Scrotal leiomyomas with atypical bizarre nuclei are rare, which might be misdiagnosed as malignant tumor. We describe a case of scrotal bizarre leiomyoma in a 65-yr-old man. The tumor was a 1 cm-sized, well circumscribed, oval mass arising from the tunica dartos muscle. Histologically, it was formed by whorling bundles of fusiform cells with occasional atypical, pleomorphic nuclei and pseudoinclusions. Mitosis was not found. Although morphologically atypical, scrotal bizarre leiomyomas take on a biologic behavior not different from that of conventional leiomyoma, they should be distinguished from leiomyosarcoma to avoid unnecessary treatment.
Aged ; Genital Neoplasms, Male/*pathology/surgery ; Human ; Leiomyoma/*pathology/surgery ; Male ; Scrotum/*pathology

We present here the case of a 73-year-old man with squamous cell carcinoma that arose in a thymic cyst, and this was incidentally found by chest radiography. Computed tomography revealed a 3.6 cm-sized predominantly cystic lesion with a mural nodule at the antero-superior mediastinum. The resected specimen was a well demarcated cystic mass with a solid mural nodule. Microscopically, the nodule was determined to be invasive squamous cell carcinoma that had originated from the benign squamous epithelium lining the thymic cyst.
Aged ; Carcinoma, Squamous Cell ; Epithelium ; Humans ; Mediastinal Cyst ; Mediastinal Neoplasms ; Mediastinum ; Thorax

Background: Homologous recombination defect is an important biomarker of chemotherapy in certain tumor types, and the presence of pathogenic or likely pathogenic mutations involving BRCA1 or BRCA2 (p-BRCA) mutations is the most well-established marker for the homologous recombination defect. Gastric cancer, one of the most prevalent tumor types in Asia, also harbors p-BRCA mutations. Methods: To investigate the clinical significance of p-BRCA mutations, we analyzed 366 gastric cancer cases through next-generation sequencing. We determined the zygosity of p-BRCA mutations based on the calculated tumor purity through variant allelic fraction patterns and investigated whether the presence of p-BRCA mutations is associated with platinum-based chemotherapy and a certain molecular subtype. Results: Biallelic p-BRCA mutation was associated with better response to platinum-based chemotherapy than heterozygous p-BRCA mutation or wild type BRCA genes. The biallelic p-BRCA mutations was observed only in the chromosomal instability subtype, while all p-BRCA mutations were heterozygous in microsatellite instability subtype. Conclusions In conclusion, patients with gastric cancer harboring biallelic p-BRCA mutations were associated with a good initial response to platinum-based chemotherapy and those tumors were exclusively chromosomal instability subtype. Further investigation for potential association with homologous recombination defect is warranted.

To verify the spectrum of CD99-expressing lymphoid malignancy, an immunohistochemical study for CD99 was carried out in 182 cases of non-Hodgkin's lymphoma, including 21 lymphoblastic lymphomas, 11 small lymphocytic lymphomas, 9 mantle cell lymphomas, 12 follicular lymphomas, 37 diffuse large B cell lymphomas, 18 Burkitt's lymphomas, 28 NK/T-cell lymphomas, 8 angioimmunoblastic T-cell lymphomas, 23 peripheral T-cell lymphomas, unspecified, and 15 systemic anaplastic large cell lymphomas. CD99 was positive in all T-lymphoblastic lymphomas and in 60% of B-lymphoblastic lymphomas. Majority of T and NK cell lymphomas were negative for CD99, except anaplastic large cell lymphomas (ALCLs). Eight of 15 cases (54%) of ALCLs reacted with anti CD99 antibody. Seven of 10 (70%) ALK positive ALCLs expressed CD99, whereas only 1 of 5 (20%) ALK negative ALCLs were positive. Of the mature B-cell lymphomas, 5.4% (2/37) of diffuse large B cell lymphomas and 11.1% (2/18) of Burkitt's lymphomas expressed CD99. In conclusion, CD99 is infrequently expressed in mature B and T cell lymphomas, except ALK-positive ALCL. High expression of CD99 in ALK-positive ALCL is unexpected finding and its biologic and clinical significances have yet to be clarified.
Antigens, CD/*metabolism ; Blotting, Western ; Cell Adhesion Molecules/*metabolism ; Humans ; Immunohistochemistry ; Lymphoma, Large-Cell/enzymology/*immunology/pathology ; Lymphoma, Non-Hodgkin/enzymology/*immunology/pathology ; Protein-Tyrosine Kinase/immunology/*metabolism

The purpose of this study was to examine the effect of preceptorship on On the Job Training of new nurses. The research design was a retrospective survey and one group pre-post test design. The subjects were 49 entry nurses and 49 preceptors. The data were collected from Feburary 1, 1998 to December 1, 1998. One questionnair applied in this study consisted of general characteristics, the responses of new entry nurses and their preceptors and their qualities. The other questionnair consisted of job satisfaction of new entry nurses and preceptors and their competencies. The data were analyzed for frequencies, mean score, standard deviation, t-test, and ANOVA. The results of the study were as follows: 1) Preceptees's responses were that the nurses' affiliation of unit, cooperation of other nurses, and competencies of nursing skills improved after OJT applied preceptorship. 2) Preceptors's answers were that preceptor- ship had a positive effect on their continuing education. 3) While preceptees's job satisfaction scores were high in interaction, administration, and organization, they were low in autonomy and pay. 4) Pre-competency scores were the same as post-competency scores. 5) After preceptorship, preceptors responded that their nursing skill & communication competency increased, but their nursing administration competency decreased. 6) Finally, preceptorship's other effects were as follows: 1. Checklists for preceptee education at the nursing unit were developed separately. 2. It was proved that 'preceptor interview note' was effective on manage preceptorship. 3. We obtained duty overlap periods; medical- surgical units-1 month, 5 ICU-2 months, operation room-3 months. 4. We prepared a preceptor program based on the study results.
Checklist ; Education ; Education, Continuing ; Evaluation Studies as Topic ; Inservice Training ; Job Satisfaction ; Nursing ; Preceptorship* ; Research Design ; Retrospective Studies ; Ships

BACKGROUND: Early hepatocellular carcinoma (HCC) is an early stage HCC, and it is sometimes difficult to identify the margins of the cancer nodules in the resected specimens. METHODS: We studied 22 cases of early HCC to investigate the clinicopathologic features of early stage HCC. RESULTS: Seven of 22 cases were single HCC, and 15 were multicentric HCC. The average tumor size was 1.34 cm (0.4-2.7 cm). Early HCCs didn't destroy the basic architecture of the liver lobules or pseudolobules and the lesions had an indistinct margin. Most tumors were uniformly composed of well-differentiated cancer tissue that was characterized by an increased cell density and an irregular thin-trabecular pattern. The tumor retained a varying number of portal tracts. There was a replacing growth pattern at the tumor-nontumor boundary without tumor capsule. Three of 22 cases had a "nodule-in-nodule" lesion, and the inner nodules consisted of moderately differentiated HCC without portal tracts. All 22 cases showed no vascular invasion. All 7 patients with single early HCC have survived for the past 11-54 months without any local recurrence. But in one patient with single early HCC, multicentric HCC developed 20 months after surgery. CONCLUSION: The clinicopathologic features of early HCCs are quite different from those of advanced HCCs. The increased recognition of early HCC during routine clinical practice will contribute to improved patient survival.
Carcinoma, Hepatocellular* ; Cell Count ; Humans ; Liver ; Recurrence

Angiosarcoma of the thyroid has long been a controversial entity, and it is histologically defined as cleft-like anastosmosing spaces lined by large, atypical cells of endothelial lineage. However, clear-cut separation between the angiosarcoma and anaplastic carcinoma of the thyroid is difficult because they yield nearly the same clinical prognosis and overlapping histologic findings. We report a case of thyroid neoplasm composed of minimally invasive well differentiated follicular carcinoma and angiosarcoma with intervening transitional area. Immunohistochemically, the angiosarcomatous portion showed focal immunoreactivity for endothelial markers such as CD31, CD34, Ulex europaeus 1 lectin, factor VIII-related antigen, and immunonegativity for epithelial markers including pancytokeratin, epithelial membrane antigen and thyroglobulin, whereas the reverse was demonstrated in the minimally invasive follicular carcinomatous portion. The follicular carcinoma portion was positive for thyroid transcription factor-1 (TTF-1). Each component showed ultrastructural findings of epithelial and endothelial differentiation, respectively. The present case was unique in that angiosarcoma of the thyroid was confirmed by immunohistochemistry and electron microscopy, as well as light microscopy, and also coexisted with a minimally invasive well differentiated follicular carcinoma in the same mass. This combination has never been described in the literature. Although restricted to a single case, the present case further supports that angiosarcoma is a true existent entity rather than a variant of anaplastic carcinoma.
Adenocarcinoma, Follicular/*pathology ; Comorbidity ; Diagnosis, Differential ; Hemangiosarcoma/*pathology ; Human ; Male ; Microscopy, Electron ; Middle Aged ; Thyroid Neoplasms/*pathology ; Tumor Markers, Biological

Herein we report a rare case of mucinous bronchioloalveolar carcinoma (BAC) associated with a solitary bronchiectatic cyst in a 29-year-old man. The patient presented with hemoptysis and had a history of pulmonary tuberculosis. Chest radiographs and computed tomography revealed a well-circumscribed, thin-walled cavitary lesion in the right upper pulmonary lobe. Gross examination of a lobectomy specimen showed a bronchiectatic cavity and a fungus ball within it. There were also several ill-defined small gray-white nodules around the cyst, nodules that were mucinous BAC. On microscopy, they were composed of columnar tumor cells along the intact alveolar walls in a single layer.
Adenocarcinoma, Bronchiolo-Alveolar ; Adult ; Bronchiectasis ; Fungi ; Hemoptysis ; Humans ; Lung Neoplasms ; Microscopy ; Mucins ; Thorax ; Tuberculosis, Pulmonary

Herein we report a rare case of mucinous bronchioloalveolar carcinoma (BAC) associated with a solitary bronchiectatic cyst in a 29-year-old man. The patient presented with hemoptysis and had a history of pulmonary tuberculosis. Chest radiographs and computed tomography revealed a well-circumscribed, thin-walled cavitary lesion in the right upper pulmonary lobe. Gross examination of a lobectomy specimen showed a bronchiectatic cavity and a fungus ball within it. There were also several ill-defined small gray-white nodules around the cyst, nodules that were mucinous BAC. On microscopy, they were composed of columnar tumor cells along the intact alveolar walls in a single layer.
Adenocarcinoma, Bronchiolo-Alveolar ; Adult ; Bronchiectasis ; Fungi ; Hemoptysis ; Humans ; Lung Neoplasms ; Microscopy ; Mucins ; Thorax ; Tuberculosis, Pulmonary

BACKGROUND: Thymic neuroendocrine carcinomas (NECs) are uncommon, for which there is no established information available because of a limited number of epidemiological study in Asia. METHODS: We reviewed 21 cases of surgically resected thymic NECs, and evaluated their pathological and clinical features. RESULTS: It showed male predominance (male/female ratio, 15/6) with wide age range from 20 to 72 years (mean age, 49 years). All 21 cases were divided into two types according to the World Health Organization criteria: atypical carcinoid (n=18) and large cell NEC (n=3). Three cases of atypical carcinoid (AC) were associated with ectopic Cushing's syndrome. All the patients (3/3) with large cell NEC (3/3) and 16.7% (3/18) of those with AC died of tumor progression. Common sites of metastasis included lung, lymph node, brain, lumbar spine, mediastinum, bone, and liver. CONCLUSIONS: In conclusion, thymic neuroendocrine tumors carry a poor prognosis. Regarding the tumor classification, our results showed that a vast majority of carcinoids in the thymus correspond to ACs. In addition, our results also indicate that typical carcinoid is a very rare entity. Some cases of AC exhibited a large size, solid pattern and they showed aggressive clinical behavior, which highlights the spectrum of histologic appearances of thymic NECs.
Female ; Male ; Humans ; Neoplasm Metastasis