High-resolution computed tomography findings of lung parenchyme changes in very low birth weight infants treated with oxygen / 소아과

PURPOSE: The objective of this study is to observe high-resolution computed tomography (HRCT) findings of lung parenchyme in very low birth weight (VLBW) infants between the corrected age of 38-42 weeks who were treated with oxygen after birth, and to compare them to the clinical severity of bronchopulmonary dysplasia (BPD). METHODS: The lungs of fourty-four VLBW infants with gestational ages of less than 32 weeks and birth weights of less than 1,500 g who were treated with oxygen after birth were examined using HRCT taken when the corrected age was between 38-42 weeks. Common findings among the infants and the frequency of their occurrences were noted. Total CT scores obtained by the summation of air trapping and actelectasis scores and the ratio of bronchus-to-pulmonary artery diameter were used to quantitatively evaluate HRCT findings and correlate them with the clinical severity of BPD as defined by Jobe-Bancalari diagnostic criteria. RESULTS: 1) The most common findings in HRCT images of the lungs were air trapping (56%), atelectasis (70.5%), linear opacity (77%), and distortion of the bronchopulmonary bundle (65.9%). These findings were more commonly observed in infants with BPD in a mixed pattern than those without (P<0.05). However, abnormal findings were also found in HRCT images of some infants without BPD. In infants with BPD, air trapping, atelectasis and total CT scores were higher than those without BPD. Also infants with BPD had a lower bronchus-to-pulmonary artery diameter than those without BPD (P<0.05). 2) The total CT scores (r=0.799, P<0.0001) and the ratio of bronchus- to-pulmonary artery diameter (r=0.576, P<0.0001) showed a linear correlation with the clinical severity of BPD. CONCLUSION: HRCT findings in VLBW infants between the corrected age of 38-42 weeks who had been treated with oxygen after birth are useful in revealing pathologic changes in the lung parenchyme and show a good correlation with the clinical severity of BPD.

Immunohistochemical Study of Heat Shock Protein(HSP) and Estrogen Receptor(ER) in the Normal Endometrium and in Adenocarcinoma of the Endometrium

Heat shock protein(HSP), first found in the MCF-7 human breast tumor cell line is one of the estrogen-regulated proteins and its synthesis is stimulated by estradiol. In this study, immunohistochemical staining was done for estrogen receptor(ER) and HSP on formalin-fixed, paraffin-embedded tissue sections in twelve normal cyclic and twenty carcinomatous endometria. 1) During the proliferative and early secretary phases, the nuclei of surface and glandular epithelial cells and stromal cells had moderate to strong staining for ER, whereas during the mid and late secretary phases, the glandular epithelial and stromal cells had weak staining for ER. The surface epithelial cells had positive staining of variable intensity. 2) From the early proliferative to mid secretary phases, the glandular and surface epithelial cells showed a positive reaction of variable intensity for HSP. In the late secretary phase, the glandular and surface epithelial cells showed a weak positive or a negative reaction for HSP. During the menstrual cycle, the stromal cells remained negative for HSP. 3) In adenocarcinomas of the endometrium, 8 of 11 (72.7%) well differentiated carcinomas were positive for both ER and HSP, while only 3 of 9(33.3%) moderately and poorly differentiated carcinomas were positive for ER and HSP. In conclusion, ER and estrogen-regulated heat shock protein(HSP) were closely related in normal and carcinomatous endometria and the reactivity was decreased according to poor differentiation.

A Case of Thoracic Angiosarcoma

Angiosarcoma of spine is a rare neoplasm derived from vascular endothelium. Synonymous term include hemangiosarcoma and malignant hemangioendothelioma. The authors present the clinical, radiological and pathological features of a patient with angiosarcoma located in the thoracic spine. The treatment of this case is discussed.

Metastatic Adenocarcinoma of Colon in Meningioma: A case report

Cases of metastases from extracranial tumor to intracranial tumor are very rare. The world wide review of the literatures until 1992 revealed 44 cases of primary intracranial tumors containing metastatic tumors which are unrelated extracranial primary malignant tumors; the intracranial recipient tumor is a meningioma in 35 cases among them. Carcinomas of the lung and the breast are the most common extracranial donor tumors. Metastases from colon cancer to meningioma are extremely rare. A 74 year-old-female presented with headache for 2 weeks. CT revealed a round mass with high signal intensity, measuring 4 cm in diameter, which is located in the left parietal lobe. The patient had colon cancer 2 years ago and lymphoma I year ago. On operation, the tumor is relatively well delineated and attached to the meninx. Microscopically, the tumor is composed of fascicles of long slender, fibroblast-like spindle cells with indistinct cytoplasmic border, variable amount of collagen deposit and many psammoma bodies. A few scattered glands are present in periphery of the meningioma. The tumor glands are composed of columnar cells with basally located hyperchromatic nuclei and similiar to the glands of the adenocarcinoma of the colon.

Plexiform Neurofibromatosis of the Mediastinum: CT Findings

PURPOSE: To evaluate the findings and the role of CT in plexiform neuro-fibromatosis of the mediastinum. MATERIALS AND METHODS: We retropectively reviewed the CT scans of five patients with plexiform neurofibromatosis of the mediastinum. The CT scans were reviewed with attention to the distribution of the lesions, appearance and attenuation of mediastinal lesions, enhancement pattern after intravenous contrast infusion and associated findingssuch as intercostal neurofibroma. RESULTS: In all five patients CT scans demonstrated fusiform low attenuated masses which were oriented longitudinally and extended over multiple contiguous scans along the distribution of major mediastinal nerves. In four patients, mediastinal lesions appeared infiltrative, obliterating adjacent mediastinal fat plane. One patient had well defined fusiform masses along the major mediastinal nerves. Postcontrast enhanced CT scans revealed slight central enhancement in two patient and no contrast enhancement in three patients. Associated findings such as neurofibromas of intercostal nerves and sympathetic trunk, or subcutaneous neurofibromas were detected on CTscans in all five patients. CONCLUSION: Characteristic CT findings of low attenuation masses along the major mediastinal nerves are helpful to differentiate plexiform neurofibromatosis from mediastinal lymphadenopathy and to prevent from misreading as a malignant disease.

Leiomyoma of the Lung: A case report

We present a 37-year-old male who was found to had mas within the bronchus. This patients was admitted for the evaluation of cough. Chest CT scan showed endobronchial mass in the bifurcation of LUL and LLL bronchus. The left lower lobe was atelectatic. Lobectomy of the left lower lobe was done. On opening of the bronchus, there was a 2x1x1 cm sized endobronchial mass. Histologically, the mass was smooth muscle tumor composed of densely packed eosinophilic spindle cells in interlacing bundles with pale elongated nuclei covered by bronchial epithelium. On immunohistochemical staining, the tumor cells were positive for desmin. Ultrastructurally, the tumor cells exhibited numberous cytoplasmic microfilaments with focal densities, pinocytotic vesicles, and a thick basal lamina.

Breast Mass as a Manifestation of Ectopic Paragonimiasis: A case report

Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.

Intraventricular neurofibroma: a case report

Intracranial nerve sheath tumors unrelated to the cranial nerve roots are extremely rare, and the origin of the tumors are debatable. We report a case of pathologically-proven neurofibroma inside the lateral ventricle. A 49-year-old man presented with headache of 6 months duration, urinary incontinence, visual disturbance and right hemiplegia. Brain CT scan showed a well defined isodense mass with homogenous contrast enhancement and marginal calcification. At surgery the tumor was found to be a 4cm-sized lobulated mass attached only to the choroid plexus. Histologically, the tumor masses consisted of fasciculating bundles of wavy spindle cells, with a considerable collagen laydown.