Fourteen total cystectomy specimens with primary carcinoma of urinary bladder were investigated to illustrate the overall prevalence and nature of mucosal changes adjacent to the overt carcinoma and to clarify the distribution pattern and extent of carcinoma in situ in regard with multiplicity, histological type and depth of invasion of the macroscopically visible tumor mass. Of 14 cases subjected to this study were 12 cases of transitional cell carcinoma of varying degree of differentiation and invasion, one adenocarcinoma, and the another one with no grossly detectable tumor but history of previous cystoscopic removal of papillary transitional cell carcinoma. Each specimen was processed by a histotopographic technique developed by authors, an easy access to reconstruct the mucosal changes using reconstruction paper. For the histological grading and staging of the overt carcinomas, Ash's and Collins' classifications were applied, respectively. Carcinoma in situ (CIS) was found in 10 out of 11 cases with overt urothelial carcinoma of urinary bladder and one case with no grossly visible neoplasm, in which cystoscopic removal of papillary carcinoma was carried out previously. Distribution pattern of CIS was mostly circular (group I) or arborizing (group II) , located around the overt carcinoma within 0.5 to 2.0cm., but not beyond 3.0cm. from its margin. Correlation between multiplicity of overt carcinomas and presence of CIS was evident together with irregularity of its distribution, but no significance was found with gross appearance, histological grading or with staging.
Adenocarcinoma ; Carcinoma in Situ* ; Carcinoma, Papillary ; Carcinoma, Transitional Cell ; Classification ; Cystectomy ; Mucous Membrane* ; Prevalence ; Urinary Bladder*

The recent development of endoscopic retrograde cholangiopancreatography (ERCP) now permits the collection of pure human pancreatic secretions via duodenoscopic cannulation. Study objectives are evaluation of exocrine pancreatic function and analysis of pure pancreatic juice collected by use of ERCP technique in subjects without pancreatic disease. From March to July 1993, we performed ERCP and collection of pure pancreatic juice in 10 patients without evidence of pancreatic disease. (continue...)
Catheterization* ; Cholangiopancreatography, Endoscopic Retrograde ; Duodenoscopy ; Humans ; Pancreatic Diseases ; Pancreatic Juice*

Condyloma acuminatum, commonly known as anogenital warts, is caused by human papillomavirus (HPV). The most common location of condyloma acuminatum in women is the vulva. Other locations are the vagina, anus and perianal area, perineum and cervix. Condyloma acuminatum most commonly occur due to receptive anal intercourse, and can enlarge to form exophytic masses on the perianal skin, but rarely involve the rectum. We experienced an occurrence of a 12 mm polypoid lesion in the rectum of a heterosexual woman detected during a colonoscopy. The polypoid lesion was excised and was diagnosed as condyloma acuminatum. The lesion was positive for HPV type 11 based on the use of an HPV DNA chip test.
Anal Canal ; Cervix Uteri ; Colonoscopy ; Female ; Heterosexuality ; Humans ; Oligonucleotide Array Sequence Analysis ; Perineum ; Polyps ; Rectum ; Skin ; Vagina ; Vulva ; Warts

Spontaneous rupture of renal artery aneurysm is a rare, but life threatening complication with high mortality. The etiology of non-traumatic renal artery aneurysm is fibromuscular dysplasia, atherosclerosis, vasculitis, and pregnancy. We here report a case of spontaneous rupture of renal artery aneurysm in a patient with untreated hypertension. A 39-year-old non-pregnant woman complained of sudden onset of right flank and lower quadrant abdominal pain. Ultrasonography showed large fluid collection in right lower abdomen. Emergency laparotomy demonstrated huge retroperitoneal hematoma due to spontaneous rupture of right renal artery aneurysm. Microscopic examination of the aneurysmal wall revealed intimal hyperplasia without atherosclerotic change.
Abdomen ; Abdominal Pain ; Adult ; Aneurysm* ; Atherosclerosis ; Emergencies ; Female ; Fibromuscular Dysplasia ; Hematoma ; Humans ; Hyperplasia ; Hypertension* ; Laparotomy ; Mortality ; Pregnancy ; Renal Artery* ; Rupture, Spontaneous* ; Ultrasonography ; Vasculitis

A paraffin injection is regarded as to be a simple and effective method of breast augmentation. However, there are few reports on the long-term complication of a paraffin injected breast. The generation of breast cancer from a paraffinoma of the breast is rare, even though there is no clear evidence to suggest any relationship between a paraffin injection and breast cancer. We encountered a case of infiltrative ductal carcinoma arising from paraffinoma tissues. A 49-year-old woman had undergone bilateral breast augmentation by paraffin injection 20 years earlier. She presented with bilateral diffuse painless palpable masses with reddish discoloration and painful swelling in her left breast. She had been managed with a bilateral simple mastectomy including the mass. After discharge, the pathology report showed infiltrative ductal carcinoma of the left breast mass. The patient was readmitted for additional surgery, and she underwent a modified radical mastectomy. Ultrasonography is a useful diagnostic tool for detecting a breast mass, particularly in a dense breast. However, ultrasonography has a limitation in the case of a paraffinoma. Through this case, it is necessary to review the radiological (mammography, ultrasonography, magnetic resonance imaging, plain film) appearances and the histopathological feature to help make an accurate diagnosis and to differentiate between a carcinoma and a paraffinoma. In rare cases, a breast ductal carcinoma can be combined with a paraffinoma. Therefore, a paraffinoma must be carefully managed due to the potential risk of a carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Middle Aged ; Paraffin ; Pathology ; Ultrasonography

A paraffin injection is regarded as to be a simple and effective method of breast augmentation. However, there are few reports on the long-term complication of a paraffin injected breast. The generation of breast cancer from a paraffinoma of the breast is rare, even though there is no clear evidence to suggest any relationship between a paraffin injection and breast cancer. We encountered a case of infiltrative ductal carcinoma arising from paraffinoma tissues. A 49-year-old woman had undergone bilateral breast augmentation by paraffin injection 20 years earlier. She presented with bilateral diffuse painless palpable masses with reddish discoloration and painful swelling in her left breast. She had been managed with a bilateral simple mastectomy including the mass. After discharge, the pathology report showed infiltrative ductal carcinoma of the left breast mass. The patient was readmitted for additional surgery, and she underwent a modified radical mastectomy. Ultrasonography is a useful diagnostic tool for detecting a breast mass, particularly in a dense breast. However, ultrasonography has a limitation in the case of a paraffinoma. Through this case, it is necessary to review the radiological (mammography, ultrasonography, magnetic resonance imaging, plain film) appearances and the histopathological feature to help make an accurate diagnosis and to differentiate between a carcinoma and a paraffinoma. In rare cases, a breast ductal carcinoma can be combined with a paraffinoma. Therefore, a paraffinoma must be carefully managed due to the potential risk of a carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Mastectomy, Modified Radical ; Mastectomy, Simple ; Middle Aged ; Paraffin ; Pathology ; Ultrasonography