Sclerotic fibroma is one of the histologic variants of soft fibroma. Clinically, it presents as a solitary skin-colored nodule, usually less than 1 cm in diameter in adults and has a wide anatomical distribution. Histologically, it is a well-circumscribed dermal nodule composed of hypocellular hyalinized collagen bundles separated by clefts and arranged in a storiform pattern. Treatment with simple excision is curative. We report a case of sclerotic fibroma in a 34-year-old man who presented an asymptomatic, bean-sized, intracutaneous nodule on his back for 3 years.
Adult ; Collagen ; Fibroma* ; Humans ; Hyalin

Dermatofibroma is a common benign fibrohistiocytic lesion which may present with a variety of pathological variants. We report an unusual case of dermatofibroma which has histological features of aneurysmal variant and atypical variant in a single lesion. The lesion was an asymptomatic, bean-sized, brownish, hard nodule occurring on the leg in a 24-year-old female. Histologically, it has features of typical dermatofibroma as well as hemorrhagic cleft-like vascular spaces at the center of the tumor, numerous monster cells, and multinucleated giant cells.
Aneurysm* ; Female ; Giant Cells ; Histiocytoma, Benign Fibrous* ; Humans ; Leg ; Young Adult

PURPOSE: Through a study of 3 diabetic patients who experienced decreased visual acuity due to deposit on the surface of hydrophilic acrylic IOLs which were inserted after cataract extraction, the authors attempted to examine pathological and histochemical characteristics of such undesirable deposit on the IOL surface and also evaluate whether a correlation exists between that and diabetes mellitus. METHODS: A 42 year old male patient with bilateral proliferative diabetic retinopathy who has had diabetes for 10 years, a 43 year old male with identical clinical history, and a 46 year old male with bilateral proliferative diabetic retinopathy and clinically significant macular edema who has had diabetes for 13 years were selected for the study. Cataract was extracted by phacoemulsification and after hydrophilic acrylic IOL was inserted into the bag, deposit appeared on IOL surface which caused decreased visual acuity. IOL exchange was conducted thereafter, and by studying the pathological and histochemical characteristics of deposit found on the surface of the retrieved IOL, and by examining the deposit's fine details with electron microscope, the authors attempted to identify the causative material and also evaluate whether diabetes plays a significant role in giving rise to such undesirable deposit. RESULTS: All three IOL that have been retrieved from the patients were covered with multiple deposits which took on a structure with fine circular granules, and all these deposits tested positive when 1% alizarin red staining and von Kossa staining (designed to identify calcium in a given material) were conducted. Electron microscopic study of the deposit also showed needlelike calcium crystals.
Adult ; Calcium* ; Cataract ; Cataract Extraction ; Diabetes Mellitus ; Diabetic Retinopathy ; Humans ; Macular Edema ; Male ; Middle Aged ; Phacoemulsification ; Visual Acuity

Genital lymphedema may be a presenting feature of cutaneous metastasis of gastric carcinoma. This underscores the importance of evaluation in persistent genital swelling and erythema. We report a case of cutaneous metastasis from gastric carcinoma by lymphatic spreading. A 30-year-old female presented faintly erythematous swelling with pruritus and prickling sensation on labia majora for 1 month. Five years ago, she had diagnosed as gastric carcinoma, and gastrectomy was done. Also, she had received oophorectomy due to matastatic gastric carcinoma, Krukenberg tumor. Histopathologic finding showed glandular structures composed of hyperchromatic cells and signet ring cells within dilated lymphatic vessels in edematous dermis, which were consistent with lymphatic metastasis from gastric carcinoma.
Female ; Humans ; Neoplasm Metastasis

Allergic angitis and granulomatosis is a kind of rare systemic vasculitis, with various manifestations of disease of lung, heart, skin, musculoskeletal system, nervous system and hepatobiliary tract. There was no report of a case with manifestation of pleuritis and pericarditis, while several cases had been reported in Korea. So we here report a case of allergic angitis and granulomatosis with manifestations of pleuritis and pericarditis. The case also showed clinical manifestations of hypereosinophilia, asthma, rhinitis, pulmonary infilterates with eosinophilia and nephritis. Open lung biopsy showed arteritis with heavy infilteration of activated eosinophil in lung, pleura and pericardium. The involvement of heart might cause critical complication leading death. The patients who are supposed as allergic angitis and granulomatosis should be examined for the involvement of heart.
Arteritis ; Asthma ; Biopsy ; Eosinophilia ; Eosinophils ; Heart ; Humans ; Korea ; Lung ; Musculoskeletal System ; Nephritis ; Nervous System ; Pericarditis* ; Pericardium ; Pleura ; Pleurisy* ; Rhinitis ; Skin ; Systemic Vasculitis

Sinusoidal hemangioma is a rare variant of cavernous hemangioma. Clinically, it develops in adults and predominantly in females, and presents as a solitary painless subcutaneous nodule. Histological finding of the sinusoidal hemangioma shows a well-circumscribed lobular architecture in the subcutaneous tissue. The lobulated mass is composed of dilated sinusoidal thin-walled vascular channels, which have a pseudopapillary pattern and back-to-back arrangement without much intervening stroma. We report a case of sinusoidal hemangioma which can be differentiated from the other vascular tumors and has never been reported in Korea.
Adult ; Female ; Hemangioma* ; Hemangioma, Cavernous ; Humans ; Korea ; Subcutaneous Tissue

BACKGROUND: There have been only a few electron microscopic studies after laser treatment of pigmented skin lesions. OBJECTIVE: The purpose was to investigate the pathologic, immunohistochemical, and electron microscopic changes following Q-switched alexandrite laser treatment of pigmented skin lesions. METHODS: Three patients with acquired bilateral nevus of Ota-like macules, and 2 patients with cafeau lait macule were irradiated with Q-switched alexandrite laser. Forty biopsies were taken before and immediately after laser treatment. Hematoxylin-eosin, Fontana-Masson, and gp100 staining were performed for the evaluation of the histopathologic and immunohistochemical findings of the specimens. Electron microscopic findings were also evaluated. RESULTS: Histopathologically, suprabasilar separations were observed immediately after laser treatment. Vacuolar alterations of pigment-containing cells were frequently found in the epidermis and/or in the dermis. Fontana-Masson and gp100 staining positivity changed to negative or decreased in the epidermis immediately after laser treatment, while they changed to negative in the dermis. Ultrastructurally, epidermal pigment-containing cells frequently showed severe vacuolar changes in the cytoplasm, pyknotic nuclei, and vacuolated and/or fragmented melanosomes immediately after laser treatment. Dermal melanocytes frequently revealed vacuolated and/or fragmented melanosomes immediately after laser treatment. CONCLUSION: Histopathologic, immunohistochemical, and electron microscopic examination of pigmented skin lesions immediately after Q-switched alexandrite laser treatment demonstrated vacuolated or fragmented melanosomes and vacuolar alteration of pigment-containing cells in the epidermis and/or in the dermis, which suggested selective photothermolysis of melanosomes.
Biopsy ; Cytoplasm ; Dermis ; Epidermis ; Humans ; Lasers, Solid-State* ; Melanocytes ; Melanosomes ; Nevus ; Skin*

PURPOSE: Gastrointestinal stromal tumors (GISTs) are of a mesenchymal origin, and they arise predominantly from the gastrointestinal tract. This study aims to aid the post operative management of GIST patients by analyzing the clinical and immunopathological features of recurrent GISTs. METHODS: We enrolled 98 GIST patients who had been operated on for their primary tumor from 1987 to 2001 at the Catholic Medical Center. Among them, 28 patients had clinical and radiological features that were proved to be recurrence, and the patients' survival rates were compared according to the treatment modalities. RESULTS: When the maximum length of tumor was shorter and the mitotic index lower, then these patients had higher disease free survival rates and lower recurrence rates. The Ki-67 negative group had lower recurrence rates than their Ki-67 positive counterparts. Recurrence was mostly observed as liver metastasis. The mean length of time to recur was 22.96 months. Fifteen patients received additional treatments such as surgery, chemotherapy and radiation therapy, but there was no significant difference in survival rates when they were compared to the 13 patients who did not receive further treatments. CONCLUSION: Of the patients diagnosed with GIST after surgery, those with worse prognostic factors, i.e. a bigger tumor size and higher mitotic index, require more meticulous surveillance for tumor recurrence, and especially for liver recurrence, which was the most common recurrence site, during the follow up exams. In addition, although there have not been any remarkably effective treatments for the recurrent GIST patients, further researches for new therapy such as STI-571 is mandated.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Imatinib Mesylate ; Liver ; Mitotic Index ; Neoplasm Metastasis ; Recurrence ; Survival Rate

OBJECTIVE: To determine the safety and efficacy of immune ablation followed by autologous hematopoietic stem cell transplantation (HSCT) in refractory systemic lupus erythematosus (SLE). METHODS: Three patients who had been refractory to steroid and one or more immunosuppressive drug were included. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/m(2)), followed by granulocyte-colony stimulating factor (5mug/kg/day). T lymphocytes were depleted from the graft by selection of CD34 positive cells. Conditioning regimens composed of high dose CTX (total dose 200 mg/kg) and anti-thymocyte globulin (total dose 90 mg/kg) in 2 patients and BEAM (BCNU 300 mg/m(2), etoposide 200 mg/m(2), cytarabine 200 mg/m(2), melphalan 200 mg/m(2)) in 1 patient. Stored stem cells were reinfused 48 hours after conditioning. RESULTS: Among 3 patients, first patient had lupus nephritis, second patient had overlap syndrome combined with rheumatoid arthritis (rhupus) and the last patient had severe thromobocytopenia and intractable polyserositis. No life threatening complications were observed during the treatment. All patients demonstrated rapid and marked improvement in organ function and quality of life just after HSCT. Previous massive proteinuria in first patient was decreased to less than 500 mg/day with 6 months follow up. Rhupus patient satisfied American college of rheumatology 70% response criteria with 3 months follow up. But third patient improved polyserositis dramatically 1 month after HSCT and relapsed at 9 weeks. CONCLUSION: In refractory SLE patients, HSCT can be performed safely with marked improvement and sustained withdrawal of all immunosuppressive medication. A further randomized trial is needed to confirm the efficacy and durability of remission.
Antilymphocyte Serum ; Arthritis, Rheumatoid ; Cyclophosphamide ; Cytarabine ; Etoposide ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Melphalan ; Proteinuria ; Quality of Life ; Rheumatology ; Stem Cells ; T-Lymphocytes ; Transplants

Multilocus sequence typing analysis was applied to determine the genotypes of 147 (137 clinical and 10 environmental) Cryptococcus neoformans and three clinical Cryptococcus gattii isolates from 1993 to 2014 in Korea. Among the 137 clinical isolates of C. neoformans, the most prevalent genotype was ST5 (n = 131), followed by ST31 (n = 5) and ST127 (n = 1). Three C. gattii strains were identified as ST57, ST7, and ST113. All environmental isolates were identified as C. neoformans with two genotypes, ST5 (n = 7) and ST31 (n = 3). Our results show that C. neoformans isolates in Korea are genetically homogeneous, and represent a close genetic relationship between clinical and environmental isolates.
Cryptococcus gattii* ; Cryptococcus neoformans* ; Cryptococcus* ; Genotype* ; Korea* ; Multilocus Sequence Typing