1.A case of primary adenosquamous carcinoma of the liver.
Gu Hyum KANG ; Byung Seok LEE ; Dae Young KANG
Korean Journal of Hepato-Biliary-Pancreatic Surgery 2013;17(1):38-41
Adenosquamous carcinoma (ASC) is a rare tumor of the liver, which carries a poor prognosis. It has been reported mostly in the form of case studies. Recently, we experienced a case of primary ASC of the liver that has been preoperatively considered as cholangiocelluar carcinoma of the liver. Microscopically, the tumor was composed of adenocarcinoma, squamous cell carcinoma, as well as transitional area, including the transformation of adenocarcinoma to squamous cell carcinoma. The patient remained well with no evidence of post-resection complication or recurrence for 15 month.
Adenocarcinoma
;
Carcinoma, Adenosquamous
;
Carcinoma, Squamous Cell
;
Humans
;
Liver
;
Prognosis
;
Recurrence
2.The polypoid ganglioneuroma associated with hyperplastic polyposis.
Gu Hyum KANG ; Byung Seok LEE ; Dae Young KANG ; Hoon CHOI
The Korean Journal of Internal Medicine 2016;31(4):788-790
No abstract available.
Ganglioneuroma*
;
Intestine, Large
3.Clinical and Histopathological Study of Pheochromocytoma Arising in the Adrenal Gland.
Suk Ho HONG ; Gu Hyum KANG ; Dae Young KANG
Korean Journal of Medicine 2012;82(1):60-66
BACKGROUND/AIMS: The diagnosis and prognosis of malignant pheochromocytoma are important. Other than distant metastasis, the pathology is insufficient to diagnose malignant versus benign pheochromocytoma. METHODS: We analyzed 33 pheochromocytoma cases using the histological grade on the Thompson and Kimura scales. We compared the Thompson and Kimura scores with the degree of immunohistochemical staining for Ki-67 and heat shock protein 90 (Hsp90). RESULTS: The most frequent symptom was hypertension (17 cases; 51.5%) and four patients had accompanying tumors: one case each of multiple endocrine neoplasm, papillary carcinoma of the thyroid, gastric adenocarcinoma, and neurofibroma. The mean Thompson score was 3.67 in benign pheochromocytoma and 10 in malignant pheochromocytoma, and the Kimura score was 2.17 and 5, respectively. The average immunohistochemical staining for Ki-67 was 5.77 and 10.44 in benign and malignant pheochromocytoma, respectively, while Hsp90 immunohistochemical staining was positive only in the cytoplasm of malignant pheochromocytoma. CONCLUSIONS: Immunohistochemical staining for Ki-67 and Hsp90 was seen in malignant pheochromocytoma. The Thompson and Kimura scales and immunohistochemical results could help to differentiate benign and malignant pheochromocytoma.
Adenocarcinoma
;
Adrenal Glands
;
Carcinoma, Papillary
;
Cytoplasm
;
Heat-Shock Proteins
;
Humans
;
Hypertension
;
Ki-67 Antigen
;
Neoplasm Metastasis
;
Neurofibroma
;
Pheochromocytoma
;
Prognosis
;
Thyroid Gland
;
Weights and Measures
4.Histological comparison of colon polyps by endoscopic forceps biopsy compared to polypectomy.
Gu Hyum KANG ; Kyu Chan HUH ; Sun Moon KIM ; Tae Hee LEE ; Euyi Hyeong IM ; Young Woo CHOI ; Beom Kyoung KIM ; Young Woo KANG ; Gu Hyun KANG
Korean Journal of Medicine 2008;74(3):258-263
BACKGROUND/AIMS: Adenomatous polyps of the colon are believed to be precursor of colon cancer. Total polyp resection is indicated when they are identified. However, resection of the polyp is not always attainable at the initial colonoscopy. The aim of this study was to assess the validity of cold biopsy findings as representative of the whole polypectomy specimen, with regard to the histopathological features. METHODS: We analyzed 221 patients with colon polyps that were biopsied at their initial colonoscopy and had their adenomas subsequently removed by polypectomy within 2 weeks from the initial procedure. We analyzed the histopathological discrepancies between the cold biopsy and the polypectomy specimens. RESULTS: We analyzed 302 cases from 221 patients. There was 71.2% agreement between the forceps biopsy and the polypectomy. When colon polyps were diagnosed as carcinoma and villous adenomas, the diagnosis was the same in the polypectomy. Discrepancy between in forceps biopsy with polypectomy was found in the tubular adenomas obtained by forceps biopsy. Fifty tubular adenoma samples obtained by forceps biopsy had a deferent diagnosis than did the polypectomy. Fourteen of 50 tubular adenomas were underestimated by the forceps biopsy samples and seven of the 50 tubular adenomas were finally diagnosed as carcinoma from the polypectomy specimens. Seven villous adenomas were diagnosed as carcinoma and had severe dysplasia (n=4) or 1>=(n=1) size. CONCLUSIONS: Accurate tissue sampling of colorectal adenomas is crucial for their management. However, forceps biopsy does not accurately reflect the histology of colon polyps. Total resection of colon polyps is needed for an accurate diagnosis.
Adenoma
;
Adenoma, Villous
;
Adenomatous Polyps
;
Biopsy
;
Cold Temperature
;
Colon
;
Colonic Neoplasms
;
Colonoscopy
;
Humans
;
Polyps
;
Surgical Instruments
5.Peg-interferon induced autoimmune thyroiditis.
Gu Hyum KANG ; Tae Hee LEE ; Dong Mee LIM ; Keun Yong PARK ; Om Sub KWAK ; Mee Hye KWON ; Mi Il KANG
Korean Journal of Medicine 2008;74(1):90-93
Peg-interferon is the main therapeutic agent in patients infected with the hepatitis C virus. It is rather safe, but it is known to induce production of autoantibodies and it can lead to the occurrence of autoimmune disease. Interferon induced thyroiditis is considered a major clinical problem for patients who receive interferon therapy. We recently experienced a 36 year-old woman who developed peg-interferon induced thyroiditis. To the best of our knowledge, this is a rare case report in Korea. We report here on this casea long with a review of the literature.
Autoantibodies
;
Autoimmune Diseases
;
Female
;
Hepacivirus
;
Humans
;
Interferons
;
Korea
;
Thyroid Gland
;
Thyroiditis
;
Thyroiditis, Autoimmune
6.A Case of Metastatic Squamous Cell Carcinomas from the Endocervix to the Stomach without Local Recurrence.
Dong Hwan KIM ; Dae Soon KWON ; Gu Hyum KANG ; Sun Hyung KANG ; Hee Seok MOON ; Jae Kyu SUNG ; Hyun Yong JEONG ; Kyu Sang SONG
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(1):55-59
Extra-pelvic spread of squamous cell carcinoma (SCC) of the cervix to the stomach is extremely rare. We report a case of a 50-year-old woman who presented with dysphagia two years after diagnosis of SCC of the cervix. At esophagogastroduodenoscopy, there was a 1.5x1.2 cm sized ulcero-fungating mass at the cardia portion just beneath the esophagogastric junction which was biopsied for a suspected neoplastic lesion. Histologic and immunohistochemical examinations showed a SCC with characteristics identical to her original tumor from the cervix confirming gastric metastasis. Therefore, we report a case of endocervical SCC with metastatic lesions in the stomach 2 years after the initial diagnosis.
Carcinoma, Squamous Cell
;
Cardia
;
Cervix Uteri
;
Deglutition Disorders
;
Endoscopy, Digestive System
;
Esophagogastric Junction
;
Female
;
Humans
;
Neoplasm Metastasis
;
Recurrence
;
Stomach
;
Uterine Cervical Neoplasms
7.A Case of Metastatic Squamous Cell Carcinomas from the Endocervix to the Stomach without Local Recurrence.
Dong Hwan KIM ; Dae Soon KWON ; Gu Hyum KANG ; Sun Hyung KANG ; Hee Seok MOON ; Jae Kyu SUNG ; Hyun Yong JEONG ; Kyu Sang SONG
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(1):55-59
Extra-pelvic spread of squamous cell carcinoma (SCC) of the cervix to the stomach is extremely rare. We report a case of a 50-year-old woman who presented with dysphagia two years after diagnosis of SCC of the cervix. At esophagogastroduodenoscopy, there was a 1.5x1.2 cm sized ulcero-fungating mass at the cardia portion just beneath the esophagogastric junction which was biopsied for a suspected neoplastic lesion. Histologic and immunohistochemical examinations showed a SCC with characteristics identical to her original tumor from the cervix confirming gastric metastasis. Therefore, we report a case of endocervical SCC with metastatic lesions in the stomach 2 years after the initial diagnosis.
Carcinoma, Squamous Cell
;
Cardia
;
Cervix Uteri
;
Deglutition Disorders
;
Endoscopy, Digestive System
;
Esophagogastric Junction
;
Female
;
Humans
;
Neoplasm Metastasis
;
Recurrence
;
Stomach
;
Uterine Cervical Neoplasms
8.A Case of Liver Fibrosis with Splenomegaly after Oxaliplatin-Based Adjuvant Chemotherapy for Colon Cancer.
Gu Hyum KANG ; Hee Seok MOON ; Eaum Seok LEE ; Seok Hyun KIM ; Jae Kyu SUNG ; Byung Seok LEE ; Hyun Yong JEONG ; Heon Young LEE ; Dae Young KANG
Journal of Korean Medical Science 2013;28(12):1835-1838
Previous studies reported that oxaliplatin is associated with sinusoidal obstruction syndrome. However few reports on oxaliplatin induced liver fibrosis are found in the literature. Furthermore pathogenesis of liver fibrosis is not well known. We report a case of 45-yr-old Korean man in whom liver fibrosis with splenomegaly developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for colon cancer (T4N2M0). Thorough history taking and serological examination revealed no evidence of chronic liver disease. Restaging CT scans demonstrated a good response to chemotherapy. Five month after chemotherapy, he underwent right hepatectomy due to isolated metastatic lesion. The liver parenchyma showed diffuse sinusoidal dilatation and centrilobular vein fibrosis with necrosis without steatosis. We could conclude that splenomegaly was due to perisinusoidal liver fibrosis and liver cell necrosis induced portal hypertension by oxaliplatin. In addition, to investigate the pathogenesis of liver fibrosis, immunohistochemical stains such as CD31 and alpha-smooth muscle actin (alpha-SMA) were conducted with control group. The immunohistochemical stains for CD31 and alpha-SMA were positive along the sinusoidal space in the patient, while negative in the control group. Chemotherapy with oxaliplatin induces liver fibrosis which should be kept in mind as a serious complication.
Actins/metabolism
;
Antigens, CD31/metabolism
;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
;
Camptothecin/*analogs & derivatives/therapeutic use
;
Chemotherapy, Adjuvant
;
Colonic Neoplasms/*drug therapy
;
Fluorouracil/therapeutic use
;
Humans
;
Hypertension, Portal/etiology
;
Immunohistochemistry
;
Leucovorin/therapeutic use
;
Liver Cirrhosis/*diagnosis/etiology/pathology
;
Liver Neoplasms/secondary/surgery
;
Male
;
Middle Aged
;
Organoplatinum Compounds/*administration & dosage/adverse effects/therapeutic use
;
Splenomegaly/*diagnosis/etiology
;
Thrombocytopenia/etiology
;
Tomography, X-Ray Computed
9.Prognostic Significance of p53, mTOR, c-Met, IGF-1R, and HSP70 Overexpression after the Resection of Hepatocellular Carcinoma.
Gu Hyum KANG ; Byung Seok LEE ; Eaum Seok LEE ; Seok Hyun KIM ; Heon Young LEE ; Dae Young KANG
Gut and Liver 2014;8(1):79-87
BACKGROUND/AIMS: The current study examines the expression of molecular biomarkers in hepatocellular carcinoma (HCC) and whether these findings correlate with the clinicopathologic features of the disease and patient survival. METHODS: We analyzed the immunohistochemical expression of p53, mammalian target of rapamycin (mTOR), c-Met, and insulin-like growth factor 1 receptor (IGF-1R) heat shock protein 70 (HSP70) with the clinicopathologic features of 83 HCCs. RESULTS: p53 expression was higher in the male patients with undifferentiated histological tumor grades, cirrhosis, and portal vein invasion. High 48 c-Met expression correlated with cirrhosis, and high mTOR expression correlated with the tumor grade and cirrhosis. High IGF-1R expression correlated with the tumor grade and cirrhosis. A multivariate analysis identified a significant relationship between the high expression of p53, tumor grade, and portal vein invasion. In addition, a high expression of mTOR was related to tumor grade and cirrhosis, and a high expression of HSP70 was related to portal vein invasion in a multivariate analysis. The Kaplan-Meier survival curve for patients with high versus low Edmondson grades and p53 expression was statistically significant. CONCLUSIONS: p53, mTOR, and IGF-1R expression correlated with the Edmondson tumor grade in a univariate analysis, while p53 and mTOR correlated with the Edmondson tumor grade in a multivariate analysis. In addition, the tumor grade was found to predict survival. p53 was primarily related to the clinicopathologic features compared to other markers, and it is a poor prognostic factor of survival.
Adult
;
Aged
;
Carcinoma, Hepatocellular/*metabolism/surgery
;
Disease-Free Survival
;
Female
;
HSP70 Heat-Shock Proteins/metabolism
;
Humans
;
Liver Neoplasms/*metabolism/surgery
;
Male
;
Middle Aged
;
Prognosis
;
Proto-Oncogene Proteins c-met/metabolism
;
Receptor, IGF Type 1/metabolism
;
Retrospective Studies
;
Risk Factors
;
TOR Serine-Threonine Kinases/metabolism
;
Treatment Outcome
;
Tumor Markers, Biological/*metabolism
;
Tumor Suppressor Protein p53/metabolism
10.A Case of Spontaneous Esophagopleural Fistula Successfully Treated by Endoscopic Stent Insertion.
Gu Hyum KANG ; Beom Yong YOON ; Beom Hee KIM ; Hee Seok MOON ; Hyun Yong JEONG ; Jae Kyu SUNG ; Eaum Seok LEE
Clinical Endoscopy 2013;46(1):91-94
The most common cause of esophagorespiratory fistulas (ERFs) is associated with malignancy. The use of self-expandable metal stents is effective for the treatment of malignant ERFs, but benign ERF is rare, which is why its optimal treatment is not defined yet. There have been few reports describing benign esophagopleural fistula and its treatments in South Korea. Here, we report a rare case of spontaneous esophagopleural fistula, which was successfully treated by endoscopic placement of a membrane covered metal stent.
Fistula
;
Membranes
;
Republic of Korea
;
Stents