We report a case of tracheopathia osteoplastica(TO) that.involvedboth larynx and tracheobronchus. On CTscans, the laryngeal and tracheobronchial cartilages were thickened with irregular calcification. Multiple nodules with or without calcification were seen protruding into the lumen from the anterior and lateral walls.
Cartilage ; Larynx

We report a case of tracheopathia osteoplastica(TO) that.involvedboth larynx and tracheobronchus. On CTscans, the laryngeal and tracheobronchial cartilages were thickened with irregular calcification. Multiple nodules with or without calcification were seen protruding into the lumen from the anterior and lateral walls.
Cartilage ; Larynx

The glandular lesions of the uterine cervix can be classified into endocervical glandular dysplasia (EGD), adenocarcinoma in situ (AIS) and adenocarcinoma, but the diagnostic criteria and the continuity of endocervical glandular lesions are still controversial. The aim of this study was to evaluate the significance of immunohistochemical findings of p53 and MIB-1 in the discrimination and the continuity of EGD, AIS and adenocarcinoma. The materials for the study included 11 cases of adenocarcinoma, 7 cases of AIS, 12 cases of high grade EGD, and 19 cases of low grade EGD. Also included were eleven benign glandular lesions (5 cases of tuboendometrial metaplasia, 3 cases of mesonephric remnant, 3 cases of microglandular hyperplasia). A strong reaction of more than 5% of the glandular epithelial nuclei was interpreted as positive for p53 protein. MIB-1 expression was analyzed semiquantitatively as negative, 1 , 2 , 3 , depending on the percentage of positive nuclei (less than 1%, 1~9%, 10~39%, > or = 40%, respectively). p53 protein expression was found in 3 (27.3%) out of 11 cases of adenocarcinoma, and 2 (28.6%) out of 7 cases of AIS. But all of high and low grade EGD cases were negative. High MIB-1 labelling index (> or =10%) was found in all adenocarcinoma cases and in 3 (42.9%) out of 7 cases of AIS. But only 2 (17.7%) out of 12 cases of high grade EGD showed high MIB-1 labelling index, and all of low grade EGD and benign lesions showed negligible MIB-1 positivities. In summary, MIB-1 labelling index might be valuable in the discrimination of malignant glandular lesions and endocervical glandular dysplasia from benign lesions, but p53 expression could be a useful parameter in the discrimination of malignant glandular lesions from endocervical glandular dysplasia and benign lesions.
Adenocarcinoma ; Cervix Uteri* ; Discrimination (Psychology) ; Female ; Metaplasia

Potter's syndrome was originally described as combination of bilateral renal agenesis and unique progeric facial characteristics in 1946 by Potter. In cases of severe renal maldevelopment such as bilateral polycystic kidney or marked hypoplasia, similar facial features has been also associated. At 1963, Potter and Osathanondth reported classification of polycystic kidney as Type I-IV by microdissection study. Recently authors experienced an autopsy case of polycystic kidney with characteristic potter face, and other combined malformations such as; absence of both ureters and urinary bladder, pulmonary hypoplasia, undescended testes and oligohydramnios, fetal growth retardation and breech presentation. According to the classification of polycystic kidney of Potter and Osathanondth, this presenting case is compatible with type IIB.

Pulmonary endometriosis is a rare disease which is characterized by hemoptysis during menstruation (catamenial hemoptysis). We report a case of pulmonary endometriosis in a 33-year-old housewife. She has had regular menses with moderate flow and minimal dysmenorrhea. She had undergone curettage in May 1995 for artificial abortion. In July 1995, she experienced the first episode of hemoptysis. A chest CT scan revealed a 2.0 1.0 cm sized ill-defined soft tissue density in the periphery of anterior segment of the left upper lobe with a surrounding irregular ground-glass opacity. A left upper lobectomy was done under the diagnosis of pulmonary endometriosis. Cut section of the resected lung showed a round red-brownish solid lesion, measuring 2.0x1.0cm in cross. Microscopically a focus of the endometrial tissue, which was composed of endometrial glands and stroma, was found in the lung parenchyme and many hemosiderin laden macrophages were seen in the surrounding alveoli. The postoperative course was favorable with no further episodes of hemoptysis.
Adult ; Curettage ; Diagnosis ; Dysmenorrhea ; Endometriosis* ; Female ; Hemoptysis ; Hemosiderin ; Humans ; Lung ; Macrophages ; Menstruation ; Rare Diseases ; Tomography, X-Ray Computed

The effect of androgen in the development of the normal prostate and the evolution of benign prostatic hypertrophy (BPH), and prostatic adenocarcinoma has been proven. In addition to androgen, estrogen and progesterone are also thought to play a role in the pathogenesis of BPH and carcinoma. However, their exact roles are not yet known because there is no conclusive evidence. Thirty cases of prostatic adenocarcinoma and 16 cases of BPH were studied. Immunohistochemical staining for estrogen receptor (ER) and progesterone receptor (PR) in epithelial and stromal cells, respectively was performed and the results were assessed semiquantitatively based on the number of positive cells per 100 total cells. Slides were scored as negative; less than 5% of cells, 1 ; 6~15% of cells, 2 ; 16~25% of cells, and 3 ; more than 26% of cells. The relationship between ER and PR expression and the patient's age, histologic grade, and clinical stage was evaluated in prostatic adenocarcinomas. ER was negative in epithelial and in stromal cells for all prostatic adenocarcinomas and BPH cases. The PR expression in epithelial cells and in stromal cells of BPH was noted in 15 (93.8%) and 16 (100.0%) out of 16, respectively. The PR expression of carcinoma cells and stromal cells in prostatic adenocarcinoma was found in 28 (93.3%) and 23 out of 30 (76.7%), respectively. The PR immunoreactivities of stromal cells around carcinoma were 3 in 18 cases, 2 in one case, and 1 in 4 cases, but those of epithelial and stromal cells of BPH and carcinoma cells of prostatic carcinoma were similar to each other with a value of 3 in most cases. The PR expression rate of stromal cells around carcinoma was significantly correlated with the patient's age (p=0.044), but not with histologic grade and clinical stage. In summary, estrogen does not have a direct effect on the biological behavior of BPH and prostatic adenocarcinoma, but progesterone appears to play a role in the pathogenesis of BPH and prostatic adenocarcinoma. Further studies should clarify the biological role of progesterone in the human prostate.
Adenocarcinoma* ; Epithelial Cells ; Estrogens* ; Humans ; Progesterone* ; Prostate ; Prostatic Hyperplasia* ; Receptors, Progesterone* ; Stromal Cells

Estrogen and progesterone receptors exist in the epithelial and stromal cells of the endometrium. Proliferative disorders of the endometrium may be associated with autocrine and paracrine actions of estrogen and progesterone in epithelial and stromal cells. This study was performed to evaluate the differences estrogen and progesterone receptor(ER/PR) expression in the epithelial and stromal cells of endometrial hyperplasias and adenocarcinomas using immunohistochemical methods. Immunohistochemical analysis of proliferating cell nuclear antigen(PCNA) was done to evaluate a possible correlation between PCNA and hormone receptor expression. Evaluation was based on samples from 31 simple hyperplasias, 30 complex hyperplasias, and 32 adenocarcinomas. The immunohistochemical expression of ER, PR and PCNA in epithelial and stromal cells were examined according to a scoring system based on the percentage of positive cells and the staining intensity. The results were as follows; 1) The expression of ER and PR in epithelial cells showed a graded, significant decreases in simple hyperplasia, complex hyperplasia and endometrial carcinoma, in that order(ER: P=0.008, PR: P= 0.026). 2) PR expression in the stromal cells showed a significant decrease between hyperplasia and adenocarcinoma(P=0.003). The difference in ER expression was not significant. 3) In stromal cells, the decrease in PR expression was more prominent than the decrease in ER expression when complex hyperplasia was compared to simple hyperplasia. 4) The PCNA expression in simple and complex hyperplasia and adenocarcinoma was not higher than the expression of PCNA in nomal proliferative endometrium. There was no significant difference in PCNA expression between simple and complex hyperplasia and adenocarcinoma(P=0.073). 5) A negative correlation between PCNA and ER/PR expression was not demonstrated in simple and complex hyperplasia, or in adenocarcinoma. Endometrial hyperplasia and adenocarcinoma are probably related to a paracrine action of estrogen and progesterone in epithelial and stromal cells. A progressive loss of PR expression in stromal cells may induce abnormal proliferation of endometrium due to a disrupted hormonal balance.
Adenocarcinoma

OBJECTIVE: In the development of squamous neoplasia of the uterine cervix, high risk HPV infection has been followed by CD44 variant expression and angiogenesis. The aim of this study is to evaluate the sequential changes and relatianship of CD44 variant expression, microvessel density (MVD), and VEGF expression in CIN III, microinvasive (MI) and invasive (CA) squamous cell carcinoma. METHODS: The materials were 17 cases of CIN III, 14 cases of MI and 15 cases of CA. In situ PCR for HPV 16/18 and immunohistochemical studies for CD44std, v6, v7/8, CD 31 for MVD, and VEGF were performed. RESULTS: CD44std expression was decreased in squarnous neoplasia compared to normal, and CD44v6 and v7/8 expressions were increased, however, there was no statistical significance. Accentuated staining of CD44v6 and v7/8 along the infiltrating borders was noted in 76.9% and 69.2% of MI and in 71.4% and 42.9% of CA, respectively. High MVD and VEGF 2+ expression were higher in the squamous neoplasia compared to narmal, however, there was no significant difference between the squamous neoplasia and no significant relationship between MVD and VEGF expression. The expression rates of CD44std and CD44v6 were higher in HPV 16/18 negative squamous neoplasia and that of CD44v7/8 was higher in HPV 16/18 pasitive squamous neoplasia, however, their differences were not significant. The incidences of high MVD and VEGF 2+ expression were higher in HPV 16/18 positive suqmaous neoplasia with no statistical significance. CONCLUSIONS: These results suggest that CD44 variants expression and angiogenesis are involved in the development of squamous neoplasia of the uterine cervix, however, HPV 16/18 might not be related to CD44 variant expression and angiogenesis.
Carcinoma, Squamous Cell ; Cervix Uteri* ; Female ; Incidence ; Microvessels* ; Polymerase Chain Reaction ; Vascular Endothelial Growth Factor A*

Sirenomelia is a severe form of caudal regression syndrome that results in a fusion of the lower extremities, which is not compatible with life. A various spectrum of anomalies affecting primarily the musculoskeletal, genitourinary and gastrointestinal systems also can occur. This rare malformation has a reported incidence rate of approximately 1 in 60,000 births, with a range of 1 to 1 percent of all malformed infants. We experienced a sirenomelic case with combined anomalies of genitourinary, cardiovascular and gastrointestinal systems. Maternal obstetric history revealed oligohydramnios and intrauterine fetal growth retardation, and the baby was spontaneously delivered at 37 weeks of gestational age, but died I hour after birth.
Infant ; Male ; Female ; Humans ; Incidence

Hepatocellular carcinoma (HCC) is malignant tumor frequently occurring in Koreans. There have been few reports regarding the cytologic findings of fine needle aspiration (FNA) of HCC. Most have suggested a diagnostic problem in the cytology distinguishing HCC from some benign hepatic lesions-for example, a regeneration nodule in cirrhosis and liver cell adenoma. In spite of its high frequency in Korea, no cytologic study has been reported, concerning the FNA of HCC. In an attempt to achieve cytologic criteria for the diagnosis of HCC, the authors studied retrospectively cytopathologic findings of 247 cases of HCC. These cases were confirmed either by histologic examination including lobectomy, biopsy, or cell block materiai, or, when tissue diagnosis was unavailable, by a high serum alpha-fetoprotein level (over 400 l. U.). All aspiration smears were stained by the Papanicolaou method. In each case, the smears were analyzed for cell patterns and various cytomorphology of the tumor cells. The smear background was assessed for the presence of tumor cell necrosis and inflammatory components and compared to that of metastatic carcinomas. The cell patterns were classified as trabecular, acinar, dispersed, and irregular. The cytologic parameters analyzed included the degree of nuclear atypia and the presence of mitoses, intranuclear cytoplasmic inclusions, nucleolar prominency, endotheiial lining, multinucleated giant cells, eosinophiic globules, bile, and Mallory body.Most of the FNA of HCC showed markedly cellular smears. The tumor cells were most frequently arranged in a trabecular pattern (80.3%). The irregular (12.6%), the acinar (5.5%), and the dispersed patterns (1.7%) followed in decreasing frequency. Individual hepatoma cells were larger than normal liver cells. However, they had morphologic features characteristic of the hepatic cells: the cells were round or polygonal, their cytoplasm was abundant and granular with eosinophilic or amphophilic stainability, and their nuclei were round to oval, located centrally, and tended to have prominent nucleoli. Anaplasia and pleomorphism of tumor cells were generally mild to moderate. These findings existed even in very well differentiated cases. Mitotic figures were present in about 85% of the cases. Prominent nucleoli were observed only in about half the cases. The frequency of other cytologic features was as follows: intranuclear cytoplasmic inclusion in 86.8%; endothelial lining in 56.1%: bile in 19.8%; and giant cells in 60.1%. Clear cells were often present in11.7%, Most aspiration smears of HCC displayed clean background without necrosis or inflammatory material in contrast to the dirty, necrotic background of metastatic cancers and cholangiocarcinomas. Based on the above mentioned features, it is suqqested that the cytologic critieria most important for the diagnosis of HCC include a markedly cellular smear, trabecular pattern, hepatocytoid appearance of tumor cells, endothelial lining, the presence of bile, giant cells, intranuclear cytoplasmic inclusions, and prominent nucleoli, Among these, trabecular pattern, endothelial lining, giant cells and clean smear background are points to be considered in differentiating HCC from metastatic and cholangiocellular carcinoma.
Adenoma, Liver Cell ; alpha-Fetoproteins ; Anaplasia ; Bile ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Cholangiocarcinoma ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Eosinophils ; Fibrosis ; Giant Cells ; Glomerulonephritis* ; Hepatocytes ; Humans ; Inclusion Bodies ; Korea ; Liver ; Mitosis ; Necrosis ; Regeneration ; Retrospective Studies