The histologic differentiation of endometrial and endocervical adenocarcinomas is a common diagnostic problum of clinical importance, because the staging, treatment and prognosis of these lesions are quite different. First, we examined the distribution of acid mucin in endometrial and endocervical adenocarcinoma (23 cases and 25 cases repectively), but distinguishing differences between endometrial and endocervical adenocarcinoma, especially of endometrioid type, were not observed. Secondly, the distribution of low-molecular weight cytokeratin, vimentin and carcino-embryonic antigen (CEA) by immunohistochemistry were examined in formalin-fixed tissues. CEA was present in 88% of endocervical adenocarcinomas and 34.8% of endometrial adenocarcinoma. vimentin was found in 91.3% of endometrial adenocarcinomas, in contrast with only in 16% of endocervical adenocarcinomas. This study showed that the presence of vimentin in neoplastic glands, in which CEA is negative, may be helpful in the differential diagnosis of endometrial from endocervical adenocarcinomas.
Diagnosis, Differential ; Adenocarcinoma

The histologic differentiation of endometrial and endocervical adenocarcinomas is a common diagnostic problum of clinical importance, because the staging, treatment and prognosis of these lesions are quite different. First, we examined the distribution of acid mucin in endometrial and endocervical adenocarcinoma (23 cases and 25 cases repectively), but distinguishing differences between endometrial and endocervical adenocarcinoma, especially of endometrioid type, were not observed. Secondly, the distribution of low-molecular weight cytokeratin, vimentin and carcino-embryonic antigen (CEA) by immunohistochemistry were examined in formalin-fixed tissues. CEA was present in 88% of endocervical adenocarcinomas and 34.8% of endometrial adenocarcinoma. vimentin was found in 91.3% of endometrial adenocarcinomas, in contrast with only in 16% of endocervical adenocarcinomas. This study showed that the presence of vimentin in neoplastic glands, in which CEA is negative, may be helpful in the differential diagnosis of endometrial from endocervical adenocarcinomas.
Diagnosis, Differential ; Adenocarcinoma

The germ cells first appear from the primitive streak, the splanchnopleure and the allantoic membrane of the embry and they migrate toward the gonadal ridge. It can happen, however, that some of these germ cells may not migrate to the gonadal ridge and may remain at ectopic sites such as the mediastium, the central nervous system, the sacrococcygeal region and the retroperitoneum. Therefore, germ cell tumors can arise from these ectopic sites and according to their totipotentiality of differentiating into embryonic and extraembryonic tissues, such as chorionic tissues and yolk sac, they can develop into various tumors. Generally, the sites in which these tumors are frequently found are the gonads, the sacrococcygeal region, the mediastinum, the retroperitoneum and the intracranial region. The aim of this study was to organize and report the data found on these tumors in the records of 412 patients whose tumor specimens were examined in the Department of Pathology of the Yonsei University, college of Medicine within the 10 year period, 1976~1985. The findings are as follows: 1) In total 412 cases, the ratio of benign to malignant tumors was 5.8:1. 2) Germ cell tumors occur commonly in the ovary (326 cases: 78.6%). It's incidence was followed by the descending order, in the mediastinum (26 cases: 6.3%), testis (23 cases: 5.6%), central nervous system (15 cases: 3.6%), sacrococcygeal region (11 cases: 2.7%) and retroperitoneal space (7 cases: 1.7%). Also, 2 were found in the intraorbital region and 1 each in the pericardium and the kidney. 3) In extragonadal sites, female were much more common and the sex ratio (M:F) showed 1:10 in sacrococcygeal region. 1:2.5 in retroperitoneum and 1:2.3 in mediastinum. 4) Mature teratoma was found most commonly (85.4%). It's incidence was followed by in descending order, seminoma (including dysgerminoma and germinoma) (6.8%), embryonal carcinoma (2.9%), endodermal sinus tumor (2.0%), immature teratoma (1.7%) and mixed forms (1.2%). 5) Benign teratoma takes up mostly at ovary, retroperitoneal space, sacrococcygeal region and mediastinum by 93.3%, 100.0%, 81.8%, 80.9%, respectively. But in testis and intracranial region, malignancy were more common. 6) Embryonal carcinoma and endodermal sinus tumor occured at similar aged group and each was distributed 41.7% and 62.5% respectively at first decade. 87.5% of dysgerminoma occured at 11~30 aged group, 91.7% of germinoma at 11~20 aged group, 67% mature teratoma at 20~40 aged group, 75% of seminoma at 31~50 aged group, so age distribution showed embryonal carcinoma, endodermal sinus tumor, dysgerminoma/germinoma, mature teratoma and seminoma, in increasing order. 7) In 352 cases of mature teratoma, 347 cases (98.6%) were cystic type and 5 cases (1.4%) were solid type. In 7 cases of immature teratoma, 5 cases (71.4%) were solid and 2 cases (28.6%) were cystic. 8) The incidence of bilaterality were 10.2% in mature teratoma, 12.5% in dysgerminoma and 16.7% in seminoma. 9) When the corredation of the tumor markers, alphafetoprotein and human chorionic gonadotropin, with malignancy was checked in 12 out of 28 cases of tumor of the testis. Either alpha fetoprotein of human chorionic gonadotropin was found to be elevated in 3 cases (75%) in which metastasis was already present at the time of diagnosis, where in 8 cases in which neither marker was elevated, metastasis was found to be present in only 1 (12.8%).
Female ; Humans ; Incidence ; Neoplasm Metastasis ; Tumor Markers, Biological

Mediastinum is bounded by sternum, vertebra, 1st rib, and diaphragm externally, and by pleural cavity internally and includes important structures such as great vessels, nerves, thymus and many lymph nodes. Primary and metastatic cancers, cysts and inflammatory lesions can develop in this region, and the tumor developing in the mediastinum has a tendency to developed in a specific area of mediastinum depending on the histologic type. Therefore the developing site of tumor and the clinical findings are very important in diagnosing the tumor of the mediastinum. We studied not only the characteristics of mediastinal tumor and tumorlike conditions but the histologic classification and frequency of mass to a specific area and then observed if there is any information that could help in diagnosis of the lesion of the mediastinum. Results obtained were as follows: 1) Of the 95 cases of mediastinal lesion which excludes inflammatory process, there were 70 cases (73.5%) of primary tumors, 13 cases (13.1%) of metastatic tumors and 12 cases (12.6%) of tumor-like conditions. 2) Of the 70 cases of primary tumor, 54 cases (76.8%) were benign, 13 cases (20%) were malignant and 3 cases were unclassified or unidentified tumor with the overall 3.8:1 prevalence rate of benign tumor compared to malignancy. 3) Histologic classification of the 70 cases of primary tumor showed 27 cases (28.4%) of germ cell tumor, 22 cases (23.2%) of neurogenic tumor, 7 cases (7.4%) of thymoma, 6 cases (6.3%) of lymphoma and 5 cases (5.3%) of soft tissue tumors with the highest frequency of germ cell tumor. Germ cell tumor and neurogenic tumor exceeded to 50% of total primary mediastinal tumor. 4) Male to female prevalence rate showed that benigh tumor had a high frequency in female with the the ratio of 1:1.4. But malignant tumor showed much higher frequency in male with the ratio of 4.2:1. 5) Anterior mediastinum had germ cell tumor, thymoma and lymphoma in order of frequency. Metastatic tumor was the most common in superior mediastinum. Superior mediastinum had germ cell tumor and neurogenic tumor with about the equal number, and soft tissue tumor was also developed. Middle mediastinal tumor was less common in number compared to other portions of mediastinum but the majority of tumors developed was developmental cysts and metastatic tumors. And the majority of neurogenic tumors occured at the posterior mediastinum. 6) Mass sized 5-10 cm in diameter were about 55.7% of all tumor, 2.5-5 cm and 10-15 cm were 20% respectively. But the mass sized smaller than 2.5 cm and larger than 15 cm were about 5% respectively. And the malignant tumors have more larger size than benign tumors. 7) Patient with benigh tumor had no symptoms at all or some complaints of chest tightness, dyspnea, chest pain, shoulder pain and dysphagia. In addition to above symptoms, patient with malignant tumor complained of systemic symptoms such as weight loss and fever.
Female ; Male ; Humans ; Cysts ; Neoplasm Metastasis

Eccrine spiradenoma is clinically characterized by a solitary, movable, tender nodule occurring most frequently on the ventral surface of the upper body. A striking symptom is paroxysmal pain. Occasionally multiple lesions may be present and may occur in a linear or zosteriform pattern. A 48-year-old female was seen with painful or tender, nomal skin colored, firm nodules distributed in a zosteriform pattern on the right thigh for 10 years, which had been slowly growing. The histopathological features were quite a characteristic of eccrine spiradenoma. We report a rare case of zosteriform network of eccrine spwadenoma occurred on the right thigh.
Female ; Humans ; Middle Aged ; Skin Pigmentation ; Strikes, Employee ; Thigh

Clear cell sarcoma of tendons and aponeuroses is the term coined by Enzinger in 1965 to describe a rare but unique type of soft tisse neoplasm whose cells characteristically have the capacity to produce melanin. The authors experienced a case of 64-year old female who presented with a 6x5x4 cm sized mass deeply seated in the left popliteal fossa. The mass was firm and multinodular, and on cut section revealed patches of brown black pigmentation. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm that contained small amounts of glycogen, separated into compact nests or short fascicles by delicate septa of fibrous tissue. The brown black pigment seen in tumor cells and stroma was proven to be melanin by special stain, and ultrastructural examination showed melanosomes in varying stages of development dispersed freely in the cytoplasm or in the lysosomes. These findings strongly support the view that clear cell sarcoma is a tumor of neural crest origin rather than of tenosynovial mesenchyme origin, and is a soft tissue variant of malignant melanoma.
Female ; Humans

Various immunologic studies were performed for the investigation of humoral immunity in 30 patients with Behcet's syndrome who had been registered in Behcet Special Clinic of Severance Hospital: direct immunofluorescent staining, quantitation of serurn Ig, complement by immunoelectrophoresis and B-cell by EAC-rosette method. The results can be summerized as follows: 1. Direct immunofluorescent staining occurs in biopsies from patients with Behcets syndrome: 11 of the 30 patients(36. 7%). Among them, vascular fluorescene with C3 was noted in 10 of 11 patients (90. 9%), in addition of IgG, IgA, IgM, and fibrinogen on dermoepidermal junction or vessel. 2. The results of direct immunofluorescence staining showed different tendency according to biopsy sites and clinical types: 5 of 10(50%,) in the specimens from oral mucosa, 5 of 13(38.5%) from leg, 1 of 3(33.3%,) from genitalia, and 0 of 7(0%) from other sites: higher in complete and incomplete types than in suspected and possible types. 3. Immunofluorescent staining rates were statistically not significant according to sex, age and Lehner's classification. 4. Serum IgG, IgA, IgM, C3, C4 and B-cell were statistically not significant between DIF positive and negative groups. Therefore it is considered that vascular deposits of immune complexes and activation of complements by immune omplexes may be a role of pathogenetic mechanisms of Behcet's syndrorne.
Antigen-Antibody Complex ; B-Lymphocytes ; Behcet Syndrome* ; Biopsy ; Classification ; Complement System Proteins ; Fibrinogen ; Fluorescent Antibody Technique, Direct ; Genitalia ; Humans ; Immunity, Humoral* ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Mouth Mucosa

Leukemia is a rare disease in the newborn infant. We have presented an autopsy case of congenital acute myelocytic leukemia in a female neonate and discussecd with review of literature. At birth, she was relatively in good health with 4.2 kg in body weight except a large cephalhematoma on left parietal scalp and multiple subcutaneous nodules with ecchymosis on entire body surface. Hemoglobin concentration was 12.0 gm/, Hct 34.6% and erythrocyte count was 2.24 millions. Of 212,400 leukocytes/mm2, 47% were myeloblast. Biopsy of skin nodules reveal leukemia cutis, which disappear dramatically with anticancer drug. The infant was expired 12 days after admission due to intracerebral hemorrhage and acute renal failure.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Biopsy

Leukemia is a rare disease in the newborn infant. We have presented an autopsy case of congenital acute myelocytic leukemia in a female neonate and discussecd with review of literature. At birth, she was relatively in good health with 4.2 kg in body weight except a large cephalhematoma on left parietal scalp and multiple subcutaneous nodules with ecchymosis on entire body surface. Hemoglobin concentration was 12.0 gm/, Hct 34.6% and erythrocyte count was 2.24 millions. Of 212,400 leukocytes/mm2, 47% were myeloblast. Biopsy of skin nodules reveal leukemia cutis, which disappear dramatically with anticancer drug. The infant was expired 12 days after admission due to intracerebral hemorrhage and acute renal failure.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Biopsy

OBJECTIVES: Polycystic ovary syndrome (PCOS) has the feature of excessive LH, hyperandrogenism and disturbance of folliculogenesis. Also, insulin, IGF-I and IGFBP-1 are involved in the pathogenesis of PCOS. Various surgical and medical therapies have been used and the action mechanisms are related to the endocrine effect. Laparoscopic ovarian electrocautery or laser vaporization is effective in the restoration of ovulation and normal menstrual cycle with minimal invasive procedure especially in the patients resistant to medical therapy. Clomiphen citrate (CC) is used for the ovulation induction in PCOS and the resistance is known to be related to insulin, IGF-I, IGFBP-1 levels. This study was performed to evaluate the effect of the laparoscopic laser vaporization on the levels of LH, FSH, testosterone, IGF-I and IGFBP-1 and on the ovarian response to clomiphen citrate in patients with CC-resistant PCOS. MATERIALS AND METHODS: The fasting basal serum LH, FSH, testosterone, IGF-I and IGFBP-1 level were measured in 10 PCOS patients with CC-resistance and 7 normal controls with regular menstrual cycle. In PCOS, after laparoscopic CO2 laser vaporization, endocrine levels were measured in 1 week interval for 4 weeks and then compared with preoperative levels. RESULTS: In PCOS group, mean serum LH/FSH ratio, testosterone, IGF-I levels were higher and IGFBP-1 level was lower than control. LH/FSH ratio decreased from 2.51+/-0.67 to 1.7+/-0.6 (p<0.05) in 2 weeks, to 0.56+/-0.2 (p<0.01) in 3 weeks and to 1.41+/-0.3 (p<0.01) in 4 weeks after operation. Testosterone level decreased from 1.51+/-0.82 ng/ml to 0.65+/-0.34 ng/ml (p<0.05) in 2 weeks, to 0.56+/-0.67 ng/ml (p<0.01) in 3 weeks after operation. IGF-I level also decreased from 436+/-47.5 microgram/l to 187+/-38 microgram/l (p<0.01) in 1 week, to 167+/-42 microgram/l (p<0.01) in 2 weeks, 179+/-55 microgram/l (p<0.01) in 3 weeks and to 120 +/-43 microgram/l (p<0.01) in 4 weeks after operation. IGFBP-1 level showed no significant change. In 8 of 10 PCOS patients, ovulation was induced with low dose clomiphen citrate. CONCLUSION: Laparoscopic CO2 laser vaporization restores normal menstrual cycle and ovulation through endocrine effect of decreasing LH/FSH ratio, testosterone and IGF-I level and increases the response to CC. Therefore it is useful for restoration of normal menstruation and induction of ovulation in CC resistant PCOS patients.
Citric Acid ; Electrocoagulation ; Fasting ; Female ; Humans ; Hyperandrogenism ; Insulin ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor I ; Laser Therapy* ; Lasers, Gas ; Menstrual Cycle ; Menstruation ; Ovulation ; Ovulation Induction ; Polycystic Ovary Syndrome* ; Testosterone ; Volatilization