ABSTRACT
Intestinal hemorrhage, fistula formation, and intestinal obstruction are the common complications associated with intestinal tuberculosis. However, duodenal fistula due to intestinal tuberculosis is very rare. We experienced a case of 26-year-old woman with a fistula in the duodenum referred to our hospital due to abdominal pain. Esophagogastroduodenoscopy showed a fistula at the duodenum with lymph node. After 2 months of anti-tuberculous medication, abdominal pain was improved and fistula size decreased. We report a case of fistula caused by duodenal tuberculosis.
Subject(s)
Adult , Female , Humans , Abdominal Pain , Duodenum , Endoscopy, Digestive System , Fistula , Hemorrhage , Intestinal Obstruction , Lymph Nodes , TuberculosisABSTRACT
Breast carcinoma is common malignancy in women and frequently metastasize to multiple organ such as lung, bone, lymph node and liver. But metastasis to gastrointestinal tract is rare and only two cases have been reported in Korea. We experienced a case of upper gastrointestinal bleeding caused by gastric metastasis from ductal carcinoma of breast and report this case with review of several literatures.
Subject(s)
Female , Humans , Breast Neoplasms , Breast , Carcinoma, Ductal , Gastrointestinal Tract , Hemorrhage , Korea , Liver , Lung , Lymph Nodes , Neoplasm MetastasisABSTRACT
BACKGROUND/AIMS: Tuberculous peritonitis is still a very important cause of exudative ascites in Korea. We analized the clinical features and laparoscopic findings in patients with tuberculous peritonitis diagnosed by laparoscopy. METHODS: We studied 51 patients who had tuberculous peritonitis confirmed by laparoscopic biopsy from 1980 to 2000, in retrospective method. RESULTS: The ratio of male to female was 1:2. The peak incidence was between 21 and 40 years of age. The mean duration of symptoms is 60 days. The most frequent chief complaints and physical findings was abdominal fullness (88.2%) and shifting dullness (94.1 %). Involvement of other organs included pulmonary tuberculosis (27.4%), cervical tuberculous lymphadenitis (3.9%). The mean ascitic fluid protein concentration was 4.9 gm/dL, mean WBC count 1,240/mm3 and lymphocyte dominant exudate 88.2%. AFB smear was positive only one patient (2.0%). Tuberculous nodules on laparoscopy were noted in all of the patients. Histolologic findings were caseating granuloma (72.6%), non-caseating granuloma (19.6%) and nonspecific inflammation (7.8%). Tissue AFB stain was positive 10 patients (19.6%). CONCLUSIONS: Tuberculous peritonitis shows nonspecific clinical features. Therefore, laparoscopic examination with biopsy is the most useful method to make differential diagnosis of patients who are suspected tuberculous peritonitis.
Subject(s)
Female , Humans , Male , Ascites , Ascitic Fluid , Biopsy , Diagnosis, Differential , Exudates and Transudates , Granuloma , Incidence , Inflammation , Korea , Laparoscopy , Lymphocytes , Peritonitis, Tuberculous , Retrospective Studies , Tuberculosis, Lymph Node , Tuberculosis, PulmonaryABSTRACT
Hepatocellular carcinoma is one of the most common malignancies reported in Korean adult males. Hepatocellular carcinoma usually spreads to regional lymph nodes around porta hepatis via lymphatics and to distant metastasis via hematogenous spread. The lung is most common distant metastatic site, followed by the adrenal glands, local lymph nodes and bones. But metastasis to the spinal cord of hepatocellular carcinoma is very rare. Recently we experienced a patient with hepatocellular carcinoma who had suffered from lower leg weakness for 10 days. The patient was proved to have hepatocellular carcinoma with metastasis to the spinal cord. MRI showed an ovoid intracordal mass between the twelfth thoracic and first lumbar vertebra level. After emergency irradiation, the patient could recover.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Hepatocellular/secondary , English Abstract , Liver Neoplasms/pathology , Magnetic Resonance Imaging , Spinal Cord Neoplasms/diagnosisABSTRACT
In spite of decrease in prevalence, yet tuberculosis is not rare disease in Korea and the morbidity is over one percent. Because extrapulmonary tuberculosis is less common than that of lung, quick and accurate diagnosis is not easy and there may be some problems in selecting the methods and the times to treat it. Especially, each or combination of abdominal lymphadenitis and duodenal tuberculosis are so rare that differential diagnosis from other common or rare diseases is difficult, and much attention is required to diagnose and treat those. Recently we experienced a case of tuberculous lymphadenitis accompanied by duodenal bulbar tuberculosis which had been conceived as submucosal tumor at endoscopy and diagnosed by explorative operation. So we report this case with review of related literatures.
Subject(s)
Diagnosis , Diagnosis, Differential , Endoscopy , Korea , Lung , Lymphadenitis , Prevalence , Rare Diseases , Tuberculosis , Tuberculosis, Lymph NodeABSTRACT
BACKGROUND/AIMS: The purpose of this study was to assess the correlation between histologic activity and fibrosis and the distribution of intrahepatic hepatitis B core antigen (HBcAg) and surface antigen (HBsAg) in patients with chronic hepatitis B. METHODS: 141 patients (M:F=141:27) with biopsy-proven chronic hepatitis B, abnormal liver function, and a positive HBV viral marker (serum HBeAg, serum HBV DNA) were enrolled. RESULTS: HBcAg was expressed in 96 of 141 patients (68.1%), nHBcAg in 23 (16.3%), cHBcAg in 58 (41.2%), and n-cHBcAg in 15 (10.6%). In the cases of HBsAg, 114 of 141 patients (80.9%) were expressed as cHBsAg, 2 (1.4%) as mHBsAg, and 16 (11.3%) as m-cHBsAg. The presence of intrahepatic HBcAg and HBsAg according to Gudat's classification was not correlated with activity and fibrosis. But the groups with nuclear expression of HBcAg revealed less inflammatory activity (grade, p=0.003), and less fibrotic stage (p = 0.002) than with cytoplasmic or no expression of HBcAg. HBsAg was not. CONCLUSIONS: These observations suggest that inflammatory activity and fibrosis of chronic hepatitis B are related to the presence of HBcAg in hepatocytes and the expression of HBcAg. This is a very important finding in hepatocytolysis.
Subject(s)
Humans , Antigens, Surface , Biomarkers , Classification , Cytoplasm , Fibrosis , Hepatitis B Core Antigens , Hepatitis B e Antigens , Hepatitis B Surface Antigens , Hepatitis B, Chronic , Hepatitis, Chronic , Hepatocytes , Immunohistochemistry , LiverABSTRACT
Carcinoma of the prostate is a common malignancy affecting elderly men. Lung metastasis from prostate cancer occurs frequently, but tumor metastasis to the central bronchi that clinically mimics primary bronchogenic carcinoma are very rare. We report a 73-year old man with endobronchial metastasis from prostatic carcinoma presented with respiratory symptom cough. Diagnosis of issues taken from materials which were used for bronchoscopic biopsy and prostate biopsy and immunohistochemical staining for prostate specific antigen(PSA) confirmed a case of endobronchial metastasis from prostatic carcinoma. Hormonal therapy(LHRH agonist) was applied to this patient.
Subject(s)
Aged , Humans , Male , Biopsy , Bronchi , Carcinoma, Bronchogenic , Cough , Diagnosis , Lung , Neoplasm Metastasis , Prostate , Prostatic NeoplasmsABSTRACT
Carcinoid tumor primarily affects the intestinal tract, which arise from the Kulchitsky cells found at the base of the crypts of Lieberk hn. Rectal carcinoids are relatively uncommon lesions, representing only 1.3 percent of all rectal tumors. Rectal carcinoids have benign course and are usually asymptomatic. While their prognosis is generally favorable, it is known that about 15% of these tumors metastasize. Rectal carcinoid tumors should be treated appropriately and aggressively when indicated. Present-day treatment programs call for radical cancer resection only for lesions larger than 2 cm in diameter and local resection for all others. We have experienced a case of carcinoid tumor of the rectum treated by endoscopic polypectomy.