The fatty hamartoma of pericardium is characterized by abnormal accumulations of adipose tissue forming a recognizable mass. We reported a case that could best be put into "fatty hamartoma" group. This 66 year old male presented with atrial fibrillation came in for a anterior mediastinal mass. He received an operation for adenocarcinoma of ascending colon several months ago. The chest CT revealed an inhomogeneous mass in the right anterior mediastinal area, which was not clearly demarcated from the right cardiac border. The heart was deviated to the left side due to the mass. Surgical excision was performed under the impression of cardiac teratoma. The large mass was well encapsulated, and was bright yellow and partly pink, and measured 12x8 cm. Microscopically, the mass consisted predominantly of mature fat cells and abundant fibrous tissue with scattered nests of primitive cardiac muscle cells. Reviewing the literature we found the term "fatty hamartoma" could also refer to rhabdomyolipoma or fibrolipoma. Since it contains entrapped cardiac muscle cells, abundant fibrous tissue, multiple blood vessels and fetal fat cells, it could best the categorized into "hamartoma". The term "fatty" represents it's main component. Therefore we propose the term "fatty hamartoma" that could to be used further.
Male ; Humans ; Adenocarcinoma ; Hamartoma

No abstract available.
Anemia, Hypoplastic, Congenital*

No abstract available.
Cystadenoma*

No abstract available.
Cystadenoma*

Atropine is a commonly used eye drug due to the effect of mydrasis and cycloplegia. The true allergic contact dermatitis to atropine is rarely reported. A case of allergic contact dermatitis due to atropine sulfate in a 35-year-old woman was confirmed by the patch test.
Adult ; Atropine* ; Dermatitis, Allergic Contact* ; Female ; Humans ; Patch Tests

Congenital atresia of left main coronary ostium is a rare congenital coronary anomaly. This anomaly was detected during elective coronary angiogram in a 40 year-old female patient with chest pain and exertional dyspnea. Treadmill exercise test demonstrated 2 mm upslope depression of ST segment at stage I and the test was terminated due to chest pain. Myocardial stress SPECT using 201 Tl-dipyridamole showed reversible perfusion defects at anterior, apex and lateral wall. It was impossible to select left coronary artery ostium and right coronary angiogram revealed 30% eccentric stenosis at proximal right coronary artery with grade 3 collateral flow to left anterior descending and circumflex arteries. Operative finding revealed totally occluded left coronary ostium with membrane-like, non-atheromatous tissue similar to aortic wall. The patient was successfully treated with coronary artery bypass grafts (CABG) using left internal mammary artery and great saphenous vein. She underwent follow-up coronary angiogram, which revealed patent grafts, at one year after CABG and no cardiovascular event was observed on 5-year clinical follow-up.
Adult ; Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Vessels ; Depression ; Dyspnea ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Mammary Arteries ; Perfusion ; Saphenous Vein ; Tomography, Emission-Computed, Single-Photon ; Transplants

The endoscopic sphincterotomy plays an important role in the treatment of common duct stones; however, with a sphincterotomy has the potential hazard of critical complications. Retroperitoneal duodenal perforation during the endoscopic sphincterotomy is a well-recognized complication causing retroperitoneal abscess, sepsis, and sometimes death. We experienced a patient who complained a severe abdominal pain with a febrile sensation after an endoscopic retrograde cholangiopancreatography with sphincterotomy. The diagnosis was delayed, but confirmed by the CT scan, and a duodenal diverticulization with T-tube drainage was performed. The patient was managed by using a duodenal diverticulization with T-tube drainage, but a conservative management is usually effective if the duodenal perforation is recognized immediately and occurs together with uninfected minimal soilage.
Abdominal Pain ; Abscess ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Drainage ; Humans ; Sensation ; Sepsis ; Sphincterotomy, Endoscopic* ; Tomography, X-Ray Computed

No abstract available.

PURPOSE: Localizing and differentiating a metastatic lesion of differentiated thyroid cancer (DTC) by using radio?iodine whole body scan could be difficult because a whole body scan (WBS) lacks anatomic information. This study was performed to evaluate the usefulness of radio-iodine SPECT/CT for differentiating equivocal lesions. MATERIALS AND METHODS: Among 253 patients with DTC who had undergone radio-iodine scan between February and July 2006, 26 patients were enrolled (M:F = 8:18, Age 50.7 +/- 12.5 years) in this study. The patients had abnormal uptakes in the WBSs that necessitated precise anatomical localization for differentiating between a metastatic lesion and a false-positive lesion. SPECT/CT was performed for the region with abnormal uptake in the WBS. WBS and SPECT/CT were evaluated visually. Metastases were diagnosed based on the results of the radio-iodine scan along with the results of other radiological examinations and serological tests. RESULTS: Based on the WBS images, 13 were suspected with cervical lymph node (LN) metastases in 16 patients with abnormal neck uptake, and in the 11 patients with abnormal extra-cervical uptakes, extra-cervical metastases were doubtful in all. After SPECT/CT was performed, the diagnostic results were altered for 16 patients (62%). SPECT/CT revealed that only 5 patients had cervical LN metastases, while 3 patients had extra-cervical (mediastinal) LN metastases. Overall, there was a 58% (15/26) change in diagnoses and plans for treatment due to SPECT/CT. Among 8 patients suspected with metastases on SPECT/CT, 6 patients underwent another radio-iodine therapy. In 96% (24/25) of the patients, the results of SPECT/CT corresponded with those of further radiological examinations and with other clinical information. CONCLUSION: Radio-iodine SPECT/CT images permitted the differentiation of abnormal radio-iodine uptake and improved anatomical interpretation in DTC.
Diagnosis ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Serologic Tests ; Thyroid Gland* ; Thyroid Neoplasms* ; Whole Body Imaging

Proliferative fasciitis is a rare reactive condition that presents with pseudosarcomatous lesions in subcutaneous tissues. Clinically, most patients present with firm, rapidly growing subcutaneous nodule and two thirds of patients complained of pain and tenderness. Most of lesions occur in the extremities, with the upper extremity (especially the forearm) affected more commonly than the lower extremity. Microscopically, proliferative fasciitis is composed of spindle cells that are deposited in a variably myxoid and collagenous stroma. It is characterized by the presence of large basophilic cells with one or two vesicular nuclei. Proliferative fasciitis could be confused with sarcomas because of intense cellularity, high mitotic index, and rapid growth. A 26-year-old woman complained of a painful nodule on her right second finger. Its size was gradually increased and pain was worsened. Histopathological examination revealed that the lesion consisted predominantly of spindle-shaped cells intermingled with a few gangliocyte-like giant cells. We herein report a rare case of proliferative fasciitis in the finger in a 26-year-old woman.
Adult ; Basophils ; Collagen ; Extremities ; Fasciitis* ; Female ; Fingers* ; Giant Cells ; Humans ; Lower Extremity ; Mitotic Index ; Sarcoma ; Subcutaneous Tissue ; Upper Extremity