Liver cell dysplasia of Anthony(LCD) is a common association in hepatocellular carcinoma(HCC)-bearing liver and has been regarded as a premalignant condition with strong linkage to hepatitis B virus infection and cirrhosis. A total of 189 surgically resected livers [HCC(168 cases), cholangiocarcinoma(3 cases), metastatic carcinoma(3 cases), and non-neoplastic lesions(15 cases)] were reviewed to elucidate the nature of LCD by means of light microscopic examination, in situ hybridization method for HBV DNA and expression of proliferatin cell nuclear antigen(PCNA) using immunohistochemical technique. LCD was present in 141 cases(74.6%), and its prevalence rate was independently significant in HCCs with or without cirrhosis than other groups. There was no difference in mean age, although LCD-positive group was younger than its negative counterpart. Association rate of LCD in HCC-cirrhosis group was statistically significant than the non-cirrhotic group, and higher histological grading of LCD was correlated well with wider distribution pattern and clustering. Seropositivity of HBsAg was not correlated with presence of LCD or with histological grading. In situ hybridization techique using HBV DNA probe demonstrated fine granular stainable particles even in LCD cells. Immunohistochemical study for PCNA revealed that the proliferative activity of LCD was lower than that of the cirrhotic cell. With the above results it is concluded that LCD reflects neither a regenerating condition nor a premalignant lesion but suggest a reactive change.
Carcinoma, Hepatocellular ; Neoplasm Metastasis

In our hospital, we experienced a case of left solitary cystic kidney. She was sixty years old woman. Her chief complaints were dull pain on left upper abdomen, terminal dysuria. tenesmus. and frequency. Cyst was situated to lower pole of kidney. Cyst was dissected from renal parenchyma. It contained about 250cc serous and clear cystic fluid, Post-operative general condition was good and her chief complaints were disappeared almostly.
Abdomen ; Bone Cysts* ; Dysuria ; Female ; Humans ; Kidney*

A carefull inspection of an AP X-ray of a normal hip reveals in the weight-bearing surface of the ilium a curved area of dense bone, called SOURCIL by Pauwels (1963). The configuration of this dense area is semilunar and represents subchnodral bony eburnation due to a respose by the articular portion of the ilium to the stress provoked by the compressive force acting on it. However, in many cases of idiopathic avascular necrosis of the femoral head, changes in SOURCIL may be seen. So we reviewed our 49 patients (unilateral 16, bilateral 33) since 1983 with comparison to normal hips (100 persons). The results are as follows; 1. SOURCIL is not visible at birth and by walking, it is developed with age and has the adult configuration at the age of 18. It is thought the configuration and sloping angle of SOURCIL is not changed with age after skeletal growth is completed. 2. Although the position of the X-ray tube may be changed, the shape and angle of SOURCIL is not changed significantly. 3. The average SOURCIL angle is 2.1° in normal hip group and 3.5° for the avascular necrosis group but, there is no meaningful statistical differences. It seems to be meaningful that the mean SOURCIL angle is 10.3° for patients under the age of 35 in avascular necrosis groups (9 persons). 4. If a high SOURCIL angle (about 10° or more) is present, the hemiarthroplasty such as bipolar endoprosthesis should be avoided because there is biomechanically far more wearing of the acetabular roof after that kind of operation. If inevitable, deepening the acetabulum by reaming is recommended for prevention of superolateral migration of prosthesis after operation. 5. With close observation of SOURCIL before and after operation, one can easily point out what is able to predict the prognosis on the biomechanical basis.
Acetabulum ; Adult ; Head ; Hemiarthroplasty ; Hip ; Humans ; Ilium ; Necrosis ; Parturition ; Prognosis ; Prostheses and Implants ; Walking ; Weight-Bearing

Elastofibroma is a rare benign tumorous growth presenting as a slowly growing ill-defined mass of fibroblastic tissue occurring in elderly persons and arising mainly form the connective tissue between the lower portion of the scapula and the chest wall. Its pathogenesis is not well established but it may be the result of nonneoplastic reactive hyperplasia taking place with constitutional predisposition in the background. A case of elastofibroma occurring in the subscapular area of a 65-year-old female cook is presented. The mass, 6x5x3 cm in maximum dimensions, was poorly circumscribed, solid, hard, pale fleshy and pray-white fibrous tumor. Microscopically, it was composed of numerous small globular and linear elastic fibers embedded in collagenous matrix. To our knowledge, it is the first case of elastofibroma in Korea.
Female ; Humans

Dedifferentiated chordoma is a rare pathologic entity presenting an additional sarcomatous component in otherwise classical chordoma. It has been also emphasized that this neoplasm is classified as a distinct entity because of its different clinical settings and aggressive behavior. Dedifferentiation is a peculiar phenomenon but its histogenesis has remained controversial. A 50-yera-old man developed a huge tumor mass in the retrorectal, presacral area, featured with two histological components. The one was a typical chordoma accounted for approximately 60% of the mass and the other was made up of highly cellular, plemorphic, undifferentiated tumor cells, reminiscent partly to the cells of plemorphic malignant fibrous histiocytoma. Ultrastructural features and immunoreactivity against cytokeratin, S-100 protein and alpha-1-antichymotrypsin in both portions support that histologically different components of this neoplasm derive from the same origin. To our knowledge, this is the first case of dedifferentiated chordoma in Korea.
Male ; Humans

Primary hemangioma of the lymph node is an extremely rare vascular neoplasm, and only four cases on the subject have been reported in the literature. We describe a case of cavernous hemangioma in an axillary lymph node that was incidentally found in 70-year-old woman who underwent a modified radical mastectomy for infiltrating duct carcinoma of the left breast. Brief review of the literature regarding vasoformative lesions occupying lymph node is made with special regard to differential diagnosis from reactive-proliferative processes and other true neoplasms.
Female ; Humans ; Diagnosis, Differential ; Hemangioma

With advance of diagnostic imaging technics, the detection rate of small hepatocellular carcinoma (HCC) has become much increased, but the questions whether the growth pattern and histologic nature of the HCC keep maintain the original gross and microscopic features with its advancement of tumor size remain still unclear. We reviewed 39 surgically resected hepatocellular carcinomas(HCCs) with a tumor size less than or equal to 3 cm in diameter(s-HCC), and their gross and microscopic features were compared with the HCCs bigger than 3 cm (i-HCC, 199 cases). Single nodular type(SN) was the most common gross type(60%) in s-HCCs, and was followed by single nodular type with perinodular extension(SNPE; 15.4%), multinodular-discrete type(10.3%) and multinodular-confluent type(5.1%). These figures contrasted to SNPE(42.2%) and SN(20.6%) in the i-HCCs. Of the 39 s-HCCs, 25 cases(64.1%) were encapsulated, and 14 cases(36%) demonstrated intratumoral fibrous septations, being contrasted to the i-HCCs in which fibrous septa formation was mord prominent but complete capsule formation was found only in 40.2% of the larger ones. Microscopically, the trabecular type was the most frequent one(53.9%), and increased with their size while the compact type transformed into trabecular one. Thirty three cases(84.6%) were associated with macronodular cirrhosis. Seropositivity for HBsAg was found in 26 cases(66.6%), and high serum alpha-fetoprotein level over 500 IU/L was found in 15 s-HCC cases(38.4%), while 53.3% in i-HCC. The above results suggest that HCCs change their pathologic features by increase of their size, and a comparison of the details with regard to the possible mechanisms involved is discussed.
Carcinoma, Hepatocellular

The cubitus varus is one of the most common complications of supracondylar fracture of humerus. The authors treated surgically 45 cases of cubitus varus in the Seoul National University Hospital, from 1977 to 1981, and the results were as follows: 1. The mild ulnar n. palsy signs were found in 11 cases(24.5%). 2. The supracondylar, closed wedge osteotomy was done through lateral approach and fixed by cross pinning with 2 K-wires. 3. The postoperative immobilization must be more complete, and the average duration of immobilization was 7 weeks. The osteotomy site united in the all cases, and no limitation of range of motion developed. 4. The incidence of postop. ulnar nerve palsy was the same in the osteotomy only group as in the osteotomy and ulnar n. transposition group. The osteotomy and ulnar n transpositin group recovered naturally, but 2 cases of the osteotomy only group did not recover so ulnar n. transposition was performed later. 5. There was no recurrence of deformity after the average follow-up of 2.2 years, so it was recommended that the correction of deformity should be done in the early childhood.
Congenital Abnormalities ; Follow-Up Studies ; Humerus ; Immobilization ; Incidence ; Osteotomy ; Paralysis ; Range of Motion, Articular ; Recurrence ; Seoul ; Ulnar Neuropathies

Solitary osseous plasmacytoma accounts for 3-5% of plasma cell tumor and are assumed to have a fairly good prognosis, with long duration of relapse free survival after local irradiation. A 64 year old woman with a lytic lesion involving left iliac bone was diagnosed as a solitary plasmacytoma, with a negative work-up for coexisting plasma cell disorders. Three months after irradiation of 5,400 cGy, the patient was readmitted with hypercalcemia and mass in left forehead and left gingiva. New multiple osteolytic lesions were developed. A aspiration cytology of forehead mass and curetted specimen of right femur due to pathologic fracture revealed plasmacytoma. MRI of thoracolumbar spine revealed abnormal high signal intensity in the L2 body, T8 and T9 vertebrae. Serum protein electropheresis revealed monoclonal gammopathy of IgG-kappa type. This aggressive case of solitary plasmacytoma, evolving into multiple myeloma after brief duration of remission, is in sharp contrast with the natural course of a solitary plasmacytoma.
Female ; Femur ; Forehead ; Fractures, Spontaneous ; Gingiva ; Humans ; Hypercalcemia ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma* ; Paraproteinemias ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Radiotherapy ; Recurrence ; Spine

A 55-year-old woman suffered from upper abdominal pain for two months and remained refractile against the anti-ulcer regimen. The palliative gastrectomy specimen revealed multiple shallow ulcerations on the thickened mucosal folds mainly in the antrum and body along the greater curvature where multiple, whitish nodules were found in the submucosa. Microscopically, individual submucosal nodules clearly corresponded to the necrotizing granulomatous vasculitis which were featured with diffuse fibrinoid necrosis of arterial walls accompanying granuloma formation and heavy infiltration of neutrophils, eosinophils, histiocytes and giant cells. Similar vasculitic lesions involved venules and arterioles. There were scattered vasculitic changes in the liver biopsy specimens and omentum. There were no clinical presentations or serological support of systemic involvement including systemic lupus erythematosus, Henoch-Schoenlein purpura, cryoglobulinemia or Churg-Strauss granulomatous vasculitis. We conclude that this is a hitherto undescribed primary necrotizing granulomatous vasculitis predominantly involving the stomach.
Abdominal Pain ; Arterioles ; Biopsy ; Cryoglobulinemia ; Eosinophils ; Female ; Gastrectomy ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Neutrophils ; Omentum ; Purpura, Schoenlein-Henoch ; Stomach* ; Ulcer ; Vasculitis* ; Venules