No abstract available.
Delivery of Health Care* ; Gyeongsangnam-do*

Spindle cell carcinoma of the upper aerodigestive tract mucosa was usually presented as polypoid mass and shows squamous cell carcinoma or dysplasia in the surface and underlying spindle cell proliferation. The spindle cell area discloses a variable pattern of sarcoma including rare osteosarcoma of 0~20% incidence. The histogenetic origin of the spindle cell component is now considered a metaplasia of squamous cell carcinoma. We experienced a case of spindle cell carcinoma of larynx showing massive underlying bone formation with proliferation of osteoclast-like cells in 75 year-old man. The immunohistochemical study demonstrates positive reaction with cytokeratin in area of squamous cells and with vimentin in area of spindle cells and osteoclasts. There are very focal reactivity for high molecular weight cytokeratin in spindle cell area.
Incidence

Adenoid cystic carcinoma (ACC) of the breast is an uncommon carcinoma accounting for less than 1% of the breast carcinoma. This type of carcinoma has a distinctive histology, such as cylindromatous, cribriform, glandlike space and solid pattern in the variable proportion. Prognosis is favorable with rare recurrence or metastasis and the guideline for therapy is not well established. We experienced a case of ACC of right breast in the 48 year-old woman. Cytologically, it showed numerous three-dimensional, well outlined cell clusters with central core of homogeneous, eosinophilic material. The mass was well demarcated, firm and measured 2.5 2.5 2 cm. Cut surface was yellowish white and granular with focal necrosis. Histologically, the tumor was composed of cylindromatous, adenoid and solid area with marked cellular atypia. Focal invasion was identified in the adipose tissue around the tumor. Histologic and nuclear grade was III by Kleer's grade. Nodal metastasis was not found.
Adenoids* ; Adipose Tissue ; Breast Neoplasms ; Breast* ; Carcinoma, Adenoid Cystic* ; Eosinophils ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Recurrence

BACKGROUND: Before the introduction of the antinuclear antibody test (ANA), the lupus erythematosus (LE) cell test was a useful diagnostic test for systemic lupus erythematosus(SLE) But, the ANA test has replaced the LE cell test in virtually all laboratories as the current routine test for SLE. However, because the LE cell test is still performed in some laboratories, the authors compared the LE cell test with the ANA test to reevaluate the LE cell test. METHODS: A total of 522 cases were evaluated from Aug. 1990 to Aug. 1994. In these cases, the LE cell test and the ANA test were performed simultaneously, and the results were compared. The authors defined the 'True LE Phenomenon' as only when the LE cell test results agreed with the anti-histone antibody pattern of the ANA test. RESULTS: Of the total 522 cases, 56 cases(10.7%) were SLE. The LE cell test was positive in 22 cases(39.3%) and the ANA test in 56 cases(100%). The LE cell test produced 6(27%) false positive cases and 3 (8.8%) false negative cases. Therefore, the sensitivity of the LE cell test that was verified by the ANA test was only 28.6%. On the other hand, the sensitivity of the ANA test was 100%. In 2 cases, the LE cell results were different in repetitive tests although the ANA results were the same. In 2 other cases, it was impossible to interprete the results of the LE cell test because of severe leukopenia. CONCLUSIONS: The authors concluded that the LE cell test showed markedly low sensitivity and a high false positive and false negative rates for SLE, and that the LE cell test was difficult to perform and interpret accurately due to numerous interfering factors. Therefore, for accurate diagnosis of SLE, the LE cell test must be replaced by more definitive and quantitative immunologic tests in all laboratories such as the ANA test.
Antibodies, Antinuclear ; Diagnosis ; Diagnostic Tests, Routine ; Hand ; Immunologic Tests ; Leukopenia ; Neutrophils*

BACKGROUND: Before the introduction of the antinuclear antibody test (ANA), the lupus erythematosus (LE) cell test was a useful diagnostic test for systemic lupus erythematosus(SLE) But, the ANA test has replaced the LE cell test in virtually all laboratories as the current routine test for SLE. However, because the LE cell test is still performed in some laboratories, the authors compared the LE cell test with the ANA test to reevaluate the LE cell test. METHODS: A total of 522 cases were evaluated from Aug. 1990 to Aug. 1994. In these cases, the LE cell test and the ANA test were performed simultaneously, and the results were compared. The authors defined the 'True LE Phenomenon' as only when the LE cell test results agreed with the anti-histone antibody pattern of the ANA test. RESULTS: Of the total 522 cases, 56 cases(10.7%) were SLE. The LE cell test was positive in 22 cases(39.3%) and the ANA test in 56 cases(100%). The LE cell test produced 6(27%) false positive cases and 3 (8.8%) false negative cases. Therefore, the sensitivity of the LE cell test that was verified by the ANA test was only 28.6%. On the other hand, the sensitivity of the ANA test was 100%. In 2 cases, the LE cell results were different in repetitive tests although the ANA results were the same. In 2 other cases, it was impossible to interprete the results of the LE cell test because of severe leukopenia. CONCLUSIONS: The authors concluded that the LE cell test showed markedly low sensitivity and a high false positive and false negative rates for SLE, and that the LE cell test was difficult to perform and interpret accurately due to numerous interfering factors. Therefore, for accurate diagnosis of SLE, the LE cell test must be replaced by more definitive and quantitative immunologic tests in all laboratories such as the ANA test.
Antibodies, Antinuclear ; Diagnosis ; Diagnostic Tests, Routine ; Hand ; Immunologic Tests ; Leukopenia ; Neutrophils*

Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

Pathologists play an important role in proper evaluation of endoscopically removed polyps of the gastrointestinal tract. This study is purposed to reclassify the polyps and review the clinicopathologic features of each histologic subtypes and their malignant potential. Our material consists of total 345 gastrointestinal polyps obtained from Jan. 1986 to Dec. 1987. The results are as follows: 1) A total of 345 gastrointestinal polyps was removed from stomach is 151 cases, from colon in 180 cases, and from small intestine in 14 cases. 2) Hyperplastic polyps were the most common type of polyps I stomach (53.6%) whereas neoplastic polyps were the most common in colon (56.1%). 3) Hyperplastic polyps of the stomach occur in any age after the 3rd decade of life and neoplastic polyps predominantly developed between the 5th and 8th decades. Juvenile retention polyps were frequently noted before the 3rd decade of age. 4) Approximately 267 cases (77.4%) of patients had a single polyp and the remainders had multiple polyps. The gastric polyps were usually located at the antrum and the colonic polyps were at the sigmoid colon and rectum. 5) Epithelial atypia was exclusively noted in the neoplastic polyps of stomach (72.7%) and colon (72.3%). Malignancy in the polyp was observed in the neoplastic polyps only (13 cases). 6) Different types of polyp may occur in the same organ.

Cytokeratins are a family of polypeptides of intermediate filaments which in diverse epithelia are expressed in diffeent, yet specific combinations. To evaluate the diagnostic value of keratin, immunohistochemical staining was done in formalin-fixed, paraffin-embedded normal and neoplastic tissues by PAP and StreptABC methods. The antiserum for cytokeratin in monoclonal antibody which gives the specificity for 40, 46, 50, 52, 56, 58, and 65-67 Kd keratin classes. The results are as follows: 1) The staining was positive for cytokeratin in all of the squamous epithelium, ductular epithelial cells of various glands, respiratory and urinary tract epithelium, and mesothelial cells. 2) No staining for cytokeratin was ovserved in respiratory alveolar epithelium, acinar cells of various glands, renal glomeruli, hepatocytes, and many mesoderm-derived tissues such as muscle, hematopoieitc and lymphoid tissues, nerve, bone, cartilage, and fibroblasts. 3) Squamous cell carcinomas, transitional cell carcinomas, mesotheliomas, and some of the adenocarcinomas (stomach, colon, uterine cervix, biliary tract and breast) exhibited positive staining for cytokeratin. Epithelial cells of thymoma, adenomatoid tumor, plemorphic adenoma of salivary gland, papillary carcinoma of thyroid, lymphoepithelioma, and craniopharyngioma were also positive. 4) Some of the adenocarcinomas (prostate and pancreas), renal cell carcinoma, ovarian stromal and germ cell tumors, hepatocellular carcinoma, malignant melanoma, and mesoderm-derived tumors including malignant lymphoma were uniformly negative for staining. 5) From the above results, the immunohistochemical study in paraffin-embedded tissues using monoclonal antibody for cyto keratin may be useful to differentiate various tumors, especially in differential of hepatocellular carcinoma from bile duct adenocarcinoma, lymphoepithelioma and other undifferentiated carcinomas from lymphoma, thymoma from lymphoma, and squamous cell carcinoma from melanoma. It will be helpful in the diagnosis of transitional cell carcinoma in which the differentiation from renal cell carcinoma and prostatic adenocarcinoma be difficult.
Adenocarcinoma ; Adenoma ; Carcinoma, Hepatocellular

Classic pulmonary blastoma is a variant of carcinosarcoma which is seen almost exclusively in adults. By contrast, most cases of pulmonary blastoma in children have been described as having an exclusive mesenchymal composition, which was proposed as pleuropulmonary blastoma. Recently we experienced a case of pleuropulmonary blastoma, type 1. This 27-month-old male baby was transferred to our hospital due to the left tension pneumothorax. Chest CT revealed a subpleural pulmonary cystic lesion on the left upper lung and an open cystectomy was performed. Histologically the lesion was composed of variable-sized cystic structures lined with a single layer of respiratory-type epithelium. the underlying stroma was composed of sheets of small, round to oval, primitive tumor cells. Some of them had eccentric, eosinophilic cytoplasm, suggestive of rhabdomyoblastic differentiation. These rhabdomyoblastic cells were fuchsinophilic and positive with desmin and vimentin on immunohistochemistry.
Child ; Adult ; Male ; Female ; Humans

The functioning filtering bleb constructed after trabeculectomy in glaucomatous patient might be fail after cataract operation probably due to transient collapse during cataract extraction and inflammatiry reaction of the filtering bleb which result in unsuccessful intraocular pressure control. To compare if the results were identical in cases with the use of encircling band to enlarge the aqueous absorbing scar tissue to trabeculectomy, intraocular pressure was followed for more than 6 months after cataract extraction and posterior chamber lens implantation in 7 eyes that previously underwent silicone tube insertion with the use of encircling band. There were no cases with increased intraocular pressure needed to control postoperatively. Therefore it could be possible to concluded that inflammatory reaction of the filtering bleb or transient collapse during cataract extraction has no negative influences on intraocular pressure in silicone tube implanted eye using encircling band.