Primary carcinoid tumors of the testis are exceedingly rare. They may originate as a pure form or as part of a testicular teratoma. To diagnose a testicular tumor as primary carcinoid, the possibility of metastasig must be carefully excluded. To our knowlege, none has been reported in Korean literature. We present a case of primary testicular carcinoid in a 36-year-old man. He had a painless, palpable mass on the right scrotum for 4 years. He underwent a radical orchiectomy. He is free of disease during 20 months postoperatively. Histologically and ultrastructurally this tumor showed a typical feature of carcinoid tumor of midgut derivation. A flow cytometric DNA analysis of this mass contained an aneuploid cell population.

We reviewed surgical or autopsy specimens of the gastrointestinal tract from 14 patients with necrotizing enterocolitis(NEC) to define the specific pathologic findings and the pathologic changes of the bowel in the premature and fullterm infants, and then to see how these findings are related each other and to clinical features. In two-thirds of patients two or more continuous segments of the gastrointestinal tract were affected, and the ileum and colon were by far the most common sites of involvement. Pathologically, coagulation necrosis, inflammatory reaction, ulceration, microthrombi, overgrowth of microorganism, and perforation were the leading changes of NEC. On the basis of these histopathologic findings of the involving intestine, we could classify the pathology of NEC into two different histologic types. Type 1 and II are thought to represent pathologic changes of the intestine in acute and chronic stages of disease process. The symptom duration of the patients was significantly different between two types. The pathologic changes of the involved bowel were similar in both premature and fullterm infants, although the premature tended to have type 1 and the fullterm babies had more cases of type II. These pathologic changes could be associated with various clinical manifestation of NEC.
Infant ; Male ; Female ; Infant, Newborn ; Humans

A total of 10 cases of surgically resected intestinal tuberculosis specimens was subjuected for analysis of its macroscopic characteristics. Intestinal tuberculosis was broadley classified into the ulcerative type (4 cases), ulcero-hypertrophic type (3 cases) and mixed type (3 cases) on the basis of its gross features. The ulcerative type was characterized by multiple, segmental lesions of napkin-ring stricture with variable length of uninvolved mucosa, secondary to the circumferential or annular ulceration. Various forms of relatively superficial ulcers were also scattered. Their ulcer beds were rather granular, being covered with a necrotic detritus although the ulcer margins were relatively well defined with areas of some nodularity. The ulcero-hypertrophic type affected the ileocecal region and ascending colon in a tubular form by segmental thickening of the wall. The diseased segment of mucosa appeared cobble-stone, represented by coalescence of irregular ulcers and hemorrhage. There were scattered small ulcers in the separate portions of terminal ileum. The macroscopic distinctions between the intestinal tuberculosis and Crohn's or ischemic enterocolitis were presented in detail.

No abstract available.
Gait*

Cystic hygroma is a congenital malformation of the lymphatic system appearing single or multiloculated fluid-filled cavities, most often around the neck. They often progress to hydrops and cause fetal death, and frequently associated with chromosomal abnormalities and other congenital malformations. The purpose of our study is to delineate the nature of cystic hygroma and determine the relationship between cystic hygroma and associated anomalies including fetal hydrops. We used data from 26 cases of cervical cystic hygroma in autopsy files of SNU Children's Hospital. Most of cystic hygroma were found in stillborn or premature infants. The fetal cases had been dead for a quite a long period since there was discrepancy between the true gestational age and the developmental age estimated from the body length. Of 26 fetuses only 2 were studied chromosomally and both of them showed 45X. Of 26 cystic hygromas 23 occurred in the posterior neck and 3 in the anterior neck. They ranged from 2.5 to 14 cm (mean: 7.9 cm). The cystic hygroma of the posterior neck consisted of two symmetric sacs on both sides and in the nape and extended to the occipital region. The cystic hygromas of the anterior neck were unilateral or bilateral, and multiloculated and extended into the adjacent cheek. Cystic hygromas of posterior neck were always associated with hydrops, while no recognizable hydrops was found in cystic hygromas of anterior neck. The cystic hygromas were larger in patients with severe hydrops than in patients with less severe hydrops. Associated abnormalities, found in 88%, included hydrops fetalis(88%), growth retardation(80%), cardiovascular anomalies(27%), horseshoe kidney(23%), skeletal anomalies(12%) and hypoxic changes(31%) in visceral organs. In summary, when a hygroma is detected during fetal life, careful sonographic examination for associated congenital anomalies, fetal karyotyping and consideration of artificial abortion are indicated.
Autopsy* ; Cheek ; Chromosome Aberrations ; Edema ; Fetal Death ; Fetus ; Gestational Age ; Humans ; Hydrops Fetalis ; Infant, Newborn ; Infant, Premature ; Karyotyping ; Lymphangioma, Cystic* ; Lymphatic System ; Neck* ; Turner Syndrome ; Ultrasonography

We report a case of alveolar soft part sarcoma(ASPS) of the uterine cervix in a 57-year-old female. She was presented with vaginal bleeding and underwent total hysterectomy. A 1.1cm-sized, polypoid mass was found at the uterine cervix. Microscopically, it had shown an alveolar arrangement of tumor cells and characteristic Periodic acid-Schiff-positive, diastase-resistant, intracytoplasmic granules. Distinct cytoplasmic crystals were found on the ultrastructural examination and tumor cells showed immunoreactivity for smooth muscle actin, myoglobin and neuron-specific enolase, while nonreactive for desmin, vimentin and S-100 protein. Myogenic origin can be suggested with these immunohistochemical results.
Female ; Humans

Sequential development pattern of the intrahepatic bile ducts is analyzed histologically and immunohistochemically using 50 embryonal and fetal liver specimens. Serial sections are made to reconstruct the intrahepatic biliary system, and monoclonal antibodies were used for differential antigenic expression of the biliary system. By 9 weeks of gestation a layer of small round cells, namely plate cells, became first noticed around large portal vein branches close to the hepatic hilum. These plate cells extended subsequently to more distal branches. The ductal plates became duplicated to contain cleft-like spaces and tubular structures. These tubules gradually became incorporated into surrounding connective tissue around the protal vein, and gave the appearance of the individualized bile duct. At term(40 weeks of gestation) the smallest branches of the portal vein were still surrounded by a discontinuous ductal plate. The ductal plate cells showed strong positive reaction for CAM 5.2 and AE1/AE3. They also expressed CK 19 and AE1 from 9 weeks of gestation on. The immunoreactivity of bile duct cells for cytokeratins persisted throughout the whole gestational period. Carcinoembryonic antigen was expressed along the luminal border of the bile duct, duplicated ductal plate and intrahepatic bile canaliculi. Laminin was demonstrated along the basement membrane of the bile duct cells from 9 weeks of gestation. Few duplicated ductal plates were composed of two different types of cells, duct-like cells and hepatocyte-like cells. The duct-like cells and hepatocyte-like cells showed same imrhunoreactivity with the hepatocytes and the bile duct cells, respectively, suggesting that the intrahepatic bile duct cells are actually coming from the hepatocytes around the branches of the portal vein.
Humans

Hereditary sensory and autonomic neuropathies (HSAN) are disorders of hereditary neuropathy mainly affecting sensation and also accompanying autonomic nervous system dysfunction. They are divided into five subtypes based on inheritance pattern and clinical manifestation. Among HSAN, type II is characterized by autosomal recessive inheritance, presentation at later stage of life, slow progression and mainly sensation abnormalities. The main pathology of the peripheral nerve is the absence of myelinated nerve fibers. Type IV is very rare disorder and only a few cases have been reported. It is characterized by autosomal recessive inheritance, presentation at birth as failure to thrive, retarded motor development, unexplained pyrexia and rapidly progressive and severe clinical course. The main pathology of the peripheral nerve is a loss of unmyelinated and small myelinated nerve fibers. We report two cases of type IV and one case of type II especially focusing on ultrastructural findings, which are characteristic of and diagnostic for HSAN.
Autonomic Nervous System ; Failure to Thrive ; Fever ; Hereditary Sensory and Autonomic Neuropathies* ; Inheritance Patterns ; Nerve Fibers, Myelinated ; Parturition ; Pathology ; Peripheral Nerves ; Sensation ; Wills

Juvenile cellular adenofibroma of the breast is a unique neoplasm of the breast that should be differentiated from other important benign and malignant lesions of the juvenile breasts. We report a case with it's characteristic clinical, gross and histological features. The tumor was in the right breast with the size of 20 cm in maximum extent. This patient was also associated with hemihypertrophy of the right side. Microscopically the masses were characterized by prominent stromal cellularity associated with pericanalicular duct proliferation.
Child ; Male ; Female ; Humans

The current classification of pituitary adenomas is based on cell type, largely ascertained by immunohistochemistry and electron microscopy. In an application of immunohistochemistry, pathologists have some problems in judging the results. An immunostaining result does not always correspond with a serum hormone level. It is also difficult to determine the nature of a tumor when a few cells are positive. We performed the immunohistochemical stains on 34 pituitary adenomas using polyclonal antibodies to six pituitary hormones [PRL (prolactin), GH (growth hormone), ACTH (adrenocorticotropic hormone), FSH (follicle-stimulating hormone), LH (luteinizing hormone), TSH (thyroid-stimulating hormone)] and compared with serum hormone level. The serum hormone level was increased in 14 cases (41.2%) of PRL, 7 cases (20.6%) of PRL & GH, 6 pleurihormonal cases (17.6%), 4 nonfunctioning cases (11.8%), 2 cases (5.9%) of FSH, and 1 case (2.9%) of GH. The most common immunohistochemical type of pituitary adenoma was 10 prolactinoma cases (38.5%), followed by 7 pleurihormonal cases (26.9%), 4 null cell cases (15.4%), 3 cases of mixed PRL & GH (11.5%), 1 case of ACTH (3.8%) and 1 FSH & LH case (3.8%). The corresponding rates of the serum hormone level and immunostaining results were 94.1% in GH, 88.9% in TSH, 85.7% in LH, 82.4% in ACTH, 66.7% FSH, and 61.8% in PRL. In the immunostaining for FSH, 12 cases showed less than 5% positivity and most of them exhibited the normal serum hormone level. In conclusion, the most common elevated serum hormone and immunohistochemical type of pituitary adenoma was prolactinoma. The corresponding rate of the serum hormone level and immunostaining result was the highest in GH cell adenoma and was the lowest in prolactinoma. The cells showing less than 5% positivity seem to be entrapped normal cells.
Adenoma ; Adrenocorticotropic Hormone ; Antibodies ; Classification ; Coloring Agents* ; Immunohistochemistry ; Luteinizing Hormone ; Lymphocytes, Null ; Microscopy, Electron ; Pituitary Hormones ; Pituitary Neoplasms* ; Prolactinoma