A case of pulmonary epithelioid hemangioendothelioma / 대한내과학회지

Epithelioid hemangioendothelioma(EH) is a rare vascular tumor of low-grade malignancy. It was previously described as intravascular bronchioloalveolar tumor (IVBAT). But electron microscopic study and immunohistochemical staining results have proved endothelial origin. Patients are usually asymptomatic and the tumors are found incidentally on routine chest X-rays. Most patients show a slowly progressive clinical course, even though some patients occasionally die as results of respiratory failure or extrathoracic complications. Confirmative diagnosis is made through thoracoscopic or open-lung biopsy. There is still no effective therapeutic modality for pulmonary EH. We have experienced a 55-year-old woman whose simple chest x-ray film revealed bilateral multiple small nodules. The nodules were histopathologically and immunohistochemically diagnosed as primary epithelioid hemangioendothelioma of the lung. The possibility of metastatic disease was excluded thorough clinical, laboratory and radiological studies. Comparison of radiographic chest film taken 3 years ago showed no significant progression of the pulmonary nodular lesions. Conservative management was instituted and careful 4 months follow-up showed no significant changes.

Primary Lymphoma of Bone Combined with Pancytopenia / 대한혈액학회지

Primary lymphoma of bone, first described by Parker and Jackson in 1939, is derived from bone marrow reticuloendothelial systems. It is uncommon neoplasm representing only 5% of all extranodal non-Hodgkin's lymphoma. Primary bone non-Hodgkin's lymphoma is characterized by initial symptoms of bone pain with associated single or multiple radiological bone lesions, with or without local soft tissue swelling, pathologic fractures,or regional/distant metastasis. Isolated bone marrow non-Hodgkin's lymphoma is rare, and determining the diagnosis difficult. The common features are fever, abnormal liver function, pancytopenia, polyserositis, neurologic symptoms, opportunistic infections, and a short, fatal course. Treatment includes surgery, radiotherapy, and chemotherapy depending on multiple factors, including histopathologic type of tumor, stage of disease, location of the lesion, and extent of osseous involvement. Five year survival rate is above 80%, when treated by combined radiation & chemotherapy. We experienced a patient who admitted to our department of Internal Medicine. She had mutiple bone pain, general weakness and diagnosed as primary lymphoma of the bone with severe pancytopenia. Her presentation, treatment, and clinical progress were discussed.

Two Cases of Collagenous Colitis / 대한소화기내시경학회지

Collagenous colitis was first described by Lindstrom in 1976. Now this disorder is recognized as one of the more common causes of chronic diarrhea of obscure origin. This disorder is described as a disease of colon associated with chronic watery diarrhea and the typical histologic findings of a thickened subepithelial collagenous band. But in korea a few cases have been reported. We had observed a 52-year-old businessman with chronic watery diarrhea without abdominal pain in the past. And then we had reported previously that case. We also recently observed a 42-year-old housewife with chronic watery diarrhea with lower abdominal discomfort for 10 years. Colonoscopy disclosed no gross abnormalities through the entire colon ineluding the terminal ileum but we could find the pronounced thickening of subepithelial collageous band and chronic inflammation in the lamina propria in the histologic examination. We summarized the above two cases of collagenous colitis with a review of literatures.

A Case of diffuse dilatated coronary artery ectasia on Marfan's Syndrome / 대한내과학회지

Marfan's syndrome is a an autosomal dominant disorder of connective tissue that is characterized by ocular, skeletal, and cardiovascular manifestation. It is estimated to have a prevalence of 4-6 per 10,000 people, and at least 25 percent of the cases occur in the absence of a family history. Coronary artery ectasia is a diffuse abnormality of the vessel wall, which has been reported in associated with coronary atherosclerosis, infectious process, congenital heart lesion, syphilis, Ehlers-Danlos syndrome. We reported a case of 25-year-old male who presented with Marfan's syndrome associated with dissecting ascending arotic aneurysm and diffuse dilatated coronary artery ectasia. Coronary angiographic study demonstrated the diffusely dilatated coronary artery ectasia.