Secretory meningioma, a histologic subtype of meningioma of World Health Organization grade 1, is clinically significant because it is frequently accompanied by peritumoral brain edema. The patient was a 53-year-old woman suffering from dysarthria and motor weakness of the right arm. Enhanced magnetic resonance images showed an enhancing mass measuring 2.5 cm in size located in the right parietal convexity. Intraoperative squash cytology showed moderately cellular smears composed mainly of clusters of ovoid cells with scattered whorl formations. The cells had round nuclei and a moderate amount of eosinophilic cytoplasm with ill-defined cell borders. Neither atypia nor mitosis was observed. Some scattered round shaped eosinophilic refractile hyaline globules, measuring from 5 to 25 microm, were observed, and a periglobular halo was occasionally observed. The diagnosis of secretory meningioma should be made as early as possible so that neurosurgeons can prevent postoperative aggravation of peritumoral edema. We emphasize that cytologic findings including eosinophilic, non-fibrillary cytoplasm with eosinophilic refractile hyaline globules are helpful in differentiating secretory meningioma from other subtypes of meningioma, primary and metastatic brain tumors.
Arm ; Brain ; Brain Edema ; Brain Neoplasms ; Cytoplasm ; Diagnosis ; Dysarthria ; Edema ; Eosinophils ; Female ; Humans ; Hyalin ; Meningioma* ; Middle Aged ; Mitosis ; Rabeprazole ; World Health Organization

PURPOSE: To compare the galactographic findings of malignant and benign disease in patients with pathologic nipple discharge and to analyze the features suggesting malignancy. MATERIALS AND METHODS: In 24 patients in whom pathologic nipple discharge had occurred, the findings of preoperative galactography were correlated with those of pathology. RESULTS: Nine of the 24 cases were malignant and the other 15 were benign. Intraductal calcification occurred in five malignant cases (56%) and two (13%) which were benign. Seven malignant cases (78%) involved the segmental ducts, and in eight (89%), the peripheral ducts below the subsegmental duct were involved. Five benign cases (33%) involved the lactiferous sinus, seven (47%) the segmental duct, and two (13%) the subsegmental duct. Distal duct dilatation occurred in four benign cases (27%), while ductal stenosis was noted in six cases (67%) and ductal distortion in seven (78%). A malignant tumor appeared as a multiple (n=5, 56%) or irregular (n=5, 56%) filling defect, and a benign tumor as a single (n=12, 80%), oval (n=6, 40%) or lobular (n=4, 27%) filling defect. CONCLUSION: At galactography, a malignant tumor frequently appeared as an irregular multiple intraductal filling defect in a peripheral duct. A benign tumor, on the other hand, appeared as an oval or lobular single lesion. The presence of ductal stenosis, distortion and intraductal microcalcifications not opacified by contrast material suggest possible malignancy.
Constriction, Pathologic ; Dilatation ; Hand ; Humans ; Nipples* ; Pathology

No abstract available.
Cytosine Deaminase* ; Cytosine* ; Genetic Therapy* ; Osteocalcin* ; Prostate* ; Prostatic Neoplasms*

Small round cell tumors (SRCTs) are a heterogeneous group of neoplasms composed of small, primitive, and undifferentiated cells sharing similar histology under light microscopy. SRCTs include Ewing sarcoma/peripheral neuroectodermal tumor family tumors, neuroblastoma, desmoplastic SRCT, rhabdomyosarcoma, poorly differentiated round cell synovial sarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, small cell malignant peripheral nerve sheath tumor, and small cell schwannoma. Non-Hodgkin\'s malignant lymphoma, myeloid sarcoma, malignant melanoma, and gastrointestinal stromal tumor may also present as SRCT. The current shift towards immunohistochemistry and cytogenetic molecular techniques for SRCT may be inappropriate because of antigenic overlapping or inconclusive molecular results due to the lack of differentiation of primitive cells and unavailable genetic service or limited moleculocytogenetic experience. Although usage has declined, electron microscopy (EM) remains very useful and shows salient features for the diagnosis of SRCTs. Although EM is not always required, it provides reliability and validity in the diagnosis of SRCT. Here, the ultrastructural characteristics of SRCTs are reviewed and we suggest that EM would be utilized as one of the reliable modalities for the diagnosis of undifferentiated and poorly differentiated SRCTs.
Chondrosarcoma, Mesenchymal ; Cytogenetics ; Diagnosis ; Gastrointestinal Stromal Tumors ; Genetic Services ; Humans ; Immunohistochemistry ; Lymphoma ; Melanoma ; Microscopy ; Microscopy, Electron ; Microscopy, Electron, Transmission* ; Neurilemmoma ; Neuroblastoma ; Neuroectodermal Tumors ; Osteosarcoma ; Pathology ; Peripheral Nerves ; Reproducibility of Results ; Rhabdomyosarcoma ; Sarcoma, Myeloid ; Sarcoma, Synovial

PURPOSE: The incidence of bronchopulmonary dysplasia(BPD) may further increase in the coming decade as advances in neonatal intensive care enable clinicians to save even smaller, younger and more critically ill infants. The purpose of this study was to evaluate risk factors and prognosis associated with BPD in premature infants. METHODS: The retrospective review on RDS infants admitted to the neonatal intensive care units at the Chonnam University Hospital was done from Jan. 1995 to July. 1997. These infants were divided into two groups, BPD group(n=25) and non-BPD group(n= 112). The incidence, risk factors and therapeutic results of BPD were analyzed. RESULTS: Infants in the BPD group had lower birth weight, gestational age, and lower 1 min Apgar score compared to that of infants in the control group. The incidence of BPD was 18.2Yo and was higher in male infants. Longer duration of oxygen, ventilatory support and higher PIP were noted in the BPD group. There were no significant differences between the two groups concerning duration of postnatal requirement of oxygen supplementation, ventilatory support, and ventilatory parameters such as FiO2 and PEEP. The incidences of PDA and pneumothorax mean fluid volume and weight loss were similar in two groups. Frequent episodes of respiratory infection occurred(31.6%) in BPD group and one patient expired during 6 to 12 month follow up. 22 infants(88%) received dexamethasone in BPD group. Side effects of dexamethasone including hypertension and hyperglycemia occurred in 59.1% and 31.8%, respectively. CONCLUSION: The overall incidence of BPD was 18.2% and the risk factors for BPD included lower birth weight and gestational age, lower Apgar score at 1 minute, longer duration of oxygen and ventilatory support with higher PIP.
Apgar Score ; Birth Weight ; Bronchopulmonary Dysplasia* ; Critical Illness ; Dexamethasone ; Follow-Up Studies ; Gestational Age ; Humans ; Hyperglycemia ; Hypertension ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Jeollanam-do ; Male ; Oxygen ; Pneumothorax ; Prognosis* ; Retrospective Studies ; Risk Factors* ; Weight Loss

A 74-year-old woman presented with an abrupt onset of dyspnea that she had experienced for a week. She had been suffering from cutaneous nodules in the scalp for a year. Thoracentesis of the pleural fluid was performed. The Papanicolaou-stained smears, Thin prep and cell block preparations revealed clusters of oval-shaped cells concentrically layered about amorphous acellular cores, i.e., there was microacinar lumen formation as well as singly scattered atypical cells. The cells occasionally demonstrated intracytoplasmic vacuoles and hemosiderin deposits. Those cells stained for CD31 and they were negative for pancytokeratin. Punch biopsy from the scalp nodules revealed angiosarcoma. There are currently few reported cases of angiosarcoma in an exfoliative pleural effusion. Angiosarcoma has diverse, heterogeneous cytologic features. Making the cytologic diagnosis of metastatic angiosarcoma in pleural fluid is a challenge for pathologists. Knowledge of the clinical history is of great help for diagnosing this tumor when it appears in rare sites. Immunopanels with CD31, pancytokeratin and TTF-1 are helpful for making the differential diagnosis. The pathologists should look for clues suggesting the presence of vascular differentiation in the exfoliative cytologic materials when a diagnosis of angiosarcoma is suspected.
Aged ; Biopsy ; Diagnosis, Differential ; Dyspnea ; Female ; Hemangiosarcoma ; Hemosiderin ; Humans ; Pleural Effusion ; Pleural Effusion, Malignant ; Scalp ; Stress, Psychological ; Vacuoles

Myoepithelioma is a rare benign tumor of salivary gland myoepithelial cells, most commonly as a spindle subtype. Here, we present two cases of fine needle aspiration cytology of plasmacytoid myoepithelioma arising from a parotid gland and a hard palate. Aspirates showed plasmacytoid cells with pink-staining, homogeneous, abundant eosinophilic cytoplasm eccentrically displacing the nucleus in cohesive and dissociated forms. Rarely, nuclear grooves and intranuclear cytoplasmic inclusions were evident. These unfamiliar cytologic findings of uncommon myoepithelioma often cause diagnostic difficulties in preoperative aspiration cytology. Recognition of those rare findings provides a reliable diagnostic clue.
Biopsy, Fine-Needle ; Cytoplasm ; Eosinophils ; Inclusion Bodies ; Myoepithelioma ; Palate, Hard ; Parotid Gland ; Salivary Gland Neoplasms ; Salivary Glands

Malignant peripheral nerve sheath tumors (MPNSTs) have rarely been reported to occur in the adrenal gland and all of the reported cases were associated with neurofibromatosis, pheochromocytoma or ganglioneuroma. We present here a case of MPNST in the bilateral adrenal glands without any history of neurofibromatosis or combined tumor. Histologic examination showed the tumor cells had a spindle to ovoid shape, they were arranged in sweeping fascicles and there were frequent mitotic figures. The immunohistochemical and ultrastructural features of the tumor are also presented. To the best of our knowledge, this is the first report in the English medical literature about MPNSTs in the bilateral adrenal glands without any history of neurofibromatosis or combined tumor.
Adrenal Glands ; Ganglioneuroma ; Nerve Sheath Neoplasms ; Neurofibromatoses ; Pheochromocytoma

No abstract available.
Carney Complex* ; Hyperplasia* ; Myxoma* ; Nevus, Blue* ; Testis*

Hyperreactio luteinalis is a rare disease characterized by marked cystic enlargement of the ovary due to multiple benign theca lutein cyst. The cause of this disease is not well known but is believed to be induced by high serum levels of human chorionic gonadotropins (hCG). It occurs usually in gestational trophoblastic disease, multiple pregnancies, and rarely in normal pregnancy. In nature, hyperreactio luteinalis is a benign condition. Therefore, the appropriate management is conservative, but surgical intervention is definitely indicated to remove infarcted tissue, control hemorrhage, or decrease androgen production in virilized patients. Here we report a case of hyperreactio luteinalis which was diagnosed at 11 weeks gestation. Lower abdominal pain was developed and progressed. Emergent right wedge oophorectomy and left salpingoophorectomy was performed due to probable torsion of left ovarian cyst and the pregnancy maintained. Theca lutein cysts were confirmed on pathologic examination.
Abdominal Pain ; Chorionic Gonadotropin ; Female ; Gestational Trophoblastic Disease ; Hemorrhage ; Humans ; Lutein ; Ovarian Cysts ; Ovariectomy ; Ovary ; Pregnancy* ; Pregnancy, Multiple ; Rare Diseases