Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.
Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Chromatin ; Diagnosis ; Financing, Organized ; Humans ; Lymphoma ; Neoplasm Metastasis ; Pleural Effusion ; Skin ; Small Cell Lung Carcinoma

The concept of a CpG island methylator phenotype (CIMP) was first introduced by Toyota and Issa to describe a subset of colorectal cancers (CRCs) with concurrent hypermethylation of multiple CpG island loci. The concept of CIMP as a molecular carcinogenesis mechanism was consolidated by the identification of the serrated neoplasia pathway, in which CIMP participates in the initiation and progression of serrated adenomas. Distinct clinicopathological and molecular features of CIMP-high (CIMP-H) CRCs have been characterized, including proximal colon location, older age of onset, female preponderance, and frequent associations of high-level microsatellite instability and BRAF mutations. CIMP-H CRCs arise in sessile or traditional serrated adenomas and thus tend to display the morphological characteristics of serrated adenomas, including epithelial serration, vesicular nuclei, and abundant cytoplasm. Both the frequent association of CIMP and poor prognosis and different responses of CRCs to adjuvant therapy depending on CIMP status indicate clinical implications. In this review, we present an overview of the literature documenting the relevant findings of CIMP-H CRCs and their relationships with the serrated neoplasia pathway.
Adenoma ; Age of Onset ; Carcinogenesis ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; CpG Islands* ; Cytoplasm ; Female ; Humans ; Microsatellite Instability ; Phenotype ; Prognosis

This study was designed to examine the effects of diets containing different levels of seeds of Benincasa hispida (wax gourd) on plasma glucose, insulin levels and lipid profiles in streptozotocin (STZ)-induced diabetic rats. Sprague-Dawley rats were induced diabetes mellitus by STZ injection (45 mg/kg) into the tail vein and were divide into 4 groups: normal, STZ-control, two experimental groups. Normal and STZ-control groups were fed an AIN-93 diet and 2 experimental groups were fed a modified diet containing 2.5% and 5.0% of wax gourd seed powder for 4 weeks. The weight gain and feed efficiency ratio in 5.0% seed groups were higher than in STZ-control group. A significant lowering effects of plasma glucose levels were observed in the wax gourd seed 2.5% and 5.0 groups. The plasma insulin level did not differ after treatment with wax gourd seed in experimental rats. The intake of 2.5% wax gourd seed did not result in significant change in plasma cholesterol levels compared to diabetic control group. The intake of 2.5% wax gourd seeds had normalized the increased levels of plasma triglyceride and free fatty acids after 4 weeks. In 5% wax gourd seed group, cholesterol, triglyceride and free fatty acid levels were elevated compared to 2.5% wax gourd seed group. The results of the present study indicate that 2.5% wax gourd seed group would be more effective to control the diabetes than 5% wax gourd seed group.
Animals ; Blood Glucose* ; Cholesterol ; Diabetes Mellitus ; Diet ; Fatty Acids, Nonesterified ; Hypoglycemic Agents ; Insulin ; Plasma ; Rats* ; Rats, Sprague-Dawley ; Streptozocin* ; Triglycerides ; Veins ; Weight Gain

Computed tomography(CT) is a new and innovative radiologic technique, the diagnostic value of which has been well established by many reports. On account of its rapidity and non-invasiveness, CT has become the diagnostic precedure of choice for the initial evaluation of head trauma patients. The authors have performed CT scan using EMI-5005 on 5 cases of subdural hematoma during the period of 8 months from October 1977 to May 1978 at the Department of Neurosurgery, Kyung Hee University Hospital. Various attenuation coefficients of hematoma such as hyperdense, hypodense, isodense and of mixed density were observed by the CT images. One case of isodensity hematoma were clearly identifiable by delayed enhancement technique, which had been confused by ordinary, noninfused method.
Brain* ; Craniocerebral Trauma ; Hematoma ; Hematoma, Subdural* ; Humans ; Neurosurgery ; Tomography, X-Ray Computed

Granular cell myoblastoma is a relatively uncommon lesion of debatable history appearing as a small, solitary but occasionally multiple neoplasm and usually benign course. Most granular cell myoblastoma have been observed tongue, skin and subcutaneous tissue and in the breast but only rarely in the orbit and we know of only 12 well-documented orbital myoblastoma at present. We have recently seen a orbital granuloma cell myoblastoma occurring in a 39 year-old woman, the tumor was firmly attached to the muscle cone and caused exophthalmos with exodeviation of the left eye and was totally removed from the transcranial-orbital unroofing procedure.
Adult ; Breast ; Exophthalmos ; Exotropia ; Female ; Granular Cell Tumor* ; Granuloma ; Humans ; Neoplasms, Muscle Tissue ; Orbit* ; Skin ; Subcutaneous Tissue ; Tongue

Arachnoid cysts are usually classified as developmental anomaly, inflammatory and traumatic in origin. Arachnoid cyst in posterior fossa occur frequently in the midline posterior to the cerebellum. These cyst usually present symptoms and signs due to increased intracranial pressure and may be confused with cerebellar or fourth ventricular tumor. Recently we had experienced a case of multiple retrocerebellar arachnoid cysts coexisted with pathologically confirmed desmoplastic medulloblastoma in eight months lod infant and reviewed the literatures.
Arachnoid Cysts* ; Arachnoid* ; Cerebellum ; Humans ; Infant ; Intracranial Pressure ; Medulloblastoma*

Only a few years following its original development by the English Physicist G.N. Hounsfield at 1971, cranial computed tomography has proved to be of revolutionary importance for the diagnosis of brain disorders. This is reflected not least by the almost immediate and worldwide acceptance of the diagnostic method. First in Korea, The EMI Scanner(CT 5005/7, 160(160 matrix) was introduced at Kyung Hee University Hospital on October 1977. Since then, we reviewed 444 CT scans for 1 year. 216 representative examples of abnormal CT findings among these have been chosen from this group of cases for more detailed discussion and illustration. The results were as follows; 1) 216 abnormal CT findings were subdivided into brain neoplasm 50, orbital tumor 6, AVM 1, intracerebral hemorrhage 44, occlusive CVD 30, craniocerebral trauma 46, cerebral abscess 3, meningoencephalitis 8, hydrocephalus 13, atrophy 16, parasite 4. 2) In most brain tumor cases the tissue undergoes a change of density. Vascularized tumors were enhanced after contrast infusion. Solid tumor area are well differentiated against cystic area and necrosis, and hemorrhage in tumor is also well visualized. Tumor type is often surmised, exact classification is not possible. Thus a glioblastoma multiforme of the ring type cannot be differentiated from a metastatic tumor with central necrosis. But tumor density, appearance of contrast enhancement, predilection site of tumor, relation to adjacent structure, a degree of perifocal edema and clinical data are aid to identify the tumor type. 3) Spontaneous intracerebral hemorrhage can be identified with certainty because of high absorption values. Extent of hemorrhage and invasion of the ventricle are usually exactly visualized. Blood filling of basal cisterns and interhemispheric fissure is also well demonstrated. As opposed to spontaneous intracerebral hemorrhage, cerebral infarction shows as a region of low absorption values as early as 6 to 8 hours after ictus, which is often poorly defined with irregular borders and having mass effect during the 1st week thereafter. Sharper margins and more homogenous low density are developed 1 to 2 weeks after ictus and surrounding edema subsides with shrinking of hypodense area. Ipsilateral ventricular dilatation, homogenous low density area and sharp margins are usually found in older infarcts. 4) CT is the best method of assessing craniocerebral injuries. Since extravascular blood is set off by its high density and edematous tissue by its lower density from normal brain tissue, sequelae from injuries whose existence could only be suspected on account of the clinical symptoms but escaped detection regardless of the method used, can now be visualized directly in the CT. 5) Brain abscess has a characteristics but non specific appearance as CT, consisting of a ring configuration of the abscess capsule which shows marked enhancement after injection of contrast material. In acute stage of the meningoencephalitis, routine CT scan may be normal. During the couse of illness, diffuse enhancement of the basal cisterns and varying degree of ventricular dilatation may be found. 6) Brain atrophy is diagnosed by an enlargement of internal and external CSF spaces. Using standard sections a classification of the grade and form of the atrophy is made. The diagnosis of cysticercosis is made primarily calcification and multiple solid dense mass or cystic lesion surrounded by edema which may become enhanced following infusion of contrast media.
Abscess ; Absorption ; Atrophy ; Brain ; Brain Abscess ; Brain Diseases ; Brain Neoplasms ; Cerebral Hemorrhage ; Cerebral Infarction ; Classification ; Contrast Media ; Craniocerebral Trauma ; Cysticercosis ; Diagnosis ; Dilatation ; Edema ; Glioblastoma ; Hemorrhage ; Hydrocephalus ; Korea ; Meningoencephalitis ; Necrosis ; Orbit ; Parasites ; Tomography, X-Ray Computed ; United Nations

Hyalinizing trabecular tumor (HTT) is a rare thyroid tumor with low to minimal malignant potential. HTT is often misinterpreted as other thyroid tumors, including papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma (MTC), on fine-needle aspiration (FNA) cytology, because of its overlapping cytologic features, such as nuclear grooves and intranulcear pseudoinclusions. Although cytopathologists cannot definitely conclude HTT by FNA cytology, suspicion of HTT is necessary to avoid misdiagnosing HTT as PTC or MTC and to avoid unnecessary aggressive treatment. Here, we report a case of HTT with novel cytologic features in CellPrep liquid based cytology that was diagnosed as suspicious for papillary carcinoma by FNA and finally diagnosed as HTT in the surgical specimen.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Hyalin ; Thyroid Gland ; Thyroid Neoplasms

BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. METHODS: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. RESULTS: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. CONCLUSIONS: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.
Diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration* ; Pancreas ; Pathology ; Retrospective Studies ; Sensitivity and Specificity ; Seoul

Asthma and chronic obstructive pulmonary disease (COPD) are characterized by chronic airway inflammation resulting in airflow limitation. They include various phenotypes and endotypes in their disease entities. For that reason, they lack proper biomarkers and epoch-making progresses in treatment nowadays. Healthy airway has been believed to be sterile traditionally. However, with the help of nonculture sequencing techniques, researchers discovered that it is full of the commensal and symbiotic microbial flora. Therefore, microbiome has emerged as a possible biomarker and a clue to understand the pathogenesis of airway disease. Microbiome research in asthma has focused on the association between characteristics of microbiome, such as composition and diversity. However, now it refers to the role of microbiome, including Proteobacteria, in the development and pathogenesis of asthma and allergic diseases. Microbiome research in COPD has revealed its different composition according to the existence and severity of the disease. Also, differences in microbiome composition according to exacerbation state or specific treatment of COPD are reported. Therefore, many researchers pay attention to the possible role of microbiome as a biomarker or a treatment target in asthma and COPD. Herein, we review recent studies on microbiome research in asthma and COPD.
Asthma* ; Biomarkers ; Inflammation ; Microbiota* ; Phenotype ; Proteobacteria ; Pulmonary Disease, Chronic Obstructive* ; Research Design