The cystic hypersecretory duct carcinoma of the breast was first described in 1984 by Rosen and Scott and warrants separate discussion because of its unusual pathological features. It is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma or mucocele-like tumor. We present a case report of intraductal cystic hypersecretory carcinoma of the breast with hormone receptor and oncogene study. The histologic differential diagnosis, with an emphasis on benign lesions that may have a predominant cystic component, is also discussed.
Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Mucins ; Oncogenes

To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squa mous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75% in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant asso ciations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.
Biopsy* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Papanicolaou Test

Systemic lupus erythemotosus (SLE) is an autoimmune disorder with dermal, renal, and cardiac manifestations. It frequently has cardiovascular complications such as pericarditis, myocarditis, and valvular heart diseases. Valvular heart diseases in SLE comes mainly in the form of mitral or aortic insufficiencies. Report of aortic stenosis is extremely rare. Surgical treatments of valvular heart disease in SLE are not done frequently because of complications in other organs. Aortic stenosis developed in a 59 year-old woman with SLE, and aortic valve replacement was done successfully.
Aortic Valve ; Aortic Valve Stenosis* ; Endocarditis ; Female ; Heart Valve Diseases ; Humans ; Lupus Erythematosus, Systemic* ; Middle Aged ; Myocarditis ; Pericarditis

Recently, the incidence of fungal infection increases because of immunosuppressive therapy and chemotherapy. In immunosuppressed transplant recipients, Aspergillus can be a dangerous pathogen, capable of inducing fulminant clinical disease. Invasive fungal infections are life-threatening complications in solid-organ transplantation. Although the rate of fungal infections in transplant recipients is lower than that of other infections, the mortality rate is higher. A 34 year-old male was admitted to our hospital with fever and gross hematuria. He had received renal transplantation 2 years ago and had been transferred the other hospital 1 month ago. Initial laboratory data evaluation showed a pancytopenia and azotemia. We thought that pancytopenia was caused by immunosuppressive agents and infection. The patient was treated with antibiotics but fever was not subsided. After 4 days, he complained of transplant site pain and tenderness to percussion. A percutaneous renal biopsy was performed. Microscopic examination showed invasive aspergillosis in transplanted kidney and perirenal area. We removed the transplanted kidney and perirenal tissue, and prescribed antifungal agents for 3 months.
Anti-Bacterial Agents ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Azotemia ; Biopsy ; Fever ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pancytopenia ; Percussion ; Transplants

Burkitt's lymphoma is a type of non-Hodgkin's lymphoma occurring predominantly in children. In some cases, the first manifest site is the jaw, and the disease may be misdiagnosed as an infectious disease. A case of a 12-year-old boy with a painful swelling on the right retromolar triangle area is presented. At the time of the first visit, it was misdiagnosed as an osteomyelitis. Included are several characteristics and differential diagnosis of this disease.
Burkitt Lymphoma* ; Child ; Communicable Diseases ; Diagnosis, Differential ; Humans ; Jaw ; Lymphoma, Non-Hodgkin ; Male ; Mandible* ; Osteomyelitis

Ocular sebaceous carcinoma (OSC) is an uncommon malignancy with a potential to recur and metastasize. Some characteristics of sebaceous carcinoma, such as female preponderance, shown in the present series during 11-year period at Korea Cancer Center Hospital, led us to study their hormone receptors and c-erbB-2 expression. c-erbB-2 overexpression was very common (83%) in OSC, and was not associated with pathologic findings or clinical outcome. Interestingly, estrogen and progesterone receptor was detected in 4 and 2 cases, respectively, suggesting a role of hormonal influence on this neoplasm. Immunohistochemical and clinicopathologic features of 18 cases of OSC in Korea are presented.
Adult ; Aged ; Aged, 80 and over ; Carcinoma/pathology* ; Carcinoma/metabolism ; Carcinoma/chemistry ; Eyelid Neoplasms/pathology* ; Eyelid Neoplasms/metabolism ; Eyelid Neoplasms/chemistry ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Necrosis ; Receptor, erbB-2/biosynthesis* ; Receptor, erbB-2/analysis ; Receptors, Estrogen/analysis ; Receptors, Progesterone/analysis ; Sebaceous Gland Neoplasms/pathology* ; Sebaceous Gland Neoplasms/metabolism ; Sebaceous Gland Neoplasms/chemistry

A 52-year-old woman was referred to our hospital due to chronic renal failure with a 10-year history of hypertension. We found polycystic kidney disease, pulmonary tuberculosis and an aldosterone-producing adrenocortical mass. At this time, her serum potassium level and blood pressure were within the normal range. She refused hemodialysis and then was hospitalized because of uremic encephalopathy. On admission, her serum potassium level was normal without treatment and plasma aldosterone concentration highly elevated. She received hemodialysis, and thereafter hypokalemia developed. We then administered spironolactone, whereupon serum potassium level returned to the normal range. In this case, we thought that normokalemia was balanced hypokalemia of primary aldosteronism with hyperkalemia of chronic renal failure, and that hypokalemia developed after hemodialysis was due to an imbalanced primary aldosteronism with end stage renal disease.
Aldosterone ; Blood Pressure ; Female ; Humans ; Hyperaldosteronism* ; Hyperkalemia ; Hypertension ; Hypokalemia ; Kidney Failure, Chronic* ; Middle Aged ; Plasma ; Polycystic Kidney Diseases ; Potassium ; Reference Values ; Renal Dialysis ; Spironolactone ; Tuberculosis, Pulmonary

BACKGROUND: Atopic dermatitis (AD) is a common inflammatory skin disease. Atopic dermatitis is associated with increased IL-4, IL-5, IL-10 and IL-13 but decreased INF-gamma and TNF production. IL-10 production has been implicated in autoimmunity because of its effect on B-cell proliferation and antibody production. The study of IL-10 gene polymorphism is of interest because of the pivotal role of IL-10 in the regulation of inflammatory and immune responses. TNF-beta significantly upregulates INF-gamma but downregulates IL-5, IL-13 and IgE, which suggests a potential role of TNF-beta in the pathogenesis of atopic dermatitis. OBJECTIVES: We have investigated polymorphism of IL-10 promoter gene and TNF-beta gene. METHODS: Seventy one patients with atopic dermatitis and one hundred and sixty six normal subjects participated in this study with analysis of polymorphism of IL-10 promoter (-1082), (-819) gene and seventy one patients with atopic dermatitis and one hundred and forty one normal subjects participated in the analysis of polymorphism of TNF-beta gene. The patients in this study were recently diagnosed with atopic dermatitis. RESULTS: The frequency of IL-10 promoter (-1082) genotypes (A/A, A/G, G/G), genes (A, G), IL-10 promoter (-819) genotypes (T/T, T/C, C/C) and genes (T, C) did not show any significant difference between atopic dermatitis patients and normal controls. There was no significant difference in the frequency of TNFB genotypes (TNFB*1/TNFB*1, TNFB*1/TNFB*2, TNFB*2/TNFB*2) and genes (TNFB*1, TNFB*2) in patients of atopic dermatitis and normal controls. CONCLUSION: The results of this study suggest that the other regions of the IL-10 promoter gene and TNFB gene should be investigated for polymorphism of atopic dermatitis. And the difference of IL-10 promoter and TNFB gene polymorphism between caucasian and Korean needs to be evaluated.
Antibody Formation ; Autoimmunity ; B-Lymphocytes ; Dermatitis, Atopic* ; Genotype ; Humans ; Immunoglobulin E ; Interleukin-10* ; Interleukin-13 ; Interleukin-4 ; Interleukin-5 ; Lymphotoxin-alpha* ; Polymorphism, Genetic* ; Skin Diseases

Primary aldosteronism is present in approximately 1 percent of hypertensive patients, and is rarely associated with pregnancy. We report a case of unilateral aldosterone producing adenoma in a pregnant woman. A 29-year-old woman was referred to with hypertension and proteinuria at 14 weeks' gestation. She had known that she had unilateral aldosterone producing adenoma for 18 months and refused medical or surgical treatment. She was prescribed antihypertensive medication and preformed laparoscopic adrenalectomy in left adrenal gland at 22 weeks' gestation. After adrenalectomy, her blood pressure was normal. At 29 weeks' gestation, she complained headache, and her blood pressure was 200/100 mmHg with pitting edema. We thought preeclampsia and performed cesarean section. After the baby was delivered, she had uncontrolled hypertension, hypokalemia with persistent proteinuria. We checked plasma renin activitity, aldoterone and abdminopelvic computed tomography. We found remnant left adrenal adenoma and perfomed laparoscopic operation. After reoperation, her blood pressure was normal and no proteinuria.
Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocortical Adenoma ; Adult ; Aldosterone ; Blood Pressure ; Cesarean Section ; Edema ; Female ; Headache ; Humans ; Hyperaldosteronism ; Hypertension ; Hypokalemia ; Plasma ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Proteinuria ; Renin ; Reoperation

Cancers of the upper aerodigestive tract (UADT) constitute 3.5-4% of all malignancies. Since the majority of cases are squamous cell carcinomas which are related with epidemiologic factors, a different pattern of UADT cancer might be present between the Western and Asian populations. We performed a pathology based statistical study on UADT cancers in Korean patients. Cases from Korea Cancer Center Hospital, from January 1, 1988 through December 31, 1998, were subjected to the study. Among 2,842 cases, epithelial malignancies accounted for 87.8%, with squamous cell carcinoma as the major type (76.5%). The larynx was the most commonly affected site (26%), followed by the oral cavity (25.1%), oropharynx (13%), nasopharynx (9%), hypopharynx (8.4%), paranasal sinuses (6.4%), nasal cavity (6%) and salivary glands (6.1%). The percentage of squamous cell carcinoma was highest (98.7%) at the hypopharynx, and lowest at the nasal cavity (42.3%), which showed the most diverse tumor entities. Korean patients with UADT cancers presented with a higher incidence of non-epidermoid malignancy including sarcoma (1.5%) and malignant melanoma (1.4%), and a higher frequency of involvement of the sinonasal tract, compared with the Western patients.
Head and Neck Neoplasms/classification/*pathology ; Humans ; Hypopharyngeal Neoplasms/classification/pathology ; Korea ; Laryngeal Neoplasms/classification/pathology ; Mouth Neoplasms/classification/pathology ; Nasal Cavity ; Nasopharyngeal Neoplasms/classification/pathology ; Oropharyngeal Neoplasms/classification/pathology ; Paranasal Sinus Neoplasms/classification/pathology ; Salivary Gland Neoplasms/classification/pathology