No abstract available.
Carcinoma, Mucoepidermoid*

We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

A 2-month-old Korean boy presented with a solitary papule on the cheek which was noted at birth. Histopathologic findings were consistent with angiofibroma of fibrous papule of the face (FPF). FPF is known to affect adults, and congenital occurrence has not been reported to the best of our knowledge. We report a case of congenital FPF which showed a facial papule clinically and an angiofibroma histologically.
Adult ; Angiofibroma ; Cheek ; Humans ; Infant ; Male ; Parturition

The present study has been carried out to enhance the specificity of computed tomography (CT) in diagnosing herniated nucleus pulposus (HNP) of the lumbar spine by the application of measure-set (MS) technic. MSCT scans of 20 patients with proven diagnosis of HNP were reviewed prospectively to sort out features of diagnostic value. Eleven were men and 9 were women with the mean age being 40 years. MSCT scan revealed dislocation of the center of the nucleus pulposus (NP) in direction of herniation in 75%, "permeation" of the annulus fibrosus (AF) by HNP material and a clear disruption of the outermost layer of AF in all patients. The site and grade of the protrusion of HNP beyond the normal saliancy of AF could be easily evaluated in 90%. The present study saliancy of AF could be easily evaluated in 90%. The present study revealed that MSCT can demonstrate four characteristic findings of HNP enabling one to directly and semiquantitatively assess the pathologic changes of NP.
Adult ; Female ; Humans ; Male ; Spinal Diseases/diagnosis/*radiography ; *Tomography, X-Ray Computed

Aspergillosis is a rare disease of fungal infection produced by the genus Aspergillus in immunocompromised patients. It mainly involves the lung and may disseminate by invasion of biood vessels into the gastrointestinal tract. Brain and kidney. We report a case of the disseminated aspergillosis in malignant lymphoma affecting the lung. Brain and thyroid gland.
Aspergillosis* ; Aspergillus ; Brain ; Gastrointestinal Tract ; Immunocompromised Host ; Kidney ; Lung ; Lymphoma* ; Rare Diseases ; Thyroid Gland

Papular xanthoma is a newly classified type of normolipemic xanthoma that resembles juvenile xanthogranuloma and xanthoma disseminatum. Papular xanthoma is asymptomatic multiple yellowish papules with granulomatous lesion composed of foam cells and few giant cells, with scarce inflammatory cell infiltration. We report a case of papular xanthoma in a 3-year-old girl who showed typical clinical manifestation. She had multiple discrete, 0.2 to 0.5cm sized elevated dome-shaped yellowish papules on the trunk and face for 2years. Histopathologic findings showed granulomatous changes mainly composed of foam cells and few histiocytes, in the dermis.
Child, Preschool ; Dermis ; Female ; Foam Cells ; Giant Cells ; Histiocytes ; Histiocytosis, Non-Langerhans-Cell ; Humans ; Xanthogranuloma, Juvenile ; Xanthomatosis*

The bleeding duodenal varices are a rare complication in patients with portal hypertension, but present a difficult diagnostic problem. If there is no bleeding esophageal, gastric fundal varices or ulcer in a patient with upper gastrointestinal bleeding and portal hypertension, the possibility of bleeding duodenal varices should be kept in mind. Thorough endoscopic examination of the entire duodenal mucosa is essential to document bleeding from duodenal varices. As an initial treatment, endoscopic sclerotherapy has had limited success in controlling active duodenal variceal bleeding. However, rebleeding rate is high, surgical treatment including shunt operation may be required for permanent control of bleeding and portal decompression. We report three cases of duodenal varices causing massive hemorrhage. All the patients had portal hypertension caused by liver cirrhosis of various etiologies and had varices in their esophagus. The second portion of the duodenum was the site of duodenal varices in all cases. The management was tailored to the condition of each patient, but only one patient among three survived.
Decompression ; Duodenum ; Esophageal and Gastric Varices ; Esophagus ; Gastrointestinal Hemorrhage* ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Cirrhosis ; Mucous Membrane ; Sclerotherapy ; Ulcer ; Varicose Veins*

BACKGROUND: Evaluation of the cell proliferation activity of neoplasm is useful in making a diagnosis and prognosis. Immunohistochemical staining using MIB1 monoclonal antibodies has recently been demonstrated to assess tumor cell proliferation activity easily, because it can be performed on paraffin-embedded specimens and is available in a retrospective study. OBJECTIVE: The purpose of this study to investigate (a) the use of Ki-67 antibodies in distinguising between benign melanocytic nevus and malignant melanoma, and (b) the correlation between the Ki-67 labelling index(positive number per 100cells) and histological parameters such as the Breslow index, Clarks level, mitotic rate(mitoses per 100cells) in malignant melanoma. METHOD: A total of 37 formalin-fixed, paraffin-embedded melanocytic skin lesions(benign melanocytic nevus 21; malignant melanoma 16) were stained with MIB1 using the one hour method. The values of the Ki-67 labelling index were measured in all the lesions. For each case of malignant melanoma, the Breslow index, Clarks level and mitotic rate were quantitatively evaluated. RESULT: The Ki-67 labelling index averaged 2.6 +1.4 in benign melanocytic nevus and 22.4+ 6.2 in malignant melanoma. In malignant melanoma, the values of the Ki-67 labelling index were significantly correlated with Breslow index(r=0.764), Clark's level(r=0.885) and mitotic rate(r=0.754). CONCLUSION: Our findings suggest that Ki-67 may be a useful tool in distinguising between benign melanocytic nevus and malignant melanoma. According as Ki-67 labelling index correlates with well-established prognostic parameters(Breslow index, Clark's level, mitotic rate), it may therefore carry additional prognostic value for patients with malignant melanoma.
Antibodies ; Antibodies, Monoclonal ; Cell Proliferation ; Diagnosis ; Humans ; Ki-67 Antigen* ; Melanoma ; Nevus, Pigmented ; Prognosis ; Retrospective Studies ; Skin*

The majority of cystic lesions of the pancreas are psudocysts and a small fraction neoplastic. Failure to recognize the true nature of neoplastic cyst will lead to an incorrct treatment strategy. Ultrasonography, computerized tomography and angiography were used to distingish these lesions, but diagnostic value of ERCP is in controversy. To evaluate the diagnostic value of ERCP in cystic lesions of the pancreas, we analysed 33 cases of pancreatic cystic lesions (pseudocyst 18 cases, retention cyst 3 cases and cystic, neoplasm l2 cases) between Apr. 1985 and June 1993. In 18 cases of pseudocysts, ERP findings were communication with cyst in 8 cases (44.4%), chronic pancreatitis in 8 cases (44.4%), obstruction in 4 cases (22.2%) and displscement of pancreatic duct in 2 cases (11.1%), and ERC findings, which were perfomed in 8 cases, showed cholangitis in 3 cases (37.5%), CBD stone in 2 cases (25%), mass effect in 1 case (12.5%) and normal in 2 cases (25%). There was no communication with the cyst and pancreatic duct, except two mucinous ductal ectasia, in 12 cases of cystic neoplasms, and the other findings were displacement of pancreatic duct in 4 cases (33.3%), obstruction in 2 cases (16.7%) and normal in 4 cases (33.3%). ERC findings of cystic neoplasm were almost normal (85.7%) except 1 case of cholangitis. In conclusion, ERCP findings of pseudocysts were communication with pancreatic duct, chronic pancreatitis and biliary tract abnormality. In contrast, ERCP findings of cystic neoplasms were displacement or obstruction of pancreatic duct without communication and chronic pancreatitis, and biliary tract abnormality were rare.
Angiography ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Dilatation, Pathologic ; Mucins ; Pancreas ; Pancreatic Cyst* ; Pancreatic Ducts ; Pancreatitis, Chronic ; Ultrasonography

The purpose of this study was to elucidate the epidemiology and the clinical characteristics of herpes zoster and chicken pox. 703 patients with herpes zoster and 237 patients with chicken pox who were seen at the Department of Dermatology, St. Marys Hospital during 8 years were taken for this retrospective study. Both groups of the patients were evaluated in regard to annual, seasonal and monthly incidence, age incidence and sex ratio. Patients with herpes zoster were further assessed concerning associated conditions, dermatomic distributions and complications. The results were as follows, 1. The annual rate for chicken pox ranged from 0.03% to 0.18% (mean 0.13%) and revealed no epidemics, however, its incidence was higher in early summer and winter. There was no sexual difference. Chicken pox was seen most. frequently in the 0-9 year age group (91.1%). 2. The annual rate for herpes zoster ranged from 0.23% to 0.52% (mean 0.38%). There were no significant annual, seasonal and monthly variations, and there was a. equal sex ratio. Herpes zoster was seen most frequently in the 50-59 year age group (19.1%) 3. The frequencies of the associated conditions in herpes zoster, in descending order, were infectious disease (2. 7%), diabetes mellitus (2.3%), malignant neoplasm(1. 4%), immunosuppressive drug (l. 4%), autoimmune disease (0.6%), and radiation therapy (0.4%). 4. The dermatomic involvement of herpes zoster was most frequent on thoracic dermatome (53.5%) and others were cervical (16.5%), lumber (10.1%), ophthalmic branch of trigeminal nerve (8.8%), sacral (1.6%), maxillary branch of trigemenal nerve (1.3%), mandibular branch of trigemical nerve (0.6%) and facial nerve dermatome (0.1%). The incidence of involving two different dermatomes was 2.9% and was most common on cervicothoracic dermatome (1.8%). However, one case of cervico thoracic dermatome showed bilateral involvement. 5. The most common complication of herpes zoster was postherpetic neuralgia (6.5%) and others were secondary bacterial infection (2.6%), keratoconjunctivitis (0.6%), keloid formation (0.3%), generalized varicelliform eruption (0.1%), Ramsay-Hunt syndrome (0.1%) and recurrent herpes zoster (0.1%). The mean age of incidence for postherpetic neuralgia was 58.4 years and its incidence was the highest over 70 years (39.5%). Postherpetic neuralgia was most frequently seen in the involvement of ophtalmic branch of trigeminal nerve.
Incidence