Though the incidence of paragonimiasis has been remarkably decreased since 1970, it is still not a rare disease in Korea. Major problems in the diagnosis of pulmonary paragonimiasis on chest radiography are its differentiation from pulmonary tuberculosis and lung cancer. Chest radiographic findings have been described in detail, but little have been reported on CT findings. We reviewed CT findings of 10 patients with pulmonary paragonimiasis. The characteristic CT findings were similar to those on chest radiography, such as air-space consolidation (70%), nodular mass (50%), pleural effusion (40%), cystic lesion (30%), small low density within the mass (30%), linear density (20%), pneumothorax(20%), and burrow track (20%). CT depicted the cystic lesions and the burrow tracks more clearly and showed the small worm-retaining cysts within the mass that were not detectable on chest radiography. In conclusion, all of these CT findings are useful in the diagnosis of pulmonary paragonimiasis especially when differentiation from tuberculosis or lung canceris difficult on chest radiography.
Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Paragonimiasis* ; Pleural Effusion ; Radiography ; Radiography, Thoracic ; Rare Diseases ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

We report a case of multiple myeloma that presented as a fluctuating sixth cranial nerve palsy in the absence of widespread signs of systemic disease. A 63-year-old woman presented with horizontal diplopia of two weeks duration that subjectively changed over time. Ocular examination showed a fluctuating sixth nerve palsy. A computed tomography (CT) scan of the brain showed multiple, enhancing, soft tissue, mass-like lesions involving the left cavernous sinus and the apex of both petrous bones. Based on bone marrow biopsy and hematologic findings, she was diagnosed with multiple myeloma. Multiple myeloma may be included in the differential diagnosis of a fluctuating sixth nerve palsy, and although ophthalmic signs are rare and generally occur late in the course of multiple myeloma, they can still be its first signs.
Abducens Nerve Diseases/diagnosis/*etiology ; Brain/pathology/radiography ; Diagnosis, Differential ; Diplopia/etiology ; Esotropia/etiology/physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma/*complications/diagnosis ; Tomography, X-Ray Computed

BACKGROUND: Syndecan-1 and beta-catenin are cell adhesion molecules, which are expressed primarily on the surface of adult epithelial cells. The expressions of them have been appeared to be inversely correlated with tumor aggressiveness and invasiveness. OBJECTIVE: The purpose of this study was to investigate the expression of syndecan-1 and beta-catenin in tissue sections of the nodular and high-risk (micronodular and infiltrative type) basal cell carcinomas. METHODS: Ten cases of nodular basal cell carcinoma and 10 cases of high-risk basal cell carcinoma (each 5 cases of micronodular and infiltrative type) were investigated. Specimens were assessed for syndecan-1 and beta-catenin expression, using a semi-quantitative method in which the intensity of membranous staining was evaluated. RESULTS: In a nodular basal cell carcinoma, syndecan-1 and beta-catenin were expressed as similar intensity to normal epidermis. In high-risk basal cell carcinoma, syndecan-1 always showed decreased staining intensity relative to that showed in the normal skin. But, beta-catenin showed similar to normal epidermis in the 5 cases, and decreased intensity relative to that of the normal epidermis in the rest. CONCLUSION: Our results suggest that the decreased expression of syndecan-1 and beta-catenin in basal cell carcinoma is associated with the tumor aggressiveness. Especially, of the two adhesion molecules, syndecan-1 is more associated with the high-risk basal cell carcinoma.
Adult ; beta Catenin ; Carcinoma, Basal Cell ; Cell Adhesion Molecules ; Epidermis ; Epithelial Cells ; Humans ; Skin ; Syndecan-1

Birt-Hogg-Dube syndrome (BHDS) is an autosomal dominantly inherited disorder characterized by multiple trichodiscomas, fibrofolliculomas, and acrocordons. There is also an increased risk of developing renal neoplasms and lung cysts/spontaneous pneumothorax. We present a 43-year-old man with multiple, 2~4 mm sized, dome-shaped, and skin-colored papules on his cheek and neck. On the basis of clinical finding and histopathologic examination on the cheek lesion, it was diagnosed as multiple trichodiscomas. Subsequently, molecular analysis revealed a mutation in the folliculin gene. We report a rare case of BHDS with a proved gene mutation.
Adult ; Birt-Hogg-Dube Syndrome ; Cheek ; Estrone ; Humans ; Kidney Neoplasms ; Lung ; Neck ; Pneumothorax

Cutaneous metastasis from the ovarian cancer has been found to be exceedingly rare. We report a case of a metastatic ovarian mucinous cystadenocarcinoma, which clinically manifested as the epidermal cyst-like skin nodule on the right upper quadrant of abdomen.
Abdomen ; Cystadenocarcinoma, Mucinous ; Humans ; Neoplasm Metastasis ; Ovarian Neoplasms ; Skin

Eruptive collagenoma is an acquired connective tissue nevus composed predominantly of collagen. We present a case of eruptive collagenoma in a 13-years-old female who had asymptomatic multiple 3 to 9 mm sized flesh colored scattered papules on both limbs. In addition, the differential diagnosis and other types of cutaneous collagenomas are briefly discussed.
Collagen ; Connective Tissue ; Diagnosis, Differential ; Extremities ; Female ; Humans ; Nevus

A 37-year-old female presented with a conjunctival mass discovered 3 years prior. An excisional biopsy revealed a patternless proliferation of round and spindle-shaped cells with an eosinophilic fibrillary cytoplasm and vesicular nuclei with occasional inclusions. Psammoma bodies were arranged around the dilated irregularly-shaped vessels. Differential diagnoses included conjunctival solitary fibrous tumor (SFT), nevus, glomangioma, ectopic meningioma, and mesectodermal leiomyoma. The tumor cells were immunoreactive for CD34, CD99, bcl-2 and vimentin, and were negative for smooth muscle actin, desmin, glial fibrillary acidic protein, S-100 protein, epithelial membrane antigen, and human melanoma black-45. Ultrastructurally, the tumor cells had rough endoplasmic reticulum, free ribosomes, and scattered mitochondria without basal lamina or cellular junctions, which are features of fibroblasts. A diagnosis of SFT was rendered based on the light microscopic, immunohistochemical, and electron microscopic findings. We report here on the second case of a SFT arising in the conjunctiva, which clinically and histologically mimics conjunctival nevus, glomangioma, ectopic meningioma, and a hybrid neurogenic-myogenic tumor such as mesectodermal leiomyoma.
Actins ; Adult ; Antigens, CD34 ; Basement Membrane ; Biopsy ; Chimera ; Conjunctiva ; Cytoplasm ; Desmin ; Diagnosis, Differential ; Electrons ; Endoplasmic Reticulum, Rough ; Eosinophils ; Female ; Fibroblasts ; Glial Fibrillary Acidic Protein ; Glomus Tumor ; Humans ; Leiomyoma ; Light ; Melanoma ; Meningioma ; Mitochondria ; Mucin-1 ; Muscle, Smooth ; Nevus ; Ribosomes ; S100 Proteins ; Solitary Fibrous Tumors ; Vimentin

BACKGROUND: The incidence of cutaneous malignant tumors has been continuously increasing worldwide. OBJECTIVE: The purpose of this study was to analyze recent trends in the incidence of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in patients from Gwangju City and Chonnam Province. METHODS: We reviewed clinical data and histopathological reports of 82 cases of BCC and 60 cases of SCC in outpatients who had visited the department of dermatology at Chosun University Hospital between 2006 and 2010. RESULTS: The male-female ratio was 0.61:1 in patients with BCC and 0.87:1 in patients with SCC. The most frequent age group was the eighth decade (42% BCC and 67% SCC). Mean patient ages were 65.1 years and 67.8 years, respectively. The most common involved site was the face (90.2% BCC and 78.3% SCC), particularly the cheek. More skin cancers were found on the left than the right side of head and neck area in male automobile drivers only. The most frequent histological BCC subtype was the nodulocystic type (59.7%), followed by the pigmented (12.1%), and adenoid type (9.7%). The most frequent histological pattern of SCC was the well-differentiated type (66.6%). Development of BCC (61.3%) was more frequent than that of SCC in sun-exposed areas. CONCLUSION: Our data were similar to those previously reported. In our study, no difference in demographic variables such as age, gender or residence were found between patients with BCC and SCC. Additionally, no differences were observed in the incidence of BCC or SCC among the other variables. Further cohort studies that include cumulative lifetime sun exposure and a large sample size are needed.
Adenoids ; Automobiles ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Cohort Studies ; Dermatology ; Head ; Humans ; Incidence ; Male ; Neck ; Outpatients ; Sample Size ; Skin Neoplasms ; Solar System ; Statistics as Topic

OBJECTIVES: Cardiopulmonary support has been used to treat the patients with refractory cardiogenic shock since 1950s. In advent of portable system its use has been widened considerably. In this retrospective study, we report our single center experience concerning possible indications, complications and outcomes of percutanous cardiopulmonary support (PCPS). METHODS: From January 2013 to March 2014, we searched the patients who were supported by PCPS system by reviewing the medical records in cardiology department at our Hospital. Infectious organism was limited to what was identified within 2 weeks after weaning of PCPS. RESULTS: A total of 9 patients were supported by PCPS with CAPIOX CX(R) system (Terumo inc., Tokyo, Japan) initially for ST-segment elevation myocardial infarction/non ST-segment elevation myocardial infarction in 4 patients, myocarditis in 3 patients, valvular heart disease in 1 patient, and acute respiratory distress syndrome in 1 patient. The mean duration of PCPS support was 79.1+/-76.6 hours and 5 of them were recovered and discharged alive. All the patients needed transfusions of various forms of blood products. And there was one major stroke and one hyperbilirubinemia in related to PCPS treatment. CONCLUSIONS: PCPS treatment was a valuable means to treat the patients with cardiovascular collapse, but not without costs. Efforts to reduce its associated complications should be made to improve outcomes.
Busan ; Cardiology ; Heart Valve Diseases ; Humans ; Hyperbilirubinemia ; Medical Records ; Myocardial Infarction ; Myocarditis ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Shock, Cardiogenic ; Stroke ; Weaning

Sinusoidal hemangioma is a rare variant of cavernous hemangioma. Clinically, it develops in adults and predominantly in females, and presents as a solitary painless subcutaneous nodule. Histological finding of the sinusoidal hemangioma shows a well-circumscribed lobular architecture in the subcutaneous tissue. The lobulated mass is composed of dilated sinusoidal thin-walled vascular channels, which have a pseudopapillary pattern and back-to-back arrangement without much intervening stroma. We report a case of sinusoidal hemangioma which can be differentiated from the other vascular tumors and has never been reported in Korea.
Adult ; Female ; Hemangioma* ; Hemangioma, Cavernous ; Humans ; Korea ; Subcutaneous Tissue