Résumé
An 18-year-old female was admitted because of dyspnea at rest. A chest computed tomography (CT) scan and fiberoptic bronchoscopy demonstrated a polypoid tumor in the left main bronchus, 0.5cm distal from the carina. Surgical resection of the tumor was performed, along with. A pathological evaluation and the immunohistochemical findings led to the diagnosis of a glomus tumor, which originated from the bronchus, an area where this type of tumor has rarely been reported.
Sujets)
Adolescent , Femelle , Humains , Bronches , Bronchoscopie , Diagnostic , Dyspnée , Tumeur glomique , ThoraxRésumé
Gastric lipoma is rare submucosal tumor, accounting for less than 3% of all be- nign gastric tumor. Most are usually asymptomatic, but on occasion, they may present with abdominal pain, obstruction, dyspepsia, intussuception and gastrointestinal bleeding. Surgical resection is definitive diagnostic and therapeutic procedure. Surgical removal of gastric lipoma should be considered in the following situations: 1) the lesion is large, 2) the lesion is difficult to differentiate from malignant tumor, 3) the patient is symptomatic or has recurrent bleeding or obstruction. We report a case of gastric lipoma with bleeding in a 67-year-old male. Gastroscopy showed active gastric ulcer with fresh blood clot. Although medical conservative treatment was done, bleeding was continued. We referred patient to general surgical department for open surgical procedure and subtotal gastrectomy was performed. Histopathological examination of surgical gastric segment showed 5 5.5 cm sized ulcerated mass. Microscopic finding of cross section showed uniform and mature adipose cell, finding consistent with lipoma. We confirmed it submucosal gastric lipoma with ulcer bleeding.
Sujets)
Sujet âgé , Humains , Mâle , Douleur abdominale , Adipocytes , Dyspepsie , Gastrectomie , Gastroscopie , Hémorragie , Lipome , Estomac , Ulcère gastrique , UlcèreRésumé
Cutaneous metastases from gastric carcinoma are uncommon. The frequency of metastses to the skin from gastric carcinoma have ranged from 0.3% to 0.4%. Carcinoma en cuirasse, first described by Velpeau in 1838, is marked sclerodermatous change and characterized by a difffuse morphea-like induration of the skin and represents a rare manifestations of breast carcinoma metastatic to the chest wall. It is vary rarely seen in lung, stomach, kidney and other metastasizing malignancies. We report a case of carcinoma en cuirase and nodular carcinoma from gastric carcinoma in a 36-year-old male who complained chiefly of multiple cutaneous nodules. He had mixed lesions of an erythematous morphea-like induration on the neck and multiple erythematous nodules on the chest and abdomen. Gastroscopy finding showed a Borrmann type IV advanced gastric carcinoma. Histopathologic examination of skin and stomach showed atypical cells with pleomorpic, hyperchromatic nuclei and scanty, eosinophilic cytoplasm, which are consistent with poorly differentiated adenocarcinoma. Immunohistochemical stainings showed positive reaction for cytokeratin. He died three months after the appearance of cutaneous lesions.
Sujets)
Adulte , Humains , Mâle , Abdomen , Adénocarcinome , Tumeurs du sein , Cytoplasme , Granulocytes éosinophiles , Gastroscopie , Kératines , Rein , Poumon , Cou , Métastase tumorale , Peau , Estomac , Paroi thoracique , ThoraxRésumé
An aortic aneurysm is described as a permanent localized dilatation of the aorta having a diameter at least 1.5 times that of the expected norrnal diameter of that given aortic segment. Thoracic aortic aneurysms are much less common than are aneurysms of the abdominal aorta. Thoracic aneurysms are classified by the portion of aorta involved, I.e., the ascending, arch, or descending thoracic aorta. We experienced a case of saccular arteriosclerotic aortic aneurysm associated with thrombus in aortic arch in a 78 year-old male who had history of hypertension. He was admitted to Kwangju Veterans Hospital complaining of drowsy mental state and swelling of left foreann. The chest X-ray, chest CT and echocardiogram showed saccular dilatation(maximal diarneter ; 7.67~7.86cm) associated with thrombus in aortic arch. He refused operation because of old age, so he was conservatively rnanaged including propranolol. We report this case of saccular arteriosclerotic aneurysm of aortic arch with a brief review of literature.
Sujets)
Sujet âgé , Humains , Mâle , Anévrysme , Aorte , Aorte abdominale , Aorte thoracique , Anévrysme de l'aorte , Anévrysme de l'aorte thoracique , Dilatation , Hôpitaux des anciens combattants , Hypertension artérielle , Propranolol , Thorax , Thrombose , TomodensitométrieRésumé
The incidence, type arid distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneurtpathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy( 13 patisnts, 30%) more conimorily occurs than clinical polyneuropathy( 9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.
Sujets)
Humains , Mâle , Bras , Axones , Incidence , Jambe , Système nerveux périphérique , Polyneuropathies , Broncho-pneumopathie chronique obstructive , Tests de la fonction respiratoireRésumé
Primary adenocarcinoma of the duodenum is a rare disease, representing 0.35% of all gastrointestinal neoplasm and 0.042% of all malignant neoplasm. Since Ham-burger described the first duodenal caricinoma in 1746, the incidence has shown an increasing tendency. Compared with upper gastrointestinal contrast studies, the gastroduodenoscopy has gained an increasing popularity as an invesitigative tool in recent years. But the diagnosis is usually made at a very late stage because the symptoms are often non-specific, which contributes to delayed diagonsiss and poorer prognosis. We have experienced two cases of the primary carcinoma of the duodenal bulb and one case of carcinoma of the second portion, which were diagnosed by biopsy with gastrofiberoscopic endoscopy and operative finding. So we report three csses with a brief review of literature.
Sujets)
Adénocarcinome , Biopsie , Diagnostic , Duodénum , Endoscopie , Tumeurs gastro-intestinales , Incidence , Pronostic , Maladies raresRésumé
Colonic lesions by irritant laxative abuse are devided into melanosis coli, cathartic colon, soap or chemical colitis. Melanosis coli is the brownish or black discoloration of the colon because of the accumulation of lipofuscin pigment in macrophages located in lamina propria and associated with anthraquinone containing laxative abuse. The site of this lesion is more common in cecum and proximal colon, but whole colon can be involved. This lesion is occurred between 4 months and 13 months from initiation of drug medication, and the lesion is benign because the pigments disappear by withdrawning the laxatives. A number of cases were reported in our country, all of the cases were associated with prolonged administration of anthraquinone type laxatives. We presents two cases of melanosis eoli that had administrated aloe to treat the chronic constipation during long terms, and one case of melanosis coli that had not administrated laxatives or a specific drug with chronic constipation. All of three cases were confirmed by colonoscopy.