Squamous cell carcinoma (SCC) of the cervix with intraepithelial extension to the endometrium is a rare event, accounting for about 0.7% of all cervical SCC. Endometrial lesion has been considered as a direct extension of cervical cancer in the early reports, and this was confirmed in a recent molecular study. I report here on the case of a 56-year-old woman who had stage IIB SCC of the cervix with extension, in an in situ fashion, to the entire endometrium. HPV type 16 was detected via PCR in both the cervical and endometrial tumors.
Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cervix Uteri* ; Endometrium* ; Female ; Humans ; Middle Aged ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms

In the immature teratoma with increased serum alpha-fetoprotein (AFP), a complete pathologic examination is especially required because coexistence with other germ cell tumors is associated with a poor prognosis. If the case is proved to be a pure immature teratoma in spite of a thorough examination, the source of AFP should be found as an AFP-producing pure immature teratoma is not associated with a poor prognosis. In this case of a grade III-immature teratoma in an ovary of a 12-year old girl, serum AFP was increased. On pathologic examination, there was no evidence of a yolk sac tumor or embryonal carcinoma. On an AFP immunohistochemical stain, immature liver tissue, digestive and respiratory epitheliums were positive.
alpha-Fetoproteins* ; Carcinoma, Embryonal ; Child ; Endodermal Sinus Tumor ; Female ; Humans ; Liver ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Prognosis ; Respiratory Mucosa ; Teratoma*

Villoglandular adenocarcinoma of uterine cervix has recently been described, and is characterized by good prognosis and occurrence in young women, except a small number of cases. Morphologically, it exclusively shows villoglandular growth and mild to moderate nuclear atypia, the cytologic diagnoses have been frequently missed due to interpretation error. We report here on the cytologic findings of two cases, and both cases were not diagnosed as adenocarcinoma before punch biopsy. One of these cases showed previously described characteristic features such as high cellularity and large tissue fragments with long villous fronds lined by columnar cell with mild nuclear atypia. The other showed moderate cellularity of somewhat smaller clusters without long villous structures. The clusters showed marked nuclear overlapping and the nuclei showed distinct moderate atypia with hyperchromasia and coarse chromatin pattern. The nucleoli were indistinct. Recognition of these features will be helpful to avoid underdiagnosis as a benign lesion, although diagnosis is still difficult in a portion of the cases.
Adenocarcinoma* ; Biopsy ; Cervix Uteri* ; Chromatin ; Diagnosis ; Female ; Humans ; Prognosis

PURPOSE: Current results of autologous stem cell transplantation (SCT) suggest that this procedure may prolong disease free survival in patients with acute myeloid leukemia (AML). Autologous SCT is increasingly used as treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous SCT for patients with AML in first remission treated by autologous SCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen. MATERIALS AND METHODS: Between January 1995 and December 1999, 29 patients with AML in first remission underwent autologous SCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine (3.0 gm/m2 for 3 days), melphalan (100 mg/m2 for 1 day) and TBI (total 1000 cGy in five fractions over 3 days). RESULTS: The median follow up was 40 months with a range of 3 to 58 months. The 4-year cumulative probability of disease free survival was 69.0%, and median survival was 41.5 months. The 4-year relapse rate was 27.6%. The factor influencing disease free survival and relapse rate was the French-American-British (FAB) classification (M3 group vs. other groups; p=0.048, p=0.043). One patient died from treatment-related toxicity. CONCLUSION: Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBI as a conditioning regimen for autologous SCT for AML in first remission appears to be safe and effective.
Classification ; Cytarabine* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Leukemia, Myeloid, Acute ; Melphalan* ; Recurrence ; Stem Cell Transplantation* ; Stem Cells* ; Whole-Body Irradiation*

OBJECTIVE: This study was performed to evaluate and introduce the clinicopathologic characteristics and treatment modalities of vulvar vestibulitis, a subset of vulvodynia, may cause physical disabilities, phycological or emotional distress, sexual dysfunction and limitation of daily activities. But its etiologies and treatments are not defined yet. We want to summarize the diagnostic methods and treatments patients of vulvar vestibulitis syndrome, could be easily overlooked in your offices. METHODS: This retrospective study was based on medical records including pathologic reports of 30 patients who underwent skin biopsy among the patients who were diagnosed as vulvar vestibulitis syndrome from August 1999 to February 2002 at Kyung-Hee University Medical Center. Skin biopsy was taken at a most painful area of vestibule in Dermatology Department to improve the accuracy of diagnosis. We evaluated the clinicopathologic characteristics of patients RESULTS: The mean age of these patients was 53.4+/-10.4 years and the mean parity was 3.13+/-1.4 times. The mean duration from symptom onset to diagnosis was 26.2+/-24.1 months. The skin biopsies showed chronic inflammation in 21 cases (70.0%), chronic inflammation with koilocytosis in 5 cases (16.7%), subacute inflammation in 3 cases (10.0%), and acute inflammation in 1 case (3.3%). The most predominant painful area is right posterior vestibular site and all patients felt pain on that site with swab test. There were 70% improvement among 30 patients with non-surgical modalities. CONCLUSION: Vulvar vestibulitis syndrome is a syndrome of severe pain, burning, stinging, irritative or raw sensation within the vestibular area by vestibular touch or attempted vaginal entry such as tampon use or intercourse. It also has vestibular redness, urge to urinate frequently or suddenly and is confirmed by history, moistened cotton-tipped swab test and gentian violet staining on the lesions. Its prevalence is 15% and it is frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. Even though it could be seen frequently in our offices and has a tendency to become a chronic disease requiring long-term treatments, it has been being overlooked in offices due to lack of understanding of its etiologies, diagnostic criteria and treatments. Here we need more concerns and studies of vulvar vestibulitis syndrome.
Academic Medical Centers ; Biopsy ; Bites and Stings ; Burns ; Chronic Disease ; Dermatology ; Diagnosis ; Female ; Gentian Violet ; Humans ; Inflammation ; Medical Records ; Parity ; Prevalence ; Retrospective Studies ; Sensation ; Sexual Behavior ; Skin ; Vulvar Vestibulitis* ; Vulvodynia

The incidence of ectopic pregnancy has been increasing for many years and ectopic pregnancy is still a leading cause of maternal death although its mortality is reduced significantly with improved early diagnosis and treatment. Intraligamentous pregnancy, a subset of ectopic pregnancy, is one of the most unusual accident so that the diagnosis of intraligamentous pregnancy is hardly ever made prior to laparotomy. We experienced intraligamentous pregnancy with hemoperitoneum. So we presented a case with brief review of literature.
Diagnosis ; Early Diagnosis ; Female ; Hemoperitoneum ; Hemorrhage* ; Incidence ; Laparotomy ; Maternal Death ; Mortality ; Pregnancy* ; Pregnancy, Ectopic

The incidence of ectopic pregnancy has been increasing for many years and ectopic pregnancy is still a leading cause of maternal death although its mortality is reduced significantly with improved early diagnosis and treatment. Intraligamentous pregnancy, a subset of ectopic pregnancy, is one of the most unusual accident so that the diagnosis of intraligamentous pregnancy is hardly ever made prior to laparotomy. We experienced intraligamentous pregnancy with hemoperitoneum. So we presented a case with brief review of literature.
Diagnosis ; Early Diagnosis ; Female ; Hemoperitoneum ; Hemorrhage* ; Incidence ; Laparotomy ; Maternal Death ; Mortality ; Pregnancy* ; Pregnancy, Ectopic

To determine the usefulness of fine needle aspiration cytology(FNAC) of bone lesions and the complementary role of FNAC and percutaneous needle biopsy, 75 cases of FNAC taken from bone lesions were analyzed. Correlations with histopathology were possible in 47 cases, including 14 cases of simultaneous core biopsy and 33 cases of subsequent open biopsy due to inadequate aspirates. Among 75 cases, 4 cases were benign tumors and tumor-like lesion, 11 cases were malignant primary bone tumors, 17 cases were metastatic tumors, and 43 cases were nonneoplastic bone lesions. The aspirates were adequate in 35 cases(46.7%), in all of which the discrimination between benignancy and malignancy was possible. The main reason for inadequate aspirates was due to hypocellularity. In the cases of aspiration and core biopsy simultaneously done, the diagnostic accuracy of aspiration, core biopsy, and both were 57%(8/14), 78.6%(11/14), and 92.9%(13/14), respectively. We conclude that a final diagnosis based on cytology is possible with the adequate aspirates and the clinical and radiological findings. Also we confirm the complementary role between FNAC and core biopsy in bone lesions.
Biopsy ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Diagnosis ; Discrimination (Psychology)

Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.
Breast* ; Carcinoma, Papillary ; Epithelial Cells ; Macrophages ; Metaplasia ; Needles ; Noma ; Papilloma ; Papilloma, Intraductal ; Retrospective Studies

To increase the success rate of intraocular pressure control in recalcitrant glaucoma, Ahmed glaucoma shunt has been used recently. Application of mitomycin C(MMC) during Ahmed implantation may be speculated to increase the success rate by decreasing the fibroblast proliferation and colagen deposition in the filtering capsule. To find out histological change with the use of MMC in the capsule of seton implant, a rabbit model of the Ahmed implant was created to obtain a serial histological specimens over 6 months. Ahmed S1 implant were implanted in 10 normal white rabbits. Five rabbits were treated with 0.04% MMC solution during the implantation under subtenon space(group 1) and the remaining ones were not(group 2). The rabbits were sacrificed at 1, 3, and 6 months to obtain histological specimen of the bleb capsules in each group. Light microscopic examinations were performed after hematoxylin and eosin staining. In group 1(MMC application group), the thickness of fibrous capsule was 0.6mm at 1 month, 0.48mm at 3 months, and 0.4mm at 6 months serially. The number of fibroblasts was 139/mm3 at 1 month, and 82/mm3 at 6 months. In group 2, the capsule thickness was not significantly different compared with roup 1 at 6 months. IN conclusion, during the period over 6 months period, there was no significant difference in thickness of bleb capsule in the two groups although the number of fibroblasts was 3 times denser in group 2 than in group 1.
Blister ; Capsules ; Eosine Yellowish-(YS) ; Fibroblasts ; Glaucoma ; Hematoxylin ; Intraocular Pressure ; Mitomycin* ; Rabbits