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A malignant rhabdoid tumor is an aggressive tumor that occurs mainly in the kidney of infants and children. When it occurs in extrarenal sites, it is referred to as an extrarenal malignant rhabdoid tumor. Although a few cases of malignant rhabdoid tumor occuring in the central nervous system, liver, brain, skin, and soft tissue have been reported, it is rarely observed in the stomach. We report the imaging findings of a malignant rhabdoid tumor of the stomach that mimicked a gastric lymphoma in a patient who presented with melena.
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A malignant rhabdoid tumor is an aggressive tumor that occurs mainly in the kidney of infants and children. When it occurs in extrarenal sites, it is referred to as an extrarenal malignant rhabdoid tumor. Although a few cases of malignant rhabdoid tumor occuring in the central nervous system, liver, brain, skin, and soft tissue have been reported, it is rarely observed in the stomach. We report the imaging findings of a malignant rhabdoid tumor of the stomach that mimicked a gastric lymphoma in a patient who presented with melena.
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Background/Aims@#With the improvement of hygiene, the incidence of amebic liver abscess is decreasing in South Korea. On the other hand, there is little data on the status of amebic liver abscess compared to pyogenic liver abscess. @*Methods@#Patients with an amebic liver abscess, in whom Entamoeba histolytica (E. histolytica) IgG was positive, were identified retrospectively in a university hospital. The clinical, laboratory, and radiological characteristics of amebic liver abscess were compared with those of pyogenic liver abscess in the same period. @*Results@#Between March 2010 and October 2016, 413 patients with a liver abscess were identified. Among them, the serologic test for E. histolytica was performed in 209 patients. Fifteen (7.2%) were classified as an amebic liver abscess, and the remainder were diagnosed with a pyogenic liver abscess. The age, gender, white blood cell, and CRP was comparable between the two groups. Procalcitonin was lower in amebic liver abscess than the pyogenic one. On CT, peripheral rim enhancement was more frequent, but cluster signs were not observed in amebic liver abscess compared to pyogenic liver abscess. None of the patients with amebic liver abscess died. In contrast, the mortality of pyogenic liver abscess was 4.7%. @*Conclusions@#Amebic liver abscess should still be considered as one of the causes of liver abscess in Korea. It is difficult to discriminate an amebic liver abscess from a pyogenic liver abscess only according to the clinical, laboratory, and radiologic findings. Therefore, it is necessary to perform a serologic test for E. histolytica for a precise evaluation of liver abscess in a high-risk group.
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Leiomyosarcoma is a malignant tumor that typically originates from either the uterus or the retroperitoneum. Furthermore, primary adrenal leiomyosarcoma is an extremely rare condition. Owing to its radiological non-specificity, differentiating leiomyosarcoma from other tumor types in the adrenal gland is difficult. We report the imaging findings of a primary adrenal leiomyosarcoma in a patient who presented with left upper quadrant abdominal pain, which increased by more than 1 cm in diameter in two years. Primary adrenal leiomyosarcoma was diagnosed considering the subsequent surgical and histopathologic findings.
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Leiomyosarcoma is a malignant tumor that typically originates from either the uterus or the retroperitoneum. Furthermore, primary adrenal leiomyosarcoma is an extremely rare condition. Owing to its radiological non-specificity, differentiating leiomyosarcoma from other tumor types in the adrenal gland is difficult. We report the imaging findings of a primary adrenal leiomyosarcoma in a patient who presented with left upper quadrant abdominal pain, which increased by more than 1 cm in diameter in two years. Primary adrenal leiomyosarcoma was diagnosed considering the subsequent surgical and histopathologic findings.
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Heterotopic pancreas is often an incidental finding and can be found at the stomach. However, heterotopic pancreas containing abundant fat is very rare. Fatty replacement of the pancreas is the most frequent pathologic finding, but the precise etiology of the entity remains unclear. The pathological findings observed in the pancreas can also occur in the heterotopic pancreas. Here, we present a case of heterotopic pancreas in the stomach. On CT and MR imaging, it manifested as a predominant fat-density submucosal mass with enhancing solid component.
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The diagnosis of fixed drug eruption is straightforward because of characteristic findings, including recurrence of similar lesions at the same site and healing with residual hyperpigmentation. However, generalized or multiple fixed drug eruption, a rare variant form, can be a diagnostic challenge. Acebrophylline is a widely prescribed oral bronchodilator with mucosecretolyic and anti-inflammatory activity and is known to be relatively safe. A 34-year-old woman presented with recurrent numerous erythematous patches after ingestion of cold medications containing clarithromycin, loxoprofen, acebrophylline, and pseudoephedrine. Skin biopsy results showed vacuolar degeneration of the basal cell layer, scattered necrotic keratinocytes in the epidermis, and perivascular lymphohistiocytic infiltration in the upper dermis. A patch test showed negative results. However, in an oral challenge with acebrophylline 3 hours later, lesions reappeared at the same sites. To the best of our knowledge, this is the first case report of acebrophylline-induced generalized fixed drug eruption.
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Adulto , Femenino , Humanos , Biopsia , Claritromicina , Dermis , Diagnóstico , Erupciones por Medicamentos , Ingestión de Alimentos , Epidermis , Hiperpigmentación , Queratinocitos , Pruebas del Parche , Seudoefedrina , Recurrencia , PielRESUMEN
The hematogenous spreading of an infectious pathogen via the portal vein from a mucosal injury in the gastrointestinal tract has been considered as one of the pathologic mechanisms of pyogenic liver abscess. Several studies have presented the association between colorectal cancer and pyogenic liver abscess. However, the cases of stomach cancer concomitant with pyogenic liver abscess have rarely been reported in the world. Herein, we present a case of advanced gastric cancer concomitant with pyogenic liver abscess in a patient who previously underwent subtotal gastrectomy due to peptic ulcer perforation.
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Humanos , Neoplasias Colorrectales , Gastrectomía , Tracto Gastrointestinal , Absceso Piógeno Hepático , Úlcera Péptica Perforada , Vena Porta , Neoplasias GástricasRESUMEN
OBJECTIVE: For development of a direct analysis method for hemophilia A, mutational analysis of F8C carried out. METHODS: The molecular analysis of F8C gene was done using DNA isolated from the peripheral blood of 106 Korean patients with hemophilia A. For the detection of inversions in F8C gene, the multiplex long amplification polymerase chain reaction (MLA-PCR) with four primers was performed. For the detection of gross deletions in F8C gene, PCR using exon-specific primers and multiplex electrophoresis was done. RESULTS: As the result of MLA-PCR, the frequency of F8C inversion was 18.9%, 20 out of 106 hemophilia A cases. The deletions of one or more exons in F8C gene were detected in 2 out of 106 hemophilia A cases (1.9%). In one case, the exon 13 was deleted and in the other case both exons 24 and 25 were found to be deleted. CONCLUSION: The PCR-based direct analysis of F8C gene for the detection of inversions and deletions could successfully detect mutations in 20.8% of Korean patients with hemophilia A. This approach would be a very useful diagnostic tool for the direct analysis of hemophilia A and prenatal diagnosis in hemophilia A families.
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Humanos , ADN , Electroforesis , Exones , Factor VIII , Hemofilia A , Reacción en Cadena de la Polimerasa , Diagnóstico PrenatalRESUMEN
OBJECTIVE: To determine the accuracy of CT and positron emission tomography (PET) in the diagnosis of recurrent uterine cervical cancer. MATERIALS AND METHODS: Imaging findings of CT and PET in 36 patients (mean age, 53 years) in whom recurrent uterine cervical cancer was suspected were analyzed retrospectively. Between October 1997 and May 1998, they had undergone surgery and/or radiation therapy. Tumor recurrence was confirmed by pathologic examination or follow-up studies. RESULTS: In detecting recurrent uterine cervical cancer, the sensitivity, specificity, and accuracy of CT were 77.8%, 83.3%, and 80.5%, respectively, while for PET, the corresponding figures were 100%, 94.4%, and 97.2%. The Chisquare test revealed no significant difference in specificity (p = .2888), but significant differences in sensitivity (p = .0339) and accuracy (p = .0244). CONCLUSION: PET proved to be a reliable screening method for detecting recurrent uterine cervical cancer, but to determine the anatomical localization of recurrent tumors, and thus decide an adequate treatment plan, CT was eventually needed.
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Adulto , Femenino , Humanos , Neoplasias del Cuello Uterino/diagnóstico por imagen , Estudio Comparativo , Medios de Contraste , Fluorodesoxiglucosa F18 , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico por imagen , Radiofármacos , Sensibilidad y Especificidad , Tomografía Computarizada de Emisión , Tomografía Computarizada por Rayos XRESUMEN
The syndromes of left atrial isomerism and right atrial isomerism, called polysplenia and asplenia syndromes, respectively, consist of congenital heart defects with disturbances in normal left right isometry, and the etiology of atrial isomerism remains unclear. Right atrial isomerism is traditionally associated with severe cardiac defects, especially complete atrioventricular septal defect, transposition of great arteries, pulmonary atresia, and total anomalous pulmonary venous return. Recently, we encountered one case of asplenia diagnosed by prenatal ultrasonography. We report a case with brief review of the literatures.
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Cardiopatías Congénitas , Síndrome de Heterotaxia , Isomerismo , Atresia Pulmonar , Síndrome de Cimitarra , Transposición de los Grandes Vasos , Ultrasonografía PrenatalRESUMEN
PURPOSE: To evaluate the radiologic findings of intra-abdominal DSRCT. MATERIALS AND METHODS: We reviewed sixcases of pathologically proven DSRCT of the abdomen. Five of these patients were men and one was a woman ; theiraverage age was 26.8 years. We retrospectively analyzed CT(n=6) and MRI(n=4). RESULTS: In all patients, largerelatively well defined lobulated mass was seen;this arose from the peritoneal surface, and its average size was12.6(range, 10-18)cm. After the administration of contrast material, the masses showed inhomogeneous enhancement,and in addition, the following features were seen: irregular internal septations (n=5); necrosis (n=3); andamorphous calcification (n=4). Various associated findings such as ascites (n=4) and multiple para-aortic lymphnode enlargement (n=4) were present; omental cake (n=5), liver metastasis (n=1), cervical lymphadenopathy (n=1),hydronephrosis (n=1), small bowel obstruction (n=1), scrotal swelling (n=1) and collateral vessels by encasedaorta and renal vein (n=1) were also seen. CONCLUSION: In young male patients with a large heterogeneous enhaneedcalcified abdominopelvic mass and findings of carcinomatosis on both CT and MR images, DSRCT should be inelvded inthe differential diagnosis.
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Femenino , Humanos , Masculino , Abdomen , Ascitis , Carcinoma , Tumor Desmoplásico de Células Pequeñas Redondas , Diagnóstico Diferencial , Hígado , Enfermedades Linfáticas , Necrosis , Metástasis de la Neoplasia , Venas Renales , Estudios RetrospectivosRESUMEN
PURPOSE: To evaluate the effectiveness of intraarterial chemotherapy(IAC) and systemic chemotherapy(SC) incases of locally advanced cervical carcinoma, and to assess the accuracy of magnetic resonance(MR) imaging fordetermining parametrial invasion after IAC or SC. MATERIALS AND METHODS: Among 44 patients with stage IIbcervical carcinoma, IAC was performed in 25 and SC in 19. MR images obtained before and after IAC or SC wereprospectively analyzed with regard to tumor volume and parametrial invasion, and tumor response to chemotherapywas classified as complete, partial, or progressive. Forty-one patients underwent radical hysterectomy within twoweeks of the second MR examination, and postoperative pathologic findings were correlated with radiologicfindings. RESULTS: The average reduction rate of tumor volume in the IAC and SC group was 89.2% and 66.3%,respectively. Between the two groups, there was no statistically significant difference(P>0.05). In the IAC group,13 patients showed a complete response and 11 a partial response, and in one there was progression. In the SCgroup, eight patients showed a complete response and nine a partial response, and in two there was progression.The accuracy of MR imaging for determining parametrial invasion after chemotherapy was 87.8%. In each patientthere was close correlation between MR imaging and pathologic findings. CONCLUSION: There was no statisticallysignificant difference in tumor reduction between the IAC and SC group. After chemotherapy for stage IIb cervicalcarcinoma, MR imaging is a valuable modality for determining surgical candidates.