The cutaneous lymphadenoma is a recently described tumor with a distinctive histologic picture representing a basaloid epithelial proliferation and intraepithelial lymphocytic infiltration; it seems to be a benign adnexal neoplasm of uncertain histogenesis. We documented one example of cutaneous lymphadenoma showing typical histologic features. The tumor typically presented as a well circumscribed nodule with scant or no epidermal connections. The proliferating one consisted of multiple rounded lobules of basaloid cells with some degree of peripheral palisading. There was an intense infiltrate of small lymphocytes within the lobules but few in the stroma. No clear adnexal differentiation is noted. Immunohistochemically, the basaloid cells show weak immunoreactivity for high molecular weight keratin and carcinoembryonic antigen, small lymphocytes for T-cell marker and some dendritic cells for S-100 protein. After surgical resection, we found no evidence of local recurrence or distant metastasis for four years, so we considered this tumor as a benign one and diagnosed as cutaneous lymphadenoma by typical histologic features.
Carcinoembryonic Antigen ; Dendritic Cells ; Lymphocytes ; Molecular Weight ; Neoplasm Metastasis ; Recurrence ; S100 Proteins ; Skin ; T-Lymphocytes

This study was conducted to illustrate the histological and morphometric features of the sebaceous gland of human fetal skin. For this purpose, we studied 12 human embryos and 60 fetuses from the 4 th to 38 th week of gestation. In each case, we sampled eight different areas of skin, i.e., scalp, forehead, face, chest, abdomen, back, extremity, and palm and sole. Through routine tissue processing, hematoxylin and eosin preparations were made for morphology and morphometric analysis. The sebaceous gland anlagen is noted in the face and scalp by the 14th week of gestation, being subsequently generalized in other parts of the body, namely by 16th week of gestation. The lobation of the sebaceous gland subsequently differentiated into multilobular appearance in the face and scalp by the 17th week of gestation and in the chest and abdomen by the 26th week of gestation. The sebaceous ducts were seen by the 21th week of gestation in face and scalp, and in the chest and abdomen by the 27th week of gestation. In morphometric observation, the number and diameter of sebaceous gland were reached its peak during the 21st to 24th week of gestation, and then decreased gradually until it became constant in later days of the gestational period. In general, cephalic portion of the body had more sebaceous glands and also was larger in diameter. This difference became negligible as fetuses reached the term.
Abdomen ; Embryonic Structures ; Eosine Yellowish-(YS) ; Extremities ; Fetus ; Forehead ; Hematoxylin ; Humans ; Pregnancy ; Scalp ; Sebaceous Glands* ; Skin ; Thorax

PURPOSE: To describe the radiological differences between tuberculous(TBB) and non-tuberculous bronchiectasis(NTBB). MATERIALS AND METHODS: Chest radiographs(n=62), bronchograms(n=18), and CT scans(n=52) of 37 patients with TBB and 25 patients with NTBB were reviewed retrospectively. Diagnostic basis for TBB were positive sputum AFB with or without history of anti-tuberculous chemotherapy(n=35), and radiological findings of pulmonary tuberculosis (n=2). Four of NTBB had a history of severe respiratory tract infection in childhood. RESULTS: Air-fluid levels on chest radiographs were seen in 2% of TBB, and 20% of NTBB. On bronchograms, all patients with TBB had combined focal bronchostenosis, whereas patients with NTBB had tubular(50%), cystic(17%), or mixed(33%) pattern of dilatation without stenosis. On CT scans, focal emphysema was seen in 86% of the patients with TBB, and 38% of the patients with NTBB. Peribronchiolar infiltration were seen in 78% and 44% of patients with TBB and NTBB, retrospectively. CONCLUSION: Basic radiological difference between TBB and NTBB was that the former had coexistent sten.
Bronchiectasis* ; Constriction, Pathologic ; Dilatation ; Humans ; Pulmonary Emphysema ; Radiography, Thoracic ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary

A primary squamous cell carcinoma of the thyroid is extremely rare disease. We evaluated this disease by fine needle aspiration cytology in a 43 year-old female. On physical examination, the thyroid was moderately enlarged and palpated with hard consistency. The cytologic aspirate revealed nests of squamous cells, malignant squame and thyroid follicular cells in the necrotic background. We diagnosed this tumor as squamous cell carcinoma with cytologic evidence. Surgically resected thyroid revealed well differentiated squamous cell carcinoma. Immunohistochemical staining for antithyroglobulin proved that this tumor was primary in origin and clinical study confirmed this lesion to be of primary thyroid origin rather than metastasis or direct invasion from contiguous structures.
Adult ; Biopsy, Fine-Needle* ; Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasm Metastasis ; Physical Examination ; Rare Diseases ; Thyroid Gland*

The cystic mesothelioma is a very rare tumor which has a clinically and histologically benign nature. Here in reported is the case of a cystic mesothelioma presented as a palpable mass of the inguinal area in a 28-year-old male. Ultrasound showed a cystic tumor at the inguinal canal, and the other physical and laboratory examinations were within normal limits. Grossly, the tumor consisted of cysts containing clear serous fluid and focally solid areas. Microscopically, the tumor was encapsulated with fibrocollagenous wall, and the tumor cells were cuboidal or polygonal epithelial cells with single or multiple layers and had clear cytoplasm. Some areas showed thyroid follicle-like structures. The content of follicle-like structures showed eosinophilia in the H&E section, but positive in mucin stain. Neither cytologic atypia nor mitoses were present. Immunohistochemical staining revealed positive reaction for keratins of low molecular weight, while negative for the thyroglobulin and CEA. These findings suggested mesothelial in origin. We concluded that this tumor was primary rather than metastatic, because he had no evidence of a tumor in gastrointestinal, genitourinary tracts and scrotum.
Adult ; Cytoplasm ; Eosinophilia ; Epithelial Cells ; Humans ; Inguinal Canal ; Male ; Mesothelioma, Cystic* ; Mitosis ; Molecular Weight ; Mucins ; Scrotum ; Thyroglobulin ; Thyroid Gland ; Ultrasonography

OBJECTIVE: We undertook this study to find out clinical characteristics and prognostic factors of neonatal survival in nonimmune hydrops fetalis (NIHF). METHODS: From Oct. 1988 to Feb. 2001, 54 cases of nonimmune hydrops fetalis diagnosed at Seoul National University Hospital (SNUH) were included in our study. The incidence and perinatal mortality were investigated. The diagnostic work-up for associated conditions (or etiology) included detailed ultrasonography, karyotyping, fetal echocardiography, infection work-up (TORCH, parvovirus), and autopsy (if fetus was dead). Among 54 cases, 20 cases of liveborns were divided into two groups. Group I survived beyond neonatal period (survived>28 days) and group II did not (expired3 (OR=21, CI 1.77, 248.1; p<0.05), and 5-min AS>3 (p<0.01). CONCLUSION: Over 3 of 1-min and 5-min AS were meaningful factors for neonatal survival in NIHF.
Apgar Score ; Autopsy ; Echocardiography ; Female ; Fetofetal Transfusion ; Fetus ; Gestational Age ; Hydrops Fetalis* ; Incidence ; Karyotyping ; Parturition ; Perinatal Mortality ; Pleural Effusion ; Polyhydramnios ; Pregnancy ; Seoul ; Ultrasonography

PURPOSE: Gastric adenocarcinoma is the most common malignant tumor in Korea and immunochemotherapy can be alternative method of the treatment for it. So we evaluated several immunologic markers, Major Histocomatibility (MHC) Antigen and Intercellular Adhesion Molecule (ICAM)-1 which play an important roles in cellular immune response of the host to the tumar cells, HLA-DR/DP antigens, one of the MHC class II which is expressed in various conditions, CD 68 antigen which are also important factor in immune response to the tumor cells. MATERIALS AND METHODS: We compared the expression of MHC class II (HLA-DR/DP) antigens, ICAM-1 and the number of tumor-infiltrating macrophages presenting CD68 antigen in formalin-fixed paraffin-embedded tissue sections of 95 gastric adenocarcinomas using immunohistochemistry. In addition to analyze the relationship between expression of these antigens in gastric adenocarcinoma, histolopathologic findings such as tumor invasion, regional lymph node metastasis and histologic differentiation are evaluated. RESULTS: The rate of HLA-DR/DP expression was 60% and strongly associated with tumor differentiation, invasion and regional lymph node metastasis. ICAM-1 was expressed in 15% and slightly increased in well-differentiated carcinoma. The lack of expression of ICAM-1 was observed in high invasive tumor (T 4). CD 68(+) macrophages counts were significantly increased in around the tumor cells, compared to normal epithelia. HLA-DR/DP expression and infiltrating CD 68(+) macrophage numbers were significantly associated (p<0.05), but there was no correlationship between ICAM-1 and CD 68(+) macrophage numbers. CONCLUSION: It was considered that enhanced expression of HLA-DR/DP antigens, ICAM-1 and CD68(+) macrophages in gastric adenocarcinomas may be an immunophenotypic deviation. HLA-DR/DP and CD68(+) macrophages infiltration showed correlationship with tumor invasion and regional lymph node metastasis, that they may be used as a prognostic factor of the tumor growth.
Adenocarcinoma* ; Biomarkers ; Immunity, Cellular ; Immunohistochemistry ; Intercellular Adhesion Molecule-1* ; Korea ; Lymph Nodes ; Macrophages* ; Neoplasm Metastasis

PURPOSE: Many studies have shown that angiogenesis has an important role in the growth, progression, and metastasis of solid tumors. Recently, several angiogenic factors have been identified. Vascular endothelial growth factor (VEGF) is a well characterized inducer of angiogenesis. In this study, we investigated the prognostic significance of the expression of VEGF in patients with an advanced gastric carcinoma. MATERIALS AND METHODS: Specimens from 54 gastric adenocarcinoma patients were stained using a polyclonal antibody against VEGF. Correlations of the expression of VEGF, microvessel density, and various other clinicopathological factors were analysed. RESULTS: Seventeen (31.5%) and 37 cases (68.5%) were VEGF-negative and positive, respectively. There was significant correlation between the expression of VEGF and pathological differentiation. There were no significant correlations between the expression of VEGF, stage and recurrence of a gastric carcinoma. The microvessel density was significantly higher in the VEGF-positive than the VEGF-negative tumors. Survivals of the VEGF-negative patients were significantly prolonged compared to those of the VEGF-positive patients. CONCLUSION: The results of this study show that the expression of VEGF may be a useful prognostic factor for patients with a gastric adenocarcinoma.
Adenocarcinoma ; Angiogenesis Inducing Agents ; Humans ; Microvessels ; Neoplasm Metastasis ; Recurrence ; Stomach Neoplasms ; Vascular Endothelial Growth Factor A*

OBJECTIVE: To compare the clinical usefulness of the posterior superior iliac spine (PSIS) with that of iliac crest (IC) for identifying the lumbar vertebral level. METHOD: Lumbar spine level was identified by the line connecting bilateral upper margin of iliac crests in the antero-posterior lumbar X-rays of 120 patients. Assumed IC level and assumed PSIS level were compared by 3 examiners' palpation in 60 patients. A marker was taped on assumed IC level and assumed PSIS level by 4 examiners and the postero-anterior lumbar X-rays was taken in randomly distributed 50 patients. RESULTS: IC intersection line was ranged from the L4 spinous process to the L5-S1 interspinous process in all patients. Inter- examiner agreement of palpation was significantly greater in PSIS than IC level (p<0.05). The marker indicating assumed IC level was higher than true IC level in all patients and was higher than L3-4 interspinous process in 8%. CONCLUSION: We may use PSIS level for assumption of the lumbar vertebral level to compensate for the limitation of iliac crest palpation, but at the same time keep in the mind the variarity of the PSIS level.
Humans ; Palpation* ; Spine*

We describe a patient with breast cancer who relapsed with an extensive pulmonary lymphovascular tumor embolism. A 38-year-old female, who previously received neoadjuvant chemotherapy and curative resection of breast cancer, underwent adjuvant chemotherapy and was referred to the emergency room because of sudden-onset pleuritic chest pain lasting for 10 days. Despite a trial of empirical antibiotics, the chest pain and the extent of consolidative lung lesion on chest radiographs rapidly aggravated. We performed an open lung biopsy to confirm the etiology. The histopathological review revealed a hemorrhagic infarction caused by lymphovascular tumor emboli from a metastatic breast carcinoma. Palliative first-line chemotherapy was administered, consisting of ixabepilone and capecitabine, and the lung lesion improved markedly.
Adult ; Anti-Bacterial Agents ; Biopsy ; Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Chest Pain ; Deoxycytidine ; Emergencies ; Epothilones ; Female ; Fluorouracil ; Humans ; Infarction ; Lung ; Neoplastic Cells, Circulating ; Thorax ; Capecitabine