Clear cell sarcoma is a rare malignant rumor of the kidney which occurs in children and is differentiated from Wilms' tumor by its different clinicopathologic features and natural history. Previous studies indicate that this tumor may be of mesenchymal cell origin; however, this has not been proven conclusively. Further accumulation and study need to be conducted in order to clarify the histogenesis of this tumor. We report two cases of clear cell sarcoma of the kidney which occurred in a 2 and a half-year old and a 2-year old boy. This report places special emphasis on the clinicopathologic characteristics of these two cases including electron microscopic and immunohistochemical findings. Attempts were also made to differentiate the clinicopathologic aspects of clear cell sarcoma from Wilms' tumor and speculate on the histogenesis of this rumor.
Child ; Male ; Female ; Humans

No abstract available.
Child* ; Humans ; Scrub Typhus*

Hidroacanthoma simplex is a rare skin tumor which most often develops on the lower extremity of an elderly person. Clinically, the lesion appears as a well-demarcated brownish flat or verrucous plaque, resembling seborrheic keratosis or Bowen's disease. Histologically, it is characterized by intraepidermal nests of basaloid cells within an acanthotic epidermis. there is some controversy over the histogenesis of hidroacanthoma simplex, many consider it an epidermal tumor differentiation into intraepidermal eccrine duct cells. We report a case of hidroacanthoma simplex presented a small verrucous papule on the left foot with the results of an immunohistochemical study.
Aged ; Bowen's Disease ; Epidermis ; Foot ; Humans ; Keratosis, Seborrheic ; Lower Extremity ; Skin

Desmoplastic melanoma is a rare variant of the spindle cell melanoma that first was recognized and described in 1971 as an invasive fibrosarcoma-like tumor that exhibits an abundant collagenous stroma. These tumors usually arise in sun-damaged skin of the head and neck in older persons, in association with lentigo maligna or de novo. The clinical presentation is often not characteristic, and they may clinically simulate other tumors of the skin. Hence they are often diagnosed late. Histologically, desmoplastic melanoma appears as a nodule of fibrous tissue containing hyperchromatic pleomorphic spindle cells that either are scattered singly, lie in fascicles, or aggregate in nests, and collagenous tissue replacing the reticular dermis. Immunohistochemistry is usually quite helpful as the tumors are almost always immunoreactive with S-100 protein and negative for HMB-45. We report a case of desmoplastic melanoma in a 67-year old male who had a walnut sized tumor upon large indurated plaque on the left thigh. A biopsy specimen of the tumor showed that fascicles of spindle cells are interspersed throughout collagenous tissue and most tumor cells are immunoreactive with S-100 protein. To our knowledge, this is the first case report in Korea.
Aged ; Biopsy ; Collagen ; Dermis ; Head ; Humans ; Hutchinson's Melanotic Freckle ; Immunohistochemistry ; Juglans ; Korea ; Male ; Melanoma* ; Neck ; S100 Proteins ; Skin ; Thigh

BACKGROUND: Molluscum contagiosum is a commom benign viral disease of the skin characterized by discrete, 2-5 mm, flesh colored, slightly umbilicated, dome-shaped papules with frequent grouping. But atypical presentation of site, number and size is recently not rare, it may give rise to difficulty in diagnosis. OBJECTIVE: The purpose of this study was to investigate the clinical and histopathological characteristics of various atypical molluscum contagiosa. METHODS: We reviewed medical records, clinical photographs, and histopathologic findings in biopsy specimens of 17 patients with molluscum contagiosa diagnosed at Korea Veterans Hospital from January 1990 to June 2001. The ratio of male to female patients was 3:1, and the mean age at diagnosis was 30 years(range: 3-67). RESULTS: 1. Most commonly involved sites were trunk(80%), extremities(30%), and perianal(12%). 2. The duration of the lesion is 15 days to 3 years. 3. The size of lesion is 2 mm to 50 mm. 4. The number of lesions is one to over a hundred. 5. The clinical features were multiple papules without umbilication(9 cases, 53%) and giant tumor(2 case), pyogenic granuloma-like lesion(2 cases), solitary papule with flat surface(2 cases). 6. The combined disease are atopic dermatitis(1 case), epidermal cyst(1 case), and liver cirrhosis(1 case), diabetes mellitus(1 cases). CONCLUSION: This study shows various atypical molluscum contagiosa in immunocompetent patients. Histopathological examination in atypical molluscum contagiosa is necessary for the proper diagnosis and treatment.
Biopsy ; Diagnosis ; Female ; Hospitals, Veterans ; Humans ; Korea ; Liver ; Male ; Medical Records ; Molluscum Contagiosum ; Skin ; Virus Diseases

Recently, we have encountered an increasing number of patients who have obtained topical steroids to self-treat various dermatosis. Tinea incognito has been used to describe a dermatophyte infection modified by corticosteroid treatment. Lesions are often atypical appearing and the diagnosis can be delayed or missed. We report a case of tinea incognito with ill-defined erythematous patch and nodules on the right upper eyelid and taken intermittently application with corticosteroid ointment over a period of l year. Mycologic studies including KOH mount and fungus culture were positive for hyphae and colonies of Trichophyton mentagrophytes. The lesion was treated with of itraconazole and cured 3 weeks later.
Arthrodermataceae ; Diagnosis ; Eyelids ; Fungi ; Humans ; Hyphae ; Itraconazole ; Skin Diseases ; Steroids ; Tinea* ; Trichophyton*

BACKGROUND: CMV Antigenemia (CMV-Ag) assay and polymerase chain reaction (PCR) have been introduced as exponents of a new generation of tests for the detection of CMV infection. So we compared Roche Amplicor test with CMV-Ag assay to evaluate their clinical usefulness. METHODS: CMV-Ag assay using CMV-vueTM kit (INCSTAR Co., U.S.A.) detects pp65 antigen in leukocytes by immunoperoxidase detection system (positive; stained nucleus > OR =1). Amplicor CMV test (Roche Diagnostic Systems, Inc., Branching, NJ, USA) using plasma or serum is based on PCR amplification of target DNA using CMV specific biotinylated primer and hybridization of the amplified products to the probe and subsequent colorimetric detection of amplified DNA. RESULTS: Of the bone marrow transplanted 73 cases, eleven cases showed discrepancy between the two methods. Of these 10 cases those showed positive results only by Amplicor CMV test, 9 cases turned out to be true positive by the follow-up test and clinical manifestation. And the remaining one case was thought to be false positive. One case which showed positive result only by CMV-Ag assay was proved to be true positive. Consequently, CMV-Ag assay had sensitivity of 73.5% and specificity of 100%, Amplicor CMV test had 97.1% and 97.4%, respectively. Amplicor CMV test detected CMV DNA average 16.3 days before the onset of clinical manifestation and sustained until 10 days after symptoms disappearance, otherwise CMV-Ag assay detected mean 3.8 days earlier and sustained 4.2 days after. CONCLUSIONS: Amplicor CMV test is more sensitive, rapid and longer sustained method than CMV-Ag assay but it lacks quantitation.
Bone Marrow* ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Follow-Up Studies ; Leukocytes ; Plasma ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Transplantation*

BACKGROUND: For the detection of HLA antibodies, solid-phase tests using purified HLA antigens are increasingly used. In this study, we analyzed the panel reactive antibody (PRA) test results using ELISA and Luminex methods, and the results were compared with those of crossmatch test. METHODS: A total of 111 sera including 90 sera from kidney transplanted patients were tested. ELISA-PRA was performed using Lambda Antigen Tray Class I and II Mixed kits (One Lambda Inc., USA) and additional test was performed to identify HLA specificities. Luminex-PRA tests were performed using LABScreen Mixed kits (One Lambda Inc., USA) and LIFECODES LifeScreen Deluxe kits (Tepnel Co., USA). RESULTS: The positive rates of PRA were higher in Tepnel (P=0.006) and One Lambda Luminex (P<0.001) methods than ELISA, without significant difference between two Luminex methods (P=0.087). The overall concordance rate among the three PRA tests was 62.2% (69/111). The positive and negative predictive values of PRA tests for the flow cytometric crossmatch were 33.3-45.7% and 85.7-89.5%, respectively. Of the two Luminex methods, One Lambda showed higher positive rate than Tepnel for the detection of class I antibodies. The sensitivity of pretransplant PRA for the detection of posttransplant acute rejection episodes was higher in Luminex (P=0.007 for Tepnel, P=0.003 for One lambda) than ELISA method. CONCLUSIONS: Different methods used to detect HLA antibodies showed discrepant results. As the Luminex method was more sensitive than ELISA for the detection of HLA antibodies, it can be used as a routine test in the transplantation laboratory.
Enzyme-Linked Immunosorbent Assay/*methods ; Flow Cytometry ; Histocompatibility Antigens Class I/*immunology ; Histocompatibility Antigens Class II/*immunology ; Humans ; Isoantibodies/*blood ; Kidney Transplantation/immunology ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

Traumatic rupture of the corpus cavernosum of the penis is rare and has been reported infrequently. We experienced 4 cases of penile fracture for recent 2 years. They occurred during coitus(1 case), masturbation(2 cases), and through blunt trauma(1 case). The former 3 cases were treated with immediate surgical intervention about 12 hours after injury. When the last case patient visited hospital 5 days after injury, the penile abscess treated immediately with surgical intervention had developed. Surgery consisted of complete evacuation of the hematoma or pus and repairing of the tear at the tunica albuginea. The results were excellent, with complete early recovery of erectile function. Delayed wound healing was observed only in a patient who underwent surgery about 5 days after injury, but this did not cause any complication afterward. In our experiences, immediate surgical treatment is recommended in patients with fracture of the penis.
Abscess ; Hematoma ; Humans ; Male ; Penis ; Rupture ; Suppuration ; Wound Healing

PURPOSE: Identification of antibody specificity is difficult using a multiple antigen PRA (MA-PRA) assay. The purpose of this study was to determine the clinical impact of single antigen PRA (SA-PRA) ELISA assay on the transplant outcome and to analyze the clinical significance of SA-PRA compared with CDC-AHG, flow cytometric crossmatch (FCXM) and MA-PRA. METHODS: A total of 151 kidney transplanted patients were tested for the presence of HLA antibodies in the pre- and posttransplant period. The HLA specificities were classified as donor-specific antibodies (DSA) including donor private antigen specific (DS-HLA) or donor public antigen specific (DS-cross reactive group (CREG)), and nondonor specific HLA antibodies. RESULTS: Of the 151 recipients, 28 patients experienced acute rejection episodes (ARE). The pretransplant CDC-AHG, FCXM and MA-PRA tests were positive in 2, 8 and 18 patients, respectively and the concordance between FCXM and MA-PRA was 89.4% (135/151). Of the 47 sera which were tested with both MA-PRA and SA-PRA, 4 sera were SA-PRA positive and MA-PRA negative. The HLA specificities which were not determined with MA-PRA were detected with SA-PRA test. The patients with DSA showed higher incidence of ARE (7/12, 58% vs. 21/139, 15%; P<0.001) and lower glomerular filtration rate (GFR) at 6 posttransplant months (54.9+/-10.2 vs. 66.2+/-19.3; P=0.023) than the patients without DSA. The patients with ARE had higher incidence of posttransplant DS-HLA (6 (21%) vs. 0 (0%); P<0.001), DS- CREG (7 (25%) vs. 0 (0%); P<0.001), de novo HLA antibody (6 (21%) vs. 0 (0%); P<0.001) than the patients without ARE. CONCLUSION: This study suggests that analysis of HLA specificities using the SA-PRA may be useful as a supportive crossmatch test or as a monitoring test after transplantation for early detection of patients at risk of poor clinical outcome.
Antibodies ; Antibody Specificity ; Enzyme-Linked Immunosorbent Assay ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney ; Rejection (Psychology) ; Tissue Donors ; Transplants