The authors examined a case of Bednar tumor(pigmented dermatofibrosarcoma protuberans). A 35-year-old woman presented with protruding black back mass 3x2.5 cm in surface dimension and 1 cm in heigh, which has grown slowly for 30 years. Microscopically the lesion is characterized by spindle cells arranged in storiform pattern and admixed with melanin containing dendritic cells. Ultrastructural study revealed three cell populations: (1) cells resembling fibroblasts, (2) cells resembling perineural cells, and (3) melanocytes. The immunohistochemical study using S-100 protein alpha-1 antitrypsin, antichymotrypsin and EMA revealed negative reaction in spindle fibroblastic tumor cells. The histogenesis of this neoplasm remains controversial; neuroectoderm, perineural cell, fibroblast and histiocyte. Through the ultrastructural study and immunohistochemical study, the authors suggested that Bedner tumor arises form the neuroectoderm with bidirectional to perineural and fibroblastic differentiation.
Female ; Humans

The purpose of this experiment is to evaluate the histopathologic findings of shark liver oil-induced lipoid pneumonia, and to determine whether shark liver oil is absorbed through lymphatics and the venous system or not. A single intratracheal administration of shark liver oil (0.6 ml/kg of B.W.) was given to Sprague-Dawley rats. They were then sacrificed sequentially from 1 hour to 12 weeks after injection. We investigated the chest radiographic findings, the serum total lipid concentration of blood obtained by cardiac puncture, lipid-laden alveolar macrophage index of the bronchoalveolar lavage fluid, and the histopathology of tracheobronchial lymph nodes and the lung (Oil red O stain & H&E stain). Chest radiographs showed no specific findings; ill-defined hazy, linear, small patch radioopacity, air space consolidation or collapse. Thirty-six percent of the experimental rats revealed normal findings. Within the lung, the shark liver oil appeared either as highly emulsified fine granules in the cytoplasm of the alveolar macrophage or as free, round oil masses. The area of the lung accumulated with lipid material was maximized 1 week after injection, and then decreased thereafter. The tissue reactions were cuboidal metaplasia of the alveolar lining, widening and lymphocytic infiltration of the alveolar septa and granuloma formation (3% of experimental rats) as a reaction to a foreign body. There were also lung abscesses due to superimposed bacterial infection (5% of experimental rats). With time after the injection of the oil, the serum total lipid tended to increase and the intracellular lipid of the alveolar macrophages in the bronchoalveolar lavage fluid tended to decrease. In summary, the histopathologic findings of the lung in the experimental lipoid pneumonia were interstitial chronic inflammation and granulomas with the presence of lipoid material in the lung parenchyma, and shark liver oil appeared to be absorbed in the blood and the lymph, then metabolized.
Animals ; Bacterial Infections ; Bronchoalveolar Lavage Fluid ; Cytoplasm ; Foreign Bodies ; Granuloma ; Inflammation ; Liver* ; Lung ; Lung Abscess ; Lymph Nodes ; Macrophages, Alveolar ; Metaplasia ; Pneumonia* ; Punctures ; Radiography, Thoracic ; Rats* ; Rats, Sprague-Dawley ; Sharks*

BACKGROUND: The purposes of the study were to examine rotator cuff tendon degeneration with respect to harvesting location, to determine a rationale for debridement of the torn end, and thus, to determine adequate debridement extent. METHODS: Twenty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from three locations; from torn ends after minimal regularization of fraying (native end group, NE group), from torn ends after complete freshening of the frayed end (freshened end group, FE group), and from the macroscopically intact portion just distal to the musculotendinous junction (musculotendinous junction group, MTJ group). Control samples were harvested from patients admitted for surgery for proximal humerus fracture. Harvested samples were evaluated using a semi-quantitative grading scale. RESULTS: Mean total degeneration scores in the NE group (13.3 +/- 3.21), the FE group (12.5 +/- 2.30), and in the MTJ group (10.8 +/- 3.10) were significantly higher than those in the normal control group (5.0 +/- 2.87; all P>0.001). Mean total degeneration score in the NE group was significantly higher than that in the MTJ group (p=0.012), but was not from that of the FE group. Mean total degeneration score in the FE group was not significantly different from that of the MTJ group. CONCLUSIONS: Tendon degeneration exists throughout the entire tendon to the macroscopically intact portion of full-thickness rotator cuff tear. Therefore, aggressive debridement to grossly normal appearing, bleeding tendon is unnecessary for enhancing healing after repair.
Debridement ; Hemorrhage ; Humans ; Humerus ; Rotator Cuff* ; Tendons*

Filiform polyposis(FP), an unusual form of inflammatory polyposis, has been recently designated to a lesion characterized by multiple, long slender, finger-like projections of mucosa and submucosa of the gastrointestinal tract. We present 5 cases of FP, of which two were associated with irritable bowel syndrome, two with advanced colon carcinoma, and one with active ileotyphlitis(Behcet's disease). The polyps ranged from 1.0 cm to 3 cm; they were either isolated or aggregated, and their numbers were up to 100. The common microscopic feature was filiform polyps which consisted of central submucosal core covered by intact or minimally inflamed intestinal mucosa, comparable with that in reparative processes and formation of inflammatory(redundant) pseudopolyps. We conclude that awareness of FP in non-inflammatory bowel disease may promote the endoscopists to search its underlying disease and prevent unnecessary surgical procedure. Behcets enterocolitis in the ileocecal junction seems an additional preceding disorder of a localized form of FP.
Colon ; Enterocolitis ; Gastrointestinal Tract ; Intestinal Mucosa ; Irritable Bowel Syndrome ; Mucous Membrane ; Polyps

Pathological proliferation of Brgnners gland is rare, and its wide range of morphologieal variations have led to confusing the terminology with considerable lack of agreement. Six cases of duodenal nodular lesions which consisted of pathological proliferation of Brunners glands were examined by light microscopy. Polypectomy was made in two cases, and the remaining 4 cases were examined with endoscopic biopsy materials. Two polypectomy specimens, 2 cm and 3 cm each in great diameters, consisted of protruded ovoid mass with broad and short stalks. Microacopically, all of 6 cases revealed thin strands of fibrous connective tissue which separated the normal-looking Brunners glands in lobules. Individual lobules were composed of groups of acini formed by cuboidal cells admixed with occasional endocrine cells. Presence of glandular and ductal configuration of the Brunners gland aside from thick, randomly arranged bundles of smooth muscle were featured without distinct relation to interlobular septa. Also, one polypectomy case disclosed the nests of fat cells interspersed with the glandular acini. One mucosal biopsy case contained not only the smooth muscle bands but also the intimate mixture of both acini and ducts. We conclude that some of heterogeneous composition of duodenal nodular proliferation of Brunners gland is indicative of a hamartomatous growth.
Adipocytes ; Biopsy ; Brunner Glands ; Connective Tissue ; Duodenum ; Endocrine Cells ; Hamartoma* ; Microscopy ; Muscle, Smooth ; Pathology

OBJECTIVE: The clinical value of preoperative serum squamous cell carcinoma antigen(SCC) in relation to clinical stage, tumor volume, disease extent and prognosis has already reported in many papers. The aim of this study is to analyse the relationship between preoperative SCC level and pelvic lymph node metastasis. Matrials and METHODS: From March 1995 to December 1998, 157 patients who examined pretreatment SCC levels before undergoing radical hysterectomy for squamous cell carcinoma of uterine cervix were included. The effect of pelvic lymph node status on the SCC level was examined by comparing 125 cases with cancer limited uterus or upper vagina and 32 cases with cancer confined to the uterus (including upper vagina) and pelvic lymph node using multivariate analysis. RESULTS: 90% of patients without pelvic lymph node metastasis showed SCC levels of 2.9ng/ml or below. 60.7% of patients with serum SCC level more than 2.9ng/ml exhibited pelvic lymph node metastasis. The marker values exceeding 2.9ng/ml increased risk of nodal metastasis 5 times compared with serum level 2.9ng/ml or below. Multivariate analysis confirmed that the pelvic lymph node metastasis had a large impact on the marker level than did tumor size or depth of stromal infilteration. CONCLUSION: SCC levels greater than 2.9ng/ml can be considered a high risk zone for nodal metastasis
Carcinoma, Squamous Cell* ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis* ; Prognosis ; Tumor Burden ; Uterine Cervical Neoplasms* ; Uterus ; Vagina

No abstract available.
Nephritis, Interstitial* ; Yersinia pseudotuberculosis* ; Yersinia*

BACKGROUND: Cancer registries are fundamental for cancer control and multicenter collaborative research. However, there have been discrepancies among pathologists in classifying cancer and assigning the codes according to the International Classification of Disease Oncology 3 (ICD-O3). To improve the quality of cancer registries as well as to prevent the conflict with medical insurance compensation, a guideline for the coding of cancer is mandatory. METHODS AND RESULTS: Funded by the Management Center for Health Promotion, 40 members of the Gastrointestinal Pathology Study Group and the Cancer Registration Committee of the Korean Society of Pathologists participated in the 1st workshop for gastrointestinal tumor registration. The subjects of gastric epithelial tumor, intramucosal carcinoma of the colon, carcinoid tumor, gastrointestinal stromal tumor and appendiceal mucinous tumor were discussed to create a guideline. A survey to obtain consensus for the guideline proposed by the workshop was carried out by the members of the Korean Society of Pathologists and 240 members completed the questionnaire. CONCLUSION: Although there are some issues to be discussed further, such as coding of high grade dysplasia/adenoma and intramucosal carcinoma of stomach and colon, the members agreed upon most parts of the proposed guideline. Therefore, we suggest using the ICD-O3 coding guideline for gastrointestinal tumor.
Adenoma

Oseltamivir (Tamiflu, the trade name) is a neuraminidase inhibitor used for the treatment and prevention of influenza virus infection as well as those of avian influenza infection. The mechanism of action is inhibition of neuraminidase for blocking the release of newly formed virus particles from the infected respiratory epithelial cells and preventing the further spread of the virus. Development of resistance is rare. The adult dose is 75mg (p.o.) b.i.d. for 5 days for treatment of influenza. The adverse drug reactions of oseltamivir are very rare but in children and adolescents careful monitoring is needed.
Adolescent ; Adult ; Animals ; Child ; Drug Toxicity ; Epithelial Cells ; Humans ; Influenza in Birds ; Influenza, Human ; Neuraminidase ; Orthomyxoviridae ; Oseltamivir ; Virion ; Viruses

A 46-year-old woman presented with multiple purpuric skin rashes together with splenomegaly and thrombocytopenia. The resected spleen weighed 720 gm, and contained multiple, discrete, dark red, bulging nodules throughout the entire splenic parenchyma. Microscopically, the nodules revealed various range of endothelial cell proliferation which included cavernous vasculature, anastomosing vascular channels, papillary intravascular growth and solid pattern. Intrasinusoidal sequestration of platelets along with extramedullary hematopoiesis was present in the neoplastic vascular spacws. Neither exposure to thorotrast nor vinyl chloride was nonfirmed. Ultrastructurally, the tumor cells demonstrated a row of pinocytotic vesicles, occasional intercellular junctional structures, and the paucity/absence of filamentous structures or Weibel-Palade bodies supports origin of sinus lining type cells. After splenectomy, the thrombocyte count returned to normal. We conclude this is the first case of primary splenic angiosarcoma with Kasabach-Merritt syndrome in Korean literature.
Female ; Humans