Struma ovarii, the most common monodennal teratoma of the ovary, causes diverse problems in differential diagnosis. The literature on the pathology of struma ovarii has focused principally on the problem of formulating criteria of malignancy. In contrast, unusual gross and microscopic features of struma ovarii and its resultant problems in differential diagnosis have received relatively little attention. We report an ovarian teratoma which was almost entirely cystic, causing the diagnosis of struma to be overlooked. The removed ovarian tumor showed all the features of adenomatous goiter of the thyroid gland. The lining epithelium of the cysts was frequently flattened, and the follicles in the cyst wall were few and atrophic. The patient was a 58-year-old woman who was found to have an ovarian tumor by routine monographic examination
Diagnosis ; Diagnosis, Differential ; Epithelium ; Female ; Goiter* ; Humans ; Middle Aged ; Ovary ; Pathology ; Struma Ovarii* ; Teratoma ; Thyroid Gland*

Neoplasms showing both carcinomatous and sarcomatous features are well established, and have been reported in practically every organ where carcinoma can occur. But the difference in terminology and difficulties in histopathologic interpretation have hampered adequate understanding of these neoplasms. We report a case of carcinosarcoma in the recurrent form of serous cystadenocarcinoma of the ovary. The patient was a 64-year-old female who underwent total hysterectomy and bilateral salpingoophorectomy three years ago, due to perforated papillary serous cysta denocarcinoma of the right ovary. Recurrent pelvic masses contained both carcinomatous and sarcomatous components. Morphological transition between carcinomatous and sarcomatous components, and epithelial characteristics in the sarcomatous component by immunohistochemistry were recognized. We postulate the histopathogenetic mechanism based on the phenotypic conversion of carcinoma into sarcoma in the carcinosarcoma.
Carcinosarcoma* ; Cystadenocarcinoma, Serous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Middle Aged ; Ovary* ; Sarcoma

A case of an ovarian mucinous cystadenocarcinoma with mural nodules of anaplastic carcinoma is reported. The patient was a 46-year-old female with a right ovarian cystic mass and underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient died of the disease in five months. Macroscopically, the right ovarian cyst wall contained numerous well-demarcated mural nodules. Histologically, the cysts were mucinous cystadenocarcinoma, and the nodules were composed of sarcoma-like spindle and polygonal cells with atypia and numerous mitoses. Spindle cells in the mural nodule showed epithelial characteristics by electron microscopy and immunohistochemistry. This case supports an epithelial origin of the mural nodule of anaplastic carcinoma in ovarian mucinous tumors.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Mitosis ; Mucins* ; Ovarian Cysts ; Ovary

Sarcomatoid renal cell carcinoma is an uncommon tumor that has to be distinguished from renal carcinosarcoma. We have described three cases of sarcomatoid renal cell carcinoma showing different clinical and light microscopic features. An ultrastructural study of the tumor cells from the sarcomatoid area revealed frequent desmosomal junction, confirming the epithelial nature of the neoplasm. All three cases showed an aggressive clinical course and tended to invade adjacent organs or tissues. We believe that an histological and immunohistochemical examination in conjunction with an electron microscopic examination are necessary to diagnose sarcomatoid renal cell carcinoma.
Carcinoma, Renal Cell* ; Carcinosarcoma* ; Desmosomes ; Microscopy, Electron

Multilocular cystic renal cell carcinoma is a distinct subtype of renal cell carcinoma with its pathological characteristics and good prognosis. Multilocular renal cysts and renal cell carcinoma with cystic change are important differential diagnoses. We report a case of multilocular cystic renal cell carcinoma in a 37-year-old woman who came to the hospital because of the right renal mass. The removed right kidney showed a 6x4 cm well defined cystic mass in the lower pole. On cut section there were multiple cavities in the mass, filled with serosanguineous fluid and focal yellowish solid area. Microscopically, these cysts were lined by a single layer of flat or cuboidal cells consisted of clear cytoplasm with small central nuclei. In some portions of the tumor, the clear neoplastic cells formed sheets within the septa or walls of the cysts.
Adult ; Carcinoma, Renal Cell* ; Cytoplasm ; Diagnosis, Differential ; Female ; Humans ; Kidney ; Multicystic Dysplastic Kidney ; Prognosis

No abstract available.
Ureaplasma urealyticum* ; Ureaplasma*

Total 40 cases of serial bone scans with Tc99-m-MDP performed on less than 24 hour, 2nd day, 3rd day, 5th day, 1 week, 4 week, 12 week and 1 year respectively after fractures in tibia were analysed. All 5 cases of bone scans performed within 24 hour after injury showed increase in generalized tracer uptake and 3 cases of them(60%) showed localized increase in tracer uptake at the fracture sites. The earliest bone sean performed 9 hour after injury showed generally and locally increased uptake at the fracture sites. All 5 cases of bone scan performed 1 year after injury sinowed localized increased uptake at the fracture sites and 2 cases of them (40%) showed generalized increase in tracer uptake. Bone scans performed 12 week after injury showed the most outstanding increase in generalized and localized tracer uptake. Bone scans performed 1 year after injury showed decreased amount of generalized increase in tracer uptake (but more increased uptake than normal) but the localized increase in traccer uptake at the fracture sites was observed persistently. More study should be needed to clarify the corelationship between the presence of cold spots during the fracture healing and the union of the fractures. It is difficult to differentiate the old fractures to fresh fractures with the bone scans performed within 1 year because of persistent increase in tracer uptake to 1 year after fracture.
Fracture Healing ; Tibia ; Tibial Fractures

We observed the effect of application of n-PTFE on mandibular bone defects in the rabbit. GTR is based on the hypothesis that during wound healing, non-osteogenic cells are mechanically blocked from entering a bone defect. This allows the slower-migrating mesenchymal cells from the surrounding bone and marrow, having osteogenic potential, to move the defect site. Bilateral through & through defects, 8mmx4mm in size, involving the inferior border of mandible, were created in the mandible angle of 15 rats. The experimental side was applied with high-density n-PTFE membrane, with the opposite side serving as a control. In the first week of the early experimental period, the bone defects of experimental groups were filled with highly vascularized fibrous connective tissue showing prominent osteoblastic activity with osteoid formation, whereas the defects of control were replaced by dense fibro-muscular tissue without osteoblastlf activity. After 3 weeks, the experimental group revealed well formed bone trabeculae and fibro-vascular marrow within surrounding membrane. With time the amount of new bone was decreased with increase of hematopoietic marrow, and the cortical plate composed of dense mature bone was more thicker. In the whole experimental periods, the inflammation and foreign body reaction were not found around the inserted n-PTFE membrane. After removal of membrane there was marked remodeling of newly formed bone by active osteoclasts in periosteal soft tissue, which decreased the bone volume apparently. These findings suggest that n-PTFE has biocompatibility, flexibility, and rigidity and offer rapid bone regeneration within limited area by the membrane. On the other hand, the early removal of membrane caused reduction of bone volume by the osteoclastic resorption. Thus, the time of removal may be more important factor for maintenance of regenerated bone volume.
Animals ; Bone Marrow ; Bone Regeneration ; Connective Tissue ; Foreign-Body Reaction ; Hand ; Inflammation ; Mandible ; Membranes ; Osteoblasts ; Osteoclasts ; Pliability ; Rabbits* ; Rats ; Wound Healing

Cerebral amyloid angiopathy (C.A.A) is characterized by the extracellular amyloid protein deposition in the vessel walls of the brain and meninges. It has been estimated to account for 5 to 10% of all primary, nontraumatic brain hemorrhage. We report two cases of C.A.A causing nontraumatic intracerebral hemorrhage in the frontal lobe. The first case was a 60-year-old female who was admitted for the left hemiplegia and dysarthralgia. Brain CT revealed right frontal lobe hemorrhage. The second case was a 72-year-old male who was admitted for amnesia and gait disturbance. Clinical impression was Alzheimer's disease. Brain MRI revealed multifocal small hemorrhage in the right frontal lobe. Microscopically, both cases showed dilated small arteries of superficial cortex and meninges with hyalinization. Some vessels showed microaneurysm and fibriniod necrosis. Congo-red stain also exhibited birefringence under polarized light. There was no evidence of Alzheimer's disease.
Aged ; Alzheimer Disease ; Amnesia ; Amyloid ; Arteries ; Birefringence ; Brain ; Cerebral Amyloid Angiopathy* ; Cerebral Hemorrhage ; Female ; Frontal Lobe ; Gait ; Hemiplegia ; Hemorrhage ; Humans ; Hyalin ; Intracranial Hemorrhages ; Magnetic Resonance Imaging ; Male ; Meninges ; Middle Aged ; Necrosis

Human papillomavirus (HPV) 16/18 is a causative agent of uterine cervical carcinoma. HPV 16/18 can alter cell cycle regulation through apoptosis. Bcl-2 is an important regulatory gene of apoptosis. A study was done to evaluate the relation between HPV 16/18 and bcl-2 and apoptosis in 21 cases of carcinoma in-situ (CIS), 5 cases of microinvasive carcinoma and 23 cases of invasive squamous cell carcinoma. HPV 16/18 was detected by hybrid capture system (HCS), bcl-2 protein by immunohistochemical method and apoptosis by using the hematoxylin-eosin stained slide. The results were as follows: Expression of the bcl-2 protein was 43% (9/21) in CIS and 26% (6/23) in invasive carcinoma. Expression of the bcl-2 protein was 42% (5/12) in CIS with HPV 16/18 infection, 44% in CIS without HPV 16/18 infection, 20% (2/10) in invasive carcinoma with HPV 16/18 infection and 31% (4/13) in invasive carcinoma without HPV 16/18 infection. Mean apoptotic index (mAI) was 3.36 in CIS, 5.23 in microinvasive and 6.25 in invasive carcinoma. mAI was 3.66 in CIS with HPV 16/18 infection, 2.86 in CIS without HPV 16/18 infection, 6.18 in invasive carcinoma with HPV 16/18 infection and 6.30 in invasive carcinoma without HPV 16/18 infection. Based on these results, we conclude that there are no correlation between HPV infection and bcl-2, and between HPV infection and apoptosis in invasive and in situ carcinoma of the uterine cervix, and apoptosis is increased according to tumor progression.
Apoptosis* ; Carcinoma, Squamous Cell* ; Cell Cycle ; Cervix Uteri* ; Female ; Genes, Regulator ; Humans