ABSTRACT
PURPOSE: To evaluate the diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) in predicting pelvic lymph node (LN) metastases in patients with cervical cancer. MATERIALS AND METHODS: From January 2009 to March 2015, 114 patients with FIGO stage IA1-IIB uterine cervical cancer who underwent hysterectomy with pelvic lymphadenectomy and took CT, MRI, and PET/CT before surgery were enrolled in this study. The criteria for LN metastases were a LN diameter ≥1.0 cm and/or the presence of central necrosis on CT, a LN diameter ≥1.0 cm on MRI, and a focally increased FDG uptake on PET/CT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for pelvic LN metastases were estimated. RESULTS: The sensitivity, specificity, PPV, NPV, and accuracy for detection of pelvic LN metastases were 51.4%, 85.9%, 41.3%, 90.1%, and 80.3% for CT; 24.3%, 96.3%, 56.3%, 86.8%, and 84.6% for MRI; and 48.6%, 89.5%, 47.4%, 90.0%, and 82.9% for PET/CT, respectively. The sensitivity of PET/CT and CT was higher than that of MRI (p=0.004 and p= 0.013, respectively). The specificity of MRI was higher than those of PET/CT and CT (p=0.002 and p=0.001, respectively). The difference of specificity between PET/CT and CT was not statistically significant (p=0.167). CONCLUSION: These results indicate that preoperative CT, MRI, and PET/CT showed low to moderate sensitivity and PPV, and moderate to high specificity, NPV, and accuracy. More efforts are necessary to improve sensitivity of imaging modalities in order to predict pelvic LN metastases.
Subject(s)
Humans , Electrons , Hysterectomy , Lymph Node Excision , Lymph Nodes , Magnetic Resonance Imaging , Necrosis , Neoplasm Metastasis , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Sensitivity and Specificity , Uterine Cervical NeoplasmsABSTRACT
BACKGROUND/AIMS: Microscopic colitis is characterized by chronic watery diarrhea with specific pathological changes that can be diagnosed by microscopic examination. We performed immunohistochemical analysis of proinflammatory cytokines to investigate the pathogenic mechanism of microscopic colitis. METHODS: This study consisted of six patients with lymphocytic colitis, six patients with collagenous colitis, and six patients with functional diarrhea but normal pathology. We performed an immunohistochemical analysis of the colonic mucosal biopsies to assess the expression of cyclo-oxygenase-2, interleukin-17, nuclear factor-kappaB, interferon-gamma, inducible nitric oxide synthase, and tumor necrosis factor-alpha. We compared the quantity score of immunohistochemical staining among the groups. RESULTS: The microscopic colitis group showed significantly higher expression of cyclo-oxygenase-2, interleukin-17, nuclear factor-kappaB, and interferon-gamma compared with the control group. Cytokine expression was similar between collagenous colitis and lymphocytic colitis. However, the expression of cyclo-oxygenase-2 was higher in collagenous colitis. CONCLUSIONS: Proinflammatory cytokines, including interleukin-17 and interferon-gamma, are highly expressed in microscopic colitis. The expression of cyclo-oxygenase-2 was higher in collagenous colitis than in lymphocytic colitis. This study is the first on interleukin-17 expression in microscopic colitis patients.
Subject(s)
Humans , Biopsy , Colitis, Microscopic/metabolism , Colon/pathology , Cyclooxygenase 2/metabolism , Cytokines/metabolism , Diarrhea/metabolism , Interferon-gamma/metabolism , Interleukin-17/metabolism , Intestinal Mucosa/pathology , NF-kappa B/metabolism , Nitric Oxide Synthase Type II/metabolism , Tumor Necrosis Factor-alpha/metabolismABSTRACT
PURPOSE: Interest is mounting in developing prevention strategies for patients at high risk of developing colorectal cancer. Recent epidemiological investigations indicate an inverse relationship between the intake of NSAIDs and colorectal cancer risk. Cyclooxygenase (COX) enzyme may be involved in the initiation and/or the promotion of carcinogenesis. A major action of NSAIDs is the inhibition of COX. We have studied the clinical significance of COX-2 expression in colorectal adenoma and carcinoma. METHODS: We studied 19 patients with colorectal adenomas (15 males and 4 females: ages 30~73 years) and 20 patients with colorectal carcinoma (12 males and 8 females: ages 35~80 years). COX-2 status were determined by immunohistochemical methods using the mouse monocolnal antibody for COX-2 (Transduction Lab, USA) on paraffin sections. RESULTS: Immunoreactive COX-2 were expressed in 9 patients (47%) of colorectal adenoma and 9 patients (45%) of colorectal carcinoma. 57% of villous adenoma and 42% of tubular adenoma were positive for COX-2 in colorectal adenoma (p=0.650). COX-2 were expressed in 12.5% of stage B and 73% of stage C of colorectal cancer (p=0.006). COX-2 expression did not relate with the size of adenoma and carcinoma. CONCLUSIONS: The data suggest that COX-2 may be more expressed in villous adenoma and advanced carcinoma. Therefore, enhanced expression of COX-2 may play a role in the carcinogenesis of colorectal cancer.
Subject(s)
Animals , Female , Humans , Male , Mice , Adenoma , Adenoma, Villous , Anti-Inflammatory Agents, Non-Steroidal , Carcinogenesis , Chemoprevention , Colorectal Neoplasms , Cyclooxygenase 2 , Paraffin , Prostaglandin-Endoperoxide SynthasesABSTRACT
No abstract available.
Subject(s)
Animals , Female , Mice , Cell Adhesion , Leiomyoma , Myometrium , Neural Cell Adhesion MoleculesABSTRACT
Cytologic finding of 2 cases of metastatic leiomyosarcoma diagnosed by fine needle aspirtion cytology are reported. Case 1 is pleomorphic leiomyosarcoma which had metastsized to the liver from the stomach of a 54-year-old male patient. The cytologic features showed highly cellular aspirates with nuclear pleomorphism and interlacing patern. Case 2 is low grade leiomyowsarcoma that occurred in the uterus of a 43-year female patient and metastsized to both lungs. The aspirates were less cellular than that of case 1, and showed spindle cells with minimal pleomorphism, but cell block revealed interlacing patterns of smooth muscle cells with occasional mitosis.
Subject(s)
Female , Humans , Male , Middle Aged , Biopsy, Fine-Needle , Leiomyosarcoma , Liver , Lung , Mitosis , Myocytes, Smooth Muscle , Needles , Neoplasm Metastasis , Stomach , UterusABSTRACT
In nonsystemic vasculitic neuropathy, clinically only nerves are affected : there are no or few constitutional symptoms or serological abnormalities. The clinical and pathological features are those of an ischemic neuropathy caused by a necrotizing vasculitis of small arterioles. This is a case report of nonsystemic vasculitic neuropathy in a 22-year-old male who has the distal symmetric poIyneuropathy as a symptom of localized vsaculitis. The sural nerve biopsy showed a few myelin digestion chamber suggesting axonal degeneration. The patient was treated with steroid daily with gradual clinical and electorophysiological improvement.
Subject(s)
Humans , Male , Young Adult , Arterioles , Axons , Biopsy , Digestion , Myelin Sheath , Sural Nerve , VasculitisABSTRACT
A patient presenting with the characteristic clinical features of the dementia of Pick's type is described, in whom neuropathological examination of brain biopsy material revealed atypical features, including extensive subcotical gliosis with mild cortical neuronal loss and without any neuronal cytoskeletal inclusions (Pick bodies, neurofibrillary tangles, and Lewy bodies) and amyloid deposits (senile plaques). And she has the suggestive family history of the same clinical features in her two brothers. So, the clinical and pathological features are discussed with particular reference to typical Alzheimer's disease and Pick's disease, and it is proposed that the case should be classified as familial progressive subcortical gliosis.
Subject(s)
Humans , Alzheimer Disease , Biopsy , Brain , Dementia , Gliosis , Neurofibrillary Tangles , Neurons , Pick Disease of the Brain , Plaque, Amyloid , SiblingsABSTRACT
One case of bezafibrate-induced myopathy was experienced and presente with a brief review of literatures. A 80-year-old woman with diabetes mellitus developed generalized myalgia and chest tightness 2 days before admission. The patient was treated with bezafibrate (800mg/day) for the previous 3 months. Serum creatine kinase, LDH and AST were markedly increased. Muscle biopsy revealed type 2 fiber atrophy. Withdrawal of the drug under the impression of bezafibrate-induced myopathy was followed by rapid clinical improvement.
Subject(s)
Aged, 80 and over , Female , Humans , Atrophy , Bezafibrate , Biopsy , Creatine Kinase , Diabetes Mellitus , Muscular Diseases , Myalgia , ThoraxABSTRACT
OBJECTIVE: To analyze neurological manifestations in hypereosinophilic syndrome. Background. According to Chusid et al (1975), the neurologic manifestations in hypereosinophilic syndrome were paralysis, seizure, abnon-nal EEG finding, and neuropathy. According to Weaver(1988), eosinophil-induced neurotoxicities were characterized by axonal neuropathy, cerebral infarction, and dementia. METHOD: We analyzed 29 patients with neurologic manifestations and hypereosinophilia who visited Kyung-hee medical center during Aug. 1991-Jul. 1994. White blood cells were differentiated by the Coulter STKS S-plus machine and confirmed manually, if hypereosinophilia had been detected, by two clinical pathologists. Symptoms, signs, imaging studies, latoratory studies and biopsies were analyzed. RESULT: The mean age was 47.2 years and the mean eosinophil count was 2700/cu mm. Main symptoms were hemiparesis(31.0%), dysesthesia(20.7%), headache(20.7%), dysarthria(13.8%), paraparesis(10.3%), seizure(6.9%), myalgia(6.9%), confusion(6.9%), vertijo(6.9%), diplopia(6.9%), 14patientswereshowntohavecerebrovasculardisease, 5patientsmeningoencephalitis, 4patientsperipheralneuropathy, 3 patients myelopathy. CONCLUSION: Cerebrovascular diseases (48.3%) were most common neurologic disease in hypereosmopluc syndrome. Others were meningoencephalitis(17.2%), polyneuropathy(13.8%), myelopathy(IO.3%), eosinophilia-myalgia syndrome(6.9Yo), temporal arteritis(3.4%).
Subject(s)
Humans , Axons , Biopsy , Cerebral Infarction , Dementia , Electroencephalography , Eosinophils , Hypereosinophilic Syndrome , Leukocytes , Neurologic Manifestations , Paralysis , Seizures , Spinal Cord DiseasesABSTRACT
No abstract available.
Subject(s)
Female , Pregnancy , C-Reactive Protein , Obstetric Labor, PrematureABSTRACT
Dermoid cysts of the posterior fossa are benign, mostly midline, congenital brain neopasm, usually located above or behind the vermis or adjacent meninges2)18)20), Dermoid lesions are slow growing and may become quite large before producing signs and symptoms12). We have recently experienced a case of dermoid which arised in cerebellar hemisphere. A 32-year old woman who had a history of chronic headache at morining was visited in our department and she was also complained of a egg-sized plapable mass which was growing nature, non-tender, soft, and movable on the right occipital area. On admission, there were no specific localizing and lateralizing neurological abnormalities. Unenhanced CT scan shows hypodense mass in the left cerebellar hemisphere and cystic mass at the right occipital scalp(Fig. 1. A). T1-weighted MR image shows hypointense mass in the left cerebellar hemisphere(Fig. 2. A). The Carotid angiography shows non-specific findings. Paramedian suboccipital approach was performed and mass was removed from the lleft cerebellar hemisphere. The cystic scalp mass was removed totally from the left cerebellar hemisphere. The cystic scalp mass was removed totally from the right occipital area. Diagnosis of dermoid cyst was confirmed pathologically by the specimens obtained from two different sites, left cerebellar hemisphere and right occipital ccalp.