Peutz-Jeghers syndrome is an autosomal dominant disease characterized by gastrointestinal ployposis and mucocutaneous melanin pigmentation involving the lip, oral mucosa, digits, palms and soles. The polyps are almost hamartomatous. The relationship of gastrointestinal carcinoma and the Peutz-Jeghers syndrome has been discussed for many years. The question is unsettled whether gastrointestinal carcinoma arise in hamartomatous polyps itself. Recently, there are a few reports that adenomatous and carcinomatous changes were superimposed upon the background of the hamartoma. Occasionally epithelial misplacement of the epithelium is found in the small intestinal polyps. Since the epithelial misplacement may involve submucosa, muscularis propria and serosa, a difficulty of histopathologic differential diagnosis between the epithelial misplacement and invasive adenocarcinoma cause overdiagnosis of cancer in the gastrointestinal polyps of Peutz-Jeghers syndrome. We present a case of Peutz-Jeghers syndrome of 39-year-old woman with multiple gastrointestinal polyps, two of which showed extensive epithelial misplacement even into the pancreas and another one at the colon showed carcinomatous change at the tip portion. Areas of hamartoma, adenoma and in situ carcinoma were noted in this colonic hamartomatous polyp. This case support that adenoma and carcinomatous changes may evolve directly within a hamartomaous polyp itself.
Female ; Humans ; Diagnosis, Differential ; Adenocarcinoma ; Adenoma

No abstract available.
Biopsy, Fine-Needle* ; Breast*

No abstract available.
Biopsy, Fine-Needle* ; Histiocytosis, Langerhans-Cell*

No abstract available.
Cyclosporine* ; Scleredema Adultorum*

No abstract available.
Acupuncture* ; Mycobacterium chelonae* ; Mycobacterium* ; Nontuberculous Mycobacteria

No abstract available.
Asthma*

Pseudopolyps represent discrete areas of mucosal inflammation and regeneration that are seen in a variety of inflammatory bowel disease including ulcerative colitis and Crohn's disease. These polyps are typically short, measuring less than 1.5 cm in height. Rarely, localized giant pseudopolyposis can occur, i.e., a collection of larger inflammatory pseudopolyps giving rise to a mass lesion within the colon. The most serious problem concerned with pseudopolyposis is a confusion with carcinoma. We experienced a case of localized giant pseudopolyposis causing partial large bowel obstruction. Right hemicolectomy was done for a preoperative diagnosis of ascending colon carcinoma. The resected specimen contained a circumferential lesion, which was composed of numerous interconnecting cylindrical villi, measuring 12 cm in length and 3 cm in height. Microscopically, these polypoid lesions were inflammatory pseudopolyps. Several deep fissure-like ulcerations were noted with multifocal microabscess, lymphoid hyperplasia and an area of noncaseating granuloma.

Pneumocystis carinii is the most common cause of diffuse pulmonary infiltrates in the immunocompromised patients. Microscopically, Pneumocystis carinii pneumonia(PCP) shows characteristic frothy intraalveolar exudate and interstitial lymphocytic and plasma cell infiltrate. However, sometimes the only histologic finding of PCP on routine hematoxylin-eosin stain is that of diffuse alveolar damage(DAD), when we can miss the diagnosis without aid of special stains. We report a case of Pneumocystis carinii pneumonia presenting as DAD in a 50-year old man after chemotherapy due to malignant lymphoma. Open lung biopsy specimen reveals the early stage of DAD without any characteristic findings, such as foamy exudate. However many cysts of Pneumocystis carinii were found on Gomori's methenamine silver(GMS) stain. Therefore, GMS stain should be routinely performed on all biopsy specimens obtained from immunocompromised patients.
Male ; Humans ; Cysts ; Biopsy

BACKGROUND: Patients infected with Staphylococcus aureus related to the use of propofol have been reported. The purpose of this study was to assess and compare the growth of S. aureus in propofol, thiopental, midazolam and ketamine. METHODS: These intravenous anesthetics were inoculated with S. aureus and they were plated onto blood agar at 0, 3, 6, 21, 24 and 27 hrs. The number of colony forming units (CFU) on the plate was counted after 24 hours of incubation. RESULTS: Samples from ketamine and midazolam showed no CFU at the 3 hr and thereafter. The 21hr, thiopental exhibited no CFU. The inoculated propofol emulsion showed a significant increase in number of CFU at the 21, 24 and 27hr compared with the zero time (P<0.05). CONCLUSIONS: This study shown that propofol was the only anesthetic that provided a medium for the growth of S. aureus. Therefore when handling propofol, meticulous sterile technique is advised.
Agar ; Anesthetics ; Anesthetics, Intravenous* ; Humans ; Ketamine ; Midazolam ; Propofol ; Staphylococcus aureus* ; Staphylococcus* ; Stem Cells ; Thiopental

No abstract available.
Colon* ; Uropathogenic Escherichia coli*