An eccrine squamous syringometaplasia (ESS) is defined as a mature squamous metaplasia of the eccrine ducts. The clinical and pathological features of an ESS are presented. Syringometaplasia is a rare lesion, mostly occuring in the extremities, and as far as we know, no report on the ESS has been published in Korean literature. We experienced a case of an ESS occured in a 15 year-old male, who had a tender erythematous plaque in the right knee. The histologic examination revealed some scattered nests of metaplastic squamous epithelium in the deep dermis, associated with acute nonspecific panniculitis. The importance of the ESS is that it histologically simulates the well differentiated squamous cell carcinoma. The histopathologic findings were discussed and a brief review of the literature was made.
Adolescent ; Carcinoma, Squamous Cell ; Dermis ; Epithelium ; Extremities ; Humans ; Knee ; Male ; Metaplasia ; Panniculitis

Trichoblastic fibroma is a benign trichogenic tumor that has both epithelial and mesenchymal components and exhibits partial follicular induction. We studied 4 cases of trichoblastic fibroma and reviewed their clinical and histologic features. Two tumors were present in the face. The remaining two were in the vulva and perianal area, respectively. The age of the patients ranged from 53 to 68 years, with an average age of 62. All were female. Histologically, the lesions showed a well circumscribed mass, located at dermo-subcutaneous junction in three patients and subcutaneous in one. They demonstrated mesenchymal induction evidenced by hair germ-like structure and perifollicular sheath. There was no connection between the tumor and epidermis. Differentiation toward hair structure led to the formation of the infundibulum through inner root sheath. Trichoblastic fibroma may be confused clinically and/or histologically with basal cell carcinoma. Identification of the mixed epithelial and mesenchymal components, and the absence of epidermal connection and cleft within the stroma are important in differentiating this benign neoplasm from basal cell carcinoma.
Carcinoma, Basal Cell ; Epidermis ; Female ; Fibroma* ; Hair ; Humans ; Vulva

We report a case of necrotizing arteritis involving the gallbladder. This case was clinically diagnosed as cholelithiasis with cholecystitis, and necrotizing arteritis was found in the surgically resected specimen. Vascular changes were similar to those seen in classic polyarteritis nodosa, involving medium-sized muscular arteries and characterized by fibrinoid necrosis and panarterial and periarterial inflammation varying from active to resolving stages. Acute cholecystitis is a rare initial clinical manifestation of the systemic vasculitis. If acute cholecystitis is found in the absence of obvious cause, careful examination is essential. Since steroid therapy improves the prognosis in the systemic vasculitis, clinicians and pathologists should be aware of this unusual lesion.
Arteries ; Cholecystitis ; Cholecystitis, Acute ; Cholelithiasis ; Gallbladder* ; Inflammation ; Necrosis ; Polyarteritis Nodosa ; Prognosis ; Systemic Vasculitis ; Vasculitis*

Orbital mesenchymal chondrosarcoma, first described by Luis et. al in 1971, is a very rare tumor of characteristic histologic features. A 21-year-woman was admitted with a 4-month histoiry of rapidly progressive proptosis and visual disturbance. Right orbital exenteration was performed under the clinical diagnosis of orbital calcifying tumor. Grossly, the tumor presented as a multibloblated, circumscribed mass that measures 5.5 cm in the greatest dimentsion. Cut sections resembled ordinary chonrosarcoma. Microscopically, the tumor was composed of undifferentiated mesenchymal cells, interspersed nodules of well differentated cartilagenous tissue, areas of gradual transition from undifferentiated mesenchymal cells to cartilage, and hemangiopericytoma-like areas. A brief summary of the histopathological aspect of this tumor and a review of literature are presented.
Female ; Humans

Until recently, the gastrointestinal lymphomas were classified according to the criteria developed for the node-based lymphomas. In recent years, the REAL classification provided a new category of MALT lymphoma and Mantle cell lymphoma in B-cell lymphomas. Low-grade MALT lymphomas have been well characterized clinically, histologically, and immunophenotypically. We retrospectively recategorized 41 cases of the primary gastrointestinal B-cell lymphoma and investigated the expression of cyclin D1, bcl-2, bcl-6, p53 protein, and PCNA by immunohistochemical method. The cases were categorized in 5 groups, low grade MALToma, low/high grade MALToma, high grade MALToma, diffuse large cell lymphoma, and mantle cell lymphoma according to the morphological findings. The expression of cyclin D1 protein was restricted to the cases of mantle cell lymphoma. The bcl-2 protein expression was higher in the low grade MALT lymphoma than in the high grade lymphoma (P=0.006). The bcl-2 protein expression was higher in the low grade area than in the high grade area in the low/high grade MALT lymphoma (P=0.005). The bcl-6 and p53 protein expression was higher in the high grade MALT lymphoma than in the low grade lymphoma (P=0.022, P<0.018). However, the bcl-6 protein expression of the tumor cells was higher in high grade area than in low grade area in the low/high grade MALT lymphoma (P=0.004). The degree of the PCNA expression was positively correlated with the grade of the malignant lymphoma (P=0.003). The above results suggest that the cellular proliferation assessed by PCNA index correlates with the histologic grade. And the bcl-2, bcl-6, p53 protein may be effective in the transition from the low grade MALT lymphoma to the high grade lymphoma. Therefore, we can differentiate the low grade lymphoma from the high grade lymphoma by the immunohistochemical staining for cyclin D1, bcl-2, bcl-6, p53 protein and can predict the prognosis of the patients in accordance with the grade of the tumor.
B-Lymphocytes* ; Cell Proliferation ; Classification* ; Cyclin D1* ; Cyclins* ; Gastrointestinal Tract ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Mantle-Cell ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Retrospective Studies

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Incidence*

This case report describes a paraganglioma of the cauda equina in a 37-year-old man, as documented by light microscopy and immunohistochemistry. The patient experienced low back pain of 3 years duration, with the recent onset of sciatic pain and altered sensation in the right leg. Magnetic resonance imaging of L4 vertebral level revealed an ovoid, solid mass in the cauda equina. The mass was measured 1.5 cm in the greatest diameter. The histologic appearance was characterized by organoid pattern with clusters of chief cells (zellballen). Immunohistochemically, tumor cells are positive for keratin, epithelial membrane antigen, vimentin, neuron specific enolase and chromogranin.
Adult ; Cauda Equina* ; Humans ; Immunohistochemistry ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Microscopy ; Mucin-1 ; Organoids ; Paraganglioma* ; Phosphopyruvate Hydratase ; Sensation ; Vimentin

Arteriovenous malformation of the uterus is rarely encountered. It is potentially lethal because of profuse, uncontrollable bleeding at the time of diagnostic dilatation and curettage. To our knowledge, only 38 cases of localized uterine arteriovenous malformation have been reported in English and Korean literature. Recently we experienced a case of uterine arteriovenous malformation in a 28-year-old multiparous woman. Under the clinical impression of uterine tumors or arteriovenous malformation, a total hysterectomy was done. Gross examination demonstrated a vascular nature of the mass in the posterior wall of the fundus. Microscopically, there was an ill-defined mass composed of numerous irregular, anastomosing large vessels with various diameters.
Female ; Humans

The dendriform pulmonary ossification (DPO) is a rare condition of unknown origin in which branching mature bony spicules, usually containing marrow, are found within the alveolar septa. DPO manifests slow progression over many years or may remain unchanged; spontaneous regression has not been recorded. Most patients have no symptoms directly attributed to the ossification, although they may have symptoms due to the underlying fibrotic process. We experienced a case of DPO in 38 year-old-man who presented with cough and sputum for a month. The chest X-ray showed marked coarsened interstitial lung markings in both lungs, especially in the lower lobes. Open lung biopsy was done. Grossly, there were significant dendriform osseous structures. Histologically, branching arrays of mature bone were found in the interstitium and occasionally in alveolar spaces. Some bony trabeculae contained fatty or cellular marrow. The alveolar septa showed fibrous thickening with chronic inflammation. The transition between fibrosis and bone tissue was observed. Our case suggests that dendriform pulmonary ossification may be a rare special manifestation of chronic fibrosing interstitial inflammation of the lung. Osseous structures seem to derive from metaplastic bone formation in the vicinity of undergoing fibrous process.
Biopsy ; Bone and Bones ; Bone Marrow ; Cough ; Fibrosis ; Humans ; Inflammation ; Lung ; Lung Diseases, Interstitial ; Osteogenesis ; Sputum ; Thorax

Linear nevus sebaceous syndrome is an uncommon neurocutaneous disorder characterized by nevus sebaceus, seizures, and mental retardation, and is often accompanied by ocular anormalies. We recently experienced a case of conjunctival choristoma associated with linear nevus sebaceous syndrome in a 17-month-old boy. The child was the product of a full-term uncomplicated pregnancy and normal delivery with normal karyotype of 46, XY. He was noted at birth to have a conjunctival mass on the right eye and linear nevi over the midline facial region and right temporoparietal scalp. Ophthalmologic examination revealed optic atrophy, peripapillary staphyloma, macular hypogenesis, and osseous choristoma of the choroid. A computed tomography scan demonstrated widening of the subarachnoid space and moderate atrophy of the cerebral and cerebellar hemispheres. He has been followed by ophthalmology and completely free of seizures since birth. The patient underwent excision of the conjunctival mass and biopsies of the skin lesion at 17 months of age. Histologic examination of the skin biopsies was characteristic for the linear sebaceous nevus of Jadassohn. Histologic findings of the conjunctival lesion showed a complex choristoma that contained lacrimal gland tissue and cartilage.
Atrophy ; Biopsy ; Cartilage ; Child ; Choristoma* ; Choroid ; Humans ; Infant ; Intellectual Disability ; Karyotype ; Lacrimal Apparatus ; Male ; Neurocutaneous Syndromes ; Nevus* ; Nevus, Sebaceous of Jadassohn ; Ophthalmology ; Optic Atrophy ; Parturition ; Pregnancy ; Scalp ; Seizures ; Skin ; Subarachnoid Space