We report a rare case of carcinosarcoma arising in the stomach. The tumor is presented in the posterior wall of the gastric lower body and antrum of a 56-year-old man. Grossly the tumor has polypoid appearance with diffuse surface ulceration and measures 5.5 cm in diameter. The tumor is accompanied with three separate well differentiated early gastric adenocarcinomas (two EGC type IIc & IIa). Microscopically, the tumor consists of moderately well differentiated adenocarcinoma in the periphery, and lobulated sarcomatous areas in the center, which shows chondroid differentiation. Transitional areas between adenocarcinoma and chondrosarcoma are evident. Immunohistochemical studies show positivity for cytokeratin and carcinoembryonic antigen in the epithelial component, and for vimentin and S-100 in the sarcomatous component. The transitional areas are positive in carcinoembryonic antigen, vimentin, S-100, and cytokeratin. The tumor extended to the subserosa and showed metastasis of only adenocarcinomatous component in six out of 47 dissected perigastric lymph nodes.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinosarcoma* ; Chondrosarcoma ; Humans ; Keratins ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Stomach* ; Ulcer ; Vimentin

Fibroepithelial polyps of the ureter are usually acquired rather than congenital. Most polyps are hamartomatous growths which tend to arise in the proximal portion of the left ureter. Most patients exibit either hematuria or persistent flank pain secondary to partial ureteral obstruction. Because of false positivity of urine cytology, as well as intravenous pyelogram, the correct diagnosis is confused with malignancy. Herein we report four cases of ureteral fibroepithelial polyp, which are associated with stones resulting in partial obstruction of the ureter. One of the four cases is associated with nephrogenic adenoma in the lamina propria of the adjacent ureter. The following report describes clinicopathologic findings of fibroepithelial polyp with review of literatures.
Adenoma

PURPOSE: To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CT findings and its usefulness in patients of abdominal trauma. MATERIALS AND METHODS: CT scans of 27 patients who were confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Of these 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed were bowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesenteric infiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury only and with both bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such as liver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. RESULTS: Findings observed were bowel wall thickening in 23 cases(85%), peritoneal fluid collection in 21 (78%), highly attenuated bowel wall in 19(70%), mesenteric infiltration in 17(63%), free intraperitoneal air in 10 (37%) and sentinel clot in 7(26%). Pneumoperioneum were observed in 10 of 24 patients(41.7%) having bowel perforation. Two cases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant difference in the prevalence of the CT findings between the patient group with bowel injury only and the patient group with both bowel and meseneric injury. CONCLUSION: CT scan is a useful tool in evaluating the degree and extent of bowel and/or mesenteric injury as well as in planning the patient's management.
Abdominal Injuries ; Abscess ; Ascitic Fluid ; Diagnosis ; Hemorrhage ; Humans ; Kidney ; Liver ; Pancreas ; Prevalence ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed ; Urinary Bladder

A rare case of hepatic metastasis with a choriocarcinomatous component from a composite adenocarcinoma and choriocarcinoma of the sigmoid colon in a 60-year-old man is reported. The hepatic metastasis displayed choriocarcinoma with extensive hemorrhagic necrosis. The tumor cells were poorly differentiated with scattered foci of bizzare syncytiotrophoblastic cells. Retrospective examination of the previous colonic carcinoma proved that the tumor was composed of two distinctive elements. One was a moderately well differentiated adenocarcinoma located in mucosa and submucosa. The other was a deep seated and undifferentiated carcinoma which was made up of hyperchromatic bizzare cells with syncytiotrophoblastic cells. There were transitional foci from adenocarcinoma to undifferentiated carcinoma with trophoblastic cells. Immunohistochemical staining showed beta-hCG expression in the undifferentiated cells of both the primary and the metastatic tumors. Implications for the possible origin and cause of tumor cell heterogeneity are briefly discussed.
Adenocarcinoma* ; Carcinoma ; Choriocarcinoma* ; Colon ; Colon, Sigmoid* ; Female ; Humans ; Middle Aged ; Mucous Membrane ; Necrosis ; Neoplasm Metastasis* ; Population Characteristics ; Pregnancy ; Retrospective Studies ; Trophoblasts

No abstract available.
Chorionic Gonadotropin* ; Fertilization in Vitro* ; Humans*

PURPOSE: We studied the accuracy of high resolution computed tomography in staging chest wall/fissural invasion of peripheral lung cancer. MATERIALS AND METHODS: HRCT findings in 27 patients with suspected chest wall (n=18) or fissural (n=16) invasion of peripheral lung cancer were correlated with surgical and pathologic findings. The HRCT images were restrospectively evaluated for pleural thickenings adjacent to mass, maximal contact length (cm) between mass and chest wall/fissure, angle between the mass and chest wall/fissure, ratio of maximal contact to mass diameter, abnormality of extrapleural fat layer, mass extension across the fissure and fissural irregularity adjacent to mass. Various CT findings and the presence or absence of chest pain were correlated with surgical and pathologic findings. RESULTS: For the evaluation of chest wall invasion, abnormality of extraphleural fat layer was the most useful finding (sensitivity 100 %, specificity 36 %, accuracy 61 %). The remaining HRCT findings proved to have high sensitivity but low specificity, and a high false positive rate. For chest pain, sensitivity was 43 % and specificity, 82 %. In cases without chest pain, the positive predictive value of extraphleural fat abnormality was 44 % ; in the absence of chest pain and extrapleural fat abnormality,positive predictive value was zero. The evaluation of transfissural tumor invasion using variable HRCT findings proved to be accurate, especially when the criteria of mass extension across the fissure and fissural irregularity adjacent to the mass were used (accuracy 81 % and 75 %, respectively). CONCLUSION: Using the finding of 'extrapleural fat abnormeality', HRCT was accurate in the staging of chest wall invasion and its predictability was betten than that of other results obtained with conventional CT. Chest pain had high specificity but low prevalence, and extrapleural fat abnormality was more valuable in cases without chest pain. HRCT proved to be accurate in the evaluation of transfissural invasion of lung cancer using the findings 'fissural cross' and 'fissural irregularity'.
Chest Pain ; Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Thoracic Wall* ; Thorax*

Among the precancerous lesions, dysplasia of the uterine cervix and adenoma of the colon have been widely studied in terms of genetic alterations. However, little has been performed regarding phenotypic alterations of the precancerous lesions. We investigated the relationship among cellular proliferation, clonality, immortality and histopathologic grading of the squamous epithelial lesions of the uterine cervix. Proliferation index (PI) was calculated based on the ratio of the epithelial cells positive for proliferating cell nuclear antigen to the total epithelial cells. Clonality was assayed by X-linked HUMARA polymorphism. For immortality assay, PCR-based TRAP (telomeric repeat amplification protocol) was done and telomerase processivity was calculated by comparison with the positive control. PI increased gradually as the lesions advanced from dysplasia to invasive carcinoma. Among informative case, all of the carcinoma in situ showed monoclonal pattern (7 of 7). Among invasive squamous cell carcinoma, 6 cases showed monoclonal pattern and 2 cases polyclonal pattern. TRAP reaction was positive in 92.6% (25 of 27) of dysplasia (high grade: 14 of 15; low grade: 11 of 12), 95.0% (19 of 20) of carcinoma in situ, 100% (9 of 9) of microinvasive carcinoma, and 92.9% (13 of 14) of invasive carcinoma. It was also positive in 12 of 12 samples of chronic cervicitis or squamous metaplasia near the lesions of dysplasia. There was no difference in TRAP positivity among the dysplasia, carcinoma in situ and invasive carcinoma, whereas telomerase processivity showed significant correlation. These results suggest that proliferative activity and telomerase processivity may be progressive events in oncogenesis, although telomerase activation may be an early event.
Adenoma ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Cell Proliferation ; Cervix Uteri ; Colon ; Epithelial Cells ; Female ; Metaplasia ; Proliferating Cell Nuclear Antigen ; Telomerase ; Uterine Cervicitis

Tumoral form of pseudoangiomatous stromal hyperplasia (PASH) of male breast is a rare disease entity. We report on a case of PASH that presented as a palpable subareolar breast mass in a 46-year-old male who has been on hemodialysis due to chronic renal failure. To the best of our knowledge, no case of PASH in a male with chronic renal failure has yet been reported. We describe its mammographic and sonographic findings with correlative histopathologic features, confirmed by surgical excision.
Angiomatosis ; Breast ; Breast Diseases ; Humans ; Hyperplasia ; Kidney Failure, Chronic ; Male ; Rare Diseases ; Renal Dialysis

PURPOSE: To obtain basic data on cyclic vomiting syndrome(CVS) and clinical findings of CVS. METHODS: Fifteen patients diagnosed as CVS from April 1995 to July 1999 were enrolled in this study. RESULTS: Among 15 children with CVS(11 boys, 4 girls), 4 patients were put in the migraine group and 11 patients in non-migraine group. The onset age ranged from 7 months to 11.4 years(mean: 5.5 years). The prodromal symptoms of the migraine group were headache, flank pain and unpleasant feeling, and those of the non-migraine group were abdominal pain and dizziness. Vomiting began at characteristic times specific for each individual in 73% of patients; in the migraine group, 75% had syrnptoms on arising in the morning. In the non-rnigraine group, 36% were wakened during the night and 27% had symptoms on arising in the morning and 9% had episodes beginning at other characteristic tirnes and the rernaining 27% at no characteristic times. Durations of episodes were of fairly uniform length and mostly between 2 days and 10 days. In regards to precipitating factors, stress was the most frequently mentioned and other reported precipitants included infections, and sensitivity to food and hot or cold weather. Continuous vomiting causes ketosis, electrolyte irnbalance, poor growth, peptic esophagitis and other cornplications, including learning problems and psychosocial dysfunction. Both groups had positive response to prokinetic agents. CONCLUSION: There was no clinical differences between the migraine group and non-migraine group. The response to therapy was poor, but the response to prokinetic agents was better than that to anti-migraine agents.
Abdominal Pain ; Age of Onset ; Child ; Dizziness ; Esophagitis, Peptic ; Flank Pain ; Headache ; Humans ; Ketosis ; Learning ; Migraine Disorders ; Precipitating Factors ; Prodromal Symptoms ; Vomiting* ; Weather

No abstract available.
Acrosome Reaction* ; Acrosome* ; Male ; Semen*