tumor), MPP ++ (constituting 11% to 30% of the tumor) and MPP +++ (constituting more than 30% of the tumor).

RESULTSThe overall 5-year survival rate was 64.8%. The 5-year survival rates were 88.9% for stage I tumors, 46.2% for stage II tumors, and 23.8% for stage III tumor respectively (P = 0.000). The extent of micropapillary component showed no correlation with tumor stage, size and 5-year survival rate (P = 0.065, 0.358 and 0.206, respectively). On the other hand, the 5-year survival rate was 41.5% for patients in the MPP-positive group (number = 41) and 84.0% for patients in the MPP-negative group (number = 50). The percentage of nodal metastasis in MPP-positive group was also higher than that in MPP-negative group (P = 0.000). In pulmonary adenocarcinoma, this characteristic histology correlated with tumor stage and size, but not with patient's gender and smoking history. Within the same stage, the 5-year survival rates of MPP-positive and MPP-negative groups were as follows: for stage I, 78.6% versus 92.6% (P = 0.1548), for stage II, 30.0% versus 100% (P = 0.0598), and for stage III, 17.7% versus 28.6% (P = 0.4045).

CONCLUSIONSMPP in primary pulmonary adenocarcinoma, even when only constituting a minor component, predicts an aggressive clinical behavior and is associated with poor prognosis. Although it may not be an independent prognostic factor, presence of this histologic pattern should alert clinicians for more active treatment and closer follow up.

Adenocarcinoma ; pathology ; surgery ; Adenocarcinoma, Bronchiolo-Alveolar ; pathology ; surgery ; Adenocarcinoma, Papillary ; pathology ; surgery ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Lung ; pathology ; surgery ; Lung Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Analysis

Patients with nasopharyngeal foreign body sensation for 3 years, and had nasal obstruction in the past six months. electric nasopharyngoscopy: a irregular ellipse shape mass occupied in the nasopharynx, the mass surface is not smooth, with erosion ulcer and filthy secretions, the mass had a root in the back-end of nasal septum, and was adjacent to the bilateral round pillow. Sinus CT showed an irregular soft tissue shadow connected to the nasal septum backend in the nasopharynx, the size is about 2.8 cm X 3.5 cm, CT value is about 43 HU. Pathological examination: papillary adenocarcinoma.
Adenocarcinoma, Papillary ; diagnosis ; surgery ; Endoscopy ; Humans ; Nasal Obstruction ; Nasal Septum ; pathology ; Nasal Surgical Procedures ; Nasopharynx ; Tomography, X-Ray Computed

OBJECTIVEThe study is to explore the extent, main-point and use of en bloc principle in re-operation of thyroid carcinoma.

METHODSClinical data of 75 patients received re-operation from 2002 to 2006 because of nonstandard operation were reviewed, including 10 men, 65 women, age ranging from 21-56. Ipsilateral completing lobectomy, isthmectomy, ipsilateral anterior cervical muscle, and level VI dissection were done in all the patients by en bloc principle.

RESULTSResidual tumor was found in 39 cases. There were, 10 in primary site, 8 in VI level, and 21 in both. Therefore tumor residual rate was 52.0%. The total metastatic lymph nodes in VI level were 63. Among the eight patients with recurrent laryngeal nerves paralyses which were hurt in the first operation, 4 were found been cut completely, 4 were ligated. The ligated locations were all near the place which the nerve enter the larynx. The ligated nerves were released, and the patients voice was improved greatly.

CONCLUSIONSIpsilateral completing lobectomy, isthmectomy, ipsilateral anterior cervical muscle and VI level dissection is adequate for thyroid carcinoma patients who received nonstandard operation. The principle of en bloc resection can be used in the reoperation of thyroid carcinoma.

Adenocarcinoma, Papillary ; pathology ; surgery ; Adult ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm, Residual ; surgery ; Reoperation ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; methods ; Young Adult

Compared with other types of cancers, pancreatic cancer is one of the most dreadful malignancies and is fifth leading cause of cancer-related death in Korea. It is difficult to expect early diagnosis or improvement in prognosis due to lack of specific early symptoms and effective diagnostic methods. Whereas cystic neoplasm of the pancreas is a rare type of pancreatic tumor, surgical resection provides good prognosis because of its low possibility of local invasion or distant metastasis. In case of pancreatic cystic tumor, radiologic differentiation between benign and malignant lesions is crucial for the selection of appropriate treatment and the prediction of prognosis. And ductal adenocarcinoma of pancreas presenting in cystic form is an uncommon type of cystic tumor, making it extremely rare among all pancreatic malignancies. We report two cases of atypical pancreatic ductal adenocarcinoma presenting as solid pseudopapillary tumor and intraductal papillary mucinous neoplasm, respectively.
Adenocarcinoma, Mucinous/*diagnosis/surgery ; Adenocarcinoma, Papillary/*diagnosis/surgery ; Adult ; Carcinoma, Pancreatic Ductal/*diagnosis/pathology/surgery ; Female ; Humans ; Male ; Middle Aged ; Pancreatectomy ; Pancreatic Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

OBJECTIVE: To analyze the factors of lymph node metastasis in papillary thyroid microcarcinoma and to evaluate the significance of the selective neck dissection. METHOD: Records of 82 patients with papillary thyroid microcarcinoma were retrospectively analyzed. Sixty patients were received a selective neck dissection (Group 1), while twenty-two were not (Group 2). RESULT: In Group 1, 13 patients were found metastasis. The incidence of metastasis was 21. 67% (13/60). The frequency of nodal metastasis with a carcinoma < 0.7 cm was 4.76%, while > or = 0.7 cm was 30.77% (P < 0.05). All patients were followed-up from 9 to 14 years (mean 59.8 months). No patients relapsed or died, and no one was found distant metastasis. CONCLUSION The papillary thyroid microcarcinoma had a high tendency to metastasize. It is more significant to perform selective neck dissection in tumors > or = 0.7 cm.
Adenocarcinoma, Papillary ; pathology ; surgery ; Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neck Dissection ; Retrospective Studies ; Thyroid Neoplasms ; pathology ; surgery ; Young Adult

OBJECTIVE: To investigate the value of sentinel lymph node of papillary thyroid carcinoma exploring and measuring in the metastasis of the cervical lymph node of thyroid carcinoma. METHOD: The sentinel lymph node were investigated by injecting the methylene blue around 25 cases of thyroid tumors. The lymph nodes dyed in blue and obtained from selective lymph node dissection were examined by pathology, respectively. The value of the sentinel lymph nod were evaluated. RESULT: The sentinel lymph nodes dyed in blue were identified in 22 cases which account for 88.0% of all the 25 cases. Nineteen cases of the sentinel lymph node were positive by pathology, of whom 13 cases were verified positive in other area. Six cases were negative. CONCLUSION It is of great value that sentinel lymph node of thyroid carcinoma can indicate the metastasis of the cervical lymph node of thyroid carcinoma.
Adenocarcinoma, Papillary ; pathology ; surgery ; Adult ; Aged ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Sentinel Lymph Node Biopsy ; Thyroid Neoplasms ; pathology ; surgery ; Young Adult

OBJECTIVETo explore a cosmetic incision in the neck dissection for differentiated thyroid carcinoma.

METHODSAn extended collar incision was used for neck dissection in 82 consecutive patients with thyroid carcinoma from May 1999 to December 2006. The incision was designed to start as a conventional thyroid collar incision, and then to extend it along the skin crease to the anterior border of trapezium, so to avoid the vertical limb of conventional hockey stick incision. There were 60 females and 22 males in this series, with a median age of 40.5 years (range, 10 to 80 years). Ninety-six procedures of neck dissection were performed in 82 patients, including one radical neck dissection, one type I modified neck dissection, 8 type II modified neck dissections, and 86 type III modified neck dissections.

RESULTSThe average time of anesthesia was 197 minutes. The average dissected lymph nodes were 37.5, with average metastasis in 8.8 nodes. Eight patients (9.8%) developed complications related to neck dissection. The follow-up period in these patients were 1 to 96 months with a median follow-up time of 23 months. Cervical recurrence was found in only one patient (1.2%). Neither death nor distant metastasis was observed in this series.

CONCLUSIONIt is feasible to perform a modified neck dissection for differentiated thyroid cancer through the extended collar incision. The preliminary results show that the above described incision is not only oncologically safe, but also offers a cosmetic benefit for the patient with thyroid carcinoma.

Adenocarcinoma, Follicular ; pathology ; surgery ; Adenocarcinoma, Papillary ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Humans ; Hypocalcemia ; etiology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; adverse effects ; methods ; Thyroid Neoplasms ; pathology ; surgery ; Young Adult