The appendiceal mucocele is a rare disease and very difficult to get the diagnosis preoperatively because of the rartity of classical symptoms. With progress in diagnostic procedures such as colonofiberscopy, preoperative diagnosis of appendiceal mucocele has become possible. We experienced a case of appendiceal mucocele in 50 years old male who was admitted due to vague RLQ discomfort, and was diagnosed by colonofiberscopy and surgical specimen obtained by right hemicolectomy. So we present this case with a review of literatures.
Appendix ; Diagnosis ; Humans ; Male ; Middle Aged ; Mucocele* ; Rare Diseases

We have experienced six new cases of mucinous ductal ectasia of the pancreas. Muci-nous ductal ectasia is characterized by mucin secretion and dilatation of the main pancreatic duct. These tuinors have been reported with increasing frequency, especially in Japan, where in 1982, it was advocated that they represent a new clinical entity. ERCP revealed a dilated pancreatic duct in the absence of obstructing ductal strictures and amorphous filling defects in the main pancreatic duct. Endoscopic findings included a patulous ampullary orifice, bulging ampulla of the Vater and mucin secretion from an orifice. We reviewed a total of twenty six cases including our six, of mucinous ductal ectasia, which were reported in various Korean literature. Clinical and radiologic studies of the twenty six cases were performed. They included nineteen men and seven women, 40-79 years of age. Twelve patients had symptoms of epigastric pain. From endoscopic retrograde pancreatography, twenty four patients showed mucin secretion from an orifice, twenty three patients showed a patulous arnpullary orifice, and twenty four patients showed dilatation of the main pancreatic duct. Pathological examination showed fifteen intraductal papillary mucinous hyperplasias, seven adenocarcinom-as, and four adenomas.
Adenoma ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Dilatation ; Dilatation, Pathologic* ; Female ; Humans ; Hyperplasia ; Japan ; Male ; Mucins* ; Pancreas* ; Pancreatic Ducts

IgA nephropathy is the most common form of glomerulonephritis characterized by deposit of IgA on mesangium. We experienced an elderly patient who was admitted for generalized edema, and diagnosed IgA nephropathy and early gastric cancer concomittantly. It has been reported that the incidence of nephrotic syndrome combined with malignancy increases with aging. Moreover, close relationship between IgA nephropathy and malignancy has been reported especially in the elderly patient. So, active investigations for possible malignancy are required in case of elderly patient with IgA nephropathy. In this case, we found improved proteinuria and hematuria of the patient after tumor resection during following up. This case suggest causal association between early gastric cancer and IgA nephropathy clinically.
Aged* ; Aging ; Delirium ; Depression ; Edema ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Incidence ; Nephrotic Syndrome ; Proteinuria ; Stomach Neoplasms*

BACKGROUND/AIMS: Helicobacter pylori eradication therapy has been used as a first-line treatment for H. pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the management strategy for H. pylori-negative MALT lymphoma remains controversial. Therefore, the aim of this study was to examine the success rate of each treatment option for H. pylori-positive and H. pylori-negative gastric MALT lymphomas. METHODS: In total, 57 patients with gastric MALT lymphoma diagnosed between December 2000 and June 2012 were enrolled in the study. The treatment responses were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphomas. RESULTS: Of the 57 patients, 43 (75%) had H. pylori infection. Forty-eight patients received H. pylori eradication as a first-line treatment, and complete remission was achieved in 31 of the 39 patients (80%) with H. pylori-positive MALT lymphoma and in five (56%) of the nine patients with H. pylori-negative MALT lymphoma; no significant difference was observed between the groups (p=0.135). The other treatment modalities, including radiation therapy, chemotherapy, and surgery, were effective irrespective of H. pylori infection status, with no significant difference in the treatment response between H. pylori-positive and H. pylori-negative MALT lymphomas. CONCLUSIONS: H. pylori eradication therapy may be considered as a first-line treatment regardless of H. pylori infection status.
Adult ; Aged ; Antineoplastic Agents/therapeutic use ; Female ; Gastric Mucosa ; Gastroscopy/*methods ; Helicobacter Infections/complications/*therapy ; *Helicobacter pylori ; Humans ; Lymphoma, B-Cell, Marginal Zone/complications/*therapy ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms/complications/*therapy ; Treatment Outcome

Undifferentiated sarcoma is one of the rare primary malignant tumor of the liver typically occur ring in later childhood. It has also been referred to embryonal sarcoma or malignant mesenchymoma. In Korea, three child and two adult cases have been reported to date in liter ature. We experienced a case of undifferentiated sarcoma in a 65- year- old female who presented with abdominal pain and right upper quadrant mass . Contrast-enhanced abdominal CT scan revealed a well demarcated mass with low at tenuation and sept ation at left lobe of the liver and the mass showed hypovas cular pattern on hepatic angiography. On cross section, the tumor was well demarcated from the adjacent liver by afibr ouspseudocapsule and showed cystic degener ation. Pathologically, the tumor was consistent with an undifferentiated sarcoma of the liver.
Abdominal Pain ; Adult* ; Angiography ; Child ; Female ; Humans ; Korea ; Liver* ; Mesenchymoma ; Sarcoma* ; Tomography, X-Ray Computed

Duplication cysts are uncommon congenital malformations that may occur anywhere throughout the alimentary tract. The stomach is an extremely rare site of occurrence. Here, we report a case of gastric duplication cyst initially presenting with a gastric submucosal tumor. A 28-year-old man complained of dyspepsia lasting 1 year and upper endoscopy revealed an ellipsoid submucosal tumor at the greater curvature of the antrum. We intended to use the injection-and-cut technique: however, after saline injection, the lesion was dented and impossible to grasp with a snare. Therefore, we decided to perform endoscopic submucosal dissection and removed the tumor without complication. Histopathology revealed a 0.6x0.6 cm-sized duplication cyst, and there has been no recurrence in 2 years.
Adult ; Cysts/congenital/*pathology/*surgery ; Dissection ; Gastric Mucosa/*pathology/*surgery ; *Gastroscopy ; Humans ; Male ; Pyloric Antrum/pathology ; Stomach Diseases/*pathology/*surgery/ultrasonography

Ectopic thyroid glands generally occur in the midline as a result of abnormal median migration and their presence in lateral to the midline is rare. Embryologically, the thyroid gland is derived from two anlages: a large median endodermal anlage and two lateral anlages. The median anlage produces most of the thyroid parenchyma, whereas the lateral anlage is derived from the fourth pharyngeal pouch and contributes 1-30% of the thyroid weight. In rare cases, failure of the lateral anlage to fuse with the median anlage can result in lateral ectopic thyroid gland. For many years, lateral, aberrant thyroid tissue in adults was a term used almost exclusively for metastatic thyroid carcinoma. However, aberrant, benign ectopic thyroid tissue rarely occurs. We present a 47-year-old man who had incidentally detected mass on the right lateral neck. He was clinically in a euthyroid status and the thyroid function test results were normal as well. Neck ultrasonography revealed a mild diffuse goiter and a 1.22 x 0.65 cm sized ovoid mass like lesion was located in the right level IV of the neck. The result of fine needle aspiration cytology was adenomatous goiter without lymphoid tissue or any malignancy. We rarely report aberrant, benign ectopic thyroid presence as a lateral neck mass.
Adult ; Biopsy, Fine-Needle ; Endoderm ; Goiter ; Humans ; Lymphoid Tissue ; Middle Aged ; Neck ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Neoplasms

Vasculitis is one of the rare complications of antithyroid drugs. In most cases, it is associated with ANCA and usually involves more than one organ. Renal involvement is the most common manifestation, and mainly presents as pauci-immune glomerulonephritis. We experienced MPO-ANCA-positive vasculitis and renal involvement presenting as membranous nephropathy following propylthiouracil (PTU) treatment. Cases of MPO-ANCA-positive vasculitis with membranous nephropathy are very uncommon, and the relationship between PTU and glomerulonephritis with immune complex deposition is unclear at present. A 58-year-old woman who had been treated with PTU for Graves' disease was admitted because of dyspnea and general edema. Chest computed tomography showed multiple nodules in both lung fields. The serum level of MPO-ANCA was positive. Initial laboratory findings included proteinuria, hematuria and increased serum creatinine. We thought that MPO-ANCA-associated vasculitis was induced by PTU and renal involvement. Renal biopsy revealed membranous nephropathy.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Antigen-Antibody Complex ; Antithyroid Agents ; Biopsy ; Creatinine ; Dyspnea ; Edema ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Graves Disease ; Hematuria ; Humans ; Lung ; Middle Aged ; Propylthiouracil ; Proteinuria ; Thorax ; Vasculitis

Gas-bloat syndrome is a characteristic disease that developed in patients who had symptoms severe enough to warrant surgery for refractory refiux esophagitis. During the first few months, most of patients have significant symptoms and gradually have been improved except some cases. Although the underlying pathophysiology is uncatain, too tense fundoplication could result in an one-way valve peventing most patients from belching or vomiting. This syndrome has been reported in western country for many years but not yet in Korea. We report a case of gas-bloat syndrome after fundoplication for sevete reflux esophagitis and hiatal hemia.
Eructation ; Esophagitis ; Esophagitis, Peptic ; Fundoplication ; Gastroesophageal Reflux ; Humans ; Korea ; Transcutaneous Electric Nerve Stimulation ; Vomiting

Symptomatic muscular rings are extremely rare, and some authors have even disputed their existence. The lower esophageal muscular ring, or A ring, located about 2cm proximal to the squamocolumnar junction and are covered by squamous epithelium. These rings consist of an annular narrowing of hypertrophic muscular tissue in the esophageal body. Recently, we experienced 2 cases of symptomatic muscular ring of the esophagus and the findings. Case 1) A 52 year-old male with dysphagia, chest pain and regurgitation for several years, had esophagogram, endoscopy, esophageal motility studies and chest CT. Under the diagnosis of esophageal muscular ring, the patient had pneumatic baUoon dilatation (3.0 cm in diameter, Rigiflex), under which the patient experienced perforation of the lower esophagus and required surgery. We confirmed muscular ring of the esophagus as shown by a thickened muscularis propria layer, without other pathologic findings. Case 2) A 60 year-old male complaining of intermittent dysphagia, had esophagogram, endoscopy, esophageal motility studies and EUS. Under the diagnosis of esophageal muscular ring, he is now being treated with calcium channel blocker and nitrate, and has experienced minimal symptom improvement. We report 2 cases of symptomatic muscular ring of low esophagus with review of literature.
Calcium Channels ; Chest Pain ; Deglutition Disorders ; Diagnosis ; Dilatation ; Endoscopy ; Epithelium ; Esophagus* ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed