Henoch-Schonlein Purpura associated with Adenocarcinomas in Stomach and Colon / 대한신장학회잡지

There are a few reports about coexistence of Henoch-Schonlein purpura (HSP) and a variety of malignancy in adults. The accompanying malignancies, in order of frequency, were hematologic malignancy, lung cancer and prostate cancer. Gastrointestinal tract (GIT) cancer associated with HSP was rarely reported which includes 2 cases of stomach cancer, 1 case of small bowel cancer and 1 case of esophageal cancer. Malignancy is proposed to be a triggering factor in the development of HSP, however pathogenesis of HSP associated with malignancy remains obscure. Here, we report 2 cases of HSP associated with malignancy in GIT. One is an adenocarcinoma of the colon and the other is a stomach adenocarcinoma with signet ring cell component.

A Case of Reactive Arthritis after Trichomonas vaginalis Infestation / 대한류마티스학회지

Reactive arthritis occurs after a preceding infection such as urogenital or gastroenteral tract infection. Trichomoniasis, due to Trichomonas vasinalis infection, is one of the most common causes of vaginitis. Reactive arthritis associated with trichomoniasis is uncommon and there has been no report in Korea. We present a 28 year-old woman who had oligoarthritis after Trichomonas vaginalis infection. The arthritis subsided with treatment of the Trichomoniasis with metronidazole and non-steroidal anti-inflammatory drug.

A Case of Desmoplastic Fibroblastoma Originated from the External Auditory Canal and Mastoid / 대한이비인후과학회지

Desmoplastic fibroblastoma is a rare but distinctive fibrous benign soft tissue tumor that presents a slowly growing, painless, fibroproliferative mass. Occuring in patients of various ages, it appears hypocellular microscopically, and consists of widely spaced bland spindles or stellar-shaped cells that are embedded in rich wavy collagenous or myxocollagenous stroma. Desmoplastic fibroblastoma was first characterized by Evans in 1995. Thereafter, there were several reports of desmoplastic fibroblastoma that it occured commonly in the upper extremity including regions such as shoulder, upper arm, and lower extremity, followed by the head and neck region. But there was no report of occurrence at the ear. We report our experience of desmoplastic fibroblastoma with histopathologic confirmation: we removed a mass at the mastoid cavity and external auditory canal. We also provide a review of literature related to it.

Cytologic Features of Signet Ring Cell Carcinoma of the Uterine Cervix: A Report of Two Cases / 대한세포병리학회지

Signet ring cell carcinoma is a rare type of mucinous adenocarcinoma of the uterine cervix. To the best of our knowledge, there is no report on cytologic findings of primary signet ring cell carcinoma of the uterine cervix in the literature. Recently, we experienced two cases of signet ring cell carcinoma of the uterine cervix. The finding of characteristic signet ring cells on cervicovaginal smear led to the diagnosis of signet ring cell carcinoma. However, primary signet ring cell carcinoma could not be cytologically distinguished from more common metastatic tumor. Therefore, diagnosis rests upon the recognition of signet ring cells and the absence of signet ring cell carcinoma elsewhere.

Chondrosarcoma of the Temporal Bone: A Case Report

Chondrosarcoma of the temporal bone is a rare lesion. Clinically it has been confused with chordoma, glomus jugulare tumor and meningioma, among other conditions, and due to its anatomic location, cranial nerve palsy is frequently observed. We report a case involving a 50-year-old woman with chondrosarcoma of the temporal bone.

Sclerosing Mucoepidermoid carcinoma with eosinophilia of the thyroid glands: a case report with clinical manifestation of recurrent neck mass

Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.

Heterogeneity of Renal Pathology in Korean NIDDM Patients with Microalbuminuria / 대한내과학회지

OBJECTIVE: It was suggested that the cause of microalbuminuria is heterogeneous in NIDDM. However, only a few studies are available that investigated the renal pathology in NIDDM patients with microalbuminuria. This study was undertaken to evaluate renal pathology in Korean NIDDM patients with microalbuminuria. METHODS: Fifty NIDDM patients with microalbuminuria and without retinopathy were undertaken renal biopsy. Renal pathologic findings were classified as follows: group A, near-normal finding; group B, typical diabetic nephropathology; group C, atypical patterns of renal injury (mild glomerular change with disproportionally severe tubulointerstitial lesion, arteriolar hyalinosis or global glomerular sclerosis); group D, non-diabetic renal lesion. RESULTS: Seventeen patients were classified into group A, 19 into group B and 8 into group C. Six patients had non-diabetic renal lesions and they were all confirmed to be IgA nephropathy. Fasting blood sugar and GFR were significantly higher in group B than in group A and group C respectively, and systolic blood pressure was higher in group C than in group A. CONCLUSION: Renal pathology in microalbuminuric NIDDM patients without retinopathy was heterogeneous. This may explain heterogeneous clinical meaning of microalbuminuria in NIDDM.

Pathological Analysis of Post-Transplantation Endomyocardial Biopsies

Heart transplantation was first performed in 1967. It is now regarded as a well-established treatment modality for end-stage cardiac diseases. Once the transplantation is performed, endomyocardial biopsy(EMB) is the examination of choice in monitoring the transplanted heart. We analyzed the pathological findings of follow-up EMB of 6 heart transplant patients. All patients have been suffered from severe heart failure. Four patients were adult male and two were adult females. All the hearts, except for one, displayed characteristic features of dilated cardiomyopathy. The remaining heart was diagnosed as having giant cell myocarditis. Post-transplantion EMBs were performed according to the protocol and standard cardiac biopsy grading of ISHT (1990). The standards were applied for grading of cellular rejection. In five patients, there were one or two episodes of biopsy proven acute rejection, grade II or IIIA without any clinical symptoms of rejection. Immediate "pulse therapy" was performed and follow-up biopsies were done. All episodes of rejection were cleared in subsequent biopsies. All patients are doing well without evidence of cardiac problem. The postoperative monitoring of acute rejection is critical since clinical signs of rejection are usually absent. At present, EMB is regarded as the most reliable method for diagnosis and grading of acute rejection and is an efficient guide to the monitoring of the cardiac recipients. Our experience of post-transplantation EMB corresponds with previously published reports.

Cytologic Features of Primary Tumors in Central Nervous System / 대한세포병리학회지

There has been a marked increase in the utility of aspiration cytology for pathologic diagnosis. It may be applied to any kinds of organs and substitutes surgical biopsy. Because of the high risk of complication and difficulties in localization, aspiration cytology in the central nervous system(CNS) has been used with less frequency compared to other sites. However, with the advent of sophisticated imaging instruments, aspiration cytology of lesions in the CNS is being used increasingly. Cytologic features of the CNS neoplasms were quite similar to those of histology except one spindle cell tumor. Reviewing various CNS neoplasms, it appears that cytology may be a useful diagnostic method.

Endodermal sinus tumor: immunophenotypic expression of a carcinoma

A series of five endodermal sinus tumors was studied for their cytoskeletal and other phenotypic markers. They included 2 ovarian, 2 testicular, and 1 inguinal tumors. The cytoskeletal expression was also studied by gel electrophoresis and immunoblotting. Every tumor was diffusely and strongly immunostained for cytokeratin. By SDS-PAGE and immunoblotting, cytokeratins 8 & 18 were detected. Vimentin was focally coexpressed in 4 cases. The stroma was diffusely immunostained for vimentin. None of them expressed desmin, neurofilament, or glial filament protein. Desmoplakin was expressed only in one ovarian tumor. Alpha-fetoprotein and S-100 protein were also diffusely positive among the neoplastic cells; intracytoplasmic globules were especially strongly immunostained. These findings suggest that endodermal sinus tumors represent a group of pure malignant epithelial neoplasms, and may be regarded as primitive carcinomas.