Laparoscopically Assisted Total Colectomy with J-pouch Formation for Intractable Chronic Constipation due to Hypoganglionosis: A Case Report / 대한내시경복강경외과학회지

Chronic constipation has been successfully treated with specific medications and bio-feedback therapy. Surgical manipulation for this condition can be an option when non-surgical interventions fail. We report here on a patient who was diagnosed as having intractable chronic constipation with hypoganglionosis. The patient was a 60 year-old male with the history of seizure and diabetes. This patient did not gain any clinical benefits from non-surgical regimens. Therefore, we performed a laparoscopically assisted total colectomy with J-pouch ileorectal anastomosis on this patient. The patient recovered from the surgery without complications and he had normal bowel functions. The postoperative anatomical pathology revealed a hypogaglionosis. In conclusion, a laparoscopically assisted total colectomy for a patient with intractable chronic constipation with hypoganglionosis is a good option and it may be a curative method.

Squamous Cell Carcinoma of the Pancreas with Invasion of Duodenum and Pylorus

Squamous cell carcinoma of the pancreas is a rare variant of pancreatic ductal cell carcinoma. Its biologic behavior and clinical features are known to be similar to the much more common ductal adenocarcinoma of pancreas. A 70-year old man with postprandial vomiting symptom was admitted to our hospital. Initial endoscopy and abdominal CT showed that 6cm sized submucosal tumor on pylous or duodenum invaded the pancreas. Subtotal gastrectomy with partial pancreatic resection was done. The resection specimen revealed of metastatic squamous carcinoma of stomach and duodenum. Follow up CT was revealed that multiple liver metastasis and a large mass in peripancreatic space. The mass was confirmed invasive squamous cell carcinoma of pancreas by aspiration biopsy. The patient died of cancer cachexia 50 days after operation. We report an unusual case of squamous cell carcinoma of the pancreas which was invaded to duodenum and pylorus with a review of literature.

Adenomatoid Tumor of the Tunica Vaginalis Testis / 대한비뇨기과학회지

Adenomatoid tumors arising in the tunica vaginalis are relative rare neoplasms, and usually benign in nature. An appropriate treatment of an adenomatoid tumor is local excision. Herein, a case of an adenomatoid tumor of the tunica vaginalis, in a 40-year-old man, is described. An orchiectomy was performed to excise the mass, and pathologic evaluation revealed an adenomatoid tumor of the tunica vaginalis.

Adenomatoid Tumor of the Tunica Vaginalis Testis / 대한비뇨기과학회지

Adenomatoid tumors arising in the tunica vaginalis are relative rare neoplasms, and usually benign in nature. An appropriate treatment of an adenomatoid tumor is local excision. Herein, a case of an adenomatoid tumor of the tunica vaginalis, in a 40-year-old man, is described. An orchiectomy was performed to excise the mass, and pathologic evaluation revealed an adenomatoid tumor of the tunica vaginalis.

Sequential Studies of Glomerular Crescent Formation in Rabbits with Anti-Glomerular Basement Membrane(GBM) Antibody Induced Glomerulonephritis(GN)

To investigate the mechanism of crescent formation, sequential pathologic changes from the New Zealand White rabbits with anti-GBM antibody induced GN by administration of guinea pig anti-GBM IgG were studied by light (LM), immunofluorescent (IF) and electron (EM) microscopy. Although no glomerular changes were observed in LM, swelling of the endothelial cells and the epithelial cells were noted in EM by day 2. By day 7, early and cellular crescents were evident. Proteinaceous materials and fibrins were noted in the glomerular capillary lumina (GCL) and Bowman's space (BS) associated with segmental hypercellularity. The GBM damage became progressively severe, followed by focal detachment of the visceral epithelial cells from the GBM. At day 14, fibrin strands, mononuclear cells and collagen fibrils were present between the proliferating extracapillary cells. At day 31, fibrocellular crescents were predominated. Elongated spindle cells, morphologically resembling myofibroblasts, were noted near the Bowman's capsule (BC). A degree of tubular atrophy, interstitial fibrosis, and inflammatory infiltrates increased as it did with fibrous organization of crescent. Intense linear IF staining for IgG and C3 were seen throughout the experiments along the GBM. In conclusion, the progression of crescent from an early "proteinaceous" stage through cellular, fibrocellular and fibrous stages was well documented in this study. Inflammatory cells and coagulation mechanism may activate the initiation of the GBM damage at the early stage. Activated periglomerular mononuclear cells may also cause disruption of BC which facilitates entry of activated periglomerular cells and fibroblasts into BS leading to progressive fibrous crescent formation.

A Pathologic Study of Renal Cell Carcinoma: Correlation between clinical and morphologic parameters and prognosis

The prognostic significance of morphologic parameters was evaluated in 36 cases of renal cell carcinoma diagnosed during five years(1986~1990). We reviewed and classified on the basis of pathologic stage, tumor size, histologic pattern, cell type and nuclear grade. Mean age was 51 years old. Average tumor size was 7.3 cm in diameter. Six of 35 patients died of disease. Overall mean survival was 43.3+/-7.3 months. An increasing nuclear grade was generally correlated with a decrease in cummlative survival rate. Similarly, a higher stage at the time of diagnosis could predicated a low survival rate only for high nuclear grade carcinoma. There was an apparent positive correlation between grade and age, grade and size, grade and cell type, cell type and histologic pattern as well as stage and age. This positive correlations are in part a function of nuclear grade; only 20% of grade 3 & 4 tumor consisted of clear cells whereass 71% of grade 1 & 2 consisted of clear cell type. All 6 cases of granular cell types and 50% of mixed cell type were grade 3 & 4. The tumor size of the primary was well correlated with the nuclear grade. Nuclear grade was the most significant factor among the morphologic parameters studied.

Cytophagic Histiocytic Panniculitis: 2 cases report

Cytophagic histiocytic panniculitis is a rescently described histiocytic disorder. It is characterized by the presence of fever, pancytopenia, and subcutaneous nodules resulting from the infiltration of lympho-histiocytes in the dermis and subcutaneous adipose tissue. The characteristic findings is presence of bean-bag histiocytes containing phagocytized red blood cells, lymphocytes, and platelets. We experienced two cases of cytophagic histiocytic panniculitis with hard and erythematous subcutaneous nodules. These skin lesions exhibited infiltration of the subcutaneous tissue by large, benign histiocytes with cytophagic features. Hemophagocytic histiocytes were observed in the cervical lymph node in case 1, and bone marrow in case 2. One patient is alive, while the other one died with hemorrhagic complications.

Amniotic Band Syndrome: An autopsy case report

We report an autopsy case of amniotic band syndrome exhibiting microcephaly, asymmetric encephalocele, microphthalmia, nasal deformity, cleft lip and palate accompanied by left maxillary and zygomatic bone deformities. The amniotic membrane of the placenta was also attached to the herniated brain. The twenty-year-old primigravid mother had no history of taking drug, irradiation, infection or trauma before or during pregnancy.

Ki-1 Positive T-Cell Lymphoma of Bone in a Child

Ki-1 monoclonal antibody is a well known marker for Reed-Sternberg cells in Hodgkin's disease, but also occasionally reacts with activated lymphoid cells of either benign or malignant nature. Recently, Ki-1 antibody positive Non-Hodgkin's lymphoma, usually of large cell and/or polymorphous type, has been reported in the lymph nodes, skin, soft tissue, and stomach, but not in the bone. We report a case of multifocal primary bone lymphoma in a seven-year old body involving the left shoulder and right frontal bone, which proved to be a large cell, polymorphous lymphoma, helper T-cell type expressing Ki-1 antigen.

Multiple Proliferating Trichilemmal Tumors with Ordinary Trichilemmal Cysts: A case report

Proliferating trichilemmal tumor is one of rare benign tumors of the skin appendages, considering as hamartoma of the terminal hair follicle, isthmic segment of the outer root sheath. We report a case of numerous proliferating trichilemmal tumors admixed with ordinary trichilemmal cysts with femilial history in 64-year-old man. He has total 157 lesions, which are chiefly located in scalp (48), back (32), and also face, neck, trunk, extremities. Histologically, the tumor is composed of irregularly arranged and ansatomosed trabeculae, lobules, or sheets of proliferated trichilemmal squamous epithelium with peripheral palisading of the basaloid cells. Several layers of squamoid or ovoid cells have PAS-positive clear cytoplasm. And it also shows abrupt amorphous, trichilemmal keratinization. Some squamous eddies with mild cellular atypism are associated, but definite invasion or other evidence of the malignancy is not found. usual multiple trichilemmal cysts are admixed with tumor and occasionally exhibit connection between them.