ABSTRACT
Localized tenosynovial giant cell tumor (TGCT) usually occurs in the hand and foot regions. However, localized TGCT with extensive cartilaginous metaplasia is rare, especially in the tendon sheath of the toe. Here, we report a case of localized TGCT with cartilaginous metaplasia in a 57-year-old man. The tumor presented as a lobular mass measuring 2.2 cm in its greatest dimension and arose in the flexor digitorum tendon sheath of the right 2nd toe. Clinically, the mass was palpable 1 year ago and brought pain during walking. Microscopically, the mass was composed of focal conventional TGCT and cartilaginous components. The conventional TGCT areas consisted of mononuclear cells, multinucleated giant cells, and hemosiderin deposition. The chondroid areas were extensive and comprised more than 90% of the whole tumor. In this case, the mononuclear cells in the conventional TGCT areas showed focal immunohistochemical staining for podoplanin and S100 protein as well as diffuse staining for CD68, which is consistent with the staining pattern of conventional TGCT. The mononuclear cells in the chondroid areas were focal positive for podoplanin and diffuse positive for S100 protein. Chondroid metaplasia in diffuse TGCT has been reported in 10 cases involving the temporomandibular, elbow, and hip joints. However, there has been no report of a localized form of chondroid TGCT involving an extra-articular region.
Subject(s)
Humans , Middle Aged , Elbow , Foot , Giant Cell Tumors , Giant Cells , Hand , Hemosiderin , Hip Joint , Metaplasia , Staphylococcal Protein A , Tendons , Toes , WalkingABSTRACT
Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was 2.5x3.0 cm sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.
Subject(s)
Adult , Humans , Abdominal Pain , Emergencies , Hamartoma , Hepatitis , Hepatitis A , Intussusception , Laparotomy , Physical Examination , Rare Diseases , VomitingABSTRACT
BACKGROUND: The leukocyte common antigen (CD45) is a transmembrane-type protein tyrosine phosphatase that has five isoforms. METHODS: We generated seven murine mAbs against human CD45 by injecting cells from different origins, such as human thymocytes, PBMCs, and leukemic cell lines. By using various immunological methods including flow cytometry, immunohistochemistry, and immunoprecipitation, we evaluated the reactivity of those mAbs to CD45 of thymus as well as tonsil lysates. Furthermore, we transiently transfected COS-7 cells with each of gene constructs that express five human CD45 isoforms respectively, and examined the specificities of the mAbs against the transfected isoforms. RESULTS: In case of thymocytes, lymphocytes, and monocytes, all the seven mAbs demonstrated positive reactivities whereas none was reactive to erythrocytes and platelets. The majority of immune cells in formalin-fixed paraffin-embedded thymus and tonsil tissues displayed strong membranous immunoreactivity, and the main antigen was detected near 220 kDa in all cases. Among the mAbs, four mAbs (AP4, DN11, SHL-1, and P6) recognized a region commonly present in all the five isoforms. One mAb, YG27, recognized four isoforms (ABC, AB, BC, and O). Two mAbs, P1 and P14, recognized the isoforms that contain exon A encoded regions (ABC and AB). CONCLUSION: In this study, we confirmed that AP4, DN11, SHL-1, YG27 and P6, are mAbs reactive with the CD45 antigen whereas P1 and P14 are reactive with the CD45RA antigen.
Subject(s)
Animals , Humans , Antibodies, Monoclonal , Leukocyte Common Antigens , Blood Platelets , Cell Line , COS Cells , Erythrocytes , Exons , Flow Cytometry , Immunohistochemistry , Immunoprecipitation , Leukocytes , Lymphocytes , Monocytes , Palatine Tonsil , Protein Isoforms , Protein Tyrosine Phosphatases , Thymocytes , Thymus GlandABSTRACT
The most frequent tumor arising from retroperitoneum is sarcoma. Most sarcomas of retroperitoneal origin have no symptoms and comprise 15% of all sarcomas. However, they can grow so great as to cause pain, which implies the possibility of invasion to adjacent organs. Moreover, if its location is between right adrenal gland and inferior vena cava (IVC) ambiguity of its origin can arise. Leiomyosarcoma of IVC is so rare that it can be seen to mimic right adrenal tumor. This 56-year-old female patient with back pain since approximately 4 months prior was transferred to our hospital via local clinic. We performed radical resection of tumor including segmental resection of IVC. Final diagnosis was leiomyosarcoma of IVC. We report this case with a review of literature.
Subject(s)
Female , Humans , Middle Aged , Adrenal Glands , Back Pain , Hydrazines , Leiomyosarcoma , Sarcoma , Vena Cava, InferiorABSTRACT
Osteoma of the tongue is a rare entity of unknown origin. Clinically, the majority of the osteoma are described as growth of pedunculated mass on the posterior dorsum of the tongue without symptoms. The mechanism for its formation is unknown, but various theories have been proposed. Surgery is an appropriate treatment and no recurrence after surgery has been reported. We experienced a 68 year old man with undiagnosed osteoma of the tongue, incidentally detected during gastroscopy. We report this case with a review of literature.
Subject(s)
Aged , Humans , Gastroscopy , Osteoma , Recurrence , TongueABSTRACT
The concern about multiple primary cancers has been raised in recent years, but their cause has yet to be elucidated clearly. It has been speculated that many factors may contribute, such as family history, genetic factors, chemotherapy, and radiotherapy.(1) The incidence of multiple primary cancers is estimated to be 13%. However, synchronous multiple primary cancers of the stomach and duodenum are uncommon due to the rarity of duodenal cancer. Duodenal cancer poses diagnostic difficulties because of its rarity, non- specific signs and symptoms, and the fact that duodenum is usually ignored during upper gastrointestinal endoscopy. This 71-year-old female patient was diagnosed with double primary cancer of the stomach and duodenum, which was found by abdominal computed tomography preoperatively, and she underwent a Whipple procedure. The histological diagnosis revealed poorly-differentiated adenocarcinoma in the stomach and moderately-differentiated adenocarcinoma in the duodenum. Here we report a case of synchronous double primary cancer of the stomach and duodenum with a review of the literature.
Subject(s)
Aged , Female , Humans , Adenocarcinoma , Duodenal Neoplasms , Duodenum , Endoscopy, Gastrointestinal , Incidence , Stomach , Stomach NeoplasmsABSTRACT
Benign and malignant tumors are found in the foot, although the incidence is low. The most common bone tumor in the foot is osteochondroma, which is thought to develop in bones that form through the process of enchondral ossification. In particularly, osteochondromas in the foot mostly occur in metatarsal bones and phalanges. It is seldom found in talus. It is usually confused with osteophyte or enthesis. We report an osteochondroma case confirmed by roentgenographical and pathological investigation, after removing the masses form bilateral tali of a 19-year-old male patient presented with bilateral ankle joint pain for three years.
Subject(s)
Humans , Male , Young Adult , Ankle Joint , Foot , Incidence , Metatarsal Bones , Osteochondroma , Osteophyte , TalusABSTRACT
The most causes of an icteric hepatoma are a late stage hepatocellular carcinoma or intrahepatic cholangiocarcinoma. A hepatocellular carcinoma, causing an obstrucution of the bile duct, rarely results in jaundice. With a late stage hepatocellular carcinoma, the accurate diagnosis and treatment may be difficult. Herein, we report a case of a hepatocellular carcinoma and obstructive jaundice, due to hilar tumor emboli, with a review of the literature.
Subject(s)
Bile Ducts , Carcinoma, Hepatocellular , Cholangiocarcinoma , Diagnosis , Jaundice , Jaundice, ObstructiveABSTRACT
Plexiform fibrohistiocytic tumor (PFT) is a rare, low-grade soft tissue tumor that occurrs primarily in children and young adults. The most common location of PFT is the upper extremity, and there are very few reports of PFT in the neck. We report here on a case of PFT presenting as a painless subcutaneous nodule in the neck of a 46-year-old woman. Histologically, this subcutaneous tumor was composed of a plexiform proliferation of histiocyte-like cells and fibroblast-like cells along with a few multinucleated osteoclast-like giant cells. Immunohistochemically, the tumor cells were positive for vimentin, CD68 and smooth muscle actin (SMA).
Subject(s)
Child , Female , Humans , Middle Aged , Young Adult , Actins , Giant Cells , Muscle, Smooth , Neck , Upper Extremity , VimentinABSTRACT
Tuberculous involvement of the colon is an uncommon clinical entity. Other colonic disease which should be considered in the differential diagnosis include inflammatory bowel disease such as Crohn's disease, ulcerative colitis and colon cancer. Intestinal tuberculosis most frequently involves the ileocecal area. The common presenting symptoms are abdominal pain, fever, weight loss and malabsorption. Pathologically, tuberculous colitis may present as an ulcerative type, hypertrophic type or in combination. Massive bleeding is said to be very rare even in the ulcerative type because of an obliterative endarteritis. We report a case of colonic tuberculosis presenting with massive bleeding in 52-year-old man with alcoholic liver cirrhosis, which was diagnosed by colonoscopic biopsy and acid-fast stain.
Subject(s)
Humans , Middle Aged , Abdominal Pain , Biopsy , Colitis , Colitis, Ulcerative , Colon , Colonic Diseases , Colonic Neoplasms , Crohn Disease , Diagnosis, Differential , Endarteritis , Fever , Hemorrhage , Inflammatory Bowel Diseases , Liver Cirrhosis, Alcoholic , Tuberculosis , Ulcer , Weight LossABSTRACT
Kaposi's sarcoma is a rare and slowly progressive disease that primarily affects the skin but has an associated visceral involvement. It can occur in the HIV-positive patients or patients treated with immunosuppressants. However, it is extremely rare in the patients receiving the treatment for inflammatory bowel disease. We used corticosteroid for the treatment of ulcerative colitis in 60-year-old woman. Then, Kaposis's sarcoma occured in the skin and colon of the patient. Since she was HIV-negative, we believed that it was developed from the condition of corticosteroid-induced immunosuppression. We present a case of skin and colonic Kaposi's sarcoma in a HIV-negative woman following treatment with corticosteroid for ulcerative colitis.
Subject(s)
Aged , Female , Humans , Colitis, Ulcerative/complications , Colonic Neoplasms/complications , English Abstract , Sarcoma, Kaposi/complications , Skin Neoplasms/complicationsABSTRACT
Mature teratoma is the most common germ cell tumor of the ovary. The tumor is essentially a benign neoplasm and surgical resection of the tumor is the treatment of choice. Recurrence with colorectal involvement after surgical removal of the primary lesion is exceedingly rare and has not been reported in Korea. We present a 43-year-old patient with a rectal mass who had already undergone left oophorectomy due to mature cystic teratoma and right oophorectomy due to hemorrhagic corpus luteum. The rectal mass was composed of a mature teratoma tissue. We postulate that leakage of the tumor elements from the cyst wall led to peritoneal tumor implantation and invasion to the rectal wall.
Subject(s)
Adult , Female , Humans , Ovarian Neoplasms/pathology , Rectal Neoplasms/diagnosis , Teratoma/diagnosisABSTRACT
Extramedullary plasmacytoma of the gallbladder is extremely rare. A review of the literature in English revealed only one case, involving a patient with initial extramedullary plasmacytoma of the maxillary sinus. In this report, we describe the case of a 63-year-old man with surgically confirmed extramedullary plasmacytoma confined to the gallbladder. At ultrasonography and computed tomography, diffuse and uniform thickening of the gallbladder wall without evidence of surrounding tissue infiltration was depicted.
Subject(s)
Humans , Middle Aged , Gallbladder , Maxillary Sinus , Plasmacytoma , UltrasonographyABSTRACT
Meigs' syndrome is defined by the presence of ascites and hydrothorax in association with "fibroma-like" benign ovarian tumors. Tumor extirpation resulted in a resorption of the ascites and a pleural effusion. A Krukenberg tumor resulting from stomach cancer would be highly suggested when stomach cancer, ovarian tumor, and ascites are found concomitantly. However, when a patient presents with ovarian tumor, stomach cancer, and repeated cytologic examination of the ascitic fluid renders negative results, stomach cancer associated with Meigs' syndrome should be considered in the differential diagnosis. We report a case of stomach cancer presenting with Meigs' syndrome in a 70-year-old woman who had been referred for control of intractable ascites. The patient was cured by radical subtotal gastrectomy and bilateral oophorectomy.
Subject(s)
Aged , Female , Humans , Ascites , Ascitic Fluid , Diagnosis, Differential , Gastrectomy , Hydrothorax , Krukenberg Tumor , Meigs Syndrome , Ovariectomy , Pleural Effusion , Stomach Neoplasms , StomachABSTRACT
We report a case of pancreatic pseudocyst presenting as an intramural gastric tumor on upper gastrointestinal examination, endoscopic ultrasound and computed tomography of the abdomen. Pancreatic pseudocysts in the stomach wall is rare and the most of them presented as a cystic mass, but this case was presented as a gastric mural solid tumor. Exploration revealed an about 4 4 2 cm sized round mass at the midbody of great curvature of stomach, it was in the muscle layer, and removed by surgical operation. The correct diagnosis of this case was established postoperately on the pathologic examination revealed pancreatic pseudocyst.
Subject(s)
Abdomen , Diagnosis , Pancreatic Pseudocyst , Stomach , UltrasonographyABSTRACT
Mesenteric lymphadenitis due to Yersinia enterocolitica infection is not common in Korea. Although most cases of Yersinia enterocolitica-induced mesenteric adenitis are self limited, cardinal features of Yersinia enterocolitica-induced mesenteric adenitis are so similar to those of acute appendicitis that some of the patients undergo laparotomy with suspected appendicitis. The findings on laparotomy in such patients are usually enlarged mesenteric nodes with a normal or slightly inflamed appendix. Because histologic examination of the removed mesenteric lymph nodes reveals reactive hyperplasia in most cases, it is usually difficult to suspect Yersinia enterocolitica infection on morphology of the resected nodes. But suppurative granulomata of mesenteric lymph nodes, uncommonly encountered in Yersinia enterocolitica infection, strongly suggest yersinial infection. We report a case of mesenteric lymphadenitis in a 10-year-old boy, who underwent laparotomy with suspected acute appendicitis. The removed lymph node showed several suppurative granulomata in the cortex, suggesting yersinial infection. Serologic study confirmed Yersinia enterocolitica serotype O:3 infection.
Subject(s)
Child , Humans , Male , Appendicitis , Appendix , Hyperplasia , Korea , Laparotomy , Lymph Nodes , Lymphadenitis , Mesenteric Lymphadenitis , Yemen , Yersinia enterocolitica , YersiniaABSTRACT
Castleman's disease is characterized by the presence of a rare benign tumor of lymphoid origin which usually arises in the mediastinum but rarely occurs in the retroperitoneum. In the radiology literature, the unenhanced CT appearance of the disease has been decribed as hypodense or isodense as compared to that of the liver, and as showing homogeneous contrast enhancement. In this case, CT revealed a well-circumscribed, homogeneous enhancing mass with an internal cystic portion, a finding different from those described in the literature. We report a case of retroperitoneal Castleman's disease in which there was unusual mucoid degeneration resulting in a large cystic component, and which has not been previously reported.