Salivary Duct Carcinoma: A Clinicopathologic Analysis and Treatment Outcome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Salivary duct carcinoma (SDC) is a rare but highly malignant tumor of the salivary glands. Authors aimed to assess the current treatment outcome and to estimate the prognostic factors in the patients with SDC. MATERIALS AND METHODS: We reviewed the medical records of 11 patients with SDC, who were treated between Jan. 1995 and Jun. 2002 at the Department of Otolaryngology, Samsung Medical Center. Follow-up duration ranged from 10 to 76 months with a mean of 29.6. RESULTS: The parotid glands were more frequently involved (9 patients) than the submandibular glands (2 patients). Most patients were diagnosed to have an advanced stage of the disease. Curative surgical resections and/or postoperative radiation were the mainstay of the treatment. The adjusted 3-year survival rate was 64.9% and the disease-free 3-year survival rate was 34.1%. Four patients died of the disease at a mean interval of 22 months after the initial diagnosis. Presentation with the facial nerve paralysis, positive surgical resection margins and pathological vascular invasion had a tendency to result in poor survivals. Treatment failures due to distant metastasis were common (54.5%). CONCLUSION: We reconfirmed the aggressive clinical natures of SDC: frequent distant metastasis and poor survival rates. These findings strongly suggest that additional treatment modalities such as an adjunctive systemic treatment need to be considered in the patients with SDC especially when they have high risk factors or an advanced disease, which need further investigation.

Severe Chronic Active Epstein-Barr Virus Infection Presenting as Fever of Unknown Origin / 감염과화학요법

Epstein-Barr virus (EBV) is one of eight human herpesvirus. Primary infection with EBV in childhood is generally asymptomatic or mild, however, often causes overt diseases such as infectious mononucleosis (IM) and lymphoproliferative disorder (LPD), the latter occursing in immunologically compromised individuals. Historically, EBV has been considered to be etiologically linked to human malignancies such as EBV genome positive Burkitt's lymphoma and nasopharyngeal carcinoma. Recently, however, another category of EBV-related disease, "chronic active EBV infection", has been made to describe persons without a clearly defined underlying disease. We report 4 cases of patients, presented with episodic fever of unknown origin (FUO), who were diagnosed as severe chronic active EBV infection. A combined application of serology for EBV and in-situ hybridization established the diagnosis of the EBV infection.

Severe Chronic Active Epstein-Barr Virus Infection Presenting as Fever of Unknown Origin / 감염과화학요법

Epstein-Barr virus (EBV) is one of eight human herpesvirus. Primary infection with EBV in childhood is generally asymptomatic or mild, however, often causes overt diseases such as infectious mononucleosis (IM) and lymphoproliferative disorder (LPD), the latter occursing in immunologically compromised individuals. Historically, EBV has been considered to be etiologically linked to human malignancies such as EBV genome positive Burkitt's lymphoma and nasopharyngeal carcinoma. Recently, however, another category of EBV-related disease, "chronic active EBV infection", has been made to describe persons without a clearly defined underlying disease. We report 4 cases of patients, presented with episodic fever of unknown origin (FUO), who were diagnosed as severe chronic active EBV infection. A combined application of serology for EBV and in-situ hybridization established the diagnosis of the EBV infection.

Fine Needle Aspiration Cytology of Metastatic Wilms' Tumor in the Lung: Report of Two Cases / 대한세포병리학회지

We describe two cases of metastatic Wilms' tumor in the lung with emphasis on the cytologic features of specimens obtained by needle aspiration. One of them was extrarenal Wilms' tumor. The findings were correlated with the histopathologic fea- tures of the primary lesion. Cellular components in the fine needle aspiration cytology (FNAC) slides included blastemal, epithelial, stromal and inflammatory cells with immature tubular differentiation and rosette formation. Recognition of these cellular components in FNAC smears help in establishing FNAC diagnosis of Wilms' tumor. The blastemal cells were represented by small to medium sized cells with scanty cytoplasm having ill-defined borders and round to slightly oval nuclei with evenly dispersed chromatin and small marginated nucleoli. They were seen in our two cases. The differential diagnosis includes neuroblastoma, malignant lymphoma, malignant rhabdoid tumor, clear cell sarcoma, Ewing's sarcoma and embryonal rhabdo-myosarcoma. In conclusion, making a definite cytologic diagnosis of metastatic Wilms' tumor may be possible by light and electron microscopy and immunohi-stochemical staining. The above findings may contribute to the diagnosis of FNAC of metastatic Wilms' tumor.

Subacute Necrotizing Lymphadenitis: I. Histopathologic Study

Since 1972, a unique lymphadenitis called "subacute necrotizing lymphadenitis" has been described in much Japanese literatures and in a few English articles. Although this condition is accepted as a new entity in Japan, it is not yet accepted other countries. Occasionally, we have encountered lymph node biopsies which showed histologic pictures of subacute necrotizing lymphadenitis with clinical impressions of malignant lymphoma. As an initial step to investigating the etiology of this disease, the common clinicopathologic features in 24 cases of subacute necrotizing lymphadenitis were studied. The lesion frequently developed in the cervical lymph node of young women, causing simple enlargement of the lymph node and was accompanied occasionally by fever or pain. The duration of symptoms was within one month and seasonal distribution was not remarkable. In laboratory tests, WBC count was below 4000/mm3 in 8 cases and Widal test was negative in all 4 cases examined. Microscopically, the characteristic finding was the wide area of patch or confluent necrosis associated with numerous karyorrhectic nuclear dust and surrounded by diffuse infiltration of immunoblastic or activated histiocytoid cells. No appreciable increase in plasma cells or neutrophilic infiltration was noted.