MRI Findings of Peripheral Schwannoma: Pathologic Correlation

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.

MRI Findings of Peripheral Schwannoma: Pathologic Correlation

PURPOSE: To characterize the MRI appearance of the peripherally located schwannoma as compared with pathologic findings. MATERIALS AND METHODS: 11 cases of 13 lesions of the schwannoma confirmed by pathology were analyzed, retrospectively. T11 T2 and Gadolinium-enhanced T1 weighted sagittal and axial images were obtained. The signal intensity, contour of lesion, and relationship with surrounding tissue were analyzed. All cases were correlated with MRI and pathologic findings. RESULTS: In 9 out of the 11 cases, schwannoma was connected to the main nerve trunk. Among them, tumors were located centrally in 6 cases and eccentrically in 3 cases. MR findings of schwannoma were iso signal intensity on T1WI(8 cases) with muscle intensity, high signal intensity on T2WI(all cases), strong heterogenous enhancement in all cases. 8 cases showing heterogenous appearance on T2WI, showed mixture of Antoni-A and B area and multifocal hemorrhage. Central low and peripheral high signal intensity on T2Wl(Target sign) was mainly high cellular component in the central portion and diffuse myxoid degeneration at the periphery, pathologically. Reversed target appea.rance(central high, peripheral low on T2WI) revealed central cystic degeneration with low cellular component and hemorrhage in the central portion, and high cellular component at the periphery. Linear band-like low signal intensity on T2WI, suggesting capsule of the schwannoma, was not the true capsule proven by pathology. Thin true capsule was not visualized on T2WI. CONCLUSION: MR appearance of schwannoma was non-specific. The signal intensity on T2 weighted MR imaging was determined by the presence of multifocal hemorrhage, focal cystic and myxoid degeneration, admixture of Antoni-A and B area.

Atypical Nodule Arising in a Hepatocellular Adenoma

This report presents a case of an atypical nodule arising in a hepatocellular adenoma(HCA) in a non-cirrhotic liver of a 42-year-old man. The patient had been relatively healthy until he developed right upper abdominal pain. Abdominal sonography and computerized tomogram revealed a 7.5x7cm sized mass in the right inferior segment of liver. The mass revealed the histologic features of HCA. At near center of the HCA, was found a I cm sized discrete nodule, a nodule within a nodule. The nodule revealed higher cellularity than the HCA and was composed of monotonous hepatocytes with an increased nuclear-cytoplasmic ratio, resembling atypical adenomatous hyperplasia. Interestingly, the atypical nodule showed a focal pseudoacinar arrangement of tumor cells. The histologic features of the atypical nodule arising in HCA may the morphological sequence of transformation from HCA to hepatocellular carcinoma

Idiopathic Intestinal Lymphangiectasia

This is a case report of idiopathic intestinal lymphangiectasia occurring in a 3-year-old boy. Idiopathic intestinal lymphangiectasia is believed to be a part of the generalized congenital disorder of lymphatic system. The present case revealed markedly ectatic lymphatics in the lamina propria of duodenal villi with lymphorrhagia. Clinical features were typical of the protein-losing enteropathy; hypoalbuminemia, hypocalcemia, chylous ascites, edema of the lower extremities and mild lymphocytopenia. This case indicates that serious protein loss may ensue, even in cases of intestinal lymphangiectasia without abnormalities of extraintestinal lymphatics.

Fine Needle Aspiration Cytology of Atypical Proliferative Lesion of the Breast / 대한세포병리학회지

We experienced a case of fine-needle aspiration(FNA) cytology of breast which showed atypical proliferative lesion. It was very difficult to differentiate this case from malignancy, because of hypercellular smear and many clusters composed of large, atypical ductal cells. However, it showed other features favoring benignancy, such as tendency of cellular cohesiveness, only slightly increased nucleus/cytoplasm ratio and most importantly presence of myoepithelial cells. It's histologic diagnosis was intraductal hyperplasia with atypia. This case indicates that all atypical breast FNA specimen should lead to the suggestion of surgical biopsy for avoiding over- or under-diagnosis.

The Assessment of Proliferating Cell Nuclear Antigen (PCNA) in Cervical Tumors / 대한부인종양콜포스코피학회잡지

Proliferating cell nuclear ntigen (FCNA) iis a nuclear protein that is syntheaimd in late Gl and S phases of cell cycle and is correlated with the cell proliferative stale. The recent study demonstrated that FCNA functions in 13NA replication. The present study evaluated proliferetive iindices (PI) for the assessment of tumor proliferation and for investigating prognostic significancx, in cervical tumors. lmmunohiatoehemical PCNA staining was perfurmed in formalin-fixed paraffin-embedded cervical tissues via the avidin-biotin-complex immunoperoxidase methad. Mean PI was 36.03+/-5.14% in normaI controls, as compared to 66.19+/-11.36% in cerviml intraepithelial neoplasia. and 63.19+/-10.94% in invasive cervical cancer. Our results showed no significant correlation between Pll and histological type. Among invasive cervical cancer (24 cases), PI waa 64.43+/-10.94% in squamoua cell carcinoma and 59.00+/-4.10% in adenocarcinoma. There was no eipiifiant relationship between Fl and clinical etage, and between PI and lesion size. This study auggeste that Pl may not serve as a new prognostie factor in cervical tumors.

A Case of Recurrent Localized Myositis

We experienced a 41-year-old male patient with the recurrent painful nodular swelling of muscles in both lower limbs for 4 years. The mass did not accompanied other general symptoms of muscle weakness and spontaneously regressed. On pathologic finding, there is marked inflammatory cell infiltration with muscle fiber destruction and regeneration. Analyzing the literature, we proposed the diagnosis of recurrent localized myositis.

A case of congenital anomaly in robertsonian translocation carrier pregnance / 대한산부인과학회잡지

No abstract available.

Histologic and Clinical Characteristics of Skin Warts According to the Human Papillomavirus Antigen Expression

Skin wart is an infectious disease of human papillomavirus(HPV). Its clinical and histopathologic characteristics are largely determined by lesion sties, viral type and host immunity. The infected basal cells and keratinocytes of the epidermis are induced to proliferate by the viral genome. It is, however, not well known how htose factors give rise to histopathologic alterations in the infected basal cells and keratinocytes. So, evaluation of correlation between HPV antigen expression in the wart tissues and clinical and histopathologic charateristics was done on 83 cases of skin warts. The age of patients ranged from 2 to 83 years. Thirty six(43.3%) cases were diagnosed before the age of third decade. The sex ratio was nearly same. Verruca vulgaris was most common(46 cases), followed by verruca plana(26 cases) and verruca palmoplantaris(11 cases). HPV antigen expression was observed in 43 out of total 83(51.8%). It was noted in 47.8%(22/46) of verruca vulgaris, in 46.2%(12/26) of verruca plana and in 81.8%(9/11) of verruca palmoplantaris. HPV antigen-positive groups included more younger patient's age and more higher PCNA than those of HPV negative groups. HPV positive groups also tend to have shorter duration of disease and more numerous mitoses than HPV negative groups. HPV antigen-positive groups showed lower inflammation grade than that of HPV negative groups(p<0.05). The higher the inflammaton grade is, the lower the HPV antigen expression rate. In summary, HPV antigen expression in cutaneous wart tissue is significantly correlated with the proliferative activity of the lesion. It is also significantly correlated with the inflammation that is considered to be the result of cell-mediated immune reaction.

Fine needle aspiration cytology of giant cell tumor of the rib-report of a case- / 대한세포병리학회지

No abstract available.

Right Atrial Myxoma Showing Granulomatous Lesion with Pulmonary Infart: A case report

Cardiac myxoma is the most common primary tumor of the heart. The tumor contains a variety of cell types that are thought to arise from a focus of primitive pluripotential mesenchymal cells in the area of the fossa ovalis. Throughout the myxoid stroma, there are variable amounts of reticular fivers, collagen, elastic fibers and smooth muscle cells. A 38-year-old female had right atrial myxoma with multiple pulmonary infarcts. In this case, we experienced an unusual degenerative change in the tumor of granulomatous lesion consisting of hemosiderin pigments, foreign body giant cells and peculiar, spheroid, semilunar or bamboo-shaped degenerated elastic fibers. Microscopically it resembles Gamna-Gandy nodule seen in the spleen of chronic passive congestion.

Localization of an Insulinoma by Endoscopic Ultrasonography / 대한소화기내시경학회지

A 45-year-old woman with recurrent disturbances of consciousness for 4 years with hypoglycemia was hospitalized with the clinical suspicion of an insulinoma. The findings of transabdominal ultrasonography, computed tomography and angiography were negative. Transhepatic venous sampling for pancreatic hormone assay showed sudden step-up of serum level of insulin in the venous blood from the tail of the pancreas. Finally, an endoscopic ultrasonographic examination established with certainty the origin of the tumor from the tail of the pancreas, which was subsequently confirmed at operation. In conclusion, endoscopic ultrasonography is a useful and valuable procedure for the localization of insulinoma especially in patient with insulinoma of the pancreas that cannot be localized by conventional methods.

Inflammatory Pseudotumor of the Lymph Node: A case report

A 21-year-old man presented with a 7 days history of fever. Careful clinical examination led to the discovery of left supraclavicular lymphadenopathy without hepatosplenomegaly. Serologic tests for Ebstein-Barr virus, HIV, hepatitis type B & C, syphilis and typhoid fever were negative. Blood, urine, and stool cultures yielded no growth. Histologically, the process mainly involved the connective tissue framework of the lymph node, sharing the features of inflammatory pseudotmor(IPT) of other organs: a storiform growth pattern, increased vascularity with associated vascular lesions, and a polymorphous inflammatory infiltrate in a collagen-rich stroma. Immunohistochemical study for spindle cells showed positive reaction for actin and vimentin but not for desmin, and lymphoid cells revealed polyclonality. Characteristics of mass formation, and the inflammatory nautre of the process enabled us adopt the term IPT which should be differentiated from hematolymphoid proliferative disorder or mesenchymal neoplasia.