We report a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which had a history of spontaneous resorption of late seroma before diagnosis. A 47-year-old woman with a history of augmentation mammoplasty with round textured implants in January 2013 presented with a swelling on her right breast 6 years later, which was diagnosed as late seroma with suspected intracapsular rupture using ultrasonography (USG). Although aspiration was not done at the time of the initial USG, the seroma resolved spontaneously within weeks. A further workup proceeded with USG-guided aspiration followed by magnetic resonance imaging. Cytology of the aspirated fluid showed atypical cells. Cell block cytology and immunohistochemical staining confirmed the diagnosis of BIA-ALCL. En bloc resection with total capsulectomy and explantation was performed as curative surgery. Pathologic stage pT2N0M0 was confirmed and the patient was followed up without further treatment. Although the classic presentation of BIA-ALCL is known as late persistent seroma, an atypical manifestation such as spontaneous resorption may occur, as in the current case. A high level of suspicion and a thorough investigation with appropriate modalities will make it possible to detect this rare and potentially devastating disease.

PURPOSE: The utility of 18-fluordesoxyglucose positron emission tomography ([¹⁸F]-FDG-PET) combined with computer tomography or magnetic resonance imaging (MRI) in gastric cancer remains controversial and a rationale for patient selection is desired. This study aims to establish a preclinical patient-derived xenograft (PDX) based [¹⁸F]-FDG-PET/MRI protocol for gastric cancer and compare different PDX models regarding tumor growth and FDG uptake. MATERIALS AND METHODS: Female BALB/c nuu mice were implanted orthotopically and subcutaneously with gastric cancer PDX. [¹⁸F]-FDG-PET/MRI scanning protocol evaluation included different tumor sizes, FDG doses, scanning intervals, and organ-specific uptake. FDG avidity of similar PDX cases were compared between ortho- and heterotopic tumor implantation methods. Microscopic and immunohistochemical investigations were performed to confirm tumor growth and correlate the glycolysis markers glucose transporter 1 (GLUT1) and hexokinase 2 (HK2) with FDG uptake. RESULTS: Organ-specific uptake analysis showed specific FDG avidity of the tumor tissue. Standard scanning protocol was determined to include 150 μCi FDG injection dose and scanning after one hour. Comparison of heterotopic and orthotopic implanted mice revealed a long growth interval for orthotopic models with a high uptake in similar PDX tissues. The H-score of GLUT1 and HK2 expression in tumor cells correlated with the measured maximal standardized uptake value values (GLUT1: Pearson r=0.743, P=0.009; HK2: Pearson r=0.605, P=0.049). CONCLUSIONS This preclinical gastric cancer PDX based [¹⁸F]-FDG-PET/MRI protocol reveals tumor specific FDG uptake and shows correlation to glucose metabolic proteins. Our findings provide a PET/MRI PDX model that can be applicable for translational gastric cancer research.

Primary malignant lymphoma of the uterine cervix is very rare. Lymphomas account for 3.5% of all malignant tumors in the females. Approximately, 25% of all malignant lymphomas arise from extranodal sites, most frequently from gastrointestinal tract and skin. Although the incidence of systemic non-Hodgkin's lymphoma (NHL) and extranodal NHL has increased in recent decades, only 1 to 1.5% arises from female genital tract. Primary pelvic sites include ovary, which is the most common site, uterine corpus, cervix, vagina, and vulva. Primary cervical lymphomas account for 0.12~0.6% of all extranodal lymphomas. However, there is still no consensus on the management of cervical lymphomas due to low incidence of the disease and limited experience in the literature. We experienced two cases of primary malignant lymphoma of the uterine cervix. A 41-year-old woman, Ann Arbor stage IE, was treated with laparoscopically assisted vaginal hysterectomy and both salpingo-oophorectomy and 4 cycles chemotherapy. A second case was a 73-year-old postmenopausal woman, Ann Arbor stage III, received five courses chemotherapy without any surgery. In this article, two cases of uterine cervical lymphoma are presented with a review of the available literature.
Adult ; Aged ; Cervix Uteri ; Consensus ; Female ; Gastrointestinal Tract ; Humans ; Hysterectomy, Vaginal ; Incidence ; Lymphoma ; Lymphoma, Non-Hodgkin ; Ovary ; Skin ; Vagina ; Vulva

OBJECTIVE: To evaluate usefulness of quantitative measurement of three phase bone scintigraphy in assessing the complex regional pain syndrome (CRPS) after stroke using reference value in healthy adults. METHOD: Twenty nine stroke patients with CRPS and 15 stroke patients without CRPS underwent three phase bone scintigraphy (TPBS). Uptake ratio was calculated by isotope count of affected side divided in isotope count of unaffected side in each phase. Reference value was obtained in 13 healthy adults. The sensitivity and specificity of quantitative measurement of TPBS was assessed. RESULTS: In the all phases of hand, uptake ratios of the CRPS group were significantly higher than non-CRPS group (p<0.05). There was no significant difference in the delayed phase of shoulder between the CRPS group and the non- CRPS group. In the delayed phase of hand, sensitivity and specificity of quantitative measurement of TPBS were 82.8% and 86.7%, whereas those of qualitative interpretation by nuclear physician were 65.5% and 66.7%, respectively. CONCLUSION: Quantitative measurement of TPBS was more sensitive and more specific than qualitative interpretation by nuclear physician in assessing the CRPS after stroke. Quantitative measurement of TPBS may be helpful in detecting CRPS after stroke.
Adult ; Hand ; Hemiplegia ; Humans ; Radionuclide Imaging* ; Reference Values ; Sensitivity and Specificity ; Shoulder ; Stroke*

PURPOSE: Increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. MATERIALS AND METHODS: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M: F=16: 7, R: L=11: 12). The mean age was 63 +/- 10 yrs. Ten normal volunteer (mean age: 60 +/- 5, M: F=1: 9) data was used as control group. TPBS was performed 59 +/- 32 days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. RESULTS: Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p< 0.001). CONCLUSION: Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.
Brain ; Diagnosis ; Extremities ; Hand ; Hand Joints ; Healthy Volunteers ; Hemiplegia ; Humans ; Radionuclide Imaging* ; Reflex Sympathetic Dystrophy* ; Reflex* ; Shoulder* ; Stroke ; Wrist

PURPOSE: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. MATERIALS AND METHODS: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age 50+/-11 years) of papillary thyroid cancer. Among them 43 patients were treated with < or =7.4 GBq, while 15 patients with > or =9.25 GBq. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. RESULTS: MPD measured by CF method using tracer and therapeutic doses were 13.3+/-1.9 and 13.8+/-2.1 GBq, respectively (p=0.20). They showed a significant correlation (r=0.8, p< 0.0001). Exposed doses to blood measured by CF and biological methods were 1.54+/-0.03 and 1.78+/-0.03 Gy (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). CONCLUSION: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.
Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Male ; Metaphase ; Mortality ; Recurrence ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

BACKGROUND: Glucose uptake has been found to ha increased in cancer cells, and FDG-PET imaging is used for diagnosis of cancer using This phenomenon. However, the exact mechanism of increased glucose uptake in cancer cells has not been clarified. Recent studies demonstrated the presence of glucose transporter(GLUT) mRNA expression in gastrointestinal cancer and bead and neck cancer, and suggested that GLUT may be associated with glucose uptake in cancer cells. In lung cancer cells, glucose metabolism is also known to ha in. creased. We evaluated GLUT mRNA expression in human lung cancer cell lines in order to find out the mechanism of increased glucose uptake in lung cancer. METHOD: Total RNA was isolated from 15 human lung cancer cell lines and immortalized bronchial epithelial cell line(BEAS-2B). After electrophoresis of 20microgram total RNA, Northern blot analysis was done using GLUT1 cDNA and GLUTS cDNA as probes RESULTS: 2 Thirteen of 14 human lung cancer cell lines expressed GLUT1 mRNA and 10 of 14 human lung cancer cell lines expressed GLUT3 mRNA. Eight human lung cancer cell lines expressed both GLUT mRNAs. BEAS-2B expressed GLUT1 mRNA and did not express det~table GLUT3 mRNA. CONCLUISON: The increase of glucose metabolism in lung cancer may be associated with GLUT1 and GLUT3 expression.
Blotting, Northern ; Cell Line* ; Diagnosis ; DNA, Complementary ; Electrophoresis ; Epithelial Cells ; Gastrointestinal Neoplasms ; Gene Expression* ; Glucose Transport Proteins, Facilitative* ; Glucose* ; Head and Neck Neoplasms ; Humans* ; Lung Neoplasms* ; Lung* ; Metabolism ; RNA ; RNA, Messenger

The safety of endoscopic retrograde cholangiopancreatography(ERCP) in patients with acute pancreatitis(AP) was confirmed in the past decade. Especially in ease of acute gallstone panereatitis, early ERCP/EST(endoscopic sphincterotomy) may reduce the incidence of complications by removing gallstone which causes acute attack of pancreatitis. To assess clinical usefulness of ERCP/EST in the setting of AP, we reviewed clinical records of 58 patients with AP who had undergone ERCP /EST during the same period of admission.(continue...)
Cholangiopancreatography, Endoscopic Retrograde* ; Gallstones ; Humans ; Incidence ; Pancreatitis*

Primary gallbladder cancer is a highly malignant tumor and is characterized by early metastasis and rapid progression of disease. Since the majority of patients have unresectable disease, laparotomy, instead of providing relief of symptoms, often adds to the morbidity and needs to be avoided in patients with advanced disease. Clinical features, peritoneoscopic findings, and comparison of peritoneoscopy with radiologic studies were reviewed in 29 patients, who underwent peritoneoscopy, with primary gallbladder cancer at Severaace Hospital, College of Medicine, Yonsei University between Aug. 1982 and Mar. 1994. (continue...)
Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Laparoscopy* ; Laparotomy ; Neoplasm Metastasis

Although variation is the rule with pancreatic duct morphology, certain variants occur as a result of altered embroological development. These ductal configurations, most striking deviations from the normal configuration, may be classfied according to alterations of embryological development. These congenital variants of pancreatic duct may be important for several reasons. First, the pseudomass effect of ductal anomalies can be mistaken for carcinoma by the inexperienced radiologists. Second, whether or not the anomaly is important, it is present in many patients with recurrent pacreatitis. Original descriptions were based on small sampling of postmortem studies and surgical specimen, but more recently the advent of endoscopic retrograde cholangiopancreatography(ERCP) has confirmed of the work of early anastomists and increased awareness of these variants. To evalute of frequency, characteristics of associated disease and clinical significance of pancreatic anomalies, we have reviewed of 5330 case of ERCP filmes which were undertaken between July, 1973 and August, 1993. Having reviewed of ERCP filmes, we found out 9 case of pancreatic duct variants. Among them, 7 cases were classified as ductal duplication anomalies, 4 cases of number variation, most, bifuricaiton and 3 cases of form variation, which were composed of loop, spiral and terminal N. Three cases of fusion anomalies were also noted, which were 2 cases of panceratic divisum and 1 case of incomplete pancreatic divisum. The associated diseases were 6 cases of bile duct and galbladder stones and 3 cases of pancreatic cancer. We could not find out the case of congenital anomalies as cause of obstructive pain and pseudomass effect.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Humans ; Pancreatic Ducts* ; Pancreatic Neoplasms ; Pancrelipase ; Strikes, Employee