Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis. It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L3-4 spine with bone involvement.
Adult ; Biopsy ; Fibromatosis, Aggressive/*diagnosis ; Humans ; *Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Spinal Neoplasms/*diagnosis ; *Zygapophyseal Joint

No abstract available.
Adenoma, Bile Duct* ; Bile Ducts* ; Bile* ; Cholangiocarcinoma*

BACKGROUND: The molecular pathogenesis of gastric carcinoma is not yet well characterized. The purpose of this study is to assess the role of beta-catenin in gastric carcinogenesis. METHODS: We analyzed beta-catenin expression using immunohistochemistry on 68 gastric adenomas and 34 gastric adenocarcinomas, and compared the result with pathological and molecular types of tumors and E-cadherin expression. RESULTS: Nuclear expression of beta-catenin was noted more frequently in gastric adenomas than in carcinomas (40% vs. 21%, 0.05< or = P<1). There was no significant relationship between nuclear beta-catenin expression and histologic degree of adenoma, histologic type of carcinoma or microsatellite instability. E-cadherin expression showed significantly more frequent decrease in the membrane stainability of carcinomas compared to adenomas (P<0.01). CONCLUSIONS: The frequent nuclear beta-catenin expression in gastric adenomas suggests that the beta-catenin alteration might play an early role in gastric carcinogenesis.
Adenocarcinoma ; Adenoma ; beta Catenin* ; Cadherins ; Carcinogenesis* ; Immunohistochemistry ; Membranes ; Microsatellite Instability ; Microsatellite Repeats ; Stomach Neoplasms

With the advent of checkpoint inhibitors, it has opened up opportunities for numerous cancer patients. However, as is the case with every treatment, complications need to be weighed. Gastrointestinal adverse effects, such as diarrhea and colitis are well-known complications for checkpoint inhibitors. In severe cases, colitis-induced colonic perforation may occur with an estimation of 1.0% to 1.5% in anti-CTLA-4 antibodies. However, only a handful of cases of such devastating complications have been reported in anti-PD-1 antibodies such as pembrolizumab and nivolumab. We here report a case of intestinal perforation in a patient treated with nivolumab.

With the advent of checkpoint inhibitors, it has opened up opportunities for numerous cancer patients. However, as is the case with every treatment, complications need to be weighed. Gastrointestinal adverse effects, such as diarrhea and colitis are well-known complications for checkpoint inhibitors. In severe cases, colitis-induced colonic perforation may occur with an estimation of 1.0% to 1.5% in anti-CTLA-4 antibodies. However, only a handful of cases of such devastating complications have been reported in anti-PD-1 antibodies such as pembrolizumab and nivolumab. We here report a case of intestinal perforation in a patient treated with nivolumab.

PURPOSE: To evaluate the safety and efficiency of the Ultrasound (US)-guided large needle core biopsy of axilla lymph nodes. MATERIALS AND METHODS: From March 2004 to September 2005, 31 patients underwent the US-guided core biopsy for axilla lymph nodes. Twenty five lesions out of 31 were detected during breast US, and 6 of 31 cases were palpable. Lymph nodes were classified based on their shape and cortical morphology. The core biopsy of axilla lymph nodes was performed on suspicious lymph nodes found during breast ultrasonography to find out whether the patients had a history of breast cancer or not. Among the 31 patients, 16 patients were associated with breast cancer. The lesion sizes varied from 0.6cm to 3.3cm (mean = 1.59 +/- 0.76cm). US-guided core biopsies were performed with 14G needles with an automated biopsy gun. Total 3 or 5 specimens were obtained. RESULTS: Among the 31 cases of axilla lymph nodes core biopsies, 11 cases showed malignant pathology. Seven out of 11 cases were metastatic lymph nodes from breast cancer; 2 cases were from primary unknown and 2 cases from lymphomas. On the other hand, 20 histopathologic results of axilla lesions were benign: subacute necrotizing lymphadenitis (n=2), dermatopathic lymphadenitis (n=1), reactive hyperplasia (n=10) and free of carcinoma (n=7). CONCLUSION: The US-guided large needle core biopsy of axilla lesions is safe and effective for the pathological evaluation. The core biopsy is believed to be easy to perform if suspicious lymph nodes or mass lesions are found in the axilla.
Adult ; *Axilla ; Biopsy, Needle/*methods ; Breast/pathology ; Female ; Humans ; Lymph Nodes/*pathology ; Middle Aged ; Reproducibility of Results ; Ultrasonography, Mammary/*methods

BACKGROUND: APC and E-cadherin are the key molecules in the Wnt/beta-catenin pathway. We attempted to define the epigenetic alteration of APC and CDH1 (the E-cadherin gene) and the expression of Wnt-related molecules in human mammary carcinomas. METHODS: Sixty-four mammary carcinomas, including 52 invasive ductal carcinomas (IDCs) and 12 invasive lobular carcinomas (ILCs), were evaluated using methylation-specific PCR and immunohistochemistry. We performed immunohistochemistry for E-cadherin, beta-catenin, APC, Wnt1, cyclin D1, ER, PR and C-erb B2. RESULTS: Hypermethylation of APC and CDH1 was observed in 38 (59%) and 28 (44%) cases, respectively. CDH1 hypermethylation in ILCs was increased compared to that in IDCs (p=0.002) and it was associated with the loss of E-cadherin (p=0.02) and beta-catenin (p=0.042). APC methylation was positively correlated with the ER expression (p=0.021). Abnormal cytoplasmic localization of beta-catenin was found in 10 cases and any expression was not detected in six cases. In ILCs, the E-cadherin or beta-catenin expression was markedly decreased compared to that in IDCs (p<0.001 in both). CONCLUSIONS: Methylation of APC or CDH1 was relatively frequent in mammary carcinomas. The loss of E-cadherin in mammary carcinoma was associated with CDH1 methylation, and abnormal beta-catenin expression was related to the loss of E-cadherin in ILC.
beta Catenin ; Breast ; Breast Neoplasms ; Cadherins ; Carcinoma, Ductal ; Carcinoma, Lobular ; Cyclin D1 ; Cytoplasm ; DNA Methylation ; Epigenomics ; Immunohistochemistry ; Methylation ; Polymerase Chain Reaction ; Wnt1 Protein

Hypersensitivity myocarditis may result from an allergic reaction to a variety of agents such as antibiotics, anticonvulsants and diuretics. A diagnosis of hypersensitivity myocarditis should be considered in any patient with an ongoing allergic reaction to a drug, evidence of peripheral eosinophilia, an appearance of new electrocardiographic changes, mildly elevated cardiac enzyme, mild cardiomegaly on chest X-ray or unexplained tachycardia. This condition is rarely recognized clinically although it is occasionally diagnosed on endomyocardial biopsy. We report a 25 year-old woman with hypersensitivity myocarditis, which was diagnosed by endomyo-cardial biopsy and successfully treated by immunosuppression therapy with corticosteroids.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Anticonvulsants ; Biopsy ; Cardiomegaly ; Diagnosis ; Diuretics ; Electrocardiography ; Eosinophilia ; Female ; Glucocorticoids ; Humans ; Hypersensitivity* ; Immunosuppression ; Myocarditis* ; Tachycardia ; Thorax

A 27-year-old woman presented with epigastric pain. Abdominal computed tomography revealed an irregular ulcer with circumferential thickening of the gastric antral wall. An endoscopy suggested advanced gastric cancer or gastric lymphoma. Biopsy of the lesion showed an inclusion body of the cytomegalovirus and positive immunohistochemical staining of the infected cell for cytomegalovirus. A thorough evaluation of her immune system revealed no abnormality. General supportive treatment for gastric ulcer did not relieve her symptoms. Intravenous infusion of ganciclovir improved her symptoms and healed the ulcer. We report a case of cytomegalovirus-associated gastric ulcer mimicking malignancy in an immunocompetent woman.
Adult ; Biopsy ; Cytomegalovirus* ; Endoscopy ; Female ; Ganciclovir ; Humans ; Immune System ; Inclusion Bodies ; Infusions, Intravenous ; Lymphoma ; Stomach Neoplasms* ; Stomach Ulcer* ; Ulcer

Primary ovarian angiosarcoma is very rare with only 27 cases reported so far in the medical literature. We report here on a rare case of ovarian microinvasive mucinous carcinoma that was coexistent with angiosarcoma in a 54-year-old woman. The tumor was a 26x19x10 cm-sized multilocular cystic mass with a 4x3 cm-sized solid hematoma-like nodule in the center. Microscopically, it was composed mostly of mucinous tumor of various grades from borderline to microinvasive carcinoma. The hematoma-like area turned out to be an angiosarcoma, composed of pleomorphic cells that formed slit-like spaces, spindle cells that formed short fascicles and anastomosing vascular channels with atypical endothelial cells. All these cells were positive for CD31, CD34 and factor VIII-related antigen. The patient developed peritoneal and pleural metastases, which were angiosarcoma and mucinous carcinoma, respectively. We believe this case is only the fourth example of an ovarian collision tumor of angiosarcoma and surface epithelial tumor.
Adenocarcinoma, Mucinous ; Cystadenocarcinoma, Mucinous ; Endothelial Cells ; Female ; Hemangiosarcoma ; Humans ; Middle Aged ; Mucins ; Neoplasm Metastasis ; Ovary ; von Willebrand Factor