Pigmented extraadrenal paraganglioma is an unusual neoplasm that has rarely been reported in the literature. Based on histochemical staining or electron microscopy, pigment has been classified as lipofuscin, neuromelanin or true melanin. We report a case of pigmented extraadrenal paraganglioma in the posterior mediastinum of a 70-year-old woman. Histologically, the tumor had a characteristic organoid architecture of "zellballen" pattern with rich delicate microvasculature. Tumor cells contained numerous coarse brown-black pigment granules. Ultrastructurally, the tumor showed abundant large electron-dense pigment granules that vary in size and shape and smaller membrane-bound neurosecretory granules. The larger granules were consistent with neuromelanin or lipofuscin. Histochemically, the pigment is most likely neuromelanin, which is a waste product of catecholamine metabolism.
Aged ; Female ; Humans ; Lipofuscin ; Mediastinum ; Melanins ; Metabolism ; Microscopy, Electron ; Microvessels ; Organoids ; Paraganglioma* ; Waste Products

Since the renal epidermoid cyst is too rare, the mechanisms of squamous morphogenesis have not well characterized. A 73-year-old female was referred with an incidentally detected renal pelvis mass. Abdominopelvic computed tomography scan revealed a noncalcified soft tissue mass in the renal pelvis. Total nephroureterectomy was performed under the impression of a renal pelvis malignancy. The patient was discharged without postoperative complication. The outer surface of mass lesion was lined with urothelia and squamous epithelia, containing keratinous materials. The urothelia were positively stained against uroplakin II and cytokeratin 7, whereas almost of the squamous epithelia were negative with uroplakin II. The two different epithelia were generally sharply demarcated. Interestingly, some part of squamous epithelia contained uroplakin-positive and many more cytokeratin 7-positive cells. The atypical clinical features in our case can reconsider the diagnostic clues of renal epidermoid cysts that have been reported before, and the unique immunohistochemical results may understand the histogenetic implications of the lesion.
Epidermal Cyst ; Female ; Humans ; Keratin-7 ; Keratins ; Kidney ; Kidney Pelvis ; Morphogenesis ; Postoperative Complications ; Uroplakin II ; Uroplakins

Pigmented(melanotic) schwannoma is a very rare variant of schwannoma that characteristically has massive cytoplasmic melanin. Since it was described in 1946 by Bjorneboe, about 44 cases have been reported in the English literature. It has a relatively benign clinical course, but the cases arising in the cranial nerve and sympathetic chain show aggressive behavior with malignant potential. We herein report a typical case of pigmented schwannoma with light microscopic findings. The results of immunohistochemical and electronmicroscopic study are also presented. The patient was a 30 year-old Korean male who had a mass in his posterior neck for 10 years that recently.began to induce neurologic manifestations. The tumor, which was mainly in the extramedullary intradural space of the cervical canal extending to the extradural space and soft tissues of the neck, was relatively well defined and composed of black solid tissue. Microscopic, densely pigmented spindle cells forming fascicles, nuclear palisading, whorling and polygonal cells with vacuolated or clear cytoplasm were characteristic. Immunohistochemically, the tumor cells were positive for vimentin, S-100 protein, and HMB-45. Electron microscopic study revealed that the tumor cells have interdigitating cytoplasmic processes containing varying stages of melanosomes with a very focal basal lamina and Luse body like collagen bundles.
Male ; Humans

No abstract available.
Colonoscopy* ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Leiomyoma of the urethra is a rare condition, which is more common in female than in male subjects. A case of leiomyoma of female urethra in a twenty-two years old female arising from anterior lip of the external urethral meatus is presented. The presenting symptoms were painless mass on the anterior lip of the external urethral meatus and voiding difficulty. The mass was easily removed by surgical resection and confirmed as leiomyoma histologically.
Female* ; Humans ; Leiomyoma* ; Lip ; Male ; Urethra*

OBJECTIVE: To determine the pattern of expression of p63, p27, and p53 as well as Ki-67 and its efficacy to discriminate the cervical lesion such as intraepithelial lesion, microinvasive carcinoma, and invasive carcinoma in surgical sample. METHODS: Cervical tissue samples were obtained from 64 patients visited Hanyang University Medical Center via hysterectomy, conization, punch biopsy, and polypectomy from September 2001 to February 2002. The biopsies were stained with Hematoxylin-Eosin (HE) to detect dysplasia (mild, moderate, severe), microinvasive carcinoma, and invasive carcinoma. All samples were stained immunohistochemically for Ki-67, p63, p27, and p53 to determine the location and proportion of positive cells. The differences of expression patterns between each group were analized using Kruskal-Wallis test of SPSS ver. 10.0 and a result of p<0.05 was judged significant. RESULTS: K-67 and p63 positive cells were highly correlated with the grade of dysplasia and invasiveness (p<0.0001). There were no differences of expression proportion between each group in p53 and p27. Ki-67 and p63 expression were increased in LSIL and HSIL groups, but not significant statistically in Ki-67 groups. In ASCUS group, Ki-67 and p63 expression level were higher but not significant statistically in p63 groups. In CIS/SCC groups, Ki-67 and p63 expression levels were higher than any other groups. CONCLUSION: We confirmed the efficacy of Ki-67, the cell proliferation marker for discrimination of CIN. Along with p63 immunohistochemical stain, Ki-67 can be used for auxiliary test to detect microinvasive squamous cell carcinoma and to discriminate CIN. p63 may be helpful in detecting cancer cell invading stromal tissue and can be used as a marker of differentiation of squamous cell for poorly differentiated tumor or mixed type tumor.
Academic Medical Centers ; Biomarkers* ; Biopsy ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervical Intraepithelial Neoplasia* ; Conization ; Discrimination (Psychology) ; Humans ; Hysterectomy

Selective termination can be used to preserve normal fetus from the other fetus with chromosomal, structural abnormality in multifetal pregnancy. This case is about twin pregnant patient who had undergone in vitro fertilization and embryo transfer. In 18 weeks of gestation, we found that one of the fetus had cranical encephalocele and was in concern for the termination by using ultrasound guided intrcardiac injection of 2.5 ml of potassium chloride solution. After performing this procedure the other healthy female newborn was naturally delivered at 38 weeks gestation with weight of 2.8 kg.
Embryo Transfer* ; Embryonic Structures* ; Encephalocele* ; Female ; Fertilization in Vitro* ; Fetus ; Humans ; Infant, Newborn ; Potassium Chloride ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Twin ; Twins, Dizygotic* ; Ultrasonography

BACKGROUND: Osteopontin (OPN) is a glycoprotein and it participates in cell-cell and cell-matrix interactions. In vitro studies suggest that the OPN expression is associated with tumor metastasis, and especially with the metastasis of osteotropic tumors originating in breast, prostate and lungs. Since no human tissue study has suggested the means by which OPN participates in the tumorigenesis, angiogenesis, progression and metastasis of renal cell carcinoma (RCC), we evaluated the expression and prognostic significance of OPN in RCC. METHODS: Immunohistochemistry was performed with using the primary antibody for OPN on the archival paraffin-embedded tissue microarray specimens from 51 RCC patients who underwent radical or simple nephrectomy. RESULTS: In the normal kidney specimens, OPN was expressed in a few compressed distal tubules adjacent to the RCCs. In RCCs, the OPN expression was elevated in larger tumors (p<0.05) and in the tumor with low microvessel density (p<0.01). In the present study, univariate analysis indicated that stage, tumor size, lymph node and distant organ metastasis are significant prognostic factors for disease free survival (DFS) in RCC patients (p<0.01), but OPN is not (p=0.0661). Multivariate analysis indicated lymph node metastasis is the independent prognostic indicator of DFS (p<0.05). CONCLUSION: Though this study has statistical limitations, these results suggest OPN plays a role in tumor progression and metastasis and it may act as a potential prognostic indicator to predict the prognosis of RCC patients.
Anoxia ; Breast ; Carcinogenesis ; Carcinoma, Renal Cell* ; Disease-Free Survival ; Glycoproteins ; Humans* ; Immunohistochemistry ; Kidney ; Lung ; Lymph Nodes ; Microvessels ; Multivariate Analysis ; Neoplasm Metastasis ; Nephrectomy ; Osteopontin* ; Prognosis ; Prostate

PURPOSE: We performed invasive thermometry to verify the elevation of local temperature in the liver during hyperthermia. MATERIALS AND METHODS: Three 40-kg pigs were used for the experiments. Under general anesthesia with ultrasonography guidance, two glass fiber-optic sensors were placed in the liver, and one was placed in the peritoneal cavity in front of the liver. Another sensor was placed on the skin surface to assess superficial cooling. Six sessions of hyperthermia were delivered using the Celsius TCS electro-hyperthermia system. The energy delivered was increased from 240 kJ to 507 kJ during the 60-minute sessions. The inter-session cooling periods were at least 30 minutes. The temperature was recorded every 5 minutes by the four sensors during hyperthermia, and the increased temperatures recorded during the consecutive sessions were analyzed. RESULTS: As the animals were anesthetized, the baseline temperature at the start of each session decreased by 1.3degrees C to 2.8degrees C (median, 2.1degrees C). The mean increases in temperature measured by the intrahepatic sensors were 2.42degrees C (95% confidence interval [CI], 1.70-3.13) and 2.67degrees C (95% CI, 2.05-3.28) during the fifth and sixth sessions, respectively. The corresponding values for the intraperitoneal sensor were 2.10degrees C (95% CI, 0.71-3.49) and 2.87degrees C (1.13-4.43), respectively. Conversely, the skin temperature was not increased but rather decreased according to application of the cooling system. CONCLUSION: We observed mean 2.67degrees C and 2.87degrees C increases in temperature at the liver and peritoneal cavity, respectively, during hyperthermia. In vivo real-time thermometry is useful for directly measuring internal temperature during hyperthermia.
Anesthesia, General ; Animals ; Fever* ; Glass ; Liver* ; Peritoneal Cavity ; Skin ; Skin Temperature ; Swine ; Thermometry ; Ultrasonography

PURPOSE: To evaluate the usefulness of color Doppler ultrasonography in the differential diagnosis of breast masses. MATERIALS AND METHODS: We prospectively evaluated to pathologically proven breast lesions. Forty-three were benign (39 fibroadenomas, two papillomas and two lipoma) and 27 were malignant (25 infiltrating ductal cardinomas, one mucinous carinoma and one atypical medullary caricinoma). In 32 cases, we categorized color signal from 0 to III, according to the degree of vascularity, and analysed peak systolic velocity (PSV) and resistive index (RI). RESULTS: Color signals of malignant lesions tended to be high grade (II, III), whereas those of benign lesions tended to be low (0, I), and the difference was statistically significant (P<0.005). In the analysis of spectral waveform , correlation between RI, PSV and malignancy was statistically significant (P<0.02). RI above 0.7 and PSV above 10 were the highest recorded values for sensitivity and specificity. CONCLUSION: Color Doppler ultrasound is a useful modality to distinguish benign from malignant breast masses. Malignancy is suggested when the color signal is grade II or III, the resistive index is higher than 0.7, and peak systolic velocity is higher than 10cm/sec.
Breast* ; Diagnosis, Differential ; Fibroadenoma ; Mucins ; Papilloma ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography ; Ultrasonography, Doppler, Color*