Eosinophilic cellulitis is a rare dermatosis first described by Wells, and characterized by recurrent episodes of sudden outbreaks of erythematous cutaneous swellings often painful or pruritic. Microscopically, the lesion shows diffuse tissue eosinophilia and fibrinoid flame figures, evolution of associated focal necrobiosis, and formation of focal microgranulomas associated with eosinophils. The cause is still unknown but the triggers which have been thought to precipitate the disease include insect bites, parasitic infections such as toxocara, onchocerciasis, nasopharyngeal carcinoma, rheumatoid arthritis and spider bites. However many cases are idiopathic. The author experienced a case of eosinophilic cellulitis of a 52-year-old woman with multiple cutaneous tender plaques of cellulitis for approximately 10 years with history of repeated remission and recurrent episodes. Biopsy was taken from ulcerated edematous nodule of inguinal region under the clinical impression of deep fungal infection, pyoderma gangrenosum and polyarteritis nodosa. Cultures for fungal and common organisms were negative. Histologically, the entire dermis was infiltrated by numerous eosinophils and scattered histiocytes. There were scattered flame figures showing necrobiotic foci in the collagen with accumulation of eosinophils, granulated free cosinophilic granules and histiocytes.
Biopsy ; Cellulitis/pathology* ; Cellulitis/therapy ; Eosinophilia/pathology* ; Eosinophilia/therapy ; Female ; Humans ; Middle Aged

Eosinophilic cellulitis is a rare dermatosis first described by Wells, and characterized by recurrent episodes of sudden outbreaks of erythematous cutaneous swellings often painful or pruritic. Microscopically, the lesion shows diffuse tissue eosinophilia and fibrinoid flame figures, evolution of associated focal necrobiosis, and formation of focal microgranulomas associated with eosinophils. The cause is still unknown but the triggers which have been thought to precipitate the disease include insect bites, parasitic infections such as toxocara, onchocerciasis, nasopharyngeal carcinoma, rheumatoid arthritis and spider bites. However many cases are idiopathic. The author experienced a case of eosinophilic cellulitis of a 52-year-old woman with multiple cutaneous tender plaques of cellulitis for approximately 10 years with history of repeated remission and recurrent episodes. Biopsy was taken from ulcerated edematous nodule of inguinal region under the clinical impression of deep fungal infection, pyoderma gangrenosum and polyarteritis nodosa. Cultures for fungal and common organisms were negative. Histologically, the entire dermis was infiltrated by numerous eosinophils and scattered histiocytes. There were scattered flame figures showing necrobiotic foci in the collagen with accumulation of eosinophils, granulated free cosinophilic granules and histiocytes.
Biopsy ; Cellulitis/pathology* ; Cellulitis/therapy ; Eosinophilia/pathology* ; Eosinophilia/therapy ; Female ; Humans ; Middle Aged

The glomus tumor or glomangioma is an uncommon benign tumor that arises from the modified smooth muscle cells of the glomus body, a neuromyoarterial receptor sensitive to temperature, that regulates arterial flow. It is most commonly found in the skin particularly in the nailbeds or fingertips, but approximately 70 cases described in the stomach. The author experienced a glomus tumor of the stomach was found in a 43 year old female patient who had discomfort in upper abdomen for 40 days. Clinically, this uncommon gastric tumor mimics most of the benign and malignant lesions of the stomach and the most important aspect of this tumor is its histologic identification and differentiation from the more common gastric lesion. Microscopically the tumor was composed of cellular lobules of various sizes separately by irregular fibrous and muscular trabeculae. Ultrastructural study showed basal lamina, pinocytotic vesicles and numerous subplaomalemmal plaque.
Female ; Humans

Leiomyomas are benign tumors of smooth muscle origin and are very rare in the female genital tract. To date, approximately 35 cases of urethral leiomyoma have been reported in the literature. A 34-year-old woman presented with a 3-year history of a mass at the urethral meatus. Physical examination showed 2 x 1.5 cm lump at the urethral meatus, posterior lip. Histologically the tumor was mainly composed of benign cigar shaped smooth muscle izells which were arranged in interlacing fascicles without cellular atypia or mitosis. Immunohistochemistry confirmed leiomyoma with positive staining for vimentin, desmin and muscle specific actin.
Female ; Humans

During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. CD44 variant glycoproteins containing sequences encoded by exon v6 are related to tumor progression of human colorectal cancer. But their expression in normal colonic epithelium is controversial and studies of CD44 on each step of colorectal carcinogenesis are scanty. We studied CD44v6 expression in the normal colonic mucosa, adenoma, carcinoma in situ, and invasive colorectal carcinomas of different Astler-Coller stages. Endoscopically or surgically resected 36 normal colonic mucosa, 19 adenomas, 8 cases of carcinoma in situ, and 25 cases of carcinoma were selected. After immunohistochemical stain with CD44v6 antibody, positivity was graded as 0 to 4 based on the estimated percentage of positively stained tumor cells. The intensity of positive staining cells was also graded as 0 to 3. In all but one cases (97.2%), normal colorectal mucosa was negative for CD44v6. Positive rates in adenoma, carcinoma in situ, Astler-Coller stage A/B and C/D carcinoma were 73.6%, 88.9% and 87.5%, respectively. There was no statistically significant difference in the positivity between these groups. The staining intensity was significantly higher in the cases of stage C/D carcinoma group than those of adenomas (p<0.05). The percentage of positivity for CD44v6 was higher in stage C/D carcinoma group than adenoma, carcinoma in situ, and stage A/B carcinoma group (p<0.05). Expression of CD44v6 in the normal colonic mucosa was extremely rare and the positivity was increased according to the progression of colorectal tumors. Furthermore, it is more important to interpret the CD44v6 positivity according to the estimated percentage of positively stained tumor cells.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Colon ; Colorectal Neoplasms* ; Epithelium ; Exons ; Glycoproteins ; Humans ; Mucous Membrane ; Neoplasm Metastasis

Helicobacter pylori(H. pylori) infection is considered the most important cause of chronic active gastritis and peptic ulcer. To determine the prevalence, distribution and it's relationship to degree of inflammation, gastric biopsy specimens were obtained from 331 nonulcer dyspepsia(NUD) patients consisting of 52 H. pylori negative normal volunteers and 279 H. pylori infected patients. Lymphoid follicles, degree of acute and chronic inflammation(Grade 0 to 3), and degree of H. pylori(Grade 0 to 4) were observed. The prevalence of H. pylori in NUD was 84.29%. The lymphoid follicles were found in 138 patients(41.7%) and only 5 patients(l.5%) without H. pylori showed lymphoid follicles. There was strong a relationship between lymphoid follicles and degree of acute and chronic inflammation and intensity of H. pylori infection(P<0.001). Acute and chronic inflammation were more serious in the antrum than body in H. pylori infected patients. There was no relationship between lymphoid follicles and the site in the stomach of H. pylori infection(P<0.078), but the body portion had an increased frequency of lymphoid follicles compared to the in antrum. Our results indicate that the prevalence of H. pylori infection in Korea is higher than in Western people and the degree of acute and chronic inflammation are strongly correlated with the presence of lymphoid follicles. The lymphoid follicles are believed to be absent from the normal stomach and their presence is strongly associated with H. pylori infection. The fact there is an that increased frequency of lymphoid follicles in H. pylori infected patients, and that they are more prevalent in the body of the antrum, support the concept that H. pylori may be a precursor in the development of primary gastric lymphoma.
Biopsy

This report presents an unusual case of primary malignant melanoma in the midesophagus. The patient was a 36-year-old woman presenting with dysphagia and odynophagia. The resected esophagus and proximal stomach showed a dark purple large polypoid mass, measuring 6.0 3.3 2.0 cm, with a diffuse tan pigmentation of surrounding mucosa in the mid-esophagus and two small daughter nodules, up to 1.2 0.3 cm, in the lower esophagus near the gastro-esophageal junction. A microscopic examination revealed a malignant melanoma of epithelioid cell type confined to mucosa and submucosa with a diffuse melanosis. Cytoplasmic immunoreactivity for HMB 45 and S-100 protein were noted. An electron microscopic examination revealed large, loosely cohesive variable shaped cells with a few cytoplasmic premelanosomes.
Adult ; Cytoplasm ; Deglutition Disorders ; Epithelioid Cells ; Esophagus* ; Female ; Humans ; Melanoma* ; Melanosis ; Mucous Membrane ; Nuclear Family ; Pigmentation ; S100 Proteins ; Stomach ; Triacetoneamine-N-Oxyl

Teratocarcinoma is a form of mixed germ cell tumor composed of a mixture of teratoma and embryonal carcinoma. It is rarely found in the brain, but when present it is most commonly found in the pineal region. We investigated a case of primary teratocarcinoma in the pineal region. The patient was a 10 year old boy who had suffered from a bitemporal headache for one month. Brain CT and MRI revealed a rather well defined ovoid heterogenous mass in the pineal gland region, measuring 4.3 x 3.8 x 3.0 cm in size. Microscopically the tumor contained areas of immature teratoma and embryonal carcinoma. Immunohistochemical staining revealed positive reactions for cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and alpha-fetoprotein in the embryonal carcinoma component.

Adrenal pseudocysts are rare benign cystic lesions resulting from a hemorrhage into a normal parenchyme of the adrenal gland. Although the frequency of adrenal cysts are increasing due to improved radiologic imaging techniques, only two cases have been reported in Korean literatures. A 63-year-old man was presented with a 10-year history of a mass in the right abdomen. Abdominal computed tomogram and a magnetic resonance image study showed a 9 cm sized well defined heterogeneous low attenuated mass in the right suprarenal area. Gross examination revealed an ovoid rubbery mass measuring 10 9 8 cm and weighing 355 gm. The content of this lesion was tan to deep brown, necrotic, and creamy with myxoid areas. Histologic examination revealed compressed, thin layers of adrenal cortex embedded in the fibrous tissue, and the cystic contents were eosinophilic fibrinoid materials with a few dilated cavernous vascular spaces lined by endothelial cells.
Abdomen ; Adrenal Cortex ; Adrenal Glands* ; Endothelial Cells ; Eosinophils ; Hemorrhage ; Humans ; Middle Aged ; Triacetoneamine-N-Oxyl

To evaluate the role of p53 and NDP-K/nm23(nm23) protein as a prognostic factor and their relation to metastasis of cancer, we studied metastatic and nonmetastatic gastric carcinoma specimens by immunohistochemical staining. Among the 101 specimens examined, 37(36.6%) showed positivity in staining for p53 protein and 64(63.4%) showed no detectable p53 protein in tumor cells. p53 overexpression was correlated with depth of invasion, lymphatic invasion, lymph node metastasis and distant metastasis. Out of 101 specimens, 35 cases had no staining for nm23. 62 cases(61.4%) exhibited a cytoplasmic staining on most cells and 42 cases (41.6%) had nuclear staining. In 16 of 101 cases(15.8%), a mild to moderate membranous staining was observed in some cells. Cytoplasmic nm23 expression was negatively correlated with lymph node metastasis(P < 0.01) and distant metastasis(P < 0.01). The nuclear nm23 expression showed negative correlation with depth of invasion(P < 0.01), lymphatic invasion(P < 0.01), lymph node metastasis(P < 0.01), and distant metastasis(P < 0.04). The membranous nm23 expression revealed negative correlation with lymphatic invasion(P < 0.02), lymph node metastasis(P < 0.01) and distant metastasis(P < 0.02).
Adult ; Aged ; Aged, 80 and over ; Female ; *Gene Expression Regulation, Neoplastic ; Human ; Immunohistochemistry ; Male ; Middle Age ; Neoplasm Metastasis ; Nucleoside-Diphosphate Kinase/*analysis ; Prognosis ; Protein p53/*genetics ; Stomach Neoplasms/*chemistry/*pathology ; Support, Non-U.S. Gov't ; Transcription Factors/*genetics