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*

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.
Adult ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Brachiocephalic Veins* ; Humans ; Tomography, X-Ray Computed

Authors reported one case of huge epidermoid cyst which is located between the eye ball and temporal wall of left orbit. This male patient, aged 33, has been a history of progressive exophthalmos without pain Bince over ten years. At the time of first visit to the hospital, exophthalmometry revealed in 12mm in right eye and 32mm in left eye. And poor vision (20/200) and notable eso-hypotropia with the oomplete limitation of extra ocular muscles of left eye was also observed. By roentgeographic study, significant enlargement of the bony orbit in the left eye was resulted from the tumor. Surgical removal of the huge intraorbital cyst was performed successfully according to the modified Klonlein's technical appoach and the cyst tumor, sized 5 X 3 X 3cm with volume content of about 30cc, was conformed histopathologically.
Epidermal Cyst* ; Exophthalmos ; Humans ; Male ; Muscles ; Orbit*

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

Author measured the degree of exophthalmos on 705 normal persons in Korea, with the use of the Hertel's Exophthalmometer. And the results are as follows; 1. The mean of exophthalmos was 13.6mm +/- 1.8(S.D.) on 705 examined normal persons, and among them it was 13.6mm +/- 1.8(S.D.) in male group (332 cases) and 13.6mm +/- 1.9(S.D.) in female group (373 cases). 2. The normal range of exophalmos was from Smm(minimum) to 19.5mm(maximum). 3. In comparing the exophthalmos in both eyes, the right eye revealed average 13.7mm +/- 1.8(S.D.) and left eye was 13.6mm +/- 1.8(S.D.). No significant differnce between the data of the right and left eye was found. 4. The degree of exophtha]mos was gradually increa3ed by aging, with the maximal protrusion of the eyes at the age group of third decade, and thereafter it was decreased.
Aging ; Exophthalmos* ; Female ; Humans ; Korea* ; Male ; Reference Values*

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.

When coexistence of carcinoma with similar histologic type is present in female genital tract, it is difficult to differentiate independent primary tumor from metastasis. Most of them are endometrial and ovarian tumors, but coexistence of uterine cervical and ovarian tumor with similar histologic type is rare. We experienced an independent primary tumor of ovarian mucinous cystadenocarcinoma associated with mucinous adenocarcinoma of uterine cervix. The patient was a 50-year-old woman. She had a lower abdominal mass which was detected as a huge cyst on ultrasonography. Although the ovarian lesions were bilateral, features that preferred to consider independent primary tumor are listed as; absence of lymphatic or vascular invasion, absence of ovarian surface implant, superficial invasion of cervical tumor, absence of tumor in abdominal cavity, and disease free follow-up after removal of the tumor.
Female ; Humans ; Cysts ; Adenocarcinoma

A case (female, 34 years old) of pseudotumor cerebri signs with bilateral papilledema and transient diplopia secondary to the use of oral contraceptives is presented. This patient has taken habitually pills (Eugynon E.D.) for over 6 months. By fundoscopy, the moderate degree of papilledema on both eyes were observed with the slight raise of intracranial pressure. But the visual acuity was normal range at first visit day. Periodic ophthalmic examination and the education for side effects of the pills are recommended to women who are taking the pills regularly.
Contraceptives, Oral* ; Diplopia ; Education ; Female ; Humans ; Intracranial Pressure ; Papilledema* ; Pseudotumor Cerebri ; Reference Values ; Visual Acuity