Inflammatory pseudotumor of the urinary bladder is an unusual, benign mesenchymal proliferative lesion of the submucosal stroma easily mistaken for a malignant neoplasm clinically and histologically. We present a case and describe the clinical presentation and radiologic, histologic, histochemical, immunohistochemical, and ultrastructural findings. A 23-year old patient presented with sudden onset of gross painless hematuria for 3 months. There was no previous instrumentation or surgery involving the genitourinary tract. Cystoscopy revealed a large polypoid and ulcerated bladder mass. The lesion consisted of plump spindle shaped, fibroblast-like cells embedded in a myxoid stroma. Mitotic figures were negligible and the lesion showed encroachment on the superficial muscle bundles. The spindle cells were immunoreactive for vimentin and muscle specific actin. Immunohistochemical and ultrastructural findings revealed the fibroblastic-myofibroblastic nature of this lesion. Complete surgical excision by partial cystectomy was successful in eradicating the lesion. The findings are described with a discussion of the pathogenesis and review of the literature.

Malignant intracranial meningioma is a rare pathologic entity. Although the topic is widely discussed, there is little agreement in the literatures as to the histological and radiological features that warrant the diagnosis of malignant meningioma. An osteolytic lesion of the skull may have been suggested in several cases. But in adults, the most commonly suspected lesion is metastatic lesion;while meningioma is rarely suspected. Meningiomas are occasionally associated even with extracranial masses. However, most of these masses are firm, and are caused by hyperostosis. Extracranial soft-tissue masses rarely arise in meningiomas, thus, the presence of both osteolytic skull lesion and soft-tissue mass is exceedingly rare in meningiomas. The authors report a case of osteolytic malignant meningioma located at the frontal fossa extending to the subgaleal space appearing as an extracranial soft-tissue mass in a 19-year-old female. The clinical, radiological, neurosurgical, and histopathological features of these lesions are discussed together with a review of the literatures.
Adult ; Diagnosis ; Female ; Humans ; Hyperostosis ; Meningioma* ; Osteolysis ; Skull ; Young Adult

Epithelioid hemangioendothelioma(EH) is a rare vascular tumor of low-grade malignancy. It was previously described as intravascular bronchioloalveolar tumor (IVBAT). But electron microscopic study and immunohistochemical staining results have proved endothelial origin. Patients are usually asymptomatic and the tumors are found incidentally on routine chest X-rays. Most patients show a slowly progressive clinical course, even though some patients occasionally die as results of respiratory failure or extrathoracic complications. Confirmative diagnosis is made through thoracoscopic or open-lung biopsy. There is still no effective therapeutic modality for pulmonary EH. We have experienced a 55-year-old woman whose simple chest x-ray film revealed bilateral multiple small nodules. The nodules were histopathologically and immunohistochemically diagnosed as primary epithelioid hemangioendothelioma of the lung. The possibility of metastatic disease was excluded thorough clinical, laboratory and radiological studies. Comparison of radiographic chest film taken 3 years ago showed no significant progression of the pulmonary nodular lesions. Conservative management was instituted and careful 4 months follow-up showed no significant changes.
Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Lung ; Middle Aged ; Respiratory Insufficiency ; Thorax ; X-Ray Film

Primary lymphoma of bone, first described by Parker and Jackson in 1939, is derived from bone marrow reticuloendothelial systems. It is uncommon neoplasm representing only 5% of all extranodal non-Hodgkin's lymphoma. Primary bone non-Hodgkin's lymphoma is characterized by initial symptoms of bone pain with associated single or multiple radiological bone lesions, with or without local soft tissue swelling, pathologic fractures,or regional/distant metastasis. Isolated bone marrow non-Hodgkin's lymphoma is rare, and determining the diagnosis difficult. The common features are fever, abnormal liver function, pancytopenia, polyserositis, neurologic symptoms, opportunistic infections, and a short, fatal course. Treatment includes surgery, radiotherapy, and chemotherapy depending on multiple factors, including histopathologic type of tumor, stage of disease, location of the lesion, and extent of osseous involvement. Five year survival rate is above 80%, when treated by combined radiation & chemotherapy. We experienced a patient who admitted to our department of Internal Medicine. She had mutiple bone pain, general weakness and diagnosed as primary lymphoma of the bone with severe pancytopenia. Her presentation, treatment, and clinical progress were discussed.
Bone Marrow ; Diagnosis ; Drug Therapy ; Fever ; Humans ; Internal Medicine ; Liver ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Mononuclear Phagocyte System ; Neoplasm Metastasis ; Neurologic Manifestations ; Opportunistic Infections ; Pancytopenia* ; Radiotherapy ; Survival Rate

Infiltrating lipoma is one of the most deep-seated benign soft tissue tumor which occupies less than 1% in lipomas. There are two different types of infiltrating lipoma, one intramuscular lipoma, and the other intermuscular lipoma. Nevus lipomatosus cutaneous superficialis is a very rare skin disease which is characterized by the ectopic presence of mature adipose tissue in the dermis. In this disease two clinical types are distinguished: The first classic type is the multiple lesions of zonal distribution usually on the buttocks or on the lower back area. The second type is the solitary papule or nodule with less restricted tendency in its distrubution. We described a 31-year-old man who had a relatively well-defined localized, skin colored, 20x20cm sized, subcutaneous mass partially covered with brown colored papules and plaque on the left subscapular area. The skin lesion began about 11 years ago with brown colored papules and gradually increased in size to 20x20cm mass. Histopathological and clinical findings showed ectopic fat lobules consisted of almost mature cells in the dermis, between the each muscle fibers, and each muscle bundles.
Adipose Tissue ; Adult ; Buttocks ; Dermis ; Fluconazole ; Humans ; Lipoma* ; Nevus* ; Skin ; Skin Diseases

Primary leptomeningeal melanomas(PLMs) are rare aggressive central nervous system(CNS) tumors without systemic foci. It can be very difficult, however, to clearly distinguish PLMs from those that have metastasized. We report a case of malignant leptomenigeal melanoma occurring in the right temporal convexity of a 77-yearold woman. Almost all malignant CNS melanomas in the old are secondary to the cutaneous melanoma and can cause diverse neurological manifestations; certain clinical findings of the presented case-namely, the patient's age, vague neurologic findings and absence of cutaneous lesions -are therefore interesting. Thorough clinical checkups, including whole-body bone scan, whole spine MRI, abdominal ultrasound, and tumor marker studies to find extracranial lesions revealed no abnormalities. Based on these clinical findings, we suppose-though are not certain-that the tumor of the presented case is a PLM.
Female ; Humans ; Magnetic Resonance Imaging ; Melanoma* ; Neurologic Manifestations ; Spine ; Ultrasonography

PURPOSE: The purpose of this study is to evaluate the diagnostic capability of MR imaging for distinguishingcholesteatoma from other causes of inflammation. MATERIALS AND METHODS: We prospectively evaluated the MR imagesof 17 patients with a fully opacified middle ear in whom CT of the temporal bone suggested cholesteatoma. Allpatients underwent middle ear surgery and cholesteatoma was verified in 15 cases, granulation tissue in 15,cholesterol granuloma in four and hemotympanium in one. For each lesion, MR and pathologic findings werecorrelated. RESULTS: All cases of cholesteatoma showed low to intermediate signal intensity on T1-weightedimages. On T2-weighted images, 11 cases showed high signal intensity, while seven were less than CSF and four werethe same. Four cases revealed central low signal intensity with peripheral rim of high signal intensity. On GdDTPA-enhanced images, peripheral or marginal enhancement due to surrounding granulation tissue was noted in 12cases. Two appeared to be totally enhanced. One case of congenital cholesteatoma showed no enhancement. OnT2-weighted images, all cases of granulation tissue showed high signal intensity, and on neither T1- norT2-weighted images could these be distinguished from cholesteatoma. On Gd DTPA-enhanced study, all cases ofgranulation tissue were enhanced, and on T1WI, all cases of cholesterol granuloma showed homogeneous bright signalintensity on T1WI. One case of cholesterol granuloma in the mastoid showed bright signal intensity mixed withirregular areas of dark signal intensity. A further comparison of MR imaging with CT is that two case oflabyrinthitis and one of meningitis were diagnosed on Gd- enhanced T1-weighted images. CONCLUSION: Todifferentiate cholesteatoma from granulation tissue and cholesterol granuloma by the evaluation of their signalintensities and enhancement patterns, MR imaging is superior to CT. When there are cholesteatoma-associatedcomplications such as labyrinthitis or meningitis, postcontrast MR imaging can provide better information.
Cholesteatoma* ; Cholesterol ; Ear, Inner ; Ear, Middle ; Granulation Tissue ; Granuloma ; Humans ; Inflammation ; Labyrinthitis ; Magnetic Resonance Imaging ; Mastoid ; Meningitis ; Prospective Studies ; Temporal Bone*

OBJECTIVES: The objective of this study is to evaluate the efficacy of conization of the cervix in patients with cervical intraepithelial neoplasia. STUDY DESIGN: Cold-Knife conization was performed in total 436 patients from June 1994 to May 2000. Indications and complications of conization were studied. And the results of cervical cytology, cervical histology, colposcopic findings and pathologic diagnosis of conization specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens and follow-up check of the patients. RESULTS: Followings are results summarized. 1. Patients distribution according to cone biopsy results was 31.0% for CIS, 43.3% for CIN III, 14.7% for CIN II, 7.6% of CIN I, 3.4% for CNI, respectively. 2. The rate of agreement between colposcopy-directed biopsy and conization was 63.1%. 3. The positive rate of resection margin was 15.1%. 4. The recurrence rate in clear resection margin group was 7.0%. But there was no recurrence after hysterectomy in cases with positive resection margin of conization specimen, and the recurrence rate of positive resection margin without hysterectomy group was 10.5%. 5. The incidence of delayed hemorrhage (bleeding after 2 weeks) in hemostatic suture group and electric cauterization only group was 4.7% (13/279) and 15.6% (23/157), respectively. CONCLUSION: We conclude that conization of the cervix as the surgical treatment was effective in CIN patients with careful patient selection.
Biopsy ; Cautery ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Conization* ; Diagnosis ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Patient Selection ; Recurrence ; Sutures

Hemangioendotheliomas are vascular neoplasms characterized by histologic appearance that are intermediate between hemangiomas and angiosarcomas first described by Weiss and Enzinger in 1982. They are classified into at least 3 subgroups, including epithelioid hemangioendothelioma, spindle cell hemangioendothelioma, and malignant endovascular angioendothelioma, and have been reported principally in soft tissues of the extremities, lung, liver, and bone. The cases involving the central nervous system reported are very rare. We report an intraspinal epithelioid hemangioendothelioma occurring in a 52-year-old man. To our knowledge, it is first case of spinal hemangioendothelioma in Korea.
Central Nervous System ; Extremities ; Hemangioendothelioma ; Hemangioendothelioma, Epithelioid* ; Hemangioma ; Hemangiosarcoma ; Humans ; Korea ; Liver ; Lung ; Middle Aged ; Spinal Cord* ; Vascular Neoplasms

Intracranial germinomas are malignant neoplasms arising from remnants of primitive germ cells that have failed to migrate to the genital crest during embryonic life. They are usually solid tumors, but focal cysts may occasionally be found within them and are thought to represent proteinaceous fluid. Cystic degeneration of the whole tumor, however, that is caused by intratumoral hemorrhage, has not yet been reported. We present a case of cystic degeneration of solid suprasellar germinoma. During surgery, cyst content was shown to be liquefied hematoma, and bleeding of the tumor had occurred. The exact time of intratumoral hemorrhage in the presented case is unknown, but since there had been no episode of apoplexy, we believe that degeneration occurred chronically. The patient's postoperative course was uneventful. On the basis of our findings we suggest that in diagnosing suprasellar cystic tumors, the possibility of germinomas must be taken into consideration and that spontaneous cystic degeneration of suprasellar germinoma can occur as a result of tumor bleeding.
Central Nervous System Cysts ; Germ Cells ; Germinoma* ; Hematoma ; Hemorrhage ; Stroke