ABSTRACT
Primary actinomycosis of the breast is an uncommon disorder, however, it must be taken into account in the differential diagnosis of chronic breast abscess and malignancy, especially in intractable breast abscess. We report a case of a 28-year-old woman presented with palpable nontender mass in the left breast who was diagnosed by tissue biopsy as primary actinomycosis. The patient was successfully treated with intravenous ceftriaxone for 3 weeks, followed by oral ampicillin for 3 months.
Subject(s)
Adult , Female , Humans , Abscess , Actinomycosis , Ampicillin , Biopsy , Breast , Breast Diseases , Ceftriaxone , Diagnosis, DifferentialABSTRACT
Primary actinomycosis of the breast is an uncommon disorder, however, it must be taken into account in the differential diagnosis of chronic breast abscess and malignancy, especially in intractable breast abscess. We report a case of a 28-year-old woman presented with palpable nontender mass in the left breast who was diagnosed by tissue biopsy as primary actinomycosis. The patient was successfully treated with intravenous ceftriaxone for 3 weeks, followed by oral ampicillin for 3 months.
Subject(s)
Adult , Female , Humans , Abscess , Actinomycosis , Ampicillin , Biopsy , Breast , Breast Diseases , Ceftriaxone , Diagnosis, DifferentialABSTRACT
Plummer-Vinson syndrome(Paterson-Kelly syndrome)is characterized by dysphagia due to upper esophageal or hypopharyngeal web,iron deficiency anemia,and atropic oral and glossal mucosa.This syndrome is usually known as precancerous lesion that develops into postcricoid carcinoma.Universally,the clinical manifestations of this syndrome were markedly improved after oral iron replacement therapy or endoscopic balloon or electrocatery treatment. 63 year-old woman was received a short segment,free jejunal transfer to be released from esophageal stricture.After the operation,the stenotic lesion proved to be Plummer-vinson syndrome with carcinoma in situ by pathologic study.
Subject(s)
Female , Humans , Middle Aged , Carcinoma in Situ , Deglutition Disorders , Iron , Plummer-Vinson SyndromeABSTRACT
Primary squamous cell carcinoma (SCC) is an uncommon tumor of the prostate, with a median incidence of 0.5-1% of all prostate malignancies. Only one case of prostate SCC has been reported in Korean medical literature. Prostate SCC usually presents clinical and evolutive aspects that are different from those of prostate adenocarcinoma, have poor response to any therapy, and shows extremely poor prognosis. We report a case of prostate SCC with rectal invasion in a 64-year-old man who complained of acute urinary retention.
Subject(s)
Humans , Middle Aged , Adenocarcinoma , Carcinoma, Squamous Cell , Incidence , Prognosis , Prostate , Urinary RetentionABSTRACT
BACKGROUND: Glomerular compensatory hypertrophy maintains decreased renal function after uninephrectomy (UNX). Proliferation and apoptosis of renal cells may be involved in hypertrophy. METHODS: In small and large male Sprague-Dawley rats, contralateral kidneys were harvested 1, 7, 14 and 30 days after UNX. Apoptosis was assessed by the Tdt-mediated dUTP-digoxigenin nick end labelling method. Proliferating cell nuclear antigen and Fas ligand (FasL) expression was determined by immunohistochemically. RESULTS: Morphometrically, glomerular hypertrophy was observed in both small and large rats after UNX, and it was more significant in the small rats. The glomerular proliferation index (PI) was gradually increased from day 7 but decreased on day 30 in the small rats. Glomerular PI was significantly increased from day 7 in large rats and peaked at day 14. Apoptotic cells in the glomeruli were slightly increased on day 1 and on day 7 in both groups of rats. The expression of FasL was gradually increased in the distal tubular epithelium in both groups. CONCLUSIONS: These results demonstrate different profiles regarding the compensatory growth of the kidney, cell proliferation, and apoptosis during the period of compensatory hypertrophy in uninephrectomized rats of different weight and age. Apoptosis may play a role in regressing a number of proliferated cells during renal compensatory hypertrophy.
Subject(s)
Animals , Humans , Male , Rats , Apoptosis , Cell Proliferation , Epithelium , Fas Ligand Protein , Hypertrophy , Kidney , Pathology , Proliferating Cell Nuclear Antigen , Rats, Sprague-DawleyABSTRACT
Although acute renal failure is common in patients with fulminant hepatitis, it has been recognized as a rare complication of non-fulrninant acute hepatitis A. So far about 30 patients have been described in the literature who had acute hepatitis A associated with acute renal failure. Variable renal biopsy findings have been described in previous reports, including mostly acute tubular necrosis, mesangial proliferative glomerulonephritis, and interstitial nephritis. But the exact mechanism by which hepatitis A causes acute renal damage is still obscure. We describe two cases with acute hepatitis A, proven by IgM anti-hepatitis A antibodies compli- cated by acute renal failure. One patient required hemodialysis. Kidney biopsy findings showed interstitial nephritis with no evidence of glomerular involvement. Our review of these cases and the relevant literature suggests that there is strong evidence to implicate hepatitis A virus as a cause of acute renal failure. It remains to be elucidated why the histologic features are variable in the cases of hepatitis A virus induced acute renal failure and which factors predispose a patients to have immunologic involvement versus interstitial and tubular involvement.
Subject(s)
Humans , Acute Kidney Injury , Antibodies , Biopsy , Glomerulonephritis , Hepatitis A virus , Hepatitis A , Hepatitis , Immunoglobulin M , Kidney , Necrosis , Nephritis, Interstitial , Renal DialysisABSTRACT
Abnormalities of body fluid and electrolyte balance, acute renal failure, nephrotic syndrome, interstitial nephritis and papillary necrosis are well known disease of wide spectrum of NSAID induced renal side effect. Many different mechanism such as inhibition of prostaglandin pathway, delayed hypersensitivity reaction and direct toxicity are reported to relate to development of disease. Recently, overuse of NSAID has steadily increased the cases of NSAID induced side effects and in some cases permanent damage to kidney has been reported. Authors experienced a 67-year-old male patient who presented with gross hematuria, edema and azotemia and diagnosed as interstitial nephritis accompanying nephrotic syndrome. Kidney biopsy shows the edema and the diffuse infiltration of lymphocytes in the interstitium. The glomerular changes suggest minimal change lesion or focal segmental glomerular sclerosis in early stage. The patient had continuously consumed piroxicam for 6 months and had improved after discontinuation of this drug as well as treatment with steroid but remained renal damage. This case suggest that piroxicam may be an agent that causes interstitial nephritis and nephrotic syndrome. Therefore clinician should use it with caution especially in patients with high risk factors.
Subject(s)
Aged , Humans , Male , Acute Kidney Injury , Azotemia , Biopsy , Body Fluids , Edema , Hematuria , Hypersensitivity, Delayed , Kidney , Lymphocytes , Necrosis , Nephritis, Interstitial , Nephrotic Syndrome , Piroxicam , Risk Factors , Sclerosis , Water-Electrolyte BalanceABSTRACT
Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure. Acute pyelonephritis without urinary tract obstruction, previous renal diseases or septic shock is a rare cause of acute renal failure. Despite appropriate antibiotic therapy, recovery of renal function could be slow and incomplete. We experienced a 45 year-old woman with diabetes who developed bilateral acute pyelonephritis followed by acute renal failure. The renal biopsy revealed diffuse edematous and focal fibrotic inters- titium with infiltration of lymphocytes compatible with interstitial nephritis. Although her renal function improved gradually with antimicrobial treatment, the process was incomplete and renal dysfunction persisted at about 10-month follow-up, suggesting permanent renal damage. Therefore, we report this case with brief review of related literature.
Subject(s)
Adult , Female , Humans , Middle Aged , Acute Kidney Injury , Biopsy , Diagnosis, Differential , Follow-Up Studies , Lymphocytes , Nephritis, Interstitial , Pyelonephritis , Shock, Septic , Urinary Tract , Urinary Tract InfectionsABSTRACT
Fine needle aspiration cytology(FNAC) has been used effectively as the initial modality in evaluating various thyroid lesions. We correlated cytologic and histopathologic features to investigate the diagnostic pitfalls of FNAC of the thyroid. A total of 1,593 FNACs of the thyroid were diagnosed at the Department of Pathology, Hanyang University Hospital, from January 1993 to December 1997. There were 963 cytologically benign cases(60.5%), 97 suspicious cases(6.1%), and 75 malignant cases(4.71%). The remaining 458 cases(28.8%) were unsatisfactory. Subsequent surgical resection was done in 192 cases. Seventy-two cases(37.5%) were cytologi cally diagnosed as benign, 45 cases(23.4%) suspicious, 56 cases(29.2%) malignant, and 19 cases(9.9%) unsatisfactory. Histopathologically, 101 cases were benign(11 thyroidites, 52 adenomatous hyperplasias, 34 follicular adenomas, and four Hurthle cell adenomas), and 91 cases malignant(72 papillary carcinomas, 16 follicular carcinomas, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor). After excluding 19 unsatisfactory cases, 63 were misdiagnosed. They included 17 benign(three thyroidites and 14 adenomatous hyperplasias), 27 suspi cious(16 follicular adenomas, four Hurthle cell adenomas, and seven follicular carcinomas), and 19 malignant(16 papillary carcinoma, one medullary carcinoma, one anaplastic carcinoma, and one granular cell tumor) lesions. The accuracy rates in the benign, suspicious, and malignant categories were 54.9%, 49.8%, & 92.8%, respectively. The cytological pitfalls were as follows: (1) bloody background, (2) crowded follicular cell clusters indistinguishable between follicular neoplasia and adenomatous hyperplasia, (3) papillary structure, irregular nuclear membrane and pleomorphism mimicking those of papillary carcinoma, (4) indistinct eosinophilia in follicular epithelial cells, (5) unusual cellular components not commonly seen in FNACs of the thyroid.
Subject(s)
Adenoma , Biopsy, Fine-Needle , Carcinoma , Carcinoma, Medullary , Carcinoma, Papillary , Diagnostic Errors , Eosinophilia , Epithelial Cells , Hyperplasia , Nuclear Envelope , Pathology , Thyroid GlandABSTRACT
Carcinosarcoma of the female genital tract, also called malignant mixed mullerian tumor (MMMT), is a rare and relatively aggressive tumor with various homologous and heterologous components. There have been various studies to find prognostic factors and to investigate the histogenesis, including tissue culture, electron microscopy, and immunohistochemical studies. We investigated carcinomatous, sarcomatous, and transitional areas of 6 cases of carcinosarcoma of the uterus and ovary by using epithelial and mesenchymal markers. Immunohistochemical profiles of the transitional areas were significantly different from those of carcinomatous and sarcomatous areas. Immunoreactivities for cytokeratin and epithelial membrane antigen (50% and 22.2%) were weaker than those of carcinomatous areas (95.2% and 100%), but stronger than those of sarcomatous areas (11.1% and 5.6%)(p<0.01). In transitional areas, vimentin, smooth muscle actin and S-100 protein were more strongly expressed than in carcinomatous areas, but more weakly expressed than in sarcomatous areas (p<0.01, p<0.01, and p=0.018, respectively). Myoglobin was entirely negative in carcinomatous areas and immunoreactive in minor portions of transitional and sarcomatous areas (22.2% and 16.7%, respectively). These results suggest that the transitional areas are between the carcinomatous and sarcomatous nature in differentiation, further supporting that the carcinosarcomas of the female genital tract may arise, through metaplastic change, from a type of carcinoma.
Subject(s)
Female , Humans , Actins , Carcinosarcoma , Immunohistochemistry , Keratins , Metaplasia , Microscopy, Electron , Mucin-1 , Muscle, Smooth , Myoglobin , Ovary , S100 Proteins , Uterus , VimentinABSTRACT
Polypoid cystitis is a rare entity and, to our knowledge, has not been described in the radiologic literature.It is frequently found in patients with indwelling catheters and is characterized by inflammation and edema of thelamina propria. We encountered a case of papillary cystitis which on a sonogram showed a solid mass withinhomogeneous internal echopattern ; on CT, a poorly-defined inhomogeneous, dense, soft-tissue density mass withenhancement and perivesical extension ; and on T2 weighted MR images an inter mediate SI mass.
Subject(s)
Humans , Carcinoma, Transitional Cell , Catheters, Indwelling , Cystitis , Edema , InflammationABSTRACT
The protein encoded by the Bcl-2 proto-oncogene has been shown to prolong cell su-rvival by preventing cell death(Apoptosis) induced by many insults including cancer therap-eutic drugs. Recently many researches have elucidated the bcl-2 expression in several hu-man solid cancers. However, there is still a few avaiable data to determine the role of Bcl-2 expression in the ovarian carcinogenesis and its prognostic significance in ovarian can-cers. Hence, we examined the expression of Bcl-2 in 68 ovarian epithelial cancers using immunohistochemistry and determined whether Bcl-2 expression has prognostic significance in the ovarian epithelial cancers. We found Bcl-2 expression(>5% positive cell) in 31 patients(40%). Bcl-2 expression were exclusively negative in the mucinous type of the ovarian epithelial cancer. Bcl-2 exp- ression was not correlated with tumor stage(stage I & II vs III & IV, p=0.63). The patients with Bcl-2 positivity had lower recurrence rate than the patients with negativity at the se- cond look operation(p0.05). These results sug- gest the Bcl-2 expression appears an early event in the ovarian carcinogenesis and has an inhibiting role in progression of ovarian tumor.
Subject(s)
Humans , Carcinogenesis , Immunohistochemistry , Mucins , Ovarian Neoplasms , Proto-Oncogenes , RecurrenceABSTRACT
E-cadherin (E-CD), a Ca2+ -dependent adhesion molecule, plays a major role in the maintenance of intercellular junctions in normal epithelial cells in most organs. Recently, a correlation has been observed between a loss of E-CD and increased invasiveness of neoplastic cells. In this study, E-CD expression in the breast carcinoma was investigated using monoclonal antibody, anti-E-CD by immunohistochemical method. Expression of E-CD were evaluated in 57 breast carcinomas and correlated with their tumor grade, lymph node involvement, and hormonal receptor status. Histological types included in this study were 54 invasive ductal carcinomas (IDCs) of otherwise not specified and 3 invasive lobular carcinomas. Cases of histologic grade I IDC were 6, grade II 30, and grade III 18. Of 54 IDCs 39 (72.2%) showed moderate to strong linear staining at the cell borders regardless of their histologic grade, status of lymph node metastasis, and status of hormone receptor. Staining intensity of E-CD was reduced in 54 cases (83%) of IDC when compared with that of normal or benign breast lesions (P<0.01). All seven cases of intraductal carcinoma, which were included in 54 IDCs showed one or two grade reduced expression of E-CD than that of infiltrative lesions. Three invasive lobular carcinomas showed strong (1 case), moderate (1 case), and negative reactivity (1 case). The data indicated that loss of E-CD expression is a crucial event in the development of breast carcinoma.
Subject(s)
Breast Neoplasms , Breast , Cadherins , Carcinoma, Ductal , Carcinoma, Intraductal, Noninfiltrating , Carcinoma, Lobular , Epithelial Cells , Intercellular Junctions , Lymph Nodes , Neoplasm MetastasisABSTRACT
Angiogenesis, the induction of new capillaries and venules, is associated with tumor growth. This study was designed to determine whether cervical carcinomas are angiogenic, and to investigate whether tumor angiogenesis can serve as a prognostic factor in cervical carcinoma. Surgical specimens of 47 cervical carcinomas were immunohistochemically stained specifically for endothelial cells with factor VIII-related antigen to identify all vessels. Microvessels were counted from photographs of 200x microscopic fields. In addition, thirty-seven cases were studied by immunohistochemical means using the monoclonal antibodies for PCNA and for Ki-67 to determine tumor cell proliferation rates in cervical carcinomas. The microvessel count(MVC), the PCNA labelling index, and the Ki-67 index were calculated and compared with known prognostic factors and disease free survival rates in cervical carcinomas. A wide range in the MVC count(range 12-100 mean=38.2+/-19.2), the PCNA labeling index(8-69% mean=33.6+/-15.2%), and in the extent of Ki-67 staining(0-43% mean=10.3+/-10.5%) was observed, indicating considerable variation of tumor angiogenic activity and tumor growth rates. This study showed statistically significant correlations in disease free survival rates with both lymph node status and the microvessel count. However, there was no significant difference in disease free survival rates between tumor stage, age, the PCNA labelling index, and the Ki-67 index.
Subject(s)
Female , Antibodies, Monoclonal , Capillaries , Cell Proliferation , Cervix Uteri , Disease-Free Survival , Endothelial Cells , Lymph Nodes , Microvessels , Proliferating Cell Nuclear Antigen , Venules , von Willebrand FactorABSTRACT
Three patients with primary non-Hodgkin's lymphoma of the uterine cervix are reported and the literature is reviewed. All the three patients in the current study presented with vaginal bleeding. They were found to have diffuse large cleaved cell lymphoma, one of which was multilobated variant with marked sclerosis. Histologically, differential diagnsis from undifferentiated small cell carcinoma, endometrial stromal sarcoma & other sarcomas was difficult and requires special stains including immunobistochemical study. Vaginal pap smears were diagnosed as 'class V; malignant lymphoma' in only one patient. Immunologically, two cases were beta-cell lineage and one case was T-cell lineage. All the patients were treated with chemotherapy only and showed good responses.
ABSTRACT
A fetal rhabdomyomatous nephroblastoma is considered to be a predominantly monophasic mesenchymal variant of Wilms' tumor, which acts less aggressively than a conventional Wilms' tumor despite its much larger size. Bilaterality of this tumor in a nine month-old girl, however, may negatively affect the overall prognosis. A radical nephrectomy for bulky masses in the left kidney and a partial nephrectomy for right kidney with five small tumor masses was performed at the same time. Two small tumor masses in the upper part of right kidney were left behind because of preserving minimal renal functional capacity. Pathological study revealed a mixed type of nephroblastoma which was composed predominantly of mesenchymal components with fetal rhabdomyomatous differentiation. After post-operative chemotherapy with vincristine, actinomycin D and adriamycin, and radiotherapy(2,130 rad), residual tumor masses became a single tumor 5 cm in diameter and well demarcated, which was resected at 15 months after first operation when the size and renal function of remained right kidney was appropriate to resect out the residual tumor. The tumor resected out at second operation was entirely composed of scattered differentiated fetal skeletal muscle cells in the fibrovascular tissue. Only a few entrapped epithelial components were seen but no blastemal cornponents were present. Follow up abdominal CT and ultrasonographic examinations revealed no evidence of tumor recurrence. The girl has developed normally without disease.
ABSTRACT
Fibrosarcoma in newborns and infants, designated as congenital, infantile, or juvenile fibrosarcoma is an uncommon soft tissue neoplasm occurring most frequently during the first year of life. Infantile fibrosarcoma is associated with favorable clinical behavior that is markedly different from that of adult fibrosarcoma., We report a case of infantile fibrosarcoma occured in a 3-year-old boy presenting as a palpable mass in the left lower extremity since 3 months of life. Histologic findings of the tumor are similar to those of f ibrosarcomas in adult.
Subject(s)
Infant , Adult , Male , Female , Infant, Newborn , HumansABSTRACT
Gastric glomus tumor is an uncommon benign, submucosal neoplasm and does not require radical surgical procedure. Because there are no specific clinical or radiologic features associated with the glomus tumor, it can be recognized only by its histologic characteristics. We report a 30-year-old woman who had 10 years history of epigastric hunger pain. Radiologically, a gastric submucosal tumor was discovered, which was suggestive of leiomyoma. Gastric antrectomy was performed. The tumor cells showed immunohistochemical and ultrastructural evidence of smooth muscle differentiation.