Epithelial myoepithelial carcinoma is a rare tumor with slightly less than one percent of salivary gland neoplasm. Histologically, the carcinomas are characterized by a mixture of trabecular structure with outer myoepithelial cells and inner ductal cells, which are confirmed by electron microscopy and immunohistochemistry. Although this neoplasm exhibits high degree of cellular differentiation histologically, it is classified into low grade carcinoma because of its locally infiltrative, destructive growth pattern, and tendency to metastasize. We report a 45-year-old woman with epithelial-myoepithelial carcinoma arising from a submandubular gland, one of the most unusual locations.
Female ; Humans ; Immunohistochemistry ; Microscopy, Electron ; Middle Aged ; Salivary Gland Neoplasms ; Submandibular Gland

A 65-year-old woman visited our hospital with a complaint of acute onset dyspnea and radiological manifestations of pulmonary thromboembolism. The patient underwent an exploratory surgery to find a whitish-blue colored mass occupying almost the whole lumen of the main pulmonary arteries. Based on the pathological and radiological findings, the patient was diagnosed to have a pulmonary arterial intramural hematoma. Intramural hematomas are usually observed in the walls of the aorta, and we believe that an isolated intramural hematoma in the pulmonary artery has not been described previously.
Aged ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Female ; Hematoma/*diagnosis/*surgery ; Humans ; Magnetic Resonance Imaging ; *Pulmonary Artery ; Thromboembolism/diagnosis ; Tomography, X-Ray Computed

Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.
Humans ; Influenza, Human ; Mediastinal Emphysema* ; Mediastinum ; Pneumorrhachis* ; Spinal Canal

BACKGROUND AND OBJECTIVES: The diagnosis of thyroid nodular diseases is critical for clinical management. Because of the histological similarity of follicular patterned thyroid lesions, the differential diagnosis is often difficult to determine, even with permanent sections. For this reason, we assessed the preoperative diagnostic usefulness of immunohistochemical staining for the four potential markers of malignant thyroid nodule, beta-galactosil binding lectin (Galectin-3), Hector Battifora Mesothelial cell (HBME-1), cytokeratin-19 (CK-19) and high molecular weight cytokeratin (HMW-CK) in tissues obtained by ultrasound-guided core needle biopsy. SUBJECTS AND METHOD: The immunohistochemical expression of Galectin-3, HBME-1, CK-19 and HMW-CK were evaluated in 43 preoperative thyroid lesions obtained to assess their potential as markers in the diagnosis and classification of thyroid malignancy. We compared the preoperative expression of the four markers with the results of postoperative permanent pathology. RESULTS: The expression patterns and positive rates of four markers were the variables in 4 thyroid lesions; however, all markers were strong in malignant thyroid nodules, especially in papillary carcinoma. There were no significant differences in the expression rates of the four markers between follicular carcinoma and follicular adenoma. The sensitivity of HBME-1 for thyroid malignancy was the highest (86%) among the four markers, but the sensitivity of combinational expression using two markers, especially Galectin-3 or HBME-1 (95%), HBME-1 or HMW-CK (90%), was higher than that of the expression using one marker for thyroid malignancy. CONCLUSION: The four markers were reliable markers for papillary carcinoma. In preoperative differential diagnosis of thyroid nodule, we suggest that the combinational expression using two makers is more useful than a single marker expression.
Adenoma ; Biopsy, Large-Core Needle ; Carcinoma, Papillary ; Diagnosis, Differential ; Galectin 3 ; Keratin-19 ; Keratins ; Molecular Weight ; Thyroid Gland ; Thyroid Nodule

A daily count of air borne pollen was done within the city limits of Seoul, Korea for a period of two years (1984-1985) using Durham's Gravity Sampling Device. Two major pollen seasons, March through May, and the month of September, were easily distinguishable. The concentration of the different types of pollen as well as all of the pollens combined varied similarly both years to a significant degree. The pollen types found in the greatest numbers were Alnus (March), Populus (April), Quercus (April-May), Pinus(May), grasses (September), and weeds (September). The main weed pollens detected in September, sagebrush, ragweed and Japanese hop would also be considered to be important allergenic pollens of respiratory allergy in Korea. The results of the survey are discussed in the light of especially relevant published literature.
Air Pollution/analysis* ; Comparative Study ; Human ; Korea ; Pollen/analysis* ; Seasons

Small cell carcinoma is primarily a lung malignancy occurring rarely in extra pulmonary sites such as the larynx, nasal cavity, paranasal sinuses, and oral cavity. The diagnosis was based on histological investigation expanded with immunohistochemical tests of a fragment of a tissue. The immunohistochemical stain was positive for synaptophysin, CD56 and cytokeratin. So we diagnosed small cell carcinoma. The treatment of small cell carcinoma diagnosis differed from the treatment of other neuroendocrine carcinomas and squamous cell carcinomas of the larynx. We report a case of 72-year-old man with a rare case of small cell carcinoma in the supraglottic region and a brief review of literature.
Aged ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Humans ; Keratins ; Larynx ; Lung ; Mouth ; Nasal Cavity ; Paranasal Sinuses ; Synaptophysin

Olfactory neuroblastoma is a rare, malignant neoplasm arising from the olfactory epithelium. It has an aggressive biological behavior that is characterized by local recurrence, atypical distant metastasis, and poor long-term prognosis. The incidence of cervical lymph node metastasis in olfactory neuroblastoma is variable, and treatment modalities are controversial. Moreover, few reports have been published concerning retropharyngeal lymph node metastasis from olfactory neuroblastoma. We present two cases of olfactory neuroblastoma with retropharyngeal lymph node metastasis. In addition, we provided a review of the current literature regarding olfactory neuroblastoma and retropharyngeal lymph node metastasis from olfactory neuroblastoma.
Esthesioneuroblastoma, Olfactory* ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Olfactory Mucosa ; Prognosis ; Recurrence

BACKGROUND AND OBJECTIVES: Olfactory neuroblastoma is a rare tumor arising from the olfactory neuroepithelium, for which surgery is the mainstay of treatment; but there are no generally accepted treatment approaches, according to tumor stage. In this study, we present our experiences with this tumor and the results of treatment to consider the clinical analysis and treatment modality. SUBJECTS AND METHOD: All of the patients, who had been treated for olfactory neuroblastoma at Severance hospital during the past ten years, were analyzed retrospectively and each of their diagnosis of olfactory neuroblastoma was histologically confirmed. RESULTS: Eleven patients aged 8 to 70 years were assessed, and 5 year disease-free survival rate were 60%. Sixty-four percent of those patients had received surgical treatment. Craniofacial resection was used mainly as an initial surgical treatment and followed by postoperative radiotherapy in 57% of the patients. If only cervical lymph node metastasis had developed at the initial diagnosis, elective neck treatment including bilateral neck dissection was performed. Chemotherapy was used either as postoperative adjuvant therapy, initial therapy with radiotherapy or salvage therapy, but not as an initial single treatment modality. Forty-five percent of the patients had recurrence and metastasis developed after the initial treatment. In the patients with cervical lymph node metastasis (n=1) and nodal recurrence (n=2), neck dissection was effective in nodal control. CONCLUSION: Complete surgical resection and postoperative radiotherapy were the main treatment modalities of olfactory neuroblastoma. Especially, postoperative radiotherapy is an essential treatment to both early- and advanced-stage olfactory neuroblastoma. Craniofacial resection is a main surgical modality, but in early stage, limited external intervention including endoscopic mass excision can be considered. If the patient has cervical lymph node metastasis or nodal recurrence, radical neck dissection should be performed. Chemotherapy seems to be considered as an adjuvant therapy, not single treatment modality.
Diagnosis ; Disease-Free Survival ; Drug Therapy ; Esthesioneuroblastoma, Olfactory* ; Humans ; Lymph Nodes ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome*

Aortobronchial fistula (ABF) involves the formation of an abnormal connection between the thoracic aorta and the central airways or the pulmonary parenchyma and is associated with an increased risk of mortality. An ABF typically manifests clinically with symptoms of hemoptysis, and currently, there is a lack of defined guidelines for its treatment. Here, we report the cases of two patients who suffered from recurrent hemoptysis due to ABF with pseudoaneurysm. We propose that removal of the aorta with concomitant lung resection and coverage of the aorta using the pericardial membrane is a definite treatment to lower recurrence of ABF and persistent infection.

Patients with traumatic aortic rupture rarely reach the hospital alive. Even among those who arrive at the hospital alive, traumatic aortic rupture after high-speed motor vehicle accidents leads to a high in-hospital mortality rate and is associated with other major injuries. Here, we report a rare case of descending midthoracic aortic rupture with blunt diaphragmatic rupture. Successful management with emergency laparotomy after an immediate endovascular procedure resulted in a favorable prognosis in this case.