Two Case Reports of Newly Diagnosed Crohn’s Disease after COVID-19 in Pediatric Patients / 대한소화기학회지

Since the coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome-coronavirus-2 virus (SARS-CoV-2), various complications have been reported. Although most COVID-19 cases exhibited flu-like symptoms, COVID-19 may dysregulate the immune response and promote overwhelming levels of inflammation in some patients. Inflammatory bowel disease (IBD) is caused by dysregulated or inappropriate immune responses to environmental factors in a genetically susceptible host, and a SARS-CoV-2 infection may act as a possible cause of IBD. This paper describes two pediatric patients who developed Crohn’s disease following a SARS-CoV-2 infection. They were previously healthy before the SARS-CoV-2 infection. On the other hand, they started to develop fever and gastrointestinal symptoms several weeks after recovery from the infection. They were diagnosed with Crohn’s disease by imaging and endoscopic studies, and their symptoms improved after treatment with steroids and azathioprine. This paper suggests that a SARS-CoV-2 infection may trigger IBD in predisposed patients.

A Case of Ceruminous Syringocystadenoma in the External Auditory Canal / 대한이비인후과학회지

It is rare to find tumor of the ceruminous gland, which is a modified apocrine gland located within the skin of external auditory canal (EAC). Syringocystadenoma papilliferum (SCAP) is a benign adnexal tumor that occurs in the head and facial area in forms of infiltrative macules, papules, or keratinous nodules, but rarely in the EAC. To date, fewer than 150 case reports of SCAP have been reported, with SCAP in the EAC being extremely rare. We report a case of 51-year-old male with 2 year-history of a left EAC mass arising from the superior wall of the EAC. We performed a microscopic surgery, with the mass resected via retro-auricular approach under general anesthesia. The histopathological examination confirmed the specimen as SCAP. There were no complications or recurrence during the 4 months follow-up period.

A Case of Nasopalatine Duct Cyst with Cholesterol Granuloma in Maxillary Sinus / 대한이비인후과학회지

Nasopalatine duct cysts are the most common non-odontogenic cysts that occur in the maxilla. Cholesterol granulomas, on the other hand, are commonly found in patients with chronic middle ear disease, but rarely occur in the paranasal sinuses. We report a rare case of a 30-year-old woman who was treated for a nasopalatine duct cyst and cholesterol granuloma at the same time. The patient complained of sudden nasolabial pressure and right nasal obstruction from three weeks ago. A 3 cm sized cystic mass, diagnosed as a nasopalatine duct cyst, was observed in the maxilla and haziness of the right maxillary sinus suspected of chronic rhinosinusitis was detected by computerized tomography. Marsupialization of the nasopalatine duct cyst was performed through the endoscopic transnasal approach. Solid mass in the maxillary sinus, diagnosed with cholesterol granuloma by pathology after surgery, was completely removed by endoscopic sinus surgery. The patient was followed up for 18 months without any recurrence or complications.

Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report / 대한족부족관절학회지

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.

Imaging Findings of Soft Fibroma of the Nipple: Two Case Reports

Soft fibromas are benign skin lesions that primarily occur in the neck, axillae, and groin locations. The occurrence of soft fibroma lesions in the nipple is extremely rare. Herein, we present two cases of soft fibroma of the nipple, which occurred in a 51-year-old woman (Case 1) and a 32-year-old woman (Case 2). The mammographic and ultrasonographic features of each case are described in this report. Mammography revealed an oval-shaped isodense mass in Case 1 and an irregular-shaped isodense mass in Case 2. On ultrasonography, Case 1 showed an oval-shaped hypoechoic mass with increased vascularity, whereas Case 2 presented a microlobulated, irregular-shaped, iso- to hypo-echoic mass with subtly increased vascularity at the stalk. In both cases, surgical excision was performed and pathological examination revealed soft fibroma.

Tuberculous Granuloma Compressing the Middle Cerebral Artery in the Sylvian Cistern

No abstract available.

A Case of Multiple Lobular Capillary Hemangiomas of the Nasal Septum / 대한이비인후과학회지

Lobular capillary hemangioma (LCH) is a benign lesion of unknown etiology. LCH is a rapidly growing lesion usually affecting skin and oral mucosa. It is known to be relatively rare in the nasal cavity or sinuses. LCH bleeds easily even with a little irritation because of its excessive vascularity. Hormonal imbalance and microtrauma are known as the major etiologic factors in the development of LCH. The authors experienced a case of multiple LCH in the nasal cavity, which was completely removed with endoscopic approach. According to the literature review, there has been no case report on multiple lobular capillary hemangioma occurring in the nasal cavity. Therefore, the authors report a case with a review of literatures.

A Case of Vascular Leiomyoma in Nasal Cavity: Case Report and Literature Review / 대한이비인후과학회지

Vascular leiomyoma may arise from the muscular layer of blood vessel wall, which is extremely rare in the nasal cavity or paranasal sinuses. According to the online search on pubmed and koreamed, only 62 cases with vascular leiomyoma arising from nasal cavity or paranasal sinuses, including 13 cases of the nasal septum, have been reported since the first case was reported in 1966. The authors experienced a case of vascular leiomyoma arising in the left side of nasal septum in a patient. It was successfully removed by trans-nasal approach. In addition, we conducted a literature review of clinical features of the 62 cases of vascular leiomyoma in the nasal cavity.

Bizarre Parosteal Osteochondromatous Proliferation in the First Metatarsal Bone: A Case Report / 대한골관절종양학회지

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare benign tumor and known to be primarily occur in the small tubular bone of the hands and feet. However, it is very unusual to be reported that it occurs in metatarsal bone in Korea. Thus, we report this tumor of metatarsal bone including the literature review because we have experienced this example.

Gnathostoma spinigerum Infection in the Upper Lip of a Korean Woman: An Autochthonous Case in Korea

Autochthonous human gnathostomiasis had never been reported in the Republic of Korea. We report here a case of Gnathostoma spinigerum infection in a 32-year-old Korean woman, presumed to have been infected via an indigenous route. The patient had experienced a painful migratory swelling near the left nasolabial fold area of the face for a year, with movement of the swelling to the mucosal area of the upper lip 2 weeks before surgical removal of the lesion. Histopathological examinations of the extracted tissue revealed inflammation with heavy eosinophilic infiltrations and sections of a nematode suggestive of a Gnathostoma sp. larva. The larva characteristically revealed about 25 intestinal cells with multiple (3-6) nuclei in each intestinal cell consistent with the 3rd-stage larva of G. spinigerum. The patient did not have any special history of travel abroad except a recent trip, 4 months before surgery, to China where she ate only cooked food. The patient is the first recorded autochthonous case of G. spinigerum infection in Korea.

A Case of Traumatic Inferior Mesenteric Arteriovenous Fistula / 대한소화기학회지

Inferior mesenteric arteriovenous fistula is rare and may be congenital or acquired. Affected patients present with abdominal pain, mass, or manifestations of portal hypertension and bowel ischemia. Until now, inferior mesenteric arteriovenous fistula due to trauma has not been reported. Herein, we report a case of a 53-year-old woman who had inferior mesenteric arteriovenous fistula considered to have originated from remote blunt trauma that was successfully treated by surgical resection of only the arteriovenous fistula without colectomy. To our knowledge, this is the first case of traumatic inferior mesenteric arteriovenous fistula.

A Ten-year Follow-up of a Case with Gastric Adenoma Accompanied with Gastritis Cystica Profunda Treated by Endoscopic Submucosal Dissection / 대한소화기학회지

Gastritis cystica profunda (GCP) is an uncommon hyperplastic benign lesion, and histologically characterized by hyperplasia and cystic dilatation of the gastric glands extending into the submucosal layer. GCP usually occurs at a gastroenterostomy site, although it can occasionally be found in an unoperated stomach. GCP is thought to be a possible precancerous lesion, since a few early gastric cancers associated with it were reported. Herein, we report a case of gastric adenoma associated with GCP in an unoperated patient. The sizes of both the GCP and adenoma overlying it have increased during a 10 year follow-up period. Adenoma on the latest biopsy showed low grade dysplasia, and it was successfully treated by endoscopic submucosal dissection.

A Case Report of Focal Ossification of the Auricular Cartilage

PURPOSE: The focal ossification of auricular cartilage is an unusual clinical entity in which the ear becomes partially or totally rigid and immalleable. This condition may result from cold injury, local trauma, inflammation, or various systemic diseases. Patients may feel mild discomfort, but there are usually no other serious symptoms. We present a case of focal ossification of auricular cartilage in which the cause is unknown. METHODS: A healthy 58-year-old man presented with a 2-year history of hard mass of right posterior auricular area. He denied any precipitating historical events like cold injury and inflammation. Routine testing did not demonstrate systemic abnormalities. Ultrasonographic examination revealed a 22 x 10 x 11 mm sized heterogenous isoechoic mass showing an acoustic shadow. RESULTS: Excisional biopsy was performed under local anesthesia. Histological examination revealed the ossification with deposition of trabecular bone in normal elastic cartilage. The patient was healed without any problems and satisfied with the result. CONCLUSION: We report clinical experience of focal ossification of auricular cartilage, which is quite a rare clinical entity. It should be considered that there is the possibility of ossification of cartilage when it meets the benign mass of the ear.

Gastric Outlet Obstruction due to Submucosal Neurofibromatous Proliferation of Duodenal Bulb in Neurofibromatosis Type 1 Patient

Neurofibromatosis type 1 (NF1; also known as von Recklinghausen's neurofibromatosis) is inherited in an autosomal dominant fashion, although it can also arise due to spontaneous mutation. Gastrointestinal involvement of NF1 is seen in 10% to 25% and causes symptoms in fewer than 5%. Histologically, the gastro intestinal (GI) manifestation of NF1 occurs in three forms: hyperplasia of the gut neural tissue, stromal tumors, and duodenal or periampullary endocrine tumors. A 31-year-old female, diagnosed with NF1, presented with poor oral intake and vomiting for 10 days prior to admission. Preoperative gastrofiberscopic finding was gastric outlet obstructing polypoid duodenal bulb lesion. The patient underwent hemigastrectomy with antecolic gastrojejunostomy due to gastric outlet obstruction. The final pathologic report was submucosal neurofibromatous proliferation with Brunner's gland hyperplasia located at the duodenal bulb in the NF1 patient. We report this case with a review of literatures.

A Case of Hamartomatous Polyp without Peutz-Jeghers Syndrome Arising from Appendix / 대한소화기내시경학회지

Peutz-Jeghers syndrome is a familial syndrome consisting of mucocutaneous pigmentation and gastrointestinal polyposis and appears to be inherited as a single pleiotropic autosomal dominant gene with variable and incomplete penetrance. Cases of hamartomatous polyps of the Peutz-Jeghers type without Peutz-Jeghers syndrome have only rarely been reported. Moreover, only one case of a Peutz-Jeghers polyp at the appendix has been reported; it was resected by appendectomy. We report here on a case of a 45 year old man who had a hamartomatous polyp of the Peutz-Jeghers type arising from the appendix. The polyp was successfully removed by endoscopic polypectomy. To our knowledge, this is the first case of a hamartomatous polyp of the Peutz-Jeghers type that originated from the appendix and that was resected endoscopically.

Fibro-osseous Pseudotumor of the Great Toe: A Case Report / 대한골관절종양학회지

Fibro-osseous pseudotumor is an extremely rare benign lesion which is fast-growing and painful. It is often misdiagnosed as a malignancy, but it is a noninvasive entity and can be cured by simple resection. We report a case of fibro-osseous pseudotumor of the distal phalanx of great toe in 20-year-old female patient who present with painful mass.

A Case of Fibrous Dysplasia Involving the Nasal Septum

Fibrous dysplasia is a developmental disease of bone in which the normal substance of the interior of the bone is replaced by fibro-osseous connective tissue. It exhibits varying degrees of osseous metaplasia histologically. Craniofacial fibrous dysplasia frequently affects the maxilla, frontal bone, and mandible. The nasal septum is rarely affected. There is only one reported case of fibrous dysplasia arising in the septum internationally. Hence, we report a case of fibrous dysplasia of the nasal septum with a review of literature.

Intracapsular and Paraarticular Chondroma of the Infrapatellar Hoffa's Fat Pad: A Case Report

Intracapsular and paraarticular chondroma is a rare benign lesion of the large joints (mostly the knee). We report a case of intracapsular and paraarticular chondroma in the infrapatellar Hoffa's fat pad that presented as a painful palpable mass in 15-yearold woman. A physical examination revealed a firm, movable and tender mass in the infrapatellar area. Magnetic resonance images showed an ovoid, well-defined, soft tissue mass with focal calcification in the infrapatellar fat pad. The final pathology revealed an intracapsular and paraarticular chondroma.

Primary Systemic Anaplastic Large Cell Lymphoma in Korean Adults: 11 Years' Experience at Asan Medical Center

PURPOSE: Anaplastic large cell lymphoma (ALCL), a CD30+ T-cell non-Hodgkin's lymphoma, represents only 2-8% of lymphoma overall. Information on the clinical findings of primary systemic ALCL in Korea is limited. Our aims were to report the clinical features and outcomes of primary systemic ALCL. PATIENTS and METHODS: We retrospectively reviewed the medical records of 36 adult patients diagnosed with primary systemic ALCL at Asan Medical Center from February 1995 through June 2006. RESULTS: Of 36 patients, 29 were male. The median age was 39 years (range, 17-67 years), and 26 (72%) presented with Ann Arbor stages III and IV. The most commonly involved extranodal sites were bone (n = 7) and soft tissue (n = 6). Thirty-two of all patients (89%) were treated with an anthracycline-based regimen including cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) as induction chemotherapy; 16 (50%) achieved complete remission (CR), and 13 (41%) achieved partial remission (PR). Median overall survival (OS) and event-free survival (EFS) were 49 and 17 months, respectively. Univariate analysis showed that performance status (p = 0.035), international prognostic index (IPI) (p = 0.025), and age-adjusted IPI (p = 0.034) were significant prognostic factors for OS, whereas anaplastic lymphoma kinase (ALK) expression did not affect OS (p = 0.483). CONCLUSION: Our retrospective analysis of Korean primary systemic ALCL patients showed that median OS was 49 months and overall response to CHOP was 91%. Performance, IPI, and age-adjusted IPI were predictors of OS, whereas ALK expression did not have prognostic significance.

The Usefulness of SurePath(TM) Liquid-Based Smear in Sono-Guided Thyroid Fine Needle Aspiration; a Comparison of a Conventional Smear and SurePath(TM) Liquid-Based Cytology / 대한세포병리학회지

Sono-guided fine needle aspiration (FNA) of the thyroid is widely used, but the aspirated samples are typically not well preserved and low cellularity makes diagnosis difficult in many cases. The object of the current study is to evaluate the adequacy and diagnostic accuracy of the use of SurePath(TM) liquid-based cytology (SP-LBC) in the sonoguided fine needle aspiration of the thyroid nodule and to compare its use with that of the use of a conventional smear (CS). A total of 172 sono-guided FNAs of thyroid nodules from April to June, 2006 were prepared by the use of the split method with either SP-LBC or CS; the samples were stained with the use of hematoxylin-eosin (H&E) and Papanicolaou (Pap) stains. A cyto-histological correlation was performed in 69 (30 SP and 39 CS) cases that had been histologically confirmed. The rate of producing unsatisfactory slides by the use of the SP-LBC method (9.3%) was less than that of the use of the CS method (20.9%). The diagnostic accuracy of the SP method (93.3%) was better than that of the CS method (85.3%). The sensitivity and specificity of the SP method (94.4% and 92.3%) was better than that of the CS method (83.3% and 70%), respectively (p<0.05). The CS of sono-guided aspirated specimens had some unavoidable limitations related to inadequate sampling such as a bloody background, low cellularity and an indication that some clinicians smeared many useless slides (averaging four to ten slides), and that most slides showed only blood that included few follicular cells. The SP method resulted in more thinly smeared slides and showed cleaner background and greater cellularity than the use of the CS method. Each follicular cell shows superior nuclear detail, and more distinct cytoplasmic features than with the use of the CS method. SP-LBC appears to be an easy, highly accurate, and reliable cytological method for employ for a diagnostic approach of thyroid disease and thyroid nodules. The SP-LBC method is a suitable alternative to the CS method to overcome diagnostic difficulties.