In an attempt to discover the factors contributing to the increased proliferative activity in hepatocytes and subsequent development of HCC, the proliferative activity of hepatocytes was compared with the size of regenerative nodules and HBcAg expression status in the surrounding nontumorous liver of 45 surgically resected hepatocellular carcinomas, including 34 HBV related ones. In the tumor, the difference in proliferative activity and the histological grade was analyzed in terms of p53 gene alteration. The proliferative activity was assessed by immunohistochemical methods using Ki-67 monoclonal antibody. HBcAg expression in the surrounding nontumorous liver correlated with both the inflammatory and proliferative activity of hepatocytes (p<0.05). p53 overexpression was associated with high proliferative activity and aggressive phenotype of tumor. No correlation was observed between the proliferative activity of hepatocytes and the size of regenerative nodules in cirrhosis (p>0.05). p53 overexpression was not evident in surrounding nontumorous liver including cirrhosis. In conclusion, the above results are in line with the view that hepatic carcinogenesis is a mutistep, progressive process. In the initial stage, chronic cellular injury incurred by immumologic reaction against HBcAg seems to play a pivotal role in increased cellular regeneration. However, once transformation of hepatocytes occur the major contributor to tumor growth seems to be alteration in p53 tumor suppresor gene.
Carcinogenesis ; Carcinoma, Hepatocellular* ; Fibrosis ; Genes, p53 ; Hepatitis B Core Antigens* ; Hepatitis B virus ; Hepatocytes ; Liver* ; Phenotype ; Regeneration

Juvenile granulosa cell tumor is rare but one of the common congenital testicular neoplasms. Although histological features are typical of its ovarian counterpart, testicular juvenile granulosa cell tumor has a distinctly different clinical presentation. We report a case of juvenile granulosa cell tumor arising in the cryptochid testis of a 4-day-old newborn. A 6 5 5 cm sized multilocular cyst containing thick, mucinous fluid was found in the peritoneal cavity. The external surface of the cyst was smooth and the septae were relatively thin. The cyst consisted of numerous mucin-filled, cystic follicles lined by cells having vacuolated cytoplasm and round to oval dark nuclei without grooves. Cells resembling granulosa cells of an ovarian follicle were also observed in the intervening stroma forming irregular solid nests.
Cryptorchidism* ; Cytoplasm ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Infant, Newborn ; Male ; Mucins ; Ovarian Follicle ; Peritoneal Cavity ; Testicular Neoplasms ; Testis

Malignant tumors of the breast which contain stromal osteoclast-like, multinucleated giant cells are a rare entity of yet unknown clinical significance. These benign multinucleated giant cells are known to occur mostly in areas of prominent angiogenesis and in close association with tumor cells. Supplementary immunohistochemical and electronmicroscopic examinations indicate that the multinucleated giant cells are of histiocytic origin. We report on a case of infiltrating ductal carcinoma with stromal osteoclast-like multinucleated giant cells occurring in the right breast of a 37 year-old woman. Grossly, the tumor was characterized by a well-circumscribed dark brown, solid firm mass. Microscopically, multinucleated giant cells were found in the stroma intermingled with malignant tumor cells. The stroma showed only a small amount of mononuclear cell infiltration and a moderate degree of vascular proliferation. Immunohistochemical stains revealed the tumor cells to be positive for carcinoembryonic antigen, epithelial membrane antigen and cytokeratin while the multinucleated giant cells were positive for vimentin, CD68 and negative for all other stains tested. Ultrastructurally the multinucleated giant cells differed from tumor cells by having abundant cytoplasmic organelles such as rough endoplasmic reticulum, lysosomes, ribosomes, and vesicles but lacking desmosomes or other types of intercellular junctions. Other characteristic features of multinucleated giant cells included, indented nuclei and prominent cytoplasmic process.
Female ; Humans

PURPOSE: To determine the clinical and mammographic characteristics of primary lymphoma of the breast. MATERIALS AND METHODS: The clinical and mammographic records of five patients (six breasts; bilateral involvement in one patient) with histologically-proven lymphoma of the breast were retrospectively reviewed. RESULTS: All patients had complained of a palpable tender mass with relatively rapid growth over a period of about 3 months. In five cases, the mass was located in the right breast and in one case in the left. Mammography revealed diffuse increased opacity of the entire breast in three cases, a homogeneous well-defined mass in one, multiple well-defined masses in one, and ill-defined lobulated opacity in one. Skin thickening and architectural distortion was seen in one case, and axillary lymphadenopathy in two. In no case was microcalcification and nipple retraction seen. CONCLUSION: In primary breast lymphoma, mammographic finding are non-specific. When a breast grows rapidly and is tender, however, and mammography shows a relatively large well defined mass and associated axillary lymphadenoapathy, the possibility of primary lymphoma should be considered.
Breast* ; Humans ; Lymphatic Diseases ; Lymphoma* ; Mammography ; Nipples ; Retrospective Studies ; Skin

Asperigillous osteomyelitis of the spine has quite rarely been reported. We present a 57-year-old man with old pulmonary tuberculosis who developed cough, sputum and back pain followed by paraplegia. Magnetic resonance imaging of the thoracic spine showed the destruction of the vertebral body through the level of T4-5 and epidural abscess. Decompressive surgery was carried out under the presumptive diagnosis of tuberculous spondylitis. However, the pathologic findings were aspergillous infection showing acute angle hyphae. To the best of our knowledge, this is the first report of aspergillous spondylitis producing compressive myelopathy in Korea.
Aspergillus* ; Back Pain ; Cough ; Diagnosis ; Epidural Abscess ; Humans ; Hyphae ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Osteomyelitis ; Paraplegia ; Spinal Cord Compression* ; Spine* ; Spondylitis ; Sputum ; Tuberculosis, Pulmonary

Primary spinal cord lymphomas are rare, and are either extra-/intradural masses with leptomeningeal infiltration or intramedullary in nature. The authors present a patient with a diffuse large B-cell lymphoma involving the sacral nerve root, extension to extradural space, and the cranial nerve.
B-Lymphocytes* ; Cranial Nerves ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Polyradiculoneuropathy* ; Spinal Cord

Primary spinal cord lymphomas are rare, and are either extra-/intradural masses with leptomeningeal infiltration or intramedullary in nature. The authors present a patient with a diffuse large B-cell lymphoma involving the sacral nerve root, extension to extradural space, and the cranial nerve.
B-Lymphocytes* ; Cranial Nerves ; Humans ; Lymphoma ; Lymphoma, B-Cell* ; Polyradiculoneuropathy* ; Spinal Cord

Peptic ulcer disease complicated with gastric outlet obstruction is rare in children. Even though NSAIDs have been reported to cause various adverse events, they are still regarded as safe and, therefore, widely utilized in children. In the past, pediatric patients who were at risk of seizure due to high fever, were treated with dipyrone (Metamizole sodium) injection which inhibits cyclooxygenase-1 and inhibit prostaglandin, to weaken the gastro-duodenal defensive mechanism. A case of an infant with multiple esophagogatroduodenal ulcers and bleeding caused by NSAID complicated with gastric outlet obstruction is reported in this paper.
Anti-Inflammatory Agents, Non-Steroidal ; Child ; Cyclooxygenase 1 ; Dipyrone ; Fever ; Gastric Outlet Obstruction* ; Hemorrhage ; Humans ; Infant ; Peptic Ulcer* ; Seizures ; Ulcer

The term neurolymphomatosis has included infiltration of the peripheral nervous system by lymphoma. In generally, direct invasion of the peripheral nervous system is rare. The difficulty in treatment of neurolymphomatosis is due to unclassified characteristic symptoms and diagnosis. We performed excision of mass on the antebrachial cutaneous nerve with no specific symptoms. After diagnosis of diffuse large B cell lymphoma, further treatment and observation were followed. However, recurrence of the lymphoma was found in the ipsilateral forearm ulnar nerve, therefore we described a case of neurolymphomatosis with a brief review of the literature.
Animals ; Diagnosis ; Forearm ; Lymphoma ; Lymphoma, B-Cell ; Marek Disease* ; Peripheral Nervous System ; Recurrence ; Ulnar Nerve

Spinal meningiomas in the epidural location are rare, accounting only 2.5% to 3.5% of all spinal meningiomas. The diagnosis of spinal epidural meningiomas, solely based on imaging findings, can be difficult. They are easily mistaken for metastatic tumors or lymphomas, especially, meningiomas of the enplaque type. Misdiagnosis of meningiomas can affect the extent of surgery and patients' outcome; hence, a careful diagnosis is needed. We report a case of pathologically confirmed epidural enplaque meningioma in the cervical spine with neural foraminal extension. Additionally, its clinical implications, radiologic features, and diagnostic difficulties are discussed.