A Case of Gastric CD56+ Extranodal NK/T-cell Lymphoma, Nasal Type / 대한소화기내시경학회지

A NK/T cell lymphoma is highly aggressive lymphoma of a putative NK-cell origin with a predominant extranodal presentation and a rapidly fatal course. CD56 has been reported to be the most reliable marker for a NK/T cell lymphoma. A NK/T cell lymphoma is strongly associated with the Epstein-Barr virus. We report a case of an aggressive NK/T cell lymphoma presenting as a gastric ulcer. A 52-year-old female patient presented with hematochezia and fever. The endoscopic finding showed a gastric ulcer with a recent bleeding stigma. Histologically, the gastric biopsy showed a diffuse infiltration of small or medium sized lymphoma cells with an angiocentric growth pattern and necrosis. The lymphoma cells were CD56+, CD3+, CD20-, which are consistent with a NK/T cell lymphoma. Unfortunately, the patient was discharged without treatment. We report this case with a review of the relevant literature.

Clinical characteristics and predisposing factors for complication of caustic injury of the upper digestive tract / 대한내과학회지

BACKGROUND: Accidental or suicidal ingestion of caustic agents is not uncommon. The caustic injury of upper digestive tract can lead to severe stenotic sequelae. We attempt to investigate clinical characteristics, endoscopic findings and predisposing factors of development of complications of caustic injury. METHODS: The medical records of 77 patients admitted to our department for caustic ingestion from March, 1993 to June, 2004 were reviewed. All patients underwent initial endoscopic examinations and caustic lesions were graded according to Zargar's classification (Grade 0~III). RESULTS: Strictures of the esophagus and the stomach occurred in 12 patients (15.6%) and 3 patients (3.9%), respectively. The development of esophageal or gastric stricture was more frequent when the grade of caustic injury of the esophagus or the stomach was more severe. Hemorrhage from exposed vessels of the injured esophagus and stomach was seen in one patient and so was jejunal hemorrhage. Two patients (2.6%) died of multiple-organ failure. All cases of hemorrhage and death resulted from grade III lesions of the esophagus, stomach and duodenum. The type or amount of the caustic agent, duration between ingestion and endoscopic examination, and initial treatment with steroid and/or antibiotics did not correlate with the development of stricture. CONCLUSIONS: Caustic injury of the esophagus and the stomach was significantly associated with esophageal stricture. Early endoscopic examination was very useful for predicting the development of complications and prognosis after caustic injury.

A Case of Crohn's Disease Confined to the Appendix / 대한소화기내시경학회지

Crohn's disease is a condition of chronic inflammation involving potentially any location in alimentary tract, but it is worldwide the rare when primary lesion with its extent is confined to the appendix alone. Because clinical manifestations of the Crohn's disease of the appendix dose not differ from those of acute appendicitis, it is difficult to diagnose preoperatively or intraoperatively, so it is usually diagnosed by postoperative pathologic examination. Because Crohn's disease confined to the appendix has favorable prognosis than typical Crohn's disease, it is considered a separate disease entity from Crohn's disease, and a new diagnostic term-"idiopathic granulomatous appendicitis"-has gained wide acceptance in recent years. We experienced a case of Crohn's disease confined to the appendix or idiopathic granulomatous appendicitis and review, we reported the care with review of the literatures.

Two cases presenting thoracic complications of deep neck infection / 결핵

The incidence of deep neck infection has been reduced by modern antibiotic therapy. Life-threatening deep neck infection of odontogenic or upper airway origin may extend to the thorax. Early diagnosis, administration of the potent antibiotics, and complete debridement and drainage are essential to improve the chances for survival in these very ill patients. We report two cases of deep neck infection which were complicated by thoracic infection such as mediastinitis, pericarditis, and empyema as a result of descending infection.

A Case of Pulmonary Sequestration Supplied with Left Gastric Artery / 결핵

The bronchopulmonary sequestration is a region of lung parenchyma that has an incomplete or no connection with the airways and is supplied by an aberrant artery arising from the aorta or one of its branches. The anatomy of supplied artery is very important during operation. We present a case of pulmonary sequestration supplied with left gastric artery. The patient was 61 years old male and had hemoptysis. The left lower lung was cystic bronchiectasis and a few air-fluid level on chest CT. Also, in aortogram, arterial supply was from left gastric artery of abdominal aorta branches. Left lower lobectomy and abnormal arterial ligation was done.

A Case of Pheochromocytoma Manifested by Generalized Seizure / 대한내분비학회지

Pheochromocytoma is originated from chromaffin cells of sympathetic nervous system and clinical symptoms are caused by catecholamine released from tumor. In typical cases, periodic attacks of hypertension, palpitation, headache, and sweating are main symptoms. But, the diagnosis of pheochromocytoma is sometimes difficult since its clinical presentation is quite variable. We evaluated a 25-year-old woman who was admitted because of left flank pain and seizure. She had a history of hemoptysis and toxemia. During the hospitalization, she experienced generalized seizure once more. The clinical diagnosis of pheochromocytoma was proven by highly elevated urinary catecholamines and confirmed histologically after operation. We think it is the first case report of pheochromocytoma manifested by seizure in korea, so we report this case with literature review.