A total of 359 cases of malignant tumors of the larynx (including 87 resected cases) obtained from the pathology file of the Department of Pathology, College of Medicine, Seoul National University during a period of 10 years from 1976 to 1985 were studied by histopathologic and gross investigation with analysis of clinical records, with following results. 1) Out of 359 cases, 356 cases were primary and 3 cases were metastatic. The primary malignant tumors consisted of 348 cases (97.8%) of squamous cell carcinoma, each 2 cases of verrucous carcinoma, malignant lymphoma and undifferentiated carcinoma, a case of adenoid cystic carcinoma and a case of unclassified sarcoma. The metastatic malignant tumors were each one case of renal cell carcinoma, malignant schwanoma and esophageal squamous cell carcinoma. 2) In primary squamous cell carcinoma, the ratio of male to female was 7.8:1 and mean age was 58.2 years (35-87 years). The location was in order of the supraglottic (54.1%), the glottic (25.0%), the transglottic (18.0%), and the subglottic (2.9%). The degree of histologic differentiation was in order of well (72.7%), moderate (23.6%) and poor (3.7%). The tumor stage was stage I in 7.8% of cases, stage II 19.7%, stage III 38.5%, and stage IV 34.0%, and the supraglottic tumors were relatively higher grade than the glottic tumors. 3) The chief complaints of the primary squamous cell carcinoma were mostly hoarseness (70.9% in total case, 49.2% in the supraglottic, 90.9% in the transglottic, and 100% in the glottic and the subglottic), and were variable in the supraglottic cases in order of sore throat, neck mass, throat pain, dyspnea, swallowing difficulty, and foreign body sensation. The duration from the time of first symptom to vistiation was average 7.34 months and was less than 3 months in 45.6% of cases, and showed two peaks, major in 1-2 months and minor in 10-12 months. 4) In the 87 resected cases of primary squamous cell carcinoma, the gross pattern was the ulcerofungating type in 49.4% of cases, the ulceroinfiltrative in 47.1% and flat in 3.5%. The size of tumor was up to 1.5 cm in 30% of cases and more than 1.6 cm in 70%. The extent of invasion was to the submucosa in 40.7% of resected cases, to the laryngeal skeletal muscle(s) 16.3%, to the laryngeal cartilage(s) 33.7%, to the perilaryngeal soft tissue 9.3%. In the 65 cases of lymph node dissection out of these 87 cases, 25 cases (38.5%) showed metastatic lesion(s). With relation to tumor location, lymph node metastases were frequent in the supraglottic, the transglottic and the subglottic region (50-60%) and less common in the glottic region (13.8%). With relation to gross pattern, the metastases were most frequent in ulceroinfiltrative type and none in flat type. And the metastasis rate was increased according to the increase of the tumor size and to the decrease of the tumor differentiation. 5) Smoking history in 140 recorded cases revealed only 8 nonsmokers and average 35.39 pack-years of cigarettes in smoker group with peak in 20-40 pack-yeas (57.2%). 6) Distant metastases were found in 8 cases. The organs were the lung in 5 cases, brain 4 cases, liver 1 case (Three cases were positive in two foci, the lung and the brain). The coexistant primary malignant tumors were found in 8 cases which were 5 bronchogenic squamous cell carcinomas, 2 gastric adenocarcinoma, 1 pancreatic head adenocarcinoma and 1 thyroid papillary carcinoma (Triple primary cancers in one case, of the larynx, the lung and the stomach). 7) Follow-up of 6-53 months (mean 25.8 months) in 115 cases resulted in NED in 62 cases (53.9%) and expired or less resulted in NED in 62 cases (53.9%) and expired or loss of follow-up after recurrence or distant metastasis in 53 cases (46.1%). The recurrence was detected in 2-34 months (average 12.0 months) after treatment.
Female ; Male ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

The binding activities of 6 plant lectins were studied in a total of 6 cases of Ewing's sarcoma of the bone, using the avidin-biotin-peroxidase complex (ABC) method on paraffin embedded material. The lectins used in this study were Ricinus communis agglutinin I (RCA I), Concanavalin A (Con-A), Peanut agglutinin (PNA), Wheat germ agglutinin (WGA), Ulex europeus I (UEA I), and Soybean agglutinin (SBA). However, no specific lectin, which showed consistent binding activity in the majority of Ewing's sarcoma cells was identified, in 5 of 6 cases, intracytoplasmic RCA I binding cells were occasionally observed, at somewhat regular intervals, among the neoplastic cell nests. Con-A stains were also positive in 4 cases, but the numbers of Cona-A binding cell were fewer than that of positive cell with RCA I, With PNA, WGA, UEA I, and SBA virtually no tumor cells were stained. These findings suggest that all Con-A positive cells and a part of RCA I binding cells are probably stromal macrophage-histiocytes, which are incorperated in neoplastic cells. And remaining RCA I positive cells seem to be either a kind of differentiating neoplastic cells or supporting cells having close correlation with the neoplastic cells.

Blue nevi commonly occur on the skin of head, neck, and arms, and in occasional instances they have been observed in the mucosa of oral cavity, vagina, hard palate, and even breast, and in very rarity observed in the uterine cervix. We have experienced a case of blue nevi on the uterine cervix of a 45 year old famale who was operated under the diagnosis of uterine myoma. In gross findings, besides two well circumscribed uterine myomas measuring 3.5 cm and 0.6 cm in diameter in the anterior myometrium, multiple pin-point sized grayish blue pigments measuring 2-3 mm in diameter aggregated in the submucosa of the uterine cervix. Microscopically the blue nevi showed greatly elongated, slender often slightly wavy melanocytes with long, occasionally branching dendritic processes lie grouped in irregular bundles in the submucosa of the uterine endocervix. The pigments showed positive response to the Fontana-Masson stain in the cytoplasm and the extracellular area.
Female ; Humans

We evaluated the characteristics of HMB-45 monoclonal antibody(MoAb) and compared it with a polyclonal anti-S-100 antibody in immunohistochemical staining of 22 primary melanomas of the skin ; 13 acral lentiginous melanomas(ALM), 3 superficial spreading melanomas(SSM), 4 lentigo maligna melanomas(LMM), 3 nodular melanomas(NMM). All speimens were formalin-fixed and paraffin-embedded, and were studied with the avidin-biotin-peroxidase complex technique. The results can be summarized as follows : l. In all tissue specimens, all or some of the melanoma cells in the dermis reacted with HMB-45 MoAb and anti-S-100 protein. 2. HMB-45 MoAb is more sensitive in detecting malignant melanoma cell heterogeneity t,han anti-S-100 protein. 3. Melanoma cells within the epidermis in 6 of 12 ALMs and 3 of 4 LMMs did not react with anti-S-100 antibody, whereas most melanoma cells within epidermis of 12 ALMs and 4 LMMs reacted with HMB-45 monoclonal antibody. These results indicated that immunohistochemical staining with HMB-45 MoAb and anti-S-100 protein is very useful in the study of biologic behavior of malignant, melanoma.
Dermis ; Epidermis ; Hutchinson's Melanotic Freckle ; Melanoma* ; Population Characteristics ; Skin

No abstract available.

A case of Osteogenic sarcoma arised from orbit 4 years after the radiation therapy for retinoblastoma in a 9 years old girl is presented. 4 Years ago, under the diagnosis of retinoblastoma, the left orbital exenteration was performed and was treated with x-ray radiation giving 4.500 gamma tumor dose in 4, weeks. On admission, the left orbital cavity was filled with hard mass and orbital bone revealed extensive destruction with osteoplastic changes on x-ray, and diffuse sarcomatous growth of anaplastic cells with abundant osteogenesis and osteoclastic activity microscopically. It is of authors' opinion that osteogenic sarcoma of orbital bone in this presented case might developed by irradition on retinoblastoma.
Child ; Diagnosis ; Female ; Humans ; Orbit ; Osteoclasts ; Osteogenesis ; Osteosarcoma* ; Retinoblastoma*

A case of postirradiation extraskeletal osteosarcoma with aggressive fibromatosis of the overlying soft tissue of radiation field is reported in a 57 year old house wife who was treated with operation and radiation therapy for cervix carcinoma of the uterus 23 years ago. The overlying aggressive fibromatosis showed characteristic radiation angiitis and atrophic vascular changes such as hyaline degeneration and obliteration of the capillaries which were highly campatible with radiation changes. She also had multiple osteogenic sarcoma in pelvic cavity, occurring in the mesentery bed. As for the histogenesis in this case, we thought the possiblity that fibroblasts went through a process of differentiation into osteoblasts that were responsible for bone formation in the process of malignant change of the aggressive fibromatosis.

Current evidence suggests that severe acute respiratory syndrome coronavirus 2 infection is associated with an increased incidence of adverse severe maternal and perinatal outcomes. However, vertical transmission is rare. The management of pregnant women with coronavirus disease 2019 (COVID-19) is similar to that of non-pregnant women, and effective treatments, including antiviral therapy, dexamethasone, and prophylactic anticoagulation should not be withheld during pregnancy.During the early COVID-19 pandemic period, the management of pregnant women was often delayed until the polymerase chain reaction (PCR) results came out or due to close contact, even among those without symptoms. Out of concern for the spread of infection, cesarean sections were performed instead of vaginal birth, since infection could have led to an increase in maternal and neonatal morbidities. Additionally, if the maternal PCR test was positive, the neonate was quarantined, and despite infectivity decreasing 10 days after symptom onset. It is necessary to ease the strict measures of infection control in the field of obstetrics.The presence or absence of maternal COVID-19 symptoms should be identified to stratify the risk, and vaginal delivery can be attempted in asymptomatic women with low infectivity. With more women being vaccinated safety data about vaccination is rapidly accumulating and no concerns have been detected. Globally, COVID-19 vaccines are recommended even during pregnancy. In order to prepare for future pandemics, it is necessary to apply lessons learned from this pandemic. Policymakers and healthcare leaders must determine efficient and effective strategies for preserving safe maternal care, even during an ongoing global emergency.

Sertolifonn endometrioid carcinoma (SEC) is a very rare malignant neoplasm arising from the surface epithelium of the ovary. We report one case of SEC occuring in the left ovary of a 73-year-old woman. The left ovary was totally replaced by a yellowish tan lobulated solid mass with focal cystic areas. Small tubules and elongated solid cord-like structures resembling a Sertoli-Leydig cell tumor or a Sertoli cell tumor were found microscopically. In some areas, confluent typical endometrioid carcinoma, adenofibromatous stroma, squamoid foci, and lutenizing stromal cell nests were noted. The tumor also demonstrated strong immunoreactivity with EMA (epithelial membrane antigen). Certain points of differentiation between SEC and SertoliLeydig or Sertoli cell tumors are discussed.
Aged ; Carcinoma, Endometrioid* ; Epithelium ; Female ; Humans ; Immunohistochemistry ; Membranes ; Ovary ; Sertoli Cell Tumor ; Sertoli-Leydig Cell Tumor ; Stromal Cells ; Triacetoneamine-N-Oxyl

PURPOSE: To evaluate the utility of FLAIR (Fluid Attenuated Inversion Recovery) MR imaging in cerebral infarction by comparing its results with those of T2-weighted spin-echo imaging. MATERIALS AND METHODS: We retrospectively evaluated fast FLAIR images and conventional spin echo images of 82 patients (47 men and 20 women; median age 60.9 years) with cerebral infarction. MR imaging used a 1.5T MR unit with conventional T2 (TR 3900, TE 90) and fast FLAIR sequence (TR 8000, TE 105, TI 2400). We analysed the size of the main lesion and number of lesions, and discrimination between old and new lesions and between small infarction and perivascular space. RESULTS: When T2-weighted and FLAIR imaging were compared, the latter showed that the main lesion was larger in 38 cases (46%), similar in 38 (46%), and smaller in six (7%). The number of lesions was greater in 23 cases (28%), similar in 52 (63%), and fewer in seven (9%). FLAIR images discriminated between old and new lesions in 31 cases ; perivascular space and small infartion were differentiated in eight cases, and CSF inflowing artifact was observed in 66 (80%). CONCLUSION: In the diagnosis of cerebral infaretion, fast FLAIR provides images that are equal or superior to T2-weighted images. The fast FLAIR sequence may therefore be used as a part of routine MR brain study in the diagnosis of cerebral infarction.
Artifacts ; Brain ; Cerebral Infarction* ; Diagnosis ; Discrimination (Psychology) ; Female ; Humans ; Infarction ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies