Interstitial lung disease is a generic term for a heterogeneous group of lung disease that primarily affect the interstitium although the disease is not clearly restricted to the interstitium. The majority of interstitial lung diseases represent inflammatory insults to the microscopic anatomic space bounded by the basement membrane of epithelial and endothelial cells, which may occur as slowly developing process and ultimately end up as end-stage honeycomb fibrosis. The currently prevalent classification of interstitial pneumonia with practical utility and easy reproducibility pertaining only to idopathic interstitial pneumonia encompasses several different entities some of which may represent different aspects of the same condition. Honeycomb fibrosis is usually caused by a variety of pulmonary disease including chronic interstitial lung disease. It is important to recognize that usual inter-stitial pneumonia and honeycomb fibrosis are not synonymous. In the era of chemotherapy for malignant tumor, aggressive immunosuppression for autoimmune diseases and transplant recipients and acquired immunodeficiency syndrome, lung disease in the immunocompromised host has been common. Diagnostic lung biopsy becomes increasingly needed because proper treatment of interstitial lung disease relies on correct morphologic diagnosis. This review summarizes the pathologic spectrum of idiopathic interstitial pneumonias together with other inflammatory process with known or suggestive etiologies simulating interstitial pneumonias.
Acquired Immunodeficiency Syndrome ; Autoimmune Diseases ; Basement Membrane ; Biopsy ; Classification ; Diagnosis ; Drug Therapy ; Endothelial Cells ; Fibrosis ; Idiopathic Interstitial Pneumonias ; Immunocompromised Host ; Immunosuppression ; Lung ; Lung Diseases ; Lung Diseases, Interstitial* ; Pathology* ; Pneumonia ; Transplantation

No abstract available.

Ovarian leiomyoma is a rare form of the ovarian mesenchymal neoplasm and about 50 cases have been reported in the literature. It is believed that many cases may go unnoticed because they are usually small in size and frequently mistaken for the more common fibroma or fibrothecoma. Its origin is still controversial and many possibilities are considered including the smooth muscle in the blood vessel wall of the hilum or the multipotential ovarian stromal cell. Herein we describe two cases of ovarian leiomyoma with its characteristic histologic finding.
Blood Vessels ; Female ; Fibroma ; Leiomyoma* ; Muscle, Smooth ; Ovary* ; Stromal Cells

Fibrous pseudotumor of paratesticular region is rare, but one of the most common neoplasm of that region. It has also been called as nodular fibrous proliferation, pseudofibromatous periorchitis, benign fibrous paratesticular tumor, and fibrous mesothelioma(pseudofibroma). We herein report a case of fibrous pseudotumor with characteristic histological findings. The patient is a 59 year-old male who had incidentally found scrotal mass and undergone radical orchiectomy. There was two separate nodules at tunica vaginalis and proximal spermatic cord which had bulging whitish-gray cut surface with focal myxoid change. Histologically, the mass was composed of dense collagenous tissue with scattered lymphoid follicles and numerous chronic inflammatory cells. There was a proliferation of spindle or stellate shaped cells, some of which featured enlarged hyperchromatic nuclei with prominent nucleoli, and abundant basophilic cytoplasm. These cells stained positive for vimentin and actin immunohistochemically, suggesting that this lesion might derive from proliferation of myofibroblasts.
Male ; Humans

The immunoreactivities of surgically removed 16 cardiac myxomas were studies for factor VIII-related Ag (F VIII-RA), Ulex europaeus agglutinin I (UEA-I) and desmin alpha1-antichymotrypsin, and this study was accompained by a clinicopathologic review. More than 50% of the patients with cardiac myxomas were in their fourth and fifth decades, and cardiac myxomas were much more common in women than in men. All but on occurred in the left atrium, and the majority were attached to the atrial septum, usually in the region corresponding to the fossa ovalis. In one case, an atrial myxoma recurred 37 months after the initial excision. Microscopically, the myxomas contained a myxoid matrix composed of acid mucopolysaccharides within which were embedded polygonal cells. The cells forming both the surface and complicated vascular like channels throuhout the myxoid stroma tested positive for F VIII-RA and UEA-I. The outer cell layers of the complex vascular structures demonstrated variable staining for F VIII-RA, while isolated bundles of smooth muscle cells were present and stained for desmin. A small number of the so-called myxoma cells, immunoreactive for alpha1-antichymotrypsin which were not laden with hemosiderin pigment but were similar to histiocytes, were present particularly around the areas of hemorrhage. These findings support the current view that cellular and histologic heterogeneity arose from the divergent differentiation of multipotential mesenchymal cells. In particular, it remains to be confirmed by further study whether or not true histiocytic differentiation occurs.
Female ; Male ; Humans

The most common malignant renal neoplasm is renal cell carcinoma. It is estimated that renal cell carcinoma accounts for 1% of all primary malignancies in Korea. Rell cell carcinoma presents diverse clinical courses with gross, histopathologic features. It has been known to be very difficult tumor to predict its clinical prognosis. In Korea, many studies have been reported concerning the clinical aspects of renal cell carcinoma. However, pathological studies of renal cell carcinoma are very few even though studies of nuclear grade have been attempted recently. We reviewed 93 cases of renal cell carcinoma examined in the period from 1978 to 1987 in the department of pathology, Yonsei university college of medicine, Yongdong Severance hospital, Wonju college of medicine and analyzed the histopathologic classification, including nuclear grade according to the Fuhrman's method. We abtained the following results by studying the relationship of the factors which had been known as correlated with the prognosis. 1) The ages of patients ranged from 9 to 74 years with a peak in the 6th decade. 2) The most common symptoms of the patients were hematuria, mass and pain, in that oder, and 7 patients complained to specific symptoms. The incidentally found cases characterized stage I, nuclear grade 2 small tumor size (not more than 4 cm) and clear cell type. 3) The renal cell carcinoma was more frequently located in the left kidney than the right by a ratio of 1.25 : 1. The incidence of intrarenal location was divided to the upper pole, 40% : mid portion, 29% : lower pole, 23% : diffuse involvement, 8%. The tumor shoing diffuse growth pattern had a large size, high nuclear grade and mixed cells. 4) The tumor size averaged 8 cm and there was no significant relationship between the size and stage. Seven cases of neoplasms not more than 3 cm were seen, of which 2 cases revealed an outcome of distant metastasis. 5) The histological pattern showed major solid, 53% : tubular, 11% : mixed, 18% : papillary, 9% and sarcomatoid type 9%. The sarcomatoid type was characterized by grade 4, a larger size(more than 10 cm), advanced stage. 6) There was no special relationship between the stage and grade but mostly grade 2 occupied the stage I. 7) The clear cell type was predominantly noted at grade 2 (65%), at the stage I (63%), granular or mixed cell type at grade 3 (87%), 4 (70%). According to these results, the tumors showing a sarcomatoid histologic pattern, diffuse growth pattern had unfavorable prognostic factors, and are thus estimated to have a poor prognosis. But the case which were incidentally found have favorable prognostic factors and probably a better prognosis. The tumor size alone can not exactly predict the metastasis and is not correlated with the stage. Small renal cell neoplasm (not more than 3 cm) generally has unfavorable prognostic factors and should be considered potentially malignant. The high grade frequently has granular cytoplasm. This represents the relationship between grade and cytoplasm, poor prognosis in the granular cell than the clear. The renal cell carcinoma shows variable prognosis and thus the prognosis should be estimated by all the factors. Nuclear grade can be used as one of the useful prognostic factors.
Incidence ; Neoplasm Metastasis

Cardiac myxoma is the most common primary tumor of the heart. The tumor contains a variety of cell types that are thought to arise from a focus of primitive pluripotential mesenchymal cells in the area of the fossa ovalis. Throughout the myxoid stroma, there are variable amounts of reticular fivers, collagen, elastic fibers and smooth muscle cells. A 38-year-old female had right atrial myxoma with multiple pulmonary infarcts. In this case, we experienced an unusual degenerative change in the tumor of granulomatous lesion consisting of hemosiderin pigments, foreign body giant cells and peculiar, spheroid, semilunar or bamboo-shaped degenerated elastic fibers. Microscopically it resembles Gamna-Gandy nodule seen in the spleen of chronic passive congestion.
Female ; Humans

A 52-year-old man with multiple myeloma developed cutaneous nodules while being treated with melphalan and prednisolone. A biopsy specimen showed dermal infiltration by well differentiated plasma cells similar to those found on bone marrow biopsy. The use of peroxidase anti-peroxidase to demonstrate the monoclonality or polyclonality of the cytomplasmic immunoglohulins in the tumor cells revealed a positivity for IgG and 1 chain (ie, monotypic staining). Ultrastructurally, each plasmacytoma cell contained varyting amounts of rough endoplasmic reticulum and Golgi-apparatus. The cutnneous nodules completely disappeared after radiotherapy
Biopsy ; Bone Marrow ; Endoplasmic Reticulum, Rough ; Humans ; Immunoglobulin G ; Melphalan ; Middle Aged ; Multiple Myeloma* ; Peroxidase ; Plasma Cells ; Plasmacytoma* ; Prednisolone ; Radiotherapy

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

Mutation in the p53 suppressor gene is the most common genetic alteration found in human cancers including primary brain tumors. Ki-67 labeling index(LI) is known to be a marker of proliferating activity. The purpose of this study was to verify whether an immunohistochemical expression of p53 antibody and Ki-67 LI could be related to different clinicopathologic parameters including histologic grade, size, invasiveness and recurrence of the brain tumors. Materials were based on the 147 surgically resected brain tumors during the last two years. Of the 147 brain tumors, there were 35 astrocytic tumors, 35 meningiomas, 10 oligodendrogliomas, 7 craniopharyngiomas, 5 dysembryoplastic neuroepithelial tumors, 4 medulloblastomas, 5 ependymomas, 23 pituitary adenomas, 9 schwannomas, and 14 other brain tumors. The p53 expression and Ki-67 LI were higher in malignant brain tumors including astrocytic tumors, medulloblastoma, PNET and gliosarcoma. The p53 positivity was correlated with histologic grades and tumor recurrence. The brain tumors with a high Ki-67 LI(>6%) also showed a close relationship to a higher histologic grading, radiological invasiveness and recurrence. There was no evident correlation with the age and tumor size with p53 expression and Ki-67 LI. These results suggest that p53 overexpression and high proliferation potential of the tumor cells are associated with the higher histologic grade and aggressive clinical course in the central nervous system tumors.
Brain Neoplasms* ; Brain* ; Central Nervous System Neoplasms ; Craniopharyngioma ; Ependymoma ; Genes, Suppressor ; Gliosarcoma ; Humans ; Medulloblastoma ; Meningioma ; Neoplasms, Neuroepithelial ; Neurilemmoma ; Neuroectodermal Tumors, Primitive ; Oligodendroglioma ; Pituitary Neoplasms ; Recurrence