Papillary carcinomas account for 85~90% of all thyroid cancers, with the tumor size considered an important prognostic factor. As the use of high-resolution ultrasonography and fine needle aspiration biopsy have increased, the diagnosis of papillary microcarcinomas of the thyroid gland; defined by the World Health Organization as being less than 1 cm in diameter, has increased. They are generally associated with an excellent prognosis, with distant metastasis being extremely rare. They usually remain clinically silent until their incidental histological diagnosis by autopsy or surgical material. The incidence discovered at autopsy varies between 3 and 36%. Cervical lymph node metastases from papillary microcarcinomas have often been discovered, which may be the first and sole manifestation of the disease, without clinical suspicion of a thyroid tumor. Herein, the case of a papillary thyroid microcarcinoma, diagnosed after a total thyroidectomy due to its first presentation as a contralateral cervical lymph node metastasis, without evidence of a clinical thyroid tumor, is described.
Autopsy ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Thyroid Gland* ; Thyroidectomy ; Ultrasonography ; World Health Organization

Extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT lymphoma) is usually indolent. Although it was reported recently that about 20-30% cases of MALT lymphoma presented with a disseminated disease at diagnosis, it was described as a disease localized at diagnosis and remaining stable for a prolonged period. However, only a few cases of MALT lymphoma involved the lung and gastrointestinal tract all at once. We report a case of a 73-year-old man with disseminated MALT lymphoma. He presented with non-productive cough, initial chest radiograph showed a nodule in the right lower lobe. The diagnosis of stage IV MALT lymphoma was made by CT scan, video-assisted thoracoscopic excisional biopy, gastrofiberscopic biopsy and bone marrow biopsy. The lymphoma involved the lung, stomach and bone marrow at the time of diagnosis. Because he refused chemotherapy, he discharged after Helicobacter pylori eradication without chemotherapy. Regular follow-up examination did not show any evidence of disease progression over 22 months.
Aged ; Biopsy ; Bone Marrow ; Cough ; Diagnosis ; Disease Progression ; Drug Therapy ; Follow-Up Studies ; Gastrointestinal Tract ; Helicobacter pylori ; Humans ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Radiography, Thoracic ; Solitary Pulmonary Nodule* ; Stomach ; Tomography, X-Ray Computed

Infectious mononucleosis is an EBV-induced infection, and this is a self-limiting clinical syndrome with such characteristics as fever, pharyngitis, headache, splenomegaly, hepatomegaly and multiple lymphadenopathy among children and young adults. On the other hand, EBV infection-induced gastrointestinal symptoms like anorexia, nausea, vomiting, dyspepsia, abdominal pain, gastric bleeding and diarrhea are non-specific signs and there is less of a chance of EBV infection being involved with gastrointestinal disease. Especially, the relation of gastric cancer and gastric lymphoma with EBV infection is well defined, but other EBV-related gastrointestinal diseases have rarely been reported. Therefore, we report here on a case of acute erosive EBV gastritis that was diagnosed as EBV-induced infectious mononucleosis, and this was confirmed by esophagogastroduodenoscopy with biopsy.
Abdominal Pain ; Anorexia ; Biopsy ; Child ; Diarrhea ; Dyspepsia ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fever ; Gastritis* ; Gastrointestinal Diseases ; Hand ; Headache ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human* ; Humans ; Infectious Mononucleosis* ; Lymphatic Diseases ; Lymphoma ; Nausea ; Pharyngitis ; Splenomegaly ; Stomach Neoplasms ; Vomiting ; Young Adult

Infectious mononucleosis is an EBV-induced infection, and this is a self-limiting clinical syndrome with such characteristics as fever, pharyngitis, headache, splenomegaly, hepatomegaly and multiple lymphadenopathy among children and young adults. On the other hand, EBV infection-induced gastrointestinal symptoms like anorexia, nausea, vomiting, dyspepsia, abdominal pain, gastric bleeding and diarrhea are non-specific signs and there is less of a chance of EBV infection being involved with gastrointestinal disease. Especially, the relation of gastric cancer and gastric lymphoma with EBV infection is well defined, but other EBV-related gastrointestinal diseases have rarely been reported. Therefore, we report here on a case of acute erosive EBV gastritis that was diagnosed as EBV-induced infectious mononucleosis, and this was confirmed by esophagogastroduodenoscopy with biopsy.
Abdominal Pain ; Anorexia ; Biopsy ; Child ; Diarrhea ; Dyspepsia ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fever ; Gastritis* ; Gastrointestinal Diseases ; Hand ; Headache ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human* ; Humans ; Infectious Mononucleosis* ; Lymphatic Diseases ; Lymphoma ; Nausea ; Pharyngitis ; Splenomegaly ; Stomach Neoplasms ; Vomiting ; Young Adult

Gastric mucosal calcinosis (GMC) is a very rare condition that is characterized by the nodular deposition of calcium salts in the gastric mucosa. It has been associated with renal failure, gastric cancer, ingestion of aluminum- containing antacids and the use of sucralfate in organ transplant patients. The etiology of this condition is uncertain, but several theories have been proposed; the condition is due secondarily to hyperparathyroidism in renal failure and to the alkalinization of the gastric mucosa. We report here on two patients who had long-term use of bismuth and/or aluminum-containing antacids to treat their gastro-esophageal reflux symptoms. The esophagogastroduodenoscopy revealed acute gastritis patterns, and GMC was confirmed histologically with biopsy. When one patient stopped ingesting bismuth-containing antacid solution, the follow-up esophagogastroduodenoscopy and the biopsy revealed a completely improved state. We report here on these interesting cases and we include a brief review of the literature.
Antacids ; Biopsy ; Bismuth ; Calcinosis* ; Calcium ; Eating ; Endoscopy, Digestive System ; Follow-Up Studies ; Gastric Mucosa ; Gastritis ; Gastroesophageal Reflux ; Humans ; Hyperparathyroidism ; Renal Insufficiency ; Salts ; Stomach Neoplasms ; Sucralfate ; Transplants

Although liver metastasis is commonly found in cancer patients, fulminant hepatic failure secondary to diffuse cancer infiltration into the liver is rare. Liver metastasis-induced fulminant hepatic failure has been reported in patients with primary cancer of the gastrointestinal tract, breast and uroepithelium, and in patients with melanoma and hematologic malignancy. Small cell lung cancer is so highly invasive that hepatic metastasis is common, but rapid progression to fulminant hepatic failure is extremely rare. We report here on a case of a patient who died because of rapid progression to fulminant hepatic failure as a result of hepatic metastasis of small cell lung carcinoma.
Aged ; Carcinoma, Small Cell/complications/pathology/*secondary ; Female ; Humans ; Liver Failure, Acute/diagnosis/*etiology ; Liver Neoplasms/complications/pathology/*secondary ; Lung Neoplasms/complications/*pathology ; Neoplasm Invasiveness ; Tomography, X-Ray Computed

Carbon monoxide(CO) is a colorless, odorless, tasteless, and non-irritating gas whose relative density is a little less than that of air. The most common sources of CO in deaths are fires, automobile exhaust, defective heaters, and incomplete combustion of burning products, such as charcoal briquets. CO is produced whenever organic materials are burned with inadequate supply of oxygen necessary to produce complete combustion. The CO poisoning is one of the most common causes of death in developing and underdeveloped countries. Almost fatal CO poisoning cases, mostly accidental or suicidal deaths occur in enclosed or restricted place nearby fuel-burning heating appliances. However, this case occurred in very unusual place away from the heating appliances due to faulty chimney duct. Because of a peculiar place, it is difficult to imagine the cause of death as a CO poisoning. Deaths from CO inhalation can occur if the individual is in proximity to a rich source of CO for a prolonged time. Therefore, even though men dies away from the heating appliance, it is necessary to bear in mind the possibility of CO poisoning.
Burns ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Cause of Death ; Charcoal ; Fires ; Heating ; Hot Temperature ; Humans ; Inhalation ; Male ; Oxygen ; Poisoning ; Specific Gravity ; Vehicle Emissions

The civilization has given us a great comfort and convenience but also it has been threatening our life at the same time. Recently among these causes of death the traffic accident is the most dangerous thing to threat our life. Most traffic accidents happen on the road but are increasing on the sea and river recently. Accordingly this paper presents an accident example for a boat collision accident which was anlalyzed from the evidences drawn by forensic medical and scientific methods for a passenger death accident by a collision between two boats. The forensic medical accident interpretation was made up by autopsy and drug toxicology inspection. A person who has met an unnatural death at the accident time was drunken condition. The cause of death was judged by the multiple viscera injury, and presumed to be killed by applying an high external force. In order to perform a forensic scientific analysis, we investigated the passenger's life jacket that a person killed in the accident was wearing and also investigated the external appearance of two boats which have 150h.p and 130h.p. Through comparing the position of two boats with the direction of impact on the surface of the water, we could assume that the 130h.p boat impacted the tail on the right side of 150h.p boat with constant acceleration or constant velocity.
Acceleration ; Accidents, Traffic ; Autopsy ; Cause of Death ; Civilization ; Humans ; Rivers ; Ships* ; Toxicology ; Viscera ; Water

Pancreatic arteriovenous malformations (AVM) are extremely rare diseases frequently complicated by gastrointestinal hemorrhage. While surgical resection of affected lesion is preferred for the treatment of pancreatic AVM, angiographic intervention can be used as an alternative treatment, especially in surgically high-risk patients. We experienced a patient with pancreatic AVM manifested by hemobilia and biliary sepsis. Superior mesenteric and common hepatic arteriography showed pancreaticoduodenal AVM composed of nidus supplied by numerous fine feeding arteries and of draining veins encircling the common bile duct (CBD). Hemobilia was controlled by transportal coil embolization of draining veins of AVM around the CBD. Herein, we report this case with the review of literatures.
Arteriovenous Malformations/pathology/*therapy ; Duodenoscopy ; *Embolization, Therapeutic ; Hemobilia/etiology/pathology/*therapy ; Humans ; Male ; Middle Aged ; Pancreas/*blood supply ; Pancreaticoduodenectomy ; Tomography, X-Ray Computed

Mucosa-associated lymphoid tissue (MALT) lymphoma is a low grade B cell lymphoma that, occurs in numerous sites including the stomach, ocular adnexa, thyroid, lung and breast; however, primary hepatic lymphoma is extremely rare. Only about 20 cases have been reported world wide. We recently experienced a case of primary hepatic B-cell lymphoma of the MALT type in a 63-year old female patient. She presented with abdominal pain. The CT, ultrasonogram and PET-CT showed a hepatic nodular mass. A biopsy specimen of the liver revealed MALT lymphoma. There was no evidence of the lymphoma in the extrahepatic lesion. She received segmentectomy of liver and was then treated with CVP (cyclophosphamide, vincristine and prednisolone) chemotherapy. She has been followed up for 6 months since the therapy, and she remains asymptomatic.
Abdominal Pain ; B-Lymphocytes* ; Biopsy ; Breast ; Drug Therapy ; Female ; Humans ; Liver ; Lung ; Lymphoid Tissue* ; Lymphoma ; Lymphoma, B-Cell* ; Lymphoma, B-Cell, Marginal Zone ; Mastectomy, Segmental ; Middle Aged ; Stomach ; Thyroid Gland ; Ultrasonography ; Vincristine