Primary intracranial hemorrhage presenting as acute myocardial ischemic syndrome / 대한내과학회지

A 44 years old woman was admitted to Inha University hospital in semicomatose state. An electrocardiogram (ECG), taken in the emergency room, showed ST segment elevation in the precordial leads. She underwent a urgent echocardiography. It showed that there was akinesia of anteroseptal segment from the mid left ventricle to the apex and inferior segment from the mid left ventrile to the lower mid left ventricle. With the impression of acute myocardial infarction (AMI), she underwent a urgent coronary angiography. There was no significant luminal narrowing of the right or the left coronary arteries but the left ventriculography revealed akinesia of anterolateral and diaphragmatic segments of the left ventricle. Computerized tomography (CT) of the brain, taken shortly after coronary angiography, showed subarachnoid hemorrhage. The abnormal ECG and echocardiography findings, simulating acute myocardial infarction, were assumed to be caused by coronary vasospasm derived from subarachnoid hemorrhage accompanied by massive adrenergic discharge.

A Case of Pulmonary Arteriovenous Fistula with Family History / 결핵

Pulmonary arteriovenous fistula is a congenital vascular malformation in lung resulting from abnormal capillary development and the exact etiology is not well known but it may occur with or without hereditary hemorrhagic telangiectasia. Hereditary hemorrhagic telangiectasia (L-IHT) or Rendu-Osler-Weber disease is an autosomal dominant vascular disorder which associates epistaxis, mucocutaneous and visceral telangicetases, and recurrent hemorrhage with chronic anemia and visceral shuntings. Recently we experienced a case of the pulmonary arteriovenous fistula in a 23 year old woman with a family history of this disease, which was confirmed by pulmonary angiography.

A Case of Angiocentric T-cell Lymphoma of the Esophagus / 대한소화기내시경학회지

In this study we present a case of an angiocentric T-cell lymphoma (ACTL) which involve the esophagus. A 37-year-old male was admitted with dysphagia, odynophagia, and weight loss for 3 months. Two months before his admission, he had undergone on endoscopy with a biopsy. The first endoscopic findings revealed a large ulcerative lesion on the esophagus, although there had been no evidence of lymphoma upon microscopic examination. On the follow up endoscopic examination, this ulcerative lesion revealed progressive and destructive change. Histopathology of the third biopsied specimens showed large atypical lymphocyte infiltrates with angiocentric and angioinvasive features. Immunohistochemical studies revealed that the atypical (large) lymphocytes had T-cell phenotypes (CD3+, CD5+, and CD43+) and contained few reactive B-cells (CD20+), We assume that this is the first case of ACTL involving the esophagus and larynx.