Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies / 영남의대학술지

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta-stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Acquired Immunodeficiency Syndrome Presenting with Abdominal Tuberculosis / 이화의대지

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.

A Case of Pleomorphic Liposarcoma Originating from Mesentery / 대한소화기학회지

Liposarcoma is one of the most common soft tissue sarcomas that occurs in adults and is currently divided into five main subgroups: well-differentiated, myxoid, round cell, pleomorphic, and dedifferentiated. Primary mesenteric liposarcoma is extremely rare, and the treatment strategy is surgical resection with a wide free margin, often followed by radiation and adjuvant chemotherapy if distant metastasis is not detected. A 73-year-old male patient presented with lower abdominal distension. Abdominal CT scan revealed a large homogeneously enhancing mass lesion abutting the sigmoid colon and urinary bladder. At laparotomy, the solid mass measured 28x26x12 cm in size, was well-demarcated, and originated from the mesentery of the middle ileum. It was removed along with some small intestine (ileocecal valve upper 50-150 cm) and ileal mesentery because of adhesion. Histologically, the tumor proved to be pleomorphic liposarcoma. The patient did not undergo any adjuvant treatment following surgery, but he remains disease free until 33 months after surgery. Herein, we report a case of pleomorphic liposarcoma arising from small bowel mesentery.

The Prevalence of Sarcopenia in Korean Hospitalized Elderly

BACKGROUND: Sarcopenia is a syndrome characterized by the progressive loss of skeletal muscle mass and muscle strength. Although data exist on the prevalence of sarcopenia among the community-dwelling elderly, there is no systematic research on hospitalized elderly patients in Korea, in accordance with the newly developed criteria. METHODS: A cross-sectional study was conducted at the Daejin Medical Center, Bundang Jesaeng Hospital, Korea, from May 2013 to March 2015. In this study, we evaluated the levels of hemoglobin, total cholesterol, serum albumin, serum prealbumin, and serum zinc. Handgrip strength was measured with a hand grip dynamometer (FT-7110). Furthermore, the skeletal muscle mass was measured by bioelectrical impedance analysis (BIA). Sarcopenia was defined by skeletal muscle mass as measured with BIA, according to the Asian Working Group for Sarcopenia. RESULTS: Of the hospitalized elderly subjects, 40 (46.5%) had a definite diagnosis of sarcopenia and 46 (53.5%) had no sarcopenia. The prevalence of sarcopenia of the subjects was higher in males than females (males, 46.9% vs. females, 46.3%). The correlation analysis showed that the score of skeletal muscle index (SMI) was negatively correlated with age; whereas, it was positively correlated with the BMI, body weight, and serum prealbumin level. CONCLUSION: The results of the study showed that sarcopenia was associated with several factors, including age, BMI, serum prealbumin level, among the study subjects. Sarcopenia can be used as a sensitive predictive marker for prognosis of the hospitalized elderly.