Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is common in young Asian women under the age of 30, and is usually characterized by fever, myalgia, fatigue, and cervical lymphadenopathy. Because patients with KFD often present with necrotic lesions that are also features of lymph node metastasis, ipsilateral or bilateral lymph node enlargement in head and neck cancer patients can be disguised as lymph node metastasis. We present an unusual case of KFD mimicking bilateral metastatic papillary carcinoma of the thyroid. This study emphasizes that KFD should be considered when diagnosing lymph nodes with necrotic lesions but without malignant cells in young women.

BACKGROUND AND OBJECTIVES: To compare the simple spitting method and the Salivette® method of collecting saliva for detecting pepsin in patients with laryngopharyngeal reflux disease (LPRD). SUBJECTS AND METHOD: Thirty-two patients diagnosed with LPRD by 24 hour multichannel intraluminal impedance and pH monitoring were enrolled prospectively. The amounts of pepsin in saliva determined by the simple spitting method and the Salivette® method were compared. RESULTS: Simple spitting showed higher sensitivity, specificity, accuracy, positive predictive value and negative predictive value. There was no statistically significant difference between the amount of pepsin detected by simple spitting (10.07±11.68 ng/mL) versus that detected using the Salivette® method (7.09±7.27 ng/mL) (p=0.258). CONCLUSIONS: The simple spitting method has higher sensitivity, specificity and accuracy than the Salivette® method for detecting pepsin in patients with LPRD.
Electric Impedance ; Humans ; Hydrogen-Ion Concentration ; Laryngopharyngeal Reflux* ; Methods* ; Pepsin A* ; Prospective Studies ; Saliva* ; Sensitivity and Specificity

No abstract available.
Autonomic Nervous System ; Hypohidrosis* ; Reflex, Abnormal*

Benign fibrous histiocytoma (BFH) is a rare benign primary skeletal tumor that occurs commonly in the long bones, spine and pelvis. BFH constitutes a diagnostic challenge because it shares clinical background, radiological characteristics, and histological features with other fibrous lesions such as non-ossifying fibroma, giant cell tumor. We present a case of BFH with cystic change that occurred in the distal femur. We did not identify any case of BFH with cystic change involving the majority of the lesion that occurred in the metaepiphysis of the long bone.
Femur* ; Fibroma ; Giant Cell Tumors ; Hemorrhage ; Histiocytoma, Benign Fibrous* ; Pelvis ; Spine

Edwards syndrome, also called trisomy 18, is one of the most common autosomal anomalies. The survival rate of patients with Edwards syndrome is very low and its characteristic findings include cardiac malformations, mental retardation, growth retardation, specific craniofacial anomalies, clenched hands, rocker-bottom feet, and omphalocele. Compared with the classic Edwards syndrome, the symptom of partial duplication of chromosome 18 is relatively mild with a good prognosis. We report the case of a baby with partial duplication 18q11.2-q12. The characteristic phenotype features of Edwards syndrome were observed in the patient. However, the symptom was milder than the typical Edwards syndrome. At present, we can expect better prognosis for this patient.
Chromosomes, Human, Pair 18 ; Foot ; Hand ; Hernia, Umbilical ; Humans ; Intellectual Disability ; Phenotype ; Prognosis ; Survival Rate ; Trisomy

Inflammatory pseudotumors, which clinically mimic neoplasms, are space-occupying collections of inflammatory cells, histiocytes, and fibroblasts. They are most often found in the orbits and lungs, but rarely in the head and neck region, and hardly ever in the nasal septum. Here we report on a 71-year-old woman with pseudotumor cerebri and an inflammatory pseudotumor of the nasal septum. This case demonstrates that inflammatory pseudotumor can cooccur in the brain and nasal septum.
Aged ; Brain ; Female ; Fibroblasts ; Granuloma, Plasma Cell* ; Head ; Histiocytes ; Humans ; Lung ; Nasal Septum* ; Neck ; Orbit ; Pseudotumor Cerebri

“Saber-sheath” trachea is a deformity of lower cervical or intrathoracic trachea. The configuration of the deformity is marked coronal narrowing associated with sagittal widening. This deformity is associated with chronic obstructive pulmonary disease. We report a case of patient with saber-sheath who underwent total laryngectomy. Although the patient had no tracheal collapse after the total laryngectomy, crusted discharge was increased. Diagnosis of the saber-sheath trachea, possible causes, and clinical implications are discussed.
Congenital Abnormalities ; Diagnosis ; Humans ; Laryngectomy ; Pulmonary Disease, Chronic Obstructive ; Trachea

In males, precocious puberty (PP) is defined as the development of secondary sexual characteristics before age 9 years. PP is usually idiopathic; though, organic abnormalities including tumors are more frequently found in male patients with PP. However, advanced puberty in male also can be an important clinical manifestation in tumors. We report 2 cases of rapidly progressive puberty in males, each associated with a germ-cell tumor. First, an 11-year-old boy presented with mild fever and weight loss for 1 month. Physical examination revealed a pubertal stage of G3P3 with 10-mL testes. Investigations revealed advanced bone age (16 years) with elevated basal luteinizing hormone and testosterone levels. An anterior mediastinal tumor was identified by chest radiography and computed tomography, and elevated α-fetoprotein (AFP) and β-human chorionic gonadotropin (β-hCG) levels were noted. Histopathologic analysis confirmed a yolk-sac tumor. Second, a 12-year-old boy presented with diplopia, polydipsia, and polyuria for 4 months. Physical examination revealed a pubertal stage of G3P3 with 8-mL testes. Bone age was advanced (16 years) and laboratory tests indicated panhypopituitarism with elevated testosterone level. A mixed germ-cell tumor was diagnosed with elevated AFP and β-hCG levels. Of course, these patients also have other symptoms of suspecting tumors, however, rapidly progressive puberty can be the more earlier screening sign of tumors. Therefore, in male patients with accelerated or advanced puberty, malignancy should be considered, with evaluation of tumor markers. In addition, advanced puberty in male should be recognized more widely as a unique sign of neoplasm.
Adolescent ; Child ; Chorionic Gonadotropin ; Diplopia ; Fever ; Humans ; Luteinizing Hormone ; Male* ; Mass Screening ; Physical Examination ; Polydipsia ; Polyuria ; Puberty* ; Puberty, Precocious ; Radiography ; Testis ; Testosterone ; Thorax ; Tumor Markers, Biological ; Weight Loss

Hypotonic hyponatremia by primary polydipsia can cause severe neurologic complications due to cerebral edema. A 10-year-and-4-month-old boy with a psychiatric history of intellectual disability and behavioral disorders who presented with chief complaints of seizure and mental change showed severe hypotonic hyponatremia with low urine osmolality (serum sodium, 101 mmol/L; serum osmolality, 215 mOsm/kg; urine osmolality, 108 mOsm/kg). The patient had been polydipsic for a few months prior, and this had been worse in the previous few days. A diagnosis of hypotonic hyponatremia caused by primary polydipsia was made. The patient was in a coma, and developed respiratory arrest and became brain death shortly after admission, despite the treatment. The initial brain magnetic resonance imaging showed severe brain swelling with tonsillar and uncal herniation, and the patient was declared as brain death. It has been reported that antidiuretic hormone suppression is inadequate in patients with chronic polydipsia, and that this inadequate suppression of antidiuretic hormone is aggravated in patients with acute psychosis. Therefore, hyponatremia by primary polydipsia, although it is rare, can cause serious and life-threatening neurologic complications.
Brain Death* ; Brain Edema ; Brain* ; Child* ; Coma ; Diagnosis ; Humans ; Hyponatremia* ; Intellectual Disability ; Magnetic Resonance Imaging ; Male* ; Osmolar Concentration ; Polydipsia ; Polydipsia, Psychogenic* ; Psychotic Disorders ; Seizures ; Sodium ; Water Intoxication

OBJECTIVES: To examine the factors which affect the improvement or the recurrence of disease after intralesional steroid injection in patients with oral lichen planus (OLP). METHODS: Sixty-two patients diagnosed as OLP were treated with intralesion corticosteroid injection. To evaluate the objective severity of OLP, total severity score of OLP was assessed. To examine the factors affecting the therapeutic effect of intralesional steroid injection, factors were compared between the symptom-improved group and symptom-not-improved group. To assess the symptom of patients, patients filled in 10-cm visual analogue scale, along with an Oral Health Impact Profile-14. RESULTS: Symptoms improved in 50 patients (80.6%, symptom-improved group), but not in 12 patients (symptom-not-improved group). In a comparison between both group, OLP with lip involvement was the only variable which showed significant difference (P=0.008). Twenty-nine of 50 patients had recurrence of OLP (58%, recurrence group) and 21 of 50 patients did not have recurrence (42%, no-recurrence group). Statistically significant differences were not found between both groups. CONCLUSION: This study suggested that patients suffering from OLP with lesion on the lip might not be effective in treating with intralesional corticosteroid injection.
Humans ; Lichen Planus, Oral* ; Lip ; Oral Health ; Recurrence