A case of myofibroblastoma of the breast in a 55-year-old man is described. Myofibroblastoma is a relatively recently recognized benign stromal tumor, and predominantly occurs in middle aged men. The pateint presented with a nontender firm mass in his right breast. Fine needle aspiration biopsy revealed bland looking stromal cell clusters without epithelial cells. Simple excision was done and the patient discharged uneventfully. The mass was well demarcated, lobulated and sligtly myxoid. Microscopically bipolar elongated spindle cell fascicles with interspersing broad collagen bands are so characteristic. Ultrastructurally the tumor cell show features of fibroblast as well as smooth muscle cell.
Male ; Humans ; Biopsy

Adrenal gland is a rare location for an oncocytic neoplasm. In English literature less than 10 cases of adrenocortical oncocytoma have been reported. We have experienced a case of adrenocortical oncocytoma in a 35-year-old man which was detected incidentally during the ultra-sonographic evaluation of the abdomen for a routine physical examination. This case did not demonstrate any clinical evidence of adrenocortical abnomalities, such as virilization or hypertension. Grossly, the tumor was light to dark tan on cut surface. Light-microscopic examination revealed tumor cells with abundant lipid- sparse eosinophilic cytoplasm and occasional pleomorphic nuclei. Mitotic figures were less than 5/50 HPFs. Tumor cells were positive for vimentin but negative for pancytokeratin, CAM 5.2, chromogranin and synaptophysin. Ultrastructural examination demonstrated abundant mitochondria containing occasional intramitochondrial dense bodies or inclusions.
Abdomen ; Adenoma, Oxyphilic* ; Adrenal Glands ; Adult ; Cytoplasm ; Eosinophils ; Humans ; Hypertension ; Mitochondria ; Physical Examination ; Synaptophysin ; Triacetoneamine-N-Oxyl ; Vimentin ; Virilism

We report a case of secretory carcinoma with axillary lymph node metastasis in a 21-year old woman. She was aware of a mass in her breast for 10 years and noticed a rapid growth of the preexisting mass during the last years. Histologically, the tumor was composed of micropapillary and microcystic or cribriform glandular structures which contained eosinophilic, mucinous, intraluminal secretions. The center had a dense hyalinized strama with a solid infiltrative growth of tumor cells with intracytoplasmic secretory vacuoles at the periphery. In addition, marked intraductal papillary epithelial proliferations were present at the superficial portions of the tumor near the nipple. Prognostic factors and their relationship to juvenile papillomatosis are discussed with a review of the literature.
Female ; Humans ; Neoplasm Metastasis ; Breast Neoplasms

Granulomatous(lobular) mastitis is a distinct disease entity of unknown etiology which is characterized by noncaseating granulomatous lobulocentric inflammation. We describe a rare case of granulomatous(lobular) mastitis of a 36 year-old pregnant woman a review of the literature. The mass which was discovered in the third month of her pregnancy, began as a localized, nontender mass on the left breast and persisted during her entire pregnancy. It decreased slightly in size when she began taking post-partum bromocriptine. Clinically and mammographically, the mass was highly suspected as a carcinoma with axillary lymph node metastasis. Fine needle aspiration smears revealed numerous aggregates of granulomas composed of epithelioid histiocytes admixed with multinucleated giant cells of Langhans' and foreign body type, and collections of polymorphonuclear leukocytes. Ziehl-Neelsen, silver methenamine and PAS stain were negative for acid-fast bacilli, fungus, and bacilli on the smear respectively. Histologically, granulomatous inflammation was centered on the breast lobules. Caseation necrosis was absent, instead, numerous microabscesses were formed in the center of the granulomas. Cultures of the fresh tissue for the AFB, aerobic and anaerobic bacteria, and fungus were all negative. Excision of the mass was performed without further treatment and there was no recurrence of the mass 6 months postoperatively. An autoimmune mechanism, infection, and some association with oral contraceptives have been suggested as etiologic factors in the literature.
Pregnancy ; Female ; Humans

PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants

In contrast to the nodular renal blastema which is defined by nests of primitive metanephric cells after 36 weeks of gestation, the nephroblastomatosis is characterized by neoplastic proliferation of the primitive cells. This lesion is presumed to be closely related to the development of Wilms' tumor. We report a case of bilateral nephroblastomatosis associated with Wilms' tumor in a child. This 4 1/2 year-old girl was admitted because of a 10 cm-sized round mass in the right kidney, and smaller nodules in the left kidney and the lung. After three cycles of chemotherapy and subsequent disappearance of the nodules in the left kidney and lung, she underwent a right nephrectomy and a wedge resection of the left kidney. A round Wilms' tumor mass was seen in the lower pole of the right kidney. Remaining right renal cortex showed multiple, slightly depressed gray-white nodules associated with multiple samll cysts. They were comprised of multifocal subcapsular nests of primitive nephrogenic cells with focal tubular or glomerular differentiation. They resembled fetal renal tissue. In the left kidney, similar nests of primitive cells were also noted. These lesions were interpreted as multifocal perilobar type of nephroblastomatosis.
Child ; Male ; Female ; Humans

Extraskeletal chondromas are relatively uncommon benign cartilaginous tumors of the soft tissue and well known to pose a considerable diagnostic problem because of histological variations including the immature appearance of their tumor cells. Recently, we have experienced a case of extraskeletal chondroma mimicking benign chondroblastoma. The patient was a 47-year-old woman who complained of a painful subcutaneous swelling on the radial aspect of 4th proximal interphalangeal (PIP) joint in the left hand for 6 months. Radiologic examination of the 4th finger revealed a 1cm-sized soft tissue mass. Histologically, the tumor was characterized by a lobulated mass which was composed of dense proliferation of chondroblast-like cells admixed with a few multinucleated giant cells of osteoclastic type. However, there were focal areas of typical chondroma which showed lace-like intense calcification around the differentiated chondrocytes.
Chondroblastoma ; Chondrocytes ; Chondroma* ; Female ; Fingers ; Giant Cells ; Hand ; Humans ; Joints ; Middle Aged ; Osteoclasts

This study was done to investigate the effect of adolescent smoking on dietary intakes and nutritional status of serum lipids and antioxidant vitamins. Subjects were 82 somkers whose average pack-year was 0.73, and 85 nonsmokers of male technical high school students in Seoul. Anthropometric measurement was performed and % body fat was also analyzed by Bioelectrical Impedance Fatness Analyzer(GIF-891). Dietary intakes and habits were examined through questionnaires and nutrient intakes were analyzed by Computer Aided Nutritional (CAN) analysis programs. Serum TG and total cholesterol levels were measured by Spotchem sp-4410 and serum HDL-cholesterol levels were measured by test kit. serum vitamin C level was measured by 2,4-dinitrophenylhydrazine method and serum levels of vitamin A and vitamin E were measured by HPLC. All data were statistically analyzed by SAS PC package program. There was a significant difference in body fat percentage and systolic blood pressure while other anthropometric measurements were not different between smokers and monsmokers. Caloric intakes(2335 kcal) in adolescent smokers tended to be higher than that of nonsmokers (2,175 kcal) but the difference was not statistically significant. Intakes of protein(76.67g) and niacin(16.49 mg) in adolescent male smokers were significantly higher(P<0.05) than those of nonsmokers although other nutrient intakes were not significantly different. Analysis of serum lipids showed that serum HDL-cholesterol level of smokers was significantly different. Analysis of serum lipids showed that serum HDL-cholesterol level of smokers was significantly lower(p<0.05) than that of nonsmokers, whereas other lipid levels were not significantly different. Serum vitamin C level was also significantly lower(p<0.05) in adolescent smokers than in nonsmokers. In addition, serum vitamin E level, which was 7.85 mg/1 in smokers, was lower than that of 9.20 mg/1 in nonsmokers(p<0.05) while serum vitamin A level was not significantly different between the two groups. These results indicate that cigarette smoking in adolescence decreases serum levels of HDL-cholesterol, vitamin C and vitamin E even thoughth their smoking history is very short.
Adipose Tissue ; Adolescent* ; Ascorbic Acid ; Blood Pressure ; Cholesterol ; Chromatography, High Pressure Liquid ; Electric Impedance ; Humans ; Male* ; Nutrition Assessment* ; Nutritional Status* ; Seoul ; Smoke* ; Smoking* ; Vitamin A ; Vitamin E ; Vitamins* ; Surveys and Questionnaires

The study evaluated the effectiveness of intervention for male adolescent smokers by making an assessment in terms of changes in food habits, nutrition knowledge, plasma catalase, superoxide dismutase(SOD), glutathione peroxidase peroxidase(GSH-px) activities and thiobarbituric acid reactive substance(TBARS) after Vit C supplementation and nutrition education. The subjects, male adolescent smokers, were assigned into four groups : Control group(19 students), education(Educ.) group(19 students), Vit C supplementation (suppl) group(19 students), and Educ. + Vit C suppl. group(19 students). The Educ. group and Educ. + Vit C suppl. group received nutrition education once a week for 2 weeks. The Vit C suppl. group Educ. + Vit C suppl. group received 500 mg ascorbic acid for 35 days. All data were collected before intervention and after intervention. Nutrition knowledge of those who received education increased, and the frequency of fruit and yellow-green vegetable consumption also increased. Plasma antioxidant enzyme activities were not different except for the SOD activity in the Educ. + Vit C suppl. group, which was significantly increased. The plasma ceruloplasmin level of groups that received Vit C supplementation was reduced more than any other groups, and the specific ceruloplasmin ferroxidase activity of groups that received Vit C supplementation was elevated more than other groups. These intervention programs had an impact on food habits, nutrition knowledge, plasma antioxidant enzyme activities, and plasma TBARS in male adolescent smokers. Various nutrition education programs must be implemented for adolescent smokers, and further studied are needed regarding sorts and amount of antioxidant nutrients and supplementation duration.
Adolescent* ; Ascorbic Acid ; Catalase ; Ceruloplasmin ; Education* ; Food Habits* ; Fruit ; Glutathione Peroxidase ; Humans ; Male* ; Plasma ; Superoxides ; Thiobarbituric Acid Reactive Substances ; Vegetables

Low-grade glioma (LGG) is the most common brain tumor in children and has excellent long-term survival. With an excellent survival rate, the choice of treatment involves careful consideration of minimizing late toxicity from surgery, radiation, and chemotherapy. Surgery, radiation therapy, and chemotherapy can be used as monotherapy or in combination, providing different therapeutic ratios and complications. As a result, establishing the selection of ideal therapies has been a controversial area, presenting challenges. Recent advances in understanding molecular characteristics of pediatric LGG affect classification and treatment approaches. This review aims to overview recent developments in medical treatment in pediatric LGG.