The endoscopic mucosal resection is a useful method of both accurate diagnosis and treatment of gastric mucosal lesion and has been accepted as a standard procedure of early gastric cancer. Over the 3 year period from 1992 to 1994, 57 adenomas and 10 early gastric carcinomas were resected endoscopically at the St. Mary's hospital of Catholic University Medical College. The purpose of this study was to clarify the technical limitations of endoscopic mucosal resection with respect to size, location, methods. (continue...)
Adenoma* ; Diagnosis ; Stomach Neoplasms

40 patients diagnosed as cholangiome of which 9 patients diagnosed by biliary cell, 13 patients diagnosed by CT scanner, and 18 patients diagnosed by operation. The biliary obstruction in the general hepatic tube occurred in 95% of patients in which the lesion involved in the 2 branches of liver was 75%. The image of cholangiome in the film of cholangiography found that biliary fair stenosid (62,5%).
Adenoma, Bile Duct ; diagnosis

Tubular apocrine adenoma is a rare benign tumor occuring most often on the scalp. We examined a case of a 69-year-old female who had a well demarcated solid nodule on the scalp. Pathol Microscopically, the tumor was composed of lobules of tubular structures. The tumor lobules were surrounded by a stroma of dense fibrous connective tissue. The tubular structures were usually formed of two rows of epithelial cells. In some areas, the widely dilated tubular structures showed papillary projections into the cavities. Some epithelial cells showed liculoma on decapitation secretion into the cystic structure. Problems of differential diagnosis with other adnexal tumors are briefly discussed.
Female ; Humans ; Diagnosis, Differential ; Adenoma

BACKGROUND: The overexpression of cyclin D1 and galectin-3 and the loss of p27 in thyroid cancers have recently been reported by many studies. The S-phase kinase associated protein 2 (skp2) plays an important role in the degradation of p27. We compared the correlation of the expressions of galectin-3, p27, cyclin D1 and skp2 in thyroid lesions. METHODS: Sixty five cases were included in this study and immunohistochemical staining for galectin-3, skp2, p27 and cyclin D1 was performed. RESULTS: The expression of galectin-3 increased in the order of nodular hyperplasia, follicular adenoma, follicular carcinoma and papillary carcinoma (p<0.01). The expression rate of skp2 was 0% for nodular hyperplasia, 16.7% for follicular adenoma, 33.3% for follicular carcinoma and 16.7% for papillary carcinoma. The loss of the expression of p27 was more frequently detected in papillary carcinoma as compared with nodular hyperplasia (p<0.01). The increased expression of cyclin D1 was noted in follicular adenoma and carcinoma as compared with nodular hyperplasia (p=0.043). The expression of galectin-3 was related with the loss of a p27 expression (p<0.01), and the expression of skp2 was related with the expression of the cyclin D1 (p=0.022). CONCLUSIONS: Galectin-3 appears to be the most useful marker for making the diagnosis of thyroid lesions. The loss of a p27 expression can help differentiate nodular hyperplasia and papillary carcinoma, and the determining the expression of cyclin D1 may be helpful for the differential diagnosis of nodular hyperplasia and follicular neoplasm.
Diagnosis, Differential ; Adenoma ; Thyroid Neoplasms

A 54-year-old man had complained of proptosis on his right eye. Computed tomography showedlarge mass on superotemporal portion of right orbit. Surgical removal was done through the lateral orbitotomy. The histopathological diagnosis demonstrated pleomophic adenoma. Seven Years later, the patient revisited complaing of proptosis on his right eye. Magnetic resonance image demonstrated ill defined mass on the same iste. We excised mass including psuedocapsule and surrounding tissue.
Adenoma ; Adenoma, Pleomorphic* ; Diagnosis ; Exophthalmos ; Humans ; Middle Aged ; Orbit

BACKGROUND/AIMS: A villous tumor, histologically villous or tubulovillous adenoma, is a clinical challenge because of its higher potential for malignancy and higher recurrence rate. However, information and experience with these tumors in the Korean people is still lacking. For that reason, we designed this study to review and analyze the colonoscopic features, the potential for malignancy, and the treatiment with respect to the confirmation of guidelines for the accurate diagnosis and reasonable management of such tumors in the Korean population. MATERIALS AND METHODS: We performed 753 polypectomies, including 4 transanal excisions and several bowel resections, from January 1996 to May 1997 at Song-Do Colorectal Hospital in Seoul, Among them, 447 cases (59.4%) were adenomas, comprising 405 (53.8%) tubular adenomas, 31 (4.1%) tubulovillous adenomas, and 11 (1.5%) villous adenomas. We analyzed the 42 (5.6%) tubulovillous and villous adenomas.
Adenoma ; Adenoma, Villous* ; Colon* ; Diagnosis ; Rectum* ; Recurrence ; Seoul

OBJECTIVETo investigate the morphologic features and diagnostic criteria of various types pf renal adenomas of the kidney.

METHODSIn addition to light microscopy, electron microscopy, histochemical and immunohistochemical assays were applied. All 19 cases of adenomas were followed up.

RESULTSThree (3) cases of papillary adenoma were featured as papillary or tubulopapillary growth in patterns consisting of tumor cells with basophilic or acidophilic cytoplasm and were positive for both epithelial membrane antigen (EMA) and cytokeratin (CK7). Thirteen (13) cases of oncocytoma were characterized by the diversity of the structures including to be nest, tubular and papillary in pattern; a mixture of cell types including the classic oncocytes, oncoblasts and clear cells which were negative for vimentin and CK7 but positive for EMA. Enormous large mitochondria were obtained in 4 cases of oncocytoma by electronic microscopy. Three (3) cases of metanephric adenoma consisted of closely packed, round tubules lined by small bland cells with solid, glomeruloid constructure. Branching, elongated tubules and polypoid fronds were also detected. Tumor cells were negative for EMA, negative or only focally positive for CK7. Eighteen (18) patients were alive except one oncocytoma patient died 5 years after the diagnosis convinced. All the cases reported in this article had been followed up of 3 - 5 years.

CONCLUSIONSThere are 3 kinds of renal adenomas, namely, the papillary adenoma, oncocytoma, and metanephric adenoma and each kind has its own clincopathological features. The latter two can be recognized by their distinctive morphology, and the former can only be diagnosed according to the size of the tumor as the reference. Histochemical and immohistochemical assays are helpful in differential diagnosis.

BACKGROUND/AIMS: Magnifying colonoscopy was developed for detailed examination of the surface of colorectal neoplastic lesions. While magnifying colonoscopy is useful for differentiating neoplastic lesions from nonneoplastic ones, for evaluating early colorectal cancers, it still has limits in practice. This study was designed to clarify the usefulness and the limits of magnifying colonoscopy. METHODS: Three hundred and fifty-two lesions, which were observed using magnifying colonoscopy from July to August 1999 and whose histologies were proven, were analyzed according to their pit patterns. The pit patterns are I, normal round pits; II, large starry-shaped pits; IIIs, small round pits; IIIL, large round or rod-shaped pits; IV, branched or gyrus-like pits; and V, irregularly shaped or nonstructural pits. In cases where a pit pattern was hard to read, the pattern was classified as 'D'. RESULTS: The dominant pit pattern for protruded lesions was IIIL, accounting for 44.6%. In diminutive lesions (< or =5 mm), II and IIIL were equally common, 40% of the total for those lesions, respectively. In medium-sized lesions (from 6 to 10 mm), IIIL was the major pit pattern, 45.6% of the total for that type of lesion. In lesions larger than 10 mm, IIIL and IV were the most common pit patterns, each accounting for 26.7% of the total. The overall accuracy ratio of pit pattern diagnoses was 79.5%. The frequency of difficult pit patterns to read was 6.3%. Among them, 77.3% were due to difficulty in interpreting the pit patterns, and 22.7% were due to an inability to clarify the pit pattern because of poor staining. Ninety-one percent of the difficult cases to read involved diminutive lesions, and 86% of those difficult cases involved tubular adenomas. CONCLUSIONS: The 80% accuracy rate for pit pattern diagnosis suggests that magnifying colonoscopy is probably useful, but problems, such as poor staining due to mucus and difficulty with interpretation, still exist.
Adenoma ; Colonoscopy* ; Colorectal Neoplasms ; Diagnosis ; Mucus

Hyalinizing trabecular adenoma of the thyroid gland is a distinctive benign epithelial lesion exhibiting a prominent trabecular arrangement and stromal hyalinization. We recently recognized a hyalinizing trabecular adenoma of the thyroid that displayed potentially misleading features of papillary and medullary carcinomas. However the immunohistochemical features, i.e. thyroglobulin-positive and calcitonin-negative as well as its trabecular arrangement and surrounding abundant hyaline materials confirmed our diagnosis.
Adenoma* ; Carcinoma, Medullary ; Diagnosis ; Hyalin* ; Thyroid Gland*

Peutz-Jeghers syndrome is an autosomal dominant disease characterized by gastrointestinal ployposis and mucocutaneous melanin pigmentation involving the lip, oral mucosa, digits, palms and soles. The polyps are almost hamartomatous. The relationship of gastrointestinal carcinoma and the Peutz-Jeghers syndrome has been discussed for many years. The question is unsettled whether gastrointestinal carcinoma arise in hamartomatous polyps itself. Recently, there are a few reports that adenomatous and carcinomatous changes were superimposed upon the background of the hamartoma. Occasionally epithelial misplacement of the epithelium is found in the small intestinal polyps. Since the epithelial misplacement may involve submucosa, muscularis propria and serosa, a difficulty of histopathologic differential diagnosis between the epithelial misplacement and invasive adenocarcinoma cause overdiagnosis of cancer in the gastrointestinal polyps of Peutz-Jeghers syndrome. We present a case of Peutz-Jeghers syndrome of 39-year-old woman with multiple gastrointestinal polyps, two of which showed extensive epithelial misplacement even into the pancreas and another one at the colon showed carcinomatous change at the tip portion. Areas of hamartoma, adenoma and in situ carcinoma were noted in this colonic hamartomatous polyp. This case support that adenoma and carcinomatous changes may evolve directly within a hamartomaous polyp itself.
Female ; Humans ; Diagnosis, Differential ; Adenocarcinoma ; Adenoma