An eccrine squamous syringometaplasia (ESS) is defined as a mature squamous metaplasia of the eccrine ducts. The clinical and pathological features of an ESS are presented. Syringometaplasia is a rare lesion, mostly occuring in the extremities, and as far as we know, no report on the ESS has been published in Korean literature. We experienced a case of an ESS occured in a 15 year-old male, who had a tender erythematous plaque in the right knee. The histologic examination revealed some scattered nests of metaplastic squamous epithelium in the deep dermis, associated with acute nonspecific panniculitis. The importance of the ESS is that it histologically simulates the well differentiated squamous cell carcinoma. The histopathologic findings were discussed and a brief review of the literature was made.
Adolescent ; Carcinoma, Squamous Cell ; Dermis ; Epithelium ; Extremities ; Humans ; Knee ; Male ; Metaplasia ; Panniculitis

Pigmented squamous cell carcinoma is a very rare malignant, pigmented, epidermal tumor. The rarity of pigmented squamous cell carcinomas may reflect in part their misdiagnosis as other pigmented neoplasms, particularly malignant melanoma. To our knowledge, only five cases have been reported in literature. We recently experienced a case of pigmented squamous cell carcinoma arising from pigmented actinic keratosis in a 77 years old female. Physical examination showed a 0.8 0.6 cm, smooth, dark brown pigmented patch with irregular but sharply defined borders located on the upper left chest. The biopsy specimen showed histologic findings of pigmented actinic keratosis with abundant melanin pigments, which became pigmented squamous cell carcinoma. Most of pigments in the squamous cell carcinoma were contained within the melanocytes along with the neoplastic squamous cells.
Actins* ; Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnostic Errors ; Female ; Humans ; Keratosis, Actinic* ; Melanins ; Melanocytes ; Melanoma ; Physical Examination ; Skin ; Thorax

We made a mistake in our recently published article.

PURPOSE: We report a case of orbital B-cell lymphoblastic lymphoma in a 7-year-old boy. METHODS: A 7-year-old boy presented with proptosis and periorbital swelling of his left eye following a periorbital blunt trauma 1-month prior. During the course of routine ophthalmologic and radiologic examinatinos, the swelling spontaneously subsided without specific treatment. An outpatient follow-up was planned, but the swelling recurred 6 months later. An orbital CT and MRI showed an irregular mass with an indistinct margin in the left orbit, for which an incisional biopsy was performed. RESULTS: The orbital mass consisited of monotonous small to medium sized lymphoid cells with evenly dispersed open chromatin, thin nuclear membrane and inconspicuous nucleoli. Immunohistochemistry revealed that the cells were positive for CD79a and TdT, but negative for CD3 and CD5. These findings were compatible with a diagnosis of B cell lymphoblastic lymphoma. CONCLUSIONS: Lymphoblastic lymphoma of the orbit should be suspected and considered in the differential diagnosis for children with acutely progressing orbital mass.
B-Lymphocytes* ; Biopsy ; Child ; Chromatin ; Diagnosis ; Diagnosis, Differential ; Exophthalmos ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lymphocytes ; Magnetic Resonance Imaging ; Male ; Nuclear Envelope ; Orbit* ; Outpatients ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

BACKGROUND: Although hyperbaric oxygen (HBO) -100% oxygen at two to three times the atmospheric pressure at sea level-has a number of beneficial biochemical, cellular, and physiologic effects, it is intrinsically associated with the potential for producing mild to severe toxic effects. The contribution of the cellular adhesion molecules and macrophages in the renal oxygen toxicity is not well understood. Thus, we have investigated the toxic effect of HBO expressed by the analysis of intercellular adhesion molecule-1 (ICAM-1) and infiltration of macrophages in rat kidney. METHODS: Male Sprague-Dawley rats weighing about 250 g were exposed to HBO at 3 ATA of 100% O2 for 4 hours. The expression of ICAM-1 and infiltration of CD68-positive macrophages were serially observed by immunohistochemical analysis. RESULTS: At 3 days after HBO exposure, CD68-positive macrophage counts were increased in glomeruli and tubulointerstitium of kidney. The expression of ICAM-1 was enhanced 1 day after HBO exposure and increased more for 3 days. There was a significant correlation between ICAM-1 expression and macrophage accumulation in the glomeruli. At 7 days after HBO, those alterations recovered to normal status. CONCLUSION: The 4-hour HBO exposure induced ICAM-1 expression and macrophage accumulation in the kidney and these change lasted for 3 days. Therefore, sustained activation of macrophages in renal oxygen toxicity may occur after prolonged (more than 4 hours) or repetitive exposures to HBO.
Animals ; Atmospheric Pressure ; Humans ; Intercellular Adhesion Molecule-1* ; Kidney* ; Macrophages ; Male ; Oxygen* ; Rats* ; Rats, Sprague-Dawley

Nerve sheath myxoma or neurothekeoma, a rare cutaneous neoplasm probably originating from the nerve sheath, is classified into three groups as classical, cellular, and mixed types based on cellularity, mucin content and growth patterns. Only two cases of nerve sheath myxoma have been reported in the Korean literatures. We report a case of nerve sheath myxoma occurring on the scalp of a 29 year-old woman. It was identified as the mixed type by histopathological, immunohistochemical and electronmicroscopic findings.
Adult ; Female ; Humans ; Mucins ; Neurothekeoma* ; Scalp ; Talus

Two cases of pulmonary atypical carcinoid tumor were diagnosed by fine needle aspiration cytology. Although the cytologic features of atypical carcinoid tumor have been relatively well described, it is easy to confuse atypical carcinoid tumor with typical carcinoid tumor, small cell carcinoma and adenocarcinoma of the lung. Atypical carcinoid tumor has been recognized as a distinct variant of pulmonary neuroendocrine carcinoma, with characteristic histopathologic and clinical features that separate it from both carcinoid and small cell carcinoma. The distinction of atypical carcinoid tumor from small cell carcinoma has important prognostic and therapeutic implications. The cytologic characteristics of atypical carcinoid tumor included polygonal to fusiform cells with a variable amount of lacy cytoplasm, oval nuclei with coarsely dispersed chromatin and frequent nucleoli, and mild pleomorphism. The malignant cells were arranged either in acinus-like clusters or in epithelial sheets.
Adenocarcinoma ; Biopsy, Fine-Needle* ; Carcinoid Tumor* ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Chromatin ; Cytoplasm ; Lung*

BACKGROUND: Acute adaptive vascular remodeling occurs in active and unstable inflammatory plaques. It has been suggested that the adaptive coronary vascular remodeling, in patients with acute coronary syndrome (ACS), may be systemic and may show similar vascular remodeling in the carotid arteries. We investigated the ultrasonographic features of the common carotid artery (CCA) to determine whether the arterial expansive remodeling found in the coronary artery occurs in the carotid arteries of patients with ACS. METHODS: We measured lumen diameter (LD), interadventitial diameter (IAD) and intima media thickness (IMT) using a B-mode ultrasound in both common carotid arteries in patients with ACS (N=74) and chronic stable angina (CSA) (N=31). Positive remodeling was arbitrarily defined as an IMTmax >1 mm and IAD >8 mm and negative remodeling as an IMTmax >1 mm and IAD <7 mm. Other values were defined as "no remodeling" RESULTS: There were no significant differences in LD IAD and maximal IMT of the right CCA and the left CCA in comparisons between the ACS and the CSA patient groups. There were no differences for number of cases with no remodeling or differences in positive and negative remodeling in the right common carotid artery and left common carotid artery in comparisons between the ACS and CSA patient groups. . Presence of plaque in both common carotid arteries showed similar frequency in the ACS and CSA patient groups. The characteristics of carotid artery plaques were not different in the two groups. The remodeling index (IAD/LD) was correlated with IMTmax (right CCA r=0.797, p<0.001; left CCA r=0.860, p<0.001). CONCLUSIONS: The common carotid arterial structure of ACS patients was not different from that of CSA patients. Therefore, these results suggest that the expansive arterial remodeling, due to coronary inflammatory plaques, appears to take place locally rather than systemically.
Acute Coronary Syndrome* ; Angina, Stable* ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Stenosis ; Coronary Vessels ; Humans ; Ultrasonography

BACKGROUND AND OBJECTIVES: Sleep related obstructive breathing disorders are frequently observed in adults. Despite extensive work of recent years, the essential pathophysiologic mechanism that mediates this process is still unclear. This study was conducted to determine whether distribution of connective tissue in the uvula is different among apneics, snorers and normal controls. MATERIALS & METHODS: Uvula was obtained by uvulopalatopharyngoplasty in 8 apneics, 6 snorers (mean apnea index: 17.1, 2.43 respectively) and by autopsy in 5 individuals not known to have snoring. The surgical specimen of uvula was fixed in 10% formalin and subsequently embedded in paraffin. Each specimen was cut into 5 micrometer-thick section and stained with hematoxylin-eosin for general appearance, Masson-Trichrome stain for collagen fiber, and Verhoeff stain for elastic fiber. Microscopic examination was performed by two pathologists who were blinded to the polysomnographic data. RESULTS: Infiltration of inflammatory cells and edema were significantly increased in the snorer and apneic groups compared with the control group (p<0.0001, p<0.05 respectively). Compared with the normal group, the density of elastic fibers and collagen fibers were significantly decreased in snorers and apneics (elastic fiber: p<0.0005, collagen fiber: <0.01). The distribution of elastic and collagen fiber showed significantly heterogeneous patterns in the snorer and apneic group compared to the control group (elastic fiber: p<0.001, collagen fiber: p<0.0005). CONCLUSION: Since connective tissue fibers have the supportive function in the body, this condition may result in increased collapsibility of upper airway and contributes to the development of obstructive sleep apnea.
Adult ; Apnea ; Autopsy ; Collagen* ; Connective Tissue ; Edema ; Elastic Tissue ; Elastin ; Formaldehyde ; Humans ; Paraffin ; Respiration ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Uvula

Previous molecular genetic studies of laryngeal squamous cell carcinoma (SCC)have shown certain chromosomal regions with recurring alterations. But studies of sequential molecular alterations and genetic progression model of laryngeal SCC have not been clearly defined. To identify the chromosomal alterations associated with the carcinogenesis of laryngeal SCC, we analyzed genomic DNA from microdissected squamous metaplasia, squamous dysplasia, invasive SCC, and metastatic carcinoma samples from 22 laryngeal SCC patients for loss of heterozygosity (LOH) at microsatellite loci. Ten microsatellite markers on chromosome 3p, 8p, 9p, and 17p were used. LOH at 9p21 was observed in the all stages including squamous metaplasia, squamous dysplasia, invasive SCC and metastatic carcinoma. LOH at 17p13.1, 3p25 and 3p14.2 was observed from the squamous dysplasia, invasive SCC and metastatic carcinoma. LOH at 8p21.3-p22 was observed mainly from the invasive SCC and metastatic carcinoma. The results suggest that 9p21 in the early event, 17p13.1, 3p25 and 3p14.2 in the intermediate event and 8p21.3- p22 in the late event may be involved in the laryngeal carcinogenesis.
Carcinoma, Squamous Cell/*genetics/pathology ; Chromosome Mapping ; *Chromosomes, Human, Pair 17 ; *Chromosomes, Human, Pair 3 ; *Chromosomes, Human, Pair 8 ; *Chromosomes, Human, Pair 9 ; Disease Progression ; Human ; Laryngeal Neoplasms/*genetics ; Larynx/pathology ; *Loss of Heterozygosity ; Lymphatic Metastasis ; Metaplasia/pathology ; Microsatellite Repeats ; Neoplasm Metastasis