Morsicatio is a condition caused by habitual chewing of the lips (labiorum), tongue (linguarum), or buccal mucosa (buccarum). Clinically, it often produces a shaggy white lesion caused by pieces of the oral mucosa torn free from the surface. The condition is generally found among people who are stressed or psychologically impaired. Most patients with this condition are not even aware of their biting habit. Clinically, morsicatio mimics hairy leukoplakia, and sometimes, it may be confused with other dermatologic diseases involving the oral cavity. It is rarely described in pathologic and dermatological textbooks. Histological features are distinctive, however, being careful to make a correct diagnosis can help one avoid providing inappropriate treatment. In this report we describe three cases of morsicatio, one that developed in the lower lip and the others that developed on the side of the tongue.
Bites and Stings ; Humans ; Leukoplakia, Hairy ; Lip ; Mastication ; Mouth ; Mouth Mucosa ; Tongue

BACKGROUND: An ovarian surface epithelial tumor is a heterogenous disease, and various biological and molecular factors are important for its development and progression. Several findings support EGFR or c-erbB-2 as adverse prognostic indicators for an ovarian carcinoma. METHODS: We reviewed the histological and clinical findings of 52 carcinomas (17 endometrioid, 16 serous, 13 mucinous and 6 clear cell tumors), and 26 borderline (10 serous and 16 mucinous) tumors. Expression of c-erbB-2, EGFR, p53, and Ki-67 was evaluated on paraffinembedded tissue from a primary ovarian tumor by immunohistochemical methods. RESULTS: Expression of c-erbB-2 was found in 7.6% of tumors and expression of EGFR was found in 9.6% of tumors by immunohistochemical analysis. No significance was found between cerbB- 2 and EGFR expression as indicators of a poor prognosis. The expression of p53 and Ki-67 (>50%) correlated with the grade and type of tumor in the ovarian cancers. p53 and Ki- 67 overexpression (>50%) was absent in the borderline ovarian tumors, whereas ovarian carcinomas showed expression of both p53 and Ki-67. CONCLUSION: Expression of c-erbB- 2, EGFR, p53, and Ki-67 as determined by immunohistochemical analysis did not correlate with prognostic significance. However, p53 and Ki-67 expression may be used as markers to predict aggressive behavior, and to differentiate between malignant and borderline epithelial ovarian tumors. Further large-scale studies are required to clarify the significance of c-erbB-2 and EGFR expression in ovarian tumors.
Epidermal Growth Factor ; Female ; Ki-67 Antigen ; Mucins ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Tumor Suppressor Protein p53

The incidence of colon cancer in South Korea has recently been the highest among gastrointestinal cancers. Early diagnosis is critical, and image-enhanced endoscopy (IEE) is a key diagnostic method. Colon tumors primarily include serrated polyps, adenomatous polyps, and colon cancer. Early endoscopic techniques relied on simple visual inspection for diagnosis, with tumor size and shape being the primary considerations. Low-resolution images made these methods ineffective for detecting small or early-stage lesions. IEE now enables detailed examination using high-resolution images and various color and structure analyses. Techniques like narrow band imaging (NBI) allow precise observation of vascular patterns and surface structures.Hyperplastic polyps often appear similar in color to the surrounding mucosa, with no visible vascular pattern. Sessile serrated lesions have a cloudy surface with distinct boundaries and irregular patterns, often with black spots in the crypts. Adenomatous polyps are darker brown, with a visible white epithelial network and various pit patterns. Magnified images help differentiate between low- and high-grade dysplasia, with low-grade showing regular patterns and high-grade showing increased irregularities. The NBI International Colorectal Endoscopic classification identifies malignant colon tumors as brown or dark brown with disorganized vascular patterns. The Japan NBI Expert Team classification includes loose vascular areas and disrupted thick vessels. The Workgroup serrAted polypS and Polyposis classification aids in differentiating between hyperplastic polyps and sessile serrated lesions/adenomas when deciding whether to resect polyps larger than 5 mm. Suspected high-grade dysplasia warrants endoscopic submucosal dissection and follow-up. Future advancements in IEE are expected to further enhance early detection and diagnostic accuracy.

This study was conducted to investigate the association between Helicobacter pylori (H. pylori) infection and the lipid profile among elderly Koreans. A total of 462 subjects (mean age 66.2 +/- 7.6 yr, 84% males) who underwent health check-up were investigated. Each subject underwent gastroduodenoscopy with gastric mucosal biopsy, and H. pylori infection was determined by histopathological examination using the updated Sydney System score. The presence of H. pylori infection was significantly associated with the elevated serum levels of total cholesterol and low density lipoprotein (LDL) cholesterol (P < 0.05 for each) in univariate analysis. H. pylori infection was not associated with triglyceride and high density lipoprotein (HDL) cholesterol levels (P > 0.05 for each). After controlling confounders, multiple logistic regression analysis showed that the odds ratio of H. pylori infection for high LDL cholesterol level (> 140 mg/dL) was 3.113 (95% confidence interval, 1.364-7.018; P = 0.007). There were no significant associations between the presence of H. pylori infection and elevated total cholesterol levels (> 200 mg/dL) in this model (P = 0.586). The results of this study demonstrate that H. pylori infection is associated with the elevated serum LDL cholesterol levels in elderly Koreans, supporting the hypothesis that H. pylori plays a role in promoting atherosclerosis by modifying lipid metabolism.
Aged ; Aged, 80 and over ; Atherosclerosis/microbiology ; Cholesterol, LDL/*blood ; Endoscopy ; Female ; Gastric Mucosa/anatomy & histology/microbiology ; Gastritis ; Helicobacter Infections/*blood/*epidemiology ; *Helicobacter pylori ; Humans ; Inflammation/microbiology ; Male ; Middle Aged ; Peptic Ulcer ; Republic of Korea/epidemiology

BACKGROUND: Smad4 and PTEN are prognostic indicators for various tumor types. Smad4 regulates tumor suppression, whereas PTEN inhibits cell proliferation. We analyzed and compared the performance of Smad4 and PTEN for predicting the prognosis of patients with colorectal adenocarcinoma. METHODS: Combined expression patterns based on Smad4+/– and PTEN+/– status were evaluated by immunostaining using a tissue microarray of colorectal adenocarcinoma. The relationships between the protein expression and clinicopathological variables were analyzed. RESULTS: Smad4–/PTEN– status was most frequently observed in metastatic adenocarcinoma, followed by primary adenocarcinoma and tubular adenoma (p<.001). When Smad4–/PTEN– and Smad4+/PTEN+ groups were compared, Smad4–/PTEN– status was associated with high N stage (p=.018) and defective mismatch repair proteins (p=.006). Significant differences in diseasefree survival and overall survival were observed among the three groups (Smad4+/PTEN+, Smad4–/PTEN+ or Smad4+/PTEN–, and Smad4–/PTEN–) (all p<.05). CONCLUSIONS: Concurrent loss of Smad4 and PTEN may lead to more aggressive disease and poor prognosis in patients with colorectal adenocarcinoma compared to the loss of Smad4 or PTEN alone.
Adenocarcinoma ; Adenoma ; Cell Proliferation ; Colonic Neoplasms ; DNA Mismatch Repair ; Humans ; Prognosis

Hairy polyps are a rare malformations of bigerminal origin that comprise of both ectodermal and mesodermal elements. Meningothelial elements are an extremely rare pathologic finding in hairy polyps. Here we report a case of a hairy polyp with a meningothelial element, which originated from the hard palate. A 1-year-old boy was evaluated for an intraoral mass accompanied by multiple congenital anomalies. A small polypoid mass was noted at the midline of the hard palate. The lesion had central fibroconnective tissue with an unusual stromal component showing reticulated anastomosing pseudovascular patterns. Immunohistochemical staining of the cells lining the pseudovascular spaces and the interstitial cells revealed vimentin and epithelial membrane antigen positivity.

Carcinosarcoma of the stomach is a rarely occurring malignant biphasic tumor that consists of both carcinomatous and sarcomatous components simultaneously in a single tumor. The common carcinoma component is tubular or papillary adenocarcinoma and the mesenchymal sarcomatous components are variable and these include leiomyosarcoma, rhabdomyosarcoma, osteosarcoma and chondrosarcoma. However, neuroendocrine carcinomatous differentiation in the carcinomatous component is extremely rare. We present here a rare gastric carcinosarcoma that demonstrated neuroendocrine carcinomatous and leiomyosarcomatous differentiation in a 47-year-old man.
Adenocarcinoma, Papillary ; Carcinosarcoma ; Chondrosarcoma ; Humans ; Leiomyosarcoma ; Middle Aged ; Muscle, Smooth ; Neurosecretory Systems ; Osteosarcoma ; Rhabdomyosarcoma ; Stomach

No abstract available.
Lymph Nodes* ; Neck* ; Thyroid Gland* ; Thyroid Neoplasms* ; Tuberculosis*

BACKGROUND: CD44 protein is known as a homing cellular adhesion molecule that is linked to diverse cellular functions such as adhesion, migration and invasion, which are all important in cancer progression and metastasis. The expression of CD44 standard and variant isoforms (CD44 standard isoform [CD44s] and CD44 splice variants containing exon v6 [CD44v6], respectively) is associated with an unfavorable clinical outcome in various neoplasms. METHODS: Forty patients who were diagnosed with diffuse large B-cell lymphoma (DLBCL) through biopsy at Hanyang University Hospital between 1996 and 2003 were included in this study. CD44 proteins expression was analyzed by immunohistochemical staining on a tissue microarray and the correlation of CD44 with the types of DLBCL and clinical parameters, including the factors defined by the International Prognostic Index, was evaluated. RESULTS: A high CD44s and intermediate to strong CD44v6 expression, including cytoplasmic membranous staining patterns, was present in 35% (14/40) and 25% (10/40) of DLBCL patients, respectively. High CD44s expression was correlated significantly with non-germinal center B-cell-like types (non-GCB, p=0.004) and patients with old age (p=0.041). CONCLUSIONS: High CD44s expression may be significantly associated with the non-GCB type compared to the GCB type and may be essential to the prediction of disease outcome in tumor stage III in DLBCL patients.
Antigens, CD44 ; B-Lymphocytes ; Biopsy ; Cytoplasm ; Exons ; Humans ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Neoplasm Metastasis ; Protein Isoforms ; Proteins

Cystitis glandularis is a benign metaplastic proliferative lesion of the urinary bladder which usually occurs in the setting of chronic irritation and infection or in some cases as a congenital process. Sometimes it presents as a tumor mass-like florid lesion, grossly mimicking malignancy. We report a case of 59-year-old man with multiple mass lesions around the trigone and the neck portion, which suggested the possibility of malignancy in clinical and radiological evaluations. Final diagnosis was confirmed by transurethral resection. The surface urothelial lining was intact. The submucosa showed von Brunn's nests, cystitis glandularis and cystitis cystica in the edematous lamina propria. There were numerous glands lined by tall columnar, mucin producing epithelium without atypia, conforming to the appearance of the intestinal variant of cystitis glandularis. The cystitis glandularis may mimic a neoplasm on gross evaluation. The intestinal variant of cystitis glandularis is particularly likely to be problematic when florid.
Cystitis* ; Diagnosis ; Epithelium ; Humans ; Middle Aged ; Mucins ; Mucous Membrane ; Neck ; Urinary Bladder Neoplasms* ; Urinary Bladder*