Ciliated foregut cyst of gallbladder is a very rare benign cystic lesion. A 39-year-old woman was referred to our hospital after abdominal ultrasonography revealed a cystic lesion of gallbladder. On abdominal ultrasonography and computed tomography, a unilocular cystic lesion was found at right upper quadrant with attachment to the gallbladder neck. The gallbladder with cystic lesion was resected through laparoscopic cholecystectomy. The cystic lesion revealed a unilocular cyst with ciliated cuboidal or columnar epithelium and abundant goblet cells. Pathologic examination is essential to distinguish from other cystic lesions of the gallbladder and avoid unnecessary additional treatment. In the current case report, we presented the clinico-pathologic findings of the ciliated foregut cyst of the gallbladder and review of literature.
Adult ; Cholecystectomy, Laparoscopic ; Congenital Abnormalities ; Epithelium ; Female ; Gallbladder* ; Goblet Cells ; Humans ; Neck ; Ultrasonography

It is difficult to distinguish colonic endometriosis with smooth muscle metaplasia from a colonic neoplasm. Especially, in a small biopsy specimen, marked smooth muscle proliferation can be misdiagnosed as a spindle cell lesion such as leiomyoma or as a gastrointestinal stromal tumor. We present the case of a woman aged 48 years who had a colonic polyp, raising suspicion of a submucosal tumor. In a endoscopic polypectomy specimen, the lesion showed marked smooth muscle proliferation but in the resection specimen, a nodular mass, composed of endometrial glands, stroma, and a smooth muscle component, was identified. By immunohistochemical staining, smooth muscle cells were positive for estrogen receptor, progesterone receptor, smooth muscle actin, and smooth muscle myosin heavy chain. Endometriosis in the colon can be misinterpreted as a benign or malignant neoplasm. When examining small biopsy specimens, clinicians and pathologists should be aware of the potential of this condition to mimic other intestinal diseases.
Actins ; Biopsy ; Colon* ; Colonic Neoplasms ; Colonic Polyps ; Endometriosis* ; Estrogens ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Intestinal Diseases ; Leiomyoma* ; Metaplasia* ; Muscle, Smooth* ; Myocytes, Smooth Muscle ; Myosin Heavy Chains ; Receptors, Progesterone

BACKGROUND/AIMS: Hepatic angiomyolipoma (AML) is a rare mesenchymal tumor of the liver and demonstrates a marked histologic diversity. HMB-45 is a promising immunomarker for this tumor and especially helpful to diagnosis of some AMLs with unusual morphology. The purpose of this study was to better define the variable histologic feature of hepatic AML. METHODS: Eight hepatic AMLs were examined, and all of that were resection specimens. The diagnosis was confirmed by the presence of HMB-45 positive cells. Median age was 41.5 years old, and mean size of tumor was 8.94 cm. RESULTS: Conventional mixed type was 5 cases which showed myomatous, angiomatous and lipomatous component, and 3 cases were myomatous predominant. Variable patterns including spider web cell morphology, solid sheet-like and trabecular pattern were identified on myomatous component and variable amount and patterns of inflammatory cell infiltration was identified. CONCLUSIONS: With only histologic features, it is difficult to distinguish hepatic AML from other hepatic tumor including hepatocellular carcinoma or inflammatory pseudotumor. A correct diagnosis of hepatic AML is possible by a close histologic examination with immunohistochemical stainings such as HMB-45 which is important to patient's prognosis.
Adult ; Aged ; Angiomyolipoma/metabolism/*pathology/surgery ; Carcinoma, Hepatocellular/metabolism/*pathology/surgery ; Female ; Granuloma, Plasma Cell/metabolism/pathology ; Humans ; Liver Neoplasms/metabolism/*pathology/surgery ; Male ; Melanoma-Specific Antigens/*metabolism ; Middle Aged ; Tomography, X-Ray Computed

Congenital lingual cyst is rare and there has been no prior case report about prenatally detected lingual cyst in Korea. When a huge oral cyst is observed at prenatal period and can cause life-threatening airway obstruction at birth, ex utero intrapartum treatment (EXIT) procedure is needed to secure the airway. Herein we present a baby with a prenatally detected huge oral cyst. He was delivered safely assisting EXIT procedure and underwent an operation for resection of the cyst from his tongue. The oral cyst was diagnosed as a lingual cyst with rare histologic type consisting mixed gastrointestinal and respiratory epithelium.
Airway Obstruction ; Korea ; Mouth ; Parturition ; Respiratory Mucosa ; Tongue

The aim of this study was to analyze the research trends in articles published in the Korean Journal of Medical Education (KJME) and Korean Medical Education Review (KMER) using keyword network analysis. The analyses included 507 papers from 2010 to 2019 published in KJME and KMER. First, keyword frequency analysis showed that the research topics that appeared in both journals were “medical student,” “curriculum,” “clinical clerkship,” and “undergraduate medical education.” Second, centrality analysis of a network map of the keywords identified “curriculum” and “medical student” as highly important research topics in both journals. Third, a cluster analysis of 20 core keywords in KMER identified research clusters related to academic motivation, achievement, educational measurement, medical competence, and clinical practice (centered on “learning,” while in KJME, clusters were related to educational method and program evaluation, medical competence, and clinical practice (centered on “teaching”). In conclusion, future medical education research needs to expand to encompass other research areas, such as educational methods, student evaluations, the educational environment, student counseling, and curriculum.

Early gastric cancer (EGC) is a "curable" disease with a high cure rate made possible through proper surgical treatment; nonetheless, some patients sustain a disease recurrence after curative resection. The aim of this study was to identify the clinicopathological characteristics of recurrent EGC and determine predictable immunohistochemical markers for recurrence. We investigated the clinicopathological features of 1,786 EGC cases, and using tissue microarray, the expression of c-erbB-2, EGFR, MLH1, MSH2, p53, and AQP1 was examined in group with recurrence and control group without recerrence. In the clinical analysis, 32 of 1,786 (1.79%) patients showed recurrence, with a 2.04% five-year cumulative recurrence rate. Age, submucosal invasion, and lymph node metastasis significantly correlated with tumor recurrence (P=0.044, 0.019, and <0.001, respectively). Multivariate analysis showed lymph node status and old age (> or =57 yr) as independent risk factors of recurrence. In a case-control study, immunopositivity for c-erbB-2 was significantly associated with disease recurrence (P=0.024). There is the probability that EGC patients with old age (> or =57 yr), lymph node metastasis, submucosal invasion, and c-erbB-2 immunopositivity will experience recurrence; therefore, it is critical that patients with these risk factors be followed-up closely and considered candidates for adjuvant treatment.
Adult ; Aged ; Animals ; Female ; Genes, erbB-2 ; Humans ; Immunohistochemistry/methods ; Male ; Microarray Analysis/methods ; Middle Aged ; Multivariate Analysis ; *Neoplasm Recurrence, Local/metabolism/pathology ; Prognosis ; Risk Factors ; *Stomach Neoplasms/metabolism/pathology ; Tumor Markers, Biological/*metabolism

The confirmative diagnosis of leptomeningeal metastasis depends on detecting malignant cells on the cytologic examination of cerebrospinal fluid (CSF). The presence of leptomeningeal metastasis is a very important factor to determine the aggressiveness of treatment. We analyzed 273 cases that were diagnosed as malignancies on the CSF cytology. The most common metastatic carcinoma was lung cancer (76 cases, 27.8%). There were 49 cases (17.9%) and 40 cases (14.7%) of breast and stomach cancers, respectively. There were 49 cases (17.9%) of lymphoma and 40 cases (14.7%) of leukemia. There were 19 cases of other types of cancer (6.9%). For the cases of primary lung cancer, there were 60 cases (78.9%) of adenocarcinoma and 7 cases (9.2%) of squamous cell carcinoma, but only 4 cases (5.3%) of small cell carcinoma. For the case of breast cancer, all of those were invasive ductal carcinoma and 25 cases (51.0%) were grade 3. Diffuse large B-cell lymphoma was the most common type of all metastatic lymphomas (22 cases, 44.9%) and lymphoblastic lymphoma was the second most common (8 cases, 16.3%). In our hospital, the most common leptomeningeal metastasis was adenocarcinoma of the lung, and breast cancer and lymphoma were the second most common. On CSF cytology, malignancies that have a tendency towards CSF metastasis should be carefully examined for to select the proper treatment.
Adenocarcinoma ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Leukemia ; Lung ; Lung Neoplasms ; Lymphoma ; Lymphoma, B-Cell ; Meningeal Neoplasms ; Neoplasm Metastasis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stomach Neoplasms

BACKGROUND: We have retrospectively assessed the incidence and outcome of women diagnosed during a hospital-based cytology screening program with "atypical squamous cells (ASC)" and followed-up with loop electrical excision procedure (LEEP). METHODS: We analyzed 173,947 cases of cervical smears' follow-up cytology and histology findings. Previous or archival cytology with LEEP results were retrieved for 390 women with ASC of undetermined significance (ASC-US) and 112 with ASC, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). RESULTS: On the follow-up cytology, of the 390 women initially diagnosed with ASC-US, 130 (33.3%) had no follow-up records of smears before LEEP; smears of 18 (4.6%) were negative for cytologic abnormalities, 193 (49.5%) were ASC-US, 24 (6.2%) were ASC-H, 111 (28.5%) were low grade squamous intraepithelial lesion (SIL), and 44 (11.4%) were high grade SIL. LEEP findings in these 390 women showed that 183 (46.9%) were negative, 73 (18.7%) were graded as cervical intraepithelial neoplasia (CIN) 1, 25 (6.4%) as CIN 2, 102 (26.2%) as CIN 3, and 7 (1.8%) had carcinoma. LEEP was performed in 112 women initially diagnosed with ASC-H; 36 (32.1%) were negative, 4 (3.6%) were graded as CIN 1, 7 (6.3%) as CIN 2, 60 (53.6%) as CIN 3, and 5 (4.5%) with carcinoma. CONCLUSIONS: Patients with ASC-H smears were at increased risk of SIL or carcnoma compared with patients with ASC-US. Careful follow-up is required in ASC patients.
Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Female ; Follow-Up Studies ; Humans ; Incidence ; Mass Screening ; Retrospective Studies

BACKGROUND: Recent reports have indicated that renal cell carcinoma (RCC) with rhabdoid features follows an aggressive clinical course. We investigated the prognostic significance and nature of the rhabdoid component. METHODS: We retrospectively analyzed the incidence and clinicopathologic characteristics of RCC with rhabdoid features in 174 radical nephrectomy cases. The specimens were examined histologically and immunohistochemically. RESULTS: Twelve of the 174 RCC cases (6.9%) showed rhabdoid features. Histologically, all the tumors with rhabdoid features were of the clear cell type. The presence of rhabdoid features was significantly associated with higher Fuhrman's nuclear grade and higher pathologic tumor stage at presentation. Among the 12 patients who showed the rhabdoid component, nine (75%) developed metastasis and seven (58.3%) died of disease-related causes. The presence of rhabdoid features was independently associated with metastasis and disease-related mortality. The rhabdoid cells were positive for vimentin; variably positive for pan-cytokeratin, epithelial membrane antigen, and CD10; and negative for cytokeratin 7, smooth muscle actin, desmin, E-cadherin, and c-Kit. No case showed loss of integrase interactor-1; one was p53 positive, and five were insulin-like growth factor mRNA binding protein 3 positive. The Ki-67 labeling index was 1-25% (mean, 5.5%). CONCLUSIONS: The rhabdoid component is an independent prognostic factor for metastasis of RCC; therefore, identification of this component is critical.
Actins ; Cadherins ; Carcinoma, Renal Cell ; Carrier Proteins ; Desmin ; Humans ; Incidence ; Integrases ; Keratin-7 ; Kidney ; Mucin-1 ; Muscle, Smooth ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Retrospective Studies ; Rhabdoid Tumor ; RNA, Messenger

PURPOSE: The purpose of this study was to evaluate the clinicopathological features and immunohistochemical features of gastrointestinal stromal tumor (GIST), and specifically the expressions of platelet derived growth factor receptor A (PDGFRA), protein kinase C theta (PKC theta), discovered on GIST-1 (DOG-1), p16 and p27. MATERIALS AND METHODS: Total 118 patients who underwent surgical resection for GIST at our institution between Jan 1997 and Dec 2007 were retrospectively studied. Immunohistochemical staining for c-kit, PDGFRA, PKC-theta, DOG-1, p16 and p27 was performed on a tissue microarray of the 118 GIST. The clinicopathologic parameters, the disease-free survival (DFS) and the overall survival rate were analyzed along with immunohistochemistry. RESULTS: The immunohistochemical stains for c-kit, CD34, PKC-theta, PDGFRA, DOG-1, p16 and p27 were positive in 89.8%, 72.0%, 56.8%, 94.9%, 90.7%, 69.5% and 44.1% of the tumor samples, respectively. The immunohistochemical expression of c-kit was strongly correlated with PKC-theta (p=0.000), DOG-1 (p=0.000) and CD34 (p=0.002). The DFS rate was significantly decreased for the patients with peritoneal GIST, high risk GIST, > or =10 cm-sized GIST, > or =10 mitoses/50 high power fields (HPFs) and p16 positivity (p=0.001, p=0.004, p=0.001, p=0.003 and p=0.028). GISTs > or =10 cm, epithelioid tumor cell type, and c-kit, and DOG-1 negativity were significantly associated with shorter period of overall survival (p=0.048, p=0.006, p=0.000 and p=0.000). CONCLUSION: The expression of p16 and no expression of c-kit and DOG-1 in GISTs, as well as peritoneal tumor site, high risk group, large tumor size, epithelioid tumor cell type and numerous mitoses, may be potentially prognostic factors for predicting worse outcome for patients who suffer from GIST.
Coloring Agents ; Disease-Free Survival ; Gastrointestinal Stromal Tumors ; Humans ; Immunohistochemistry ; Mitosis ; Prognosis ; Protein Kinase C ; Receptors, Platelet-Derived Growth Factor ; Retrospective Studies ; Survival Rate