Helicobacter pylori infection has been shown to be associated with gastric carcinoma. However, despite the frequent detection of seropositivity for H. pylori and histologic detection in biopsy specimen, histologic detection rate of H. pylori in surgical specimens has been low. In this study, we investigated the prevalence of H. pylori infection in gastrectomy specimens bearing gastric adenocarcinoma and compared it with both endoscopic biopsy and serologic results. H. pylori infection was identified by Giemsa stain in the mucosa stripped from the tumor, body, and antrum in 61 gastrectomy specimens. We evaluated the effect of H. pylori infection on gastric mucosal cell proliferation by using monoclonal antibody for Ki-67. H. pylori detection rate using Giemsa stain was higher in gastrectomy specimens (67.3%) compared to that (48.1%) of biopsy specimens (p=0.006). The detection rate was higher in body than that of antrum or tumor site in the same patients (p=0.001). The H. pylori seropositivity was 60.5% and relatively nonspecific. The mean value of Ki-67 labeling index in the H. pylori-positive group was higher than that in the H. pylori-negative group (p<0.05). The increase in gastric epithelial cell proliferation was not influenced by the location of the tumor or the site of the specimen. The results suggest that the actual prevalence of H. pylori infection in patients with gastric carcinoma is considerably higher than that evaluated on endoscopic biopsy specimens. In addition, the increased cell proliferation in the H. pylori-positive group suggests some evidence that H. pylori may be involved in gastric carcinogenesis.
Adenocarcinoma* ; Azure Stains ; Biopsy ; Carcinogenesis ; Cell Proliferation ; Epithelial Cells ; Epithelium* ; Gastrectomy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Mucous Membrane ; Prevalence

Three cases of sclerosing stromal tumor of the ovary are presented. All three patients were nulliparous young wemen of 23~25 years of age, presenting with menstrual irregularity for 6 months to 4 years. Grossly the tumors ranged in size from 8 to 22cm in greatest diameter, showing gray white to yellow solid or predominantly cystic tissue with serous fluid. The common microscopic finding was that of cellular areas admixed with densel fibrous and/or edematous tissue, presenting pseudolobular appearance. Two types of tumor cells were rounded cells with clear vacuolated cytoplasm and less numerous spindle shaped cells. Postoperative course was uneventful and menstrual irregularity disappeared postoperatively. In case 2, the patient got pregnant after 1 year and 4 months. This clinical course suggests that sclerosing stromal tumor of the ovary may be endocrinologically active.
Pregnancy ; Female ; Humans

Sex cord tumor with annular tubules (SCTAT) is a rare ovarian neoplasm which usually occurs in two forms. In patients associated with Peutz-Jeghers syndrome, the tumors are usually small, bilateral or multifocal, and show benign clinical course. However, tumors from patients without the syndrome are often large, usually unilateral, and rarely show malignant behavior. Serous surface papillary carcinoma (SSPC) is an aggressive neoplasm which involves peritoneal linings, including ovarian surface. Recently, we encountered a case of an unusual combination of SCTAT and SSPC in the ovary of a 55-year-old Korean woman presented with abdominal distention for one year. Systemic review and physical examination were within normal limit, except for abdominal discomfort and distention. There was no stigmata of Peutz-Jeghers syndrome in all diagnostic examinations, including gastroscopy and colonoscopy. Pelvic computed tomography showed adnexal mass with multiple peritoneal nodules. Exploration revealed uterine and ovarian surfaces covered with multiple, yellow-white papillary nodules. However, the sizes of both ovaries were within normal limit. Typical serous papillary carcinomas were identified in nodules from peritoneum and ovarian surfaces. Well-circumscribed columnar epithelial cell nests composed of ring-shaped tubules encircling hyalinized basement membrane-like materials were found in the ovary away from serous surface papillary carcinoma.
Carcinoma, Papillary* ; Christianity ; Colonoscopy ; Epithelial Cells ; Female ; Gastroscopy ; Humans ; Hyalin ; Middle Aged ; Ovarian Neoplasms ; Ovary* ; Peritoneum ; Peutz-Jeghers Syndrome ; Physical Examination

Pagets disease has been well known disease in western countries, but it is extremely rare in orient and no case has been reported in Korea yet. It is a chronic osseous disease affecting middle and late life, characterized by progressive skeletal deformities which consist of excessive resorption and abnormal regeneration. We experienced a case of Paget's disease in a 57-year old man with involvement of pelvis, femur and skull, and confirmed with open biopsy.
Biopsy ; Congenital Abnormalities ; Femur ; Korea ; Pelvis ; Regeneration ; Skull

A total of 36 typical Krukenberg tumors of the ovary was obtained from the pathology file of the Department of Pathology, College of Medicine, Seoul National University during a period of 17 years from January 1968 to December 1984. By definition, all were characterized by the presence of mucin containg signet ring cells within the cellular, nonneoplastic ovarian stroma. The clinico-pathologic characteristics of 36 Krukenberg tumors were as follow: The Krukenberg tumors accounted for 16.3% of all ovarian malignancies. The age of the patient at the time of diagnosis of the Krukenberg tumor ranged from 28 to 69 years with an average of 43 years. A primary carcinoma of stomach (31 cases) of colon (1 case) was found in 32 (88.9%) of 36 patients. The primary carcinomas was not detected in four cases, and autopsy was not performed in any case. In 22 cases the primary carcinomas had been diagnosed before ovarian tumors were found. The ovarian and the primary carcinomas were identified synchronously in 6 cases, while in 8 cases the primary carcinomas were not discovered until after the ovarian tumors had been treated. The gross diameter of the ovarian tumor ranged from 1.5cm to 28cm with an average of 10.3cm. The largest weighed 4,550gm. The Krukenberg tumors typically formed rounded or reniform, solid mass that were coarsely lobulated or bosselated. The cut surface was yellow white and associated frequently with nodular, myxoid or gelatinous area and cystic changes of various size. Both ovaries were involved in 29(80.6%) of the cases and one ovary in 7(19.4%). Krukenberg tumors classified into the three major types on the basis of the characteristic morphologic patterns of signet ring cells. The first type was classic Krukenberg tumor(28 cases) represented by predominent components of typical signet ring cells. The second type was tubular Krukenberg tumor(5 cases) characterized by tubular structures resembling a Sertoli-Leydig cell tumor. The third type was re tiform Krukenberg tumor (3 cases) characterized by an irregular network of elongated, often slitlike tubules and cysts, which resembled the rete testis.

Three cases of angiosarcoma of the breast are described. One case in a 66 year old woman was a solid mass and histologically showed poor differentiation leading to a death 14 months after the diagnosis. Another two in 46 and 25 year old females were large vascular masses showing moderate differentiation with endothelial tufting and papillary projections, and abdominal and contralateral mammary, and liver metastasis occurred within postoperative 10 months and 6 months in each case. A radical mastectomy and adjuvant chemotherapy in case 2 were not lifesaving. Although histologic degree of differentiation seems prognosis-related, angiosarcoma is the most malignant tumor of the breast.
Female ; Humans ; Neoplasm Metastasis

The epidermoid cyst of the testis is a rare benign lesion with a characteristic gross and microscopic appearances. This 25 year old male who had been previously diagnosed as Klinefelter's snydrome (47/XXY) had right orchiectomy due to hard testicular nodule for a presented malignant testicular tumor. Sectioning of the testis revealed a intraparenchy matous cystic lesion, 1.5 cm in diameter, filled with cheesy white material. Histologically, stratified squamous epithelium lined the cyst. The remaining testis showed advanced tubular sclerosis and Leydig cell hyperplasia. It is necessary to submit multiple sections to rule out other histologic elements in the cyst wall or the presence of a scar. Although epidermoid cyst occurring as a solitary testicullar nodule could be regarded as a stage in the development of a teratoma, they need to be distinguished from the complex differentiated teratomas because of a distinct difference in prognosis.
Male ; Humans ; Cysts

Fibrous hamartoma of infancy is a distinct clinicopathologic entity with unique microscopic findings and benign clinical course. This tumor is composed of intervening dense fibrocollagenous trabeculae, well defined mucoid areas and varying amounts of mature fat, which are arranged in organoid growth pattern. We report three typical cases of this tumor which were experienced during the recent two years at the Seoul National University Hospital. It is the first description on this tumor in Korean literature. Case 1 was a 10 month old boy who was admitted due to a mass in the right infra clavicular area for 6 months. The mass showed irregular and poorly circumscribed outer surface. Case 2 was a one month old girl who was presented with a diffuse ill defined hairy mass in the left buttock since birth. Case 3 was a 15 month old boy who was brought to the hospital due to well circumscribed scrotal mass fot 8 months. Microscopically all three cases showed very similar histological features. And all 3 cases are well after the removal of the tumors.
Hamartoma

Seventy five cases of squamous cell carcinoma of the uterine cervix, invasion depth of which was less than 5 mm from the basement membrane, were reviewed during a period of 9 years from 1975 to 1983 at SNUH and investigated clinicopathologically by the following items; 1) lymphnode metastasis 2) vascular invasion 3) recurrence 4) pattern of invasion 5) cell type. Following results were obtained. 1) Lmyphnode metastasis was demonstrated in 4 out of 75 cases (5.3%). One of them had stromal invasion to 1.3 mm and the other three to a depth of 3.1 to 5.0 mm. 2) Vascular invasion was seen in 5 among the cases (6.7%) and well related to the depth of invasion. Vascular invasion did not occur in tumors with 3 mm depth of stromal invasion. 3) Three patients were with recurrence, treated by postoperative radiation. The depth of stromal invasion was over 2 mm in all of them. 4) The pattern of invasion was confluent in 26 out of 28 cases (92%) whose stromal invasion were over 2 mm depth, while only 3 confluency of 27 cases (11%) invaded less than 1 mm depth. 5) There was no good relationship between the tumor cell type and the depth of stromal invasion. Based on the above results, it is concluded that diagnostic criteria of microinvasive squamous cell carcinoma of the uterine cervix is stromal invasion not exceeding a depth of 3 mm from basement membrane of surface or glandular epithelium.
Neoplasm Metastasis

The diagnosis of calcifying epithelioma is more easily made on the basis of the histopathological findings than the clinical manifestations. Calcifying epidermal cyst is only one that must be differentiated from calcifying epitheIioma because of its similarity in histopathological findings. 9 cases of calcifying epithelioma which have been collected at Seoul National University Hospital for the past ten years, frorn October 1960 to September 1970, are reported. Summary of the clinical and histopathological findings are as follows; 1) Range of age: one to sixty years old. 2) Ratio of sex: nearly equal in both sexes (5 male, 4 female.) 3) The final diagnosis of all of the cases was made not on the clinical basis but on the histopathological findings. 4) Only one case out of nine showed multiple skin lesions.
Carcinoma* ; Diagnosis ; Epidermal Cyst ; Humans ; Male ; Seoul ; Skin