Fine Needle Aspiration Cytologic Features of Schwannomas / 대한세포병리학회지

Schwannoma is a benign encapsulated nerve sheath tumor and is histologically characterized by a mixture of Antoni type A and B tissue. A preoperative diagnosis of schwannoma by fine needle aspiration cytology or by any other means is important to preserve clinically important nerves. Therefore, it is necessary to make a specific cytological diagnosis of nerve sheath tumor. However, there are a few reports regarding cytological features of schwannoma in Korea. We experienced seven cases of solitary schwannoma and here we report their characteristic cytological features with a review of literatures. The characteristic features of schwannoma on cytology were the presence of both Antoni type A and B tissue. The cytologic findings common to all cases of schwannoma generally corresponded to the histologic findings of Antoni type A tissue, consisting of fragments of tightly cohesive fascicles with variable cellularity. Dense fibrillary substances were found, along with palisading nuclei and Verocay bodies. Individual tumor cells consisted of cohesive cells having spindle or oval nuclei, with pointed ends and indistinct cell borders. Variation in nuclear size and shape was also present. The Antoni type B consisted of scattered wavy or short spindle cells and some histiocytes and lymphocytes in the abundant myxoid background with formation of microcysts. Immunohistochemistry for S-100 protein revealed a uniformly strong positive reaction and was helpful to make more accurate diagnosis of schwannoma.

Fine Needle Aspiration Cytology of Unusual Epidermoid Cyst with Diffuse Parakeratosis and Aggressive Growth: A Case Report / 대한세포병리학회지

An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year. On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was irregularly destroyed and filled with gray-white cheesy material and necrotic bone debris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.

Gastric Duplication Associated with Marked Atypism: A case report

A case of gastric duplication associated with marked atypism in an adult is reported. The patient was a 62-year-old woman presenting a mass in left upper quadrant of abdomen. The mass was a closed gastric cyst located in the greater curvature, measuring 11 9 cm in diameter. The cyst had common muscular layer with stomach. It showed gray-white firm cystic wall with yellowish brown soft necrotic tissue. Microscopically, the cyst was lined by columnar mucin-secreting epithelium having marked cellular atypism. The cyst wall was supported by layers of smooth muscle, accompanied with severe fibrosis and chronic inflammation.

Radiologic Findings of Primary Epiploic Appendagitis: Focused on the Ultrasonographic Findings

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.

A case of pseudomelanosis duodeni associated with chronic renal failure / 대한내과학회지

No abstract available.

Histopathologic findings of necrotizing lymphadenitis / 영남의대학술지

Necrotizing lymphadenitis was first recognised as a self-limiting lymphadenitis by Japanese workers in 1972. It is a distinct clinicopathologic entity, but can be mistaken as malignant lymphoma. We have studied clinicopathologic features in 15 cases of necrotizing lymphadenitis. This disease occurs predominantly in young adult. Male-female ratio is 2 : 1. The commonest presentation is lateral cervical lymphadenopathy. Pain, tenderness, and fever can be seen. Biopsy of the lymph nodes from all patients demonstrates the characteristic histologic features : multifocal, relatively circumscribed nodules in the cortex and/or paracortex, consisting of a mixture of activated large lymphoid cells, histiocytes and Small lymphocytes. Numerous karyorrhetic debris are present. Neutrophils and plasma cells are strikingly absent.

Histopathologic consideration of hepatocellular carcinoma / 영남의대학술지

Hepatocellular carcinoma represents approximately 90% of the primary liver cancers. Recently, its incidence tends to be increased. Thirsty seven cases from 1986 to 1991 diagnosed as hepatocellular carcinoma by resection were analyzed to know their histopathologic feature and related clinical findings. The average age at the time of resection was 53.1 years, with frequent occurrence in third and fourth decades. Microscopically, the trabecular type was the most frequent growth pattern (35.1%) and classic hepatocyte-like cell type was the most frequent cell type (75.7%). The tumors are mainly moderately differentiated and frequently associated with liver cirrhosis. In comparison of cytological differentiation with liver cirrhosis, there was a tendency for well-differentiated tumors to arise in cirrhotic livers more often than poorly differentiated tumors, and the tendency was statistically significant. But differentiation and tumor size did not show significant correlation. Also statistically significant correlations were not observed between the level of alpha-fetoprotein and tumor size, and between the level of alpha-fetoprotein and differentiation.

Effect of phenobarbital pretreatment on the hepatotoxicity of carbon tetrachloride in rat / 영남의대학술지

The purpose of this study was to evaluate the influence of phenobarbital (PB) on hepatotoxic effect of carbon tetrachloride (CCI4) which induces centrilobular necrosis in liver. Rats were injected intraperitoneally CCI4 dissolved in olive oil by a dose of 0.4 mg/kg. For change related to PB pretreatment, rats were injected CCI₄ 0.4mg/kg after PB pretreatment. The liver samples were taken in 6, 12, 24, 48, 72 and 120 hours after CCI₄ and/ or PB injection. Extracted liver tissue was examined with light and electron microscopes. The results were summarized as follows: 1. Light microscopic findings: In CCI₄ group, centrilobular necrosis developed from 6 hours after injection, was the most severe in 48 hours, and recovered after 72 hours. In addition to necrosis, fatty change and pale cell change were accompanied. In PB-CCI4 group, necrosis occurred from 6 hours after CCI₄ injection and continued to 72 hours, and the degree of necrosis was more severe than that of CCI₄ group and pale cell change was decreased. 2. Electron microscopic findings: In CCI4 group, the early principal change was clumping and vesicular dilatation of endoplasmic reticulum. In PB-CCI₄ group, the degenerative change of endoplasmic reticulum was aggravated and the mitochondria also revealed severe degenerative change. According to the results, it was revealed that CCI₄ hepatotoxicity primarily began with the damage of endoplasmic reticulum, then damage of other cell organelles and cell necrosis followed, and these cytotoxic effects were aggravated by PB pretreatment.

Computerization of Surgical Pathology Reporting by Personal Computer

The authors have been developed a menu-driven FoxBASE system for surgical pathology reporting and automatic encoding in Systematized Nomenclature of Medicine. The system requires no prior knowledge of FoxBASE and is readily installed on any IBM or it's compatible personal computer. Working sheet generation is automatically accompanied by data from previous cases on the same patient. Important data which include patient name, age, sex, surgical number, hospital unit number and encoded diagnoses, are stored on the hard disk permanently; complete reports are saved on floppy diskettes. Cases can be retrieved by patient name, surgical number, hospital unit number and SNOMED codes within 0.1 second. Daily work lists and listings of incomplete cases are easily obtained. This FoxBASE system has been in use for 1 year and 6 months and resulted in increased efficiency of retrieval and gathering of basic information for specific study, cost effectiveness, markedly diminished workload of typist and very short wasting time during complete restoration of data file for hard disk failure.

Nucleolar organizer regions in glioma / 영남의대학술지

Nucleolar organizer regions (NOR) are loops of ribosomal DNA (rDNA) which are transcribed by RNA polymerase I. They produce ultimately ribosome and protein. Thus they are believed to reflect nuclear activity. We applied silver colloid staining technique to human glioma to examine relationship between the mean number of Ag-NOR and histopathological grading. The mean number of Ag-NOR (±S. E of the mean) were 1.17±0.07 in normal brain, 1.53±0.25 in astrocytoma, 2.37±0.71 in malignant astrocytoma. And 2.88±0.41 in glioblastoma multiforme. And there was a statistically significant difference among these. The results show that Ag-NOR technique is a rather simple and rapid method and will become a helpful tool for estimation of the proliferative potential of glioma.

Metastatic tumors in supraclavicular lymph node: pathological analysis of 125 cases / 영남의대학술지

Supraclavicular lymph nodes are unique in that they can attract metastases from almost anywhere in the body and most common sites of metastasis from an unknown primary source. 125 cases which had been diagnosed as metastatic supraclavicular lymph node during the period between May 1983 and August 1991, were analyzed pathologically, and following distinctive characteristics could be outlined: 1) The most frequent sites of metastasis from primary lesions are lung (43%), stomach (23%), lymphoreticular (6%), biliary (5%), esophagus (2%), and pancreas (2%). 2) Histologic examination of metastatic supraclavicular lymph node revealed adenocarcinoma (57%), squamous cell carcinoma (12%), undifferentiated carcinoma (9%), small cell carcinoma (7%), malignant lymphoma (6%), malignant melanoma (1%) and undetermined carcinoma (8%). 3) In cases that histologic types were squamous cell carcinoma, undifferentiated carcinoma, small cell carcinoma and undetermined carcinoma, the most frequent primary site was lung.

Histopathological study of gastric adenoma / 영남의대학술지

A total of 53 gastric adenomas from endoscopically biopsied gastric mucosa were examined histopathologically. The average age at the time of endoscopic biopsy was 59 years, and gastric adenomas were found to be more frequent in the aged, particularly above the age of 50. The majority of adenomas occurred at the antrum. Concerning the shape of the adenomas, Yamada type II was more frequent (55%). All adenomas were accompanied by varying degree of intestinal metaplasia, and this findings suggest that gastric adenoma develops from intestinal metaplasia. In adenomas with severe atypia (grade III), endocrine cells (argyrophil and argentaffin cells) were markedly decreased or absent. Gastric adenocarcinomas coexistent with adenoma were seen in 5 (9.4%) out of 53 cases, and were more frequent in male than female patients (sex ratio, 4:1) and the average age was 61.4 years. It is suggested that there is a necessity of thorough follow-up study for definitive correlation between gastric adenoma and adenocarcinoma.

Effects of carbon tetrachloride on structures in hepatocytes following DMN induced hepatotoxicity / 영남의대학술지

The purpose of this study was to evaluate the influence of high dose carbon tetrachloride (CCI4) on the hepatotoxic effect of dimethylnitrosamine (DMN) which induces acute hemorrhagic necrosis in liver. Rats were injected intraperitoneally DMN dissolved in physiologic saline by a dose of 40 mg/kg. For changes related to CCI⁴ pretreatment, rats were injected intraperitoneally CCI⁴ dissolved in olive oil by a dose of 0.4 mg/kg, and then injected DMN. The livers were extracted from the rats 3, 6, 12, 24, 48, 72, and 120 hours after CCI⁴ and/ or DMN injection. Liver tissues were examined with light and electron microscopes. The results were summarized as follows; Light microscopic findings: Severe centrilobular hemorrhagic necrosis developed from 12 hours after injection of DMN and continued to 120 hours. On injection of DMN after CCI4 pretreatment, Massive necrosis occurred early. But active regenerative changes were produced in 24 hours. In 120 hours, the liver recovered in almost normal appearance. The degree of necrosis in pretreated group was similar to that in DMN injection only, and the time of recovery was faster in pretreated group. Electron microscopic findings: The early change was mainly disorganization of RER in DMN injection, and clumping and vesicular dilatation of ER in injection of CCI4. In pretreatment group, the early change was similar in appearance with CCI4 group, but severer in degree. According to the results, it was revealed that acute toxic effect of DMN was recovered more rapidly in pretreatment group. Thus it was suggested that CCI4 had protective effect in DMN hepatotoxicity.

Ependymoma in Pelvic Cavity : A case report

A case of ependymoma originated in pelvic cavity is reported. Metastasis to regional lymph nodes and abdominal cavity developed. This tumor is thought to arise from heterotopic ependymal rests. The patient was 32 year old woman. A 10.0x7.0x7.0 cm sized mass was located between the uterus and rectum, which was attached to the rectal wall. It was a well circumscribed tumor with massive hemorrhage and necrosis. Histologically, tumor showed variegated appearance. Plump oval or round cells were arranged oval of elongated cells with fibrillary cytoplasmic process. Occasionally perivascular pseudorosette and ependymal rosette were seen. Immunohistochemical staining for GFAP showed intense positivity. Ultrastructural examination showed intracytoplasmic microfilaments, cilia, microvilli, and blepharoplasts.

The Comparison of Histopathology of Cats Received Conventional Mechanical Ventilation and High Frequency Oscillation Ventilation / 영남의대학술지

The tracheobronchial histopathologic findings in 7 healthy cats used with high frequency oscillation ventilation (HFOV) were compared with those in 6 cats used with conventional mechanical ventilation (CMV). 4-point, 9-variable scoring system was used to evaluate the injury in the trachea, right & left main bronchi and parenchyma. The following results were obtained; 1) The tracheobronchial tree received HFOV had no significant damage compared with CMV (P>0.05). 2) Intraepithelial mucus loss and emphysema were slightly more prominent in CMV groups. As above results; the tracheobronchial histopathologic difference was not prominent between CMV and HFOV groups received with relatively short period, however, the cellular of function and barotrauma may be more prominent in CMV groups. From now on, as causes of tracheobronchial injury in HFV, interaction between humidification and mechanical trauma considers further study.

A Case of Conjoined Twins / 영남의대학술지

Conjoined twinning is a rare congenital malformation, accounting for 1% monozygotic twins. Conjoined twins result if twining is initiated after the embryonic disc and rudimentary amniotic sac have been formed and if division of the embryonic disc is incomplete. Recently we experienced a case of conjoined twins, dicephalus dipus dibrachius, who had died at 3 hours of life, and performed autopsy. Autopsy revealed a total duplication of the heads, spines up to sacrum, small bowels, thymus and lungs. Two hearts existed within a common pericardium.

Four Cases of Primary Malignant Melanoma of the Nasal Cavity / 영남의대학술지

The primary malignant melanoma of the nasal cavity and paranasal sinuses is extremely rare and accounts for only between 0.6 and 2.5% of the total number of malignant melanoma at all sites. In the nose, the left side is involved in 60% of cases and the most frequent site is the septum followed by the inferior and middle turbinates. In the sinuses, the maxillary sinus is the site of origin 80% of cases, followed by ethmoid sinus. The tumors are sessile or polypoid, with variable color such as pink, white, brown or blank. Of all tumors, 10-30% are amelanotic, requiring special stains for melanin. When primary site of melanoma is mucosal origin, treatment of primary lesion is often hampered by anatomic restrictions and large size, which results from the delayed diagnosis caused by their location. We report 4 cases of primary malignant melanoma of nasal cavity with review of literature.

Benign Fibrous Histiocytoma of Spinal Cord

Fibrous histiocytoma composed of fibroblasts and histiocytes is quite variable in histologic pattern. The biologic behavior is unpredictable by histologic ground. This tumor is well-known in subcutaneous tissue and deep soft tissue, but quite rare in central nervous system. We experienced a case of the fibrous histiocytoma involving the dura mater of spinal cord in a 26 year old female patient. In gross findings, the mass was a well demarcated, ovoid mass attached to the dura matter, and measured 2.5x1.5 cm in diameter. The cut surface was rubbery, solid, gray-white or yellow. Microscopically, the lesion consisted of polyhedral cells with round or oval nuclei and faintly eosinophilic or vaculoated cytoplasm, and multinucleated giant cells. Some giant cells were Touton-type. Composing cells were bland-looking. Mitotic figures were average 3 per 10 high power fields.

Three Cases of Primary Adenosquamous Carcinoma of Stomach / 영남의대학술지

Adenosquamous carcinoma of stomach is a mixed glandular-epidermoid tumor where both components are neoplastic. Its incidence is extremely rare. The five theories on the origin of squamous components are 1) island of ectopic squamous epithelium in the gastric mucosa, 2) squamous metaplasia of gastric epithelium, 3) squamous differentiation in a preexisting adenocarcinoma, 4) endothelial cell differentiated toward squamous elements, and 5) totipotential undifferentiated cells of the gastric mucosa. We experienced three cases of adenosquamous carcinoma. Case 1 was a 71-year-old female patient; an ulcerative lesion was present in the pylorus, measuring 5 cm in diameter. Case 2 was a 57-year-old male patient; an ulcerative lesion is present in the pylorus, measuring 6 cm in diameter. Case 3 was a 58-year-old female patient; an ulcerative lesion was present in the body and fundus, measuring 10 cm in diameter. Microscopic examination revealed a mixed malignant squamous and adenomatous component.

Splenic Abscess: Three cases report

Splenic abscess is uncommon, but often fatal entity characterized by high mortality rate which ranges from 60 to 100%, due to nonspecific clinical presentation and failure to preoperative definitive diagnosis. Clinical symptom or simple X-ray was not helpful in diagnosing splenic abscess. Perhaps the most useful information was obtained from the scanning and computerized tomography. Emphasis is placed on the necessity for prompt diagnosis and surgical intervention when splenic abscess was suspected. We have experienced three cases of splenic abscess. Case 1 was a 59 year-old male patient; the cause was possibly direct spreading from pancreatitis; The culture demonstrated klebsiella oxytoca. Case 2 was a 42 year-old female patient; the abscess was produced by preceding infarct. Case 3 was a 64 year-old female; metastatic adenocarcinoma was identified in the soft tissue around spleen, that suggest causative factor. All three cases showed multiple abscesses.