PURPOSE: This study was conducted to compare the PET and CT findings for patients with a pulmonary lymphangitic metastasis. MATERIALS AND METHODS: We retrospectively reviewed the PET and CT findings of seven patients diagnosed with a pulmonary lymphangitic metastasis between May 2005 and May 2007. RESULTS: All patients had interstitial thickening, as seen on a CT scan, while the PET scans showed abnormal findings in only three patients. In these three patients, one patient had interlobular septal thickening of more than 10, another patient had interlobular septal thickening of more than 5 but less than 10, and another patient had interlobular septal thickening of less than 5. All of the patients had bronchovascular bundle thickening. However, among the four patients that had normal FDG uptake, no patient had interlobular septal thickening of more than 10, two of the patients had interlobular septal thickening of more than 5 but less than 10, and the remaining patients had interlobular septal thickening of less than 5. Only two of the patients had bronchovascular bundle thickening. CONCLUSION: All patients with pulmonary lymphangitic metastasis have typical CT findings, but some of the patients had FDG uptake, as seen in the PET scans. Thus, CT is a more useful modality for diagnosis for pulmonary lymphangitic metastases.
Diagnosis ; Humans ; Lung Neoplasms ; Lymphatic Metastasis ; Neoplasm Metastasis* ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed

To our knowledge, MR findings of neuroshistosomiasis has not been reported in Korea. A case of neuroshistosomiasis involving cerebellum and presumably spinal cord is reported. A 40 year old man who had lived in Middle East complained of low back pain and progressive paraparesis for 6 months, and subsequently developed headache, dizziness and diplopia. On cervical spine MRI, there was diffuse enlargement of cervical cord with increased signal intensity on T2 weighted image and nodular heterogenous enhancement after Gd-DTP^ administration. Brain MR imaging obtained 4 months later showed ill-defined, irregularly enhancing heterogenous mass in cerebellar vermis which was proved to be a granulomatous lesion containing shistosomiasis mansoni ova.
Adult ; Brain ; Cerebellum ; Diplopia ; Dizziness ; Granuloma* ; Headache ; Humans ; Korea ; Low Back Pain ; Magnetic Resonance Imaging* ; Middle East ; Myelitis, Transverse* ; Neuroschistosomiasis* ; Ovum ; Paraparesis ; Spinal Cord ; Spine

No abstract available.

Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an uncommon disease which can occurs secondary to tuberculous meningitis. A 31-year-old woman was diagnosed as tuberculous meningitis after mental disorientation. Her mentality was recovered after antituberculous therapy. After 7 months of antituberculous therapy, paraplegia has developed. Magnetic resonance imaging (MRI) revealed a mass lesion between the T1 and T12 spinal levels with arachnoid thickening which results in the development of tuberculoma. She received surgical resection of IETSC followed by antituberculous therapy and neurological function has been improved. The two years after surgical treatment, spinal MRI showed syringomyelia between T1 to L1. But, her neurological outcome was not aggravated.
Adult ; Arachnoid ; Female ; Humans ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord* ; Syringomyelia ; Tuberculoma* ; Tuberculosis, Meningeal*

PURPOSE: To clarify the chracteristic sonographic features of benign soft tissue tumors and to evaluate the usefulness of sonographic imaging. MATERIALS AND METHODS: We retrospectively reviewed ultrasonographic images of 70 cases in 68 patients with histologically proved benign soft tissue tumors. RESULTS: The tumors included 33 lipomas, 11 hemangiomas. 11 lymphangiomas, 7 neurilemmomas, 4 epidermold cysts, 2 fibromas, 1 mesenchymoma, and 1 myxoma. The SOhographic appearances of the lesions were mainly solid in 53 cases(33 lipomas, 8 hemangiomas, 2 lymphangiomas, 7 neurilemmomas, 2 fibromas and 1 mesenchymoma), mainly cystic in 14 cases(1 hemangioma, 8 lymphangiomas, 4 epidermoid cysts, and 1 myxoma), and mixed in 3 cases(2 hemangiomas and 1 lymphangioma). Although an accurate histologic prediction could not be made in most cases, certain patterns appeared to be characteristic of specific tumor types. 26 cases(78%) of lipoma were seen as lentiform, iso- or hyperechoic, solid mass. Hemangioma had variable appearance and chacteristic calcifications were seen in 3 cases. Unicameral or multiseptated cystic mass with variable thickness of echogenic septa and solid portion was the characteristic finding of lymphangioma. Neurilemmoma showed Iobulated, oval to round, relatively hypoechoic mass with or without internal cystic portion. CONCLUSION: Sonographic evaluation of benign soft tissue tumros is useful in demonstrating the location, size, extent, and internal characteristics of the mass. A relatively confident diagnosis can be made when the characteristic features of the benign soft tissue tumor are present on sonographic imaging.
Diagnosis ; Epidermal Cyst ; Fibroma ; Hemangioma ; Humans ; Lipoma ; Lymphangioma ; Mesenchymoma ; Myxoma ; Neurilemmoma ; Retrospective Studies ; Ultrasonography

The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly

Scrub typhus (Tsutsugamushi disease)is an acute febrile systemic illness caused by Rickettsia tsutsugamushi that is transmitted to humans by the bite of larval-stage trombiculid mites (chiggers). The authors analyzed chest radiographic findings of scrub typhus in 160 patients in Ulsan area. One hundred and eight (67.5%) of160 patients showed abnormal findings which included lung lesions in 108 patients (67.5%), cardiomegaly in 37 patients (23.1%), lymphadenopathy in 25 patients (15.6%) and pleural effusion in 11 patients (6.9%). Among the lung lesions, interstitial patterns were seen in 107 patients (66.9%), mostly fine or medium reticulonodular, and air-space patterns in 14 patients(8.8%) and combined interstitial and air-space patterns in 13 patients (8.1%). Sixty-four patients(40%) had combined chest radiographic findings. The typical chest radiographic findings of scrub typhus would be helpful in evaluation of the causes of acute febrile illness that occur during late fall in the endemic area.
Cardiomegaly ; Humans ; Lung ; Lymphatic Diseases ; Orientia tsutsugamushi ; Pleural Effusion ; Radiography, Thoracic* ; Scrub Typhus* ; Thorax* ; Trombiculidae ; Ulsan*

Pancreatic ductal rupture can be an elusive diagnosis. The early signs and symptoms are often vague, and when it goes unnoticed, ductal rupture results in inceased morbidity and mortality. Unfortunately, no diagnoatic test has proven reliable in its timely detection. Endoscopic retrograde cholangiopancreatography (ERCP) is routinely utilized to visualize the anatomy of the pancreatic duct in elective situation. But the utilization of emergent ERCP will allow detection of pancreatic rupture in clincal settings where surgery might not otherwise have been prompted by complications. In addition, present, timely visualization of the pancreatic duct will permit intelligent planning for pancreatic sugery. Recently, we experienced a case of 36-year-old female who had upper abdominal blunt trauma with heavy iron. Her serum amylase was high but the physical examination was vague. Emergent ERCP was performed and it revealed dye leak from rurptured pancreatic duct at tail portion of pancreas. Emergent distal pancreatectomy and splenectomy was successfully performed. So we report this case with a review of literatures.
Adult ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Female ; Humans ; Iron ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Physical Examination ; Rupture ; Splenectomy

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena