A case of idiopathic hypoparathyroidism combined with hypothyroidism diagnosed by tetanic symptom during treatment for idiopathic epilepsy / 대한내과학회지

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.

A case of idiopathic hypoparathyroidism combined with hypothyroidism diagnosed by tetanic symptom during treatment for idiopathic epilepsy / 대한내과학회지

Idiopathic hypoparathyroidism is activating mutation of the calcium sensor receptor lead to inhibition of parathyroid hormone (PTH) secertion at inappropriately low serum ionized calcium levels and are a cause of autosomal dominant hypoparathyroidism. This disease often show slight mental retardation and associated endocrine abnormalities, most commonly hypothyroidism (without goiter) and hypogonadism. We diagnosed this in 20 year old male who presented with left foot pain with rigidity during he was treated for idiopathic epilepsy and had goiter. We report this case with a review of the literature.

A Case of Anaplastic Large Cell Lymphoma Misdiagnosed as Pulmonary Tuberculosis / 결핵

Anaplastic large cell lymphoma(ALCL) is a recently recognized large cell lymphoma characterized by large pleomorphic cells, with prominent nucleoli, expressing the CD3O(Ki-1) antigen. It is often misdiagnosed as metasfatic carcinoma, malignant histiocytosis or Hodgkin's disease. Primary pulmonary ALCL is extremely rare although it frequently involves extranodal sites, e.g. skin, bone, gastrointestinal tract, soft tissue and lung. We report a case of ALCL suspected as primarily involving lung.

A Case of Idiopathic Kaposi's Sarcoma of the Skin and Oropharynx / 대한이비인후과학회지

Kaposi's sarcoma is one of the important features of acquired immunodeficiency syndrome (AIDS) patients, renal transplanted patients, young African men, and elderly Ashkenazi Jews. It is well recognized as the most common malignancy asssociated with AIDS and there is also an increased incidence among patients with iatrogenic immunosuppression secondary to renal transplantation. However, a few cases of Kaposi's sarcoma in immunosuppressed patients not related to the renal trans-plantation had been reported. In this study, we present a case of Kaposi's sarcoma involving the oropharynx and the skin of a patient who was not associated with AIDS nor treated with special immunosuppressive agents for renal transplantation.

Clinical Characteristics of Pulmonary Aspergilloma / 결핵

BACKGROUND: Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergllloma. METHODS: During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria: 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagnosis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). RESULTS: 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7:1 (57men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis(6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes ; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients(7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. CONCLUISON: During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.

A Case of Hypertrophic Osteoarthropathy Resolved After Resection of Lung Cancer / 결핵

Hypertrophic osteoarthropathy(HOA) is a systemic disorder characterized by proliferative periostitis of long bone and polysynovitis. Clubbing of the fingers and toes usually accompanies HOA. This syndrome is most frequently with lung cancer. Although disappearance of HOA with removal of the tumor is well known, very few typical cases are reported in Korea. We report case of lung cancer with HOA, which was dramatically relieved after the surgical resection of the tumor.