We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.

Prenatal chromosome analysis of amniotic cells at 18 weeks of gestation showed a male fetus to carry a large 15p+ derivative chromosome inherited from his mother. Extra genetic material on the short arm of chromosome IS was silver-negative with Ag-NOR (nucleolus organizer regions) stain, but stained darkly with C-banding method like the distal heterochromatic segment of the Y long arm. Fluorescence in situ hybridization (FISH) using two DNA probes (DYZ1 and D15Zl) showed a red fluorescent signal on 15p+ In addition to a green chromosome 15 centromere signal, confirming 15p to be from the distal Yq heterochromatin.
Arm ; Centromere ; Chromosomes, Human, Pair 15 ; DNA Probes ; Fetus ; Fluorescence ; Heterochromatin ; Humans ; In Situ Hybridization ; Male ; Mothers ; Pregnancy

Plasmapheresis has been used for some conditions during pregnancy and puerperium, such as hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. We present one case of the HELLP syndrome which was treated with plasmapheresis and also review the indications, complications and guidelines for repetitive plasma exchange.
Blood Platelets ; Female ; HELLP Syndrome* ; Hemolysis ; Liver ; Plasma Exchange ; Plasmapheresis* ; Postpartum Period* ; Pregnancy

Carcinomatous meningitis is a relatively common late complication of systemic cancer but there is difficulty in diagnosis when there is no clinical evidence of primary malignant lesion. We have experienced a patient who entered our hospital with complaints of headache, vomiting and deteriorated consciousness. On neurological examination, both optic fundi showed hemorrhagic papilledema and central type facial palsy was observed on the right side. All routine laboratory and radiological examination revealed no abnormality except suspiciously dilated ventricles on Conray ventriculogram. She had been treated under the impression of pseudotumor cerebri. She went downhill course and expired on the 18 th. Hospital day. Autopsy was performed. Pathological findings were limited to the central nervous system. The brain was diffusely swollen and weighed 1510 gms. The cerebral hemispheres were cloudy throughout with dusky gray appearance. Sulci were tight and gyri became flat. No evidence of herniation was present. Coronal sections disclosed two foci of yellow and granular lesions in the left parieto-occipital cortex just under the menengeal coverings. These lesions were less than 0.5 cm in maximum dimensions. Microscopically almost entire cerebral, cerebellar and spinal cord leptomeninges were infiltrated by neoplastic cells that often formed glandular structures. These tumorous growths in the meninges were continuous with the subjacent tumor masses found in the cortex. No other foci of tumor were seen in the CNS. The ventricular system was mild to moderately dilated with slightly cloudy surface. Microscopically no tumor was seen along the ependyma. Search for the primary site of meningeal carcinomatosis included multiple sections of entire visceral organs with particular emphasis on the lung. There was a focus of metastatic papillary carcinoma in one of the left hilar lymph node. Meticulous gross dissection and multiple sections of the lungs, however, failed to show any tumor.
Autopsy ; Brain ; Carcinoma, Papillary ; Central Nervous System ; Cerebrum ; Consciousness ; Diagnosis ; Ependyma ; Facial Paralysis ; Headache ; Humans ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis* ; Meninges ; Neurologic Examination ; Papilledema ; Pseudotumor Cerebri ; Spinal Cord ; Vomiting

PURPOSE: Subacute necrotizing myelopathy(SNM) is a rare non-tumorous disease of spinal cord characterized by subacute clinical course of progressive neurological deterioration. We report MR findings of a patient with pathologically proved SNM. MATERIALS AND METHODS: 1 case of pathologically proved subacute necrotizing myelopathy. RESULTS: The patient was a 56-year-old man with progressive motor weakness and sensory loss of the lower extremities, and urinary and fecal incontinence for 11 months. Spine MRI revealed diffuse enlargement of the thoracic spinal cord from T2 to T7 level. Signal intensity of the expanded spinal cord was isointense relative to normal cord on T1 -weighted image and hyperintense on proton-density and T2-weighted images. On contrast enhanced T1-weighted image, there was diffuse homogeneous enhancement in the expanded cord lesion. CONCLUSION: MR demonstration of stable persistence of spinal cord lesion or atrophy over months or years with clinical findings of radual progressive neurologic deterioration may be helpful in the diagnosis of SN M(1 ).
Atrophy ; Diagnosis ; Fecal Incontinence ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Spinal Cord ; Spinal Cord Diseases* ; Spine

Neurenteric cyst is an extremely rare developmental cyst of the central nervous system. It is lined withintestinal epithelium and is usually found in the subarachnoid space of the cervical and thoracic spine. We reporta case of intracranial neurenteric cyst in a 40-year-old man, and describe the MRI findings. This modality showeda large cyst, ventral to the pons and extending bilaterally to the cerebellopontine angles and craniovertebraljunction;its signal was hyperintense on both T-1and T2-weighted images and there is no enhancement on postcontrastT1-weighted images.
Adult ; Central Nervous System ; Cerebellopontine Angle ; Epithelium ; Humans ; Magnetic Resonance Imaging ; Neural Tube Defects* ; Pons ; Spine ; Subarachnoid Space

Intracerebral venous angiomas with arterial components have been reported rarely. A case of venous angioma with arterial component is presented. The patient was a 29-year-old-female who presented with abrupt headache followed by left hemiparesis. Computerized tomography and magnetic resonance imaging revealed intracerebral hematoma in right temporoparietal lobe and basal ganglia with surrounding signal voids. The cerebral angiography showed the characteristic umbrella appearance and single large draining vein of venous angioma in right temporoparietal lobe and fine arterial branches supplying the vascular malformation. At the operation, multiple arteriovenous fistulas without nidus were observed and delicate angiomatous network with red veins were found around the hematoma cavity, Histologic examination of the angiomatous network proved it to be an arteriovenous malformation. It was a variant of mixed angioma, venous angioma combined with arteriovenous malformation. Clinical, angiographic, and pathological features of intracerebral venous angiomas with arterial components were reviewed from literatures.
Arteriovenous Fistula ; Arteriovenous Malformations* ; Basal Ganglia ; Central Nervous System Venous Angioma* ; Cerebral Angiography ; Headache ; Hemangioma ; Hematoma ; Humans ; Magnetic Resonance Imaging ; Paresis ; Vascular Malformations ; Veins

Anterior cerebral artery(ACA) dissecting aneurysms are extremely rare and optimal treatment remains unclear. The majority of cases manifest as cerebral infarction or as intracranial bleeding. The authors report two cases of ACA dissecting aneurysm, one with a large partially thrombosed gradually growing aneurysm and one with a cerebral infarction in the ACA territory. The patient with a large aneurysm was treated by trapping the aneurysm, and the patient with infarction by conservative management. We report on two cases of dissecting aneurysm of the ACA and include a review of pertinent literature.
Aneurysm ; Aneurysm, Dissecting* ; Anterior Cerebral Artery* ; Cerebral Infarction ; Hemorrhage ; Humans ; Infarction

A 24-year-old woman complained of chronic eczematous lichenified skin lesions with itching on both hands. The lesions were distributed mainly on the lateral and dorsal sides of the fingers. She had a history of atopic dermatitis and noticed itching sensation followed by erythema within minutes of contact with salmon at the respective contact sites, and subsequent formation of papules. Additionally, the ingestion of salmon resulted in swelling on her lips and throat. She had been working as a cook for 2 years and her sister had suffered from allergy to metal. Patch test with Korean standards and bakery series yielded positive to nickel and cobalt without clinical relevance. In a standardized skin prick test, strongly positive reactions to raw salmon and red snapper were observed after 20 min, but a patch test with the same substances was negative. We report a case of protein contact dermatitis due to salmon and red snapper.
Cobalt ; Dermatitis, Atopic ; Dermatitis, Contact* ; Eating ; Erythema ; Female ; Fingers ; Hand ; Humans ; Hypersensitivity ; Lip ; Nickel ; Patch Tests ; Pharynx ; Pruritus ; Salmon ; Sensation ; Siblings ; Skin ; Young Adult

No abstract available.
Leukemia*