We performed a histopathologic and immunohistochemical study of 23 cases of surgically resected large cell undifferentiated carcinoma(LCUC) of the lung. The relative incidence of LCUC was 7.6% among the total resected cases of primary lung cancer over 7 years(1987-1993). The mean age of the patients was 56 years and 21 cases were male. The mean size of the mass was 5 cm and 11 cases were located peripherally. According to the histologic features, LCUC could be divided into three groups: squamous cell carcinoma-like(6 cases), adenocarcinoma-like(13 cases), and small cell carcinoma-like(4 cases) groups. The histologic differences were related to the variations of the immunohistochemical properties, but there were no differences in prognosis among these groups. Immunoreactivity to cytokeratin(CAM 5.2) was demonstrated in 22/23(96%). Carcinoembryonic antigen was positive in 13/23(57%). Neuron specific enolase and chromogranin were positive in 11/23(48%) and 5/23(22%), respectively. Vimentin was seen in 11/23(48%). From these observations, we could subclassify them by their immunologic phenotypes; exocrine features in 6/23(26%), neuroendocrine(NE) features in 4/23(17%), both exocrine and NE phenotypes in 7/23(30%), and 6 cases(26%) showed neither phenotype. The group with NE features showed a worse prognosis(P<0.05) and immunoreactivity for vimentin was also related to a worse prognosis(P<0.05). These findings imply that the immunohistochemical properties of LCUC are closely related to the histopathologic features. The groups, subdivided by histology and immunoreactivity, showed no prognostic difference except for the NE differentiation and reaction for vimentin.
Incidence ; Lung Neoplasms

Giant cell tumor is a relatively uncommon neoplasm with high rate of local recurrence following curettage and bone graft. The histologic grading was not proven useful in predictiog outcome. Histologically benign giant cell tumor may metastasize. We report a case of histologically benign giant cell tumor occurred at left distai femur with local recurrences and multiple pulmonary metastases which was proven by percutaneous needle aspiration lung biopsy. Recurred local lesion was treated by curettage and filling with methylmethacrylate and pulmonary metastases was treated with adriamycine and dacarbazine.
Biopsy ; Curettage ; Dacarbazine ; Doxorubicin ; Femur ; Giant Cell Tumors ; Giant Cells ; Lung ; Methylmethacrylate ; Needles ; Neoplasm Metastasis ; Recurrence ; Transplants

No abstract available.
Biopsy, Fine-Needle* ; Thymoma*

A case of metastatic mucoepidermoid carcinoma of the lung, originating from the hard palate, was diagnosed by sputum and bronchial washing cytology. Although the cytologic features of mucoepidermoid carcinoma have been well described, it is easy to confuse mucoepidermoid carcinoma with the more common primary adenocarcinoma or squamous cell carcinoma of the lung. The features distinguishing mucoepidermoid carcinoma from other primary neoplasms includ 1) mucus-secreting cells individually and in clusters admixed with other cell components, 2) epidermoid cells identified by the presence of abundant spread-out cytoplasm and an oval dark nucleus and 3) intermediate cells resembiling normal ductal epithelial cells with moderate-toscanty cytoplasm, a central, round vesicular nucleus and a prominent nucleolus, The morphologic features of metastatic mucoepidermoid carcinoma in the case were similar to those of primary sallvary mucoepidermoid carcinoma.
Adenocarcinoma ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Cellular Structures ; Cytoplasm ; Epithelial Cells ; Lung* ; Palate, Hard ; Sputum

Primary hemangioma of the heart is very rare and is difficult to be diagnosed during life. We present a case of pericardial hemangioma with spontaneous hemopericardium, which was diagnosed by operation and confirmed histologically by excisional biopsy. This 58-yr old patients had pericardial effusion on echodardiography. After evacuation of bloody pericardial effusion by pericardiocentesis, his symptoms were subsided. After then, he uneventfully convalesced. On the 32th day, sudden dyspnea developed with narrow pulse pressure. So exploratory pericardiotomy was done under the impression of cardiac tamponade. At operation, we noticed diffuse hemangiomatous lesion at epicardium and large amount of bloody pericardial effusion. We performed only diagnostic excisional biopsy because the lesion was too extensive and location was not suitable for total excision. The lesion was confirmed to be pericardial hemangioma histologically.
Biopsy ; Blood Pressure ; Cardiac Tamponade ; Dyspnea ; Heart ; Hemangioma* ; Humans ; Pericardial Effusion* ; Pericardiectomy ; Pericardiocentesis ; Pericardium

Colonoscopy is a relatively safe tool for diagnosis and treatment of colorectal disease. But colonic perforation during colonoscopy is a severe complication and sometimes becomes a life-threatening condition. It occurs with a frequency of 0.07% among patients having diagnostic colonoscopy and in up to 0.40% of patients having therapeutic colonoscopy. In these cases, surgical treatment is needed but endoscopic repair and conservative management could reduce the need for immediate operations. Endoscopic clipping has been the principal method for non-operative treatment of iatrogenic colonic perforation, but it has important limitations. One of them is that it is technically difficult to clip when the angle of approach is tangential. Here we report a case of an iatrogenic colonic perforation treated with endoscopic band ligation rather than endoscopic clipping, because of approach difficulties.
Colon ; Colonoscopy ; Humans ; Intestinal Perforation ; Ligation

Macrolides antibiotics synthesized by Streptomyces strains are prescribed widely and seldom produce hypersensitivity reactions, even when administered topically. Consequently, they are considered very safe drugs. We report the case of a 32.year.old woman who developed anaphylactic shock after ingesting erythromycin, which she had taken twice before. The previous exposure to erythromycin, clinical findings, and a positive skin intradermal test with erythromycin (10 mg/mL) support the postulate that anaphylaxis was induced by erythromycin.
Anaphylaxis ; Anti-Bacterial Agents ; Erythromycin ; Female ; Humans ; Hypersensitivity ; Intradermal Tests ; Macrolides ; Skin ; Skin Tests ; Streptomyces

Gangliocytic paraganglioma is a rare tumor that is usually seen in the duodenum. This neoplasm generally behaves in a benign fashion, although instances of recurrence and lymph node metastasis have been described. We experienced a case of incidentally found gangliocytic paraganglioma treated with endoscopic resection. A 61-year-old man was referred because of submucosal tumor adjacent to the major papilla. Endoscopic biopsy revealed paraganglioma. Abdominal CT showed that there was no evidence of a duodenal mass or lymphadenopathy. This tumor was resected endoscopically by electrosurgical snare polypectomy. The excised tumor measured 1.0 cm in diameter. Histopathological examination revealed a benign gangliocytic paraganglioma and the resection margins were free of tumor. At the 6-month follow-up, the patient was still asymptomatic and no residual tumor was detected at the resection site.
Biopsy ; Duodenum ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neoplasm Metastasis ; Neoplasm, Residual ; Paraganglioma ; Recurrence ; SNARE Proteins

Raoultella ornithinolytica (formerly Klebsiella ornithinolytica ) is a Gram-negative aerobic bacillus which belongs to the family Enterobacteriaceae. However, human infections caused by bacteria of the genus Raoultella are uncommon and their pathogenicity is not well known yet. Herein, we report a case of necrotizing fasciitis caused by R. ornithinolytica in a 51 years old female patient who presented with erythematous swelling after a plantar puncture wound from a thumbtack.
Bacillus ; Bacteria ; Enterobacteriaceae ; Fasciitis, Necrotizing ; Female ; Humans ; Klebsiella ; Punctures

This study outlines the current status of the autopsy practice and the medical records for autopsies at the Department of Pathology, Seoul National University Hospital. Total number of autopsy cases from 1954 to 1995 was 3,131. Adults aged over 17 were 371 cases and children were 2,515 cases. The demographic data in 245 cases was not available. The number of adult autopsies and its proportion among total number of autopsies during 10-year periods decreased from 144 cases (40%) during the 10-year-period from 1956 to 52 cases (3%) during the 10-year-period from 1986. The number of children cases during the same period groups increased slightly from 210 cases (58%) to 393 cases (25%). But the number of fetal cases increased rapidly from 7 cases (2%) to 1,146 cases (72%). Among fetal autopsies the proportion of fetuses died earlier than 24 weeks of gestation increased and this figure exceeds that of fetuses that died later than 24 weeks of gestation from 1992. Forty percent of the cases were submitted from the clinical departments of the Seoul National University Hospital but the remainders were referred from 73 hospitals. Final autopsy diagnoses were analysed according to the Korean Standard Classification of Disease (KCD)-3 coding system and by searching key words for all cases. Common diagnoses as coded among cases from 1990 were P9, P0, P2, Q2 and Q0. Common diseases by key words for adult cases were liver disease, tuberculosis and pneumonia. Common diseases for children cases were pneumonia, hyaline membrane disease, meningitis and tuberculosis. Through this study we could show the importance of autopsy services for fetuses. We could also establish a regular registration system for autopsies at general hospitals.
Adult ; Autopsy* ; Child ; Classification ; Clinical Coding ; Diagnosis ; Epidemiology ; Fetus ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Infant, Newborn ; Liver Diseases ; Medical Records ; Meningitis ; Pathology ; Pneumonia ; Pregnancy ; Seoul* ; Tuberculosis