A Case of AILD-like T Cell Lymphoma with Monoclonal Gammopathy / 대한혈액학회지

We report a case of 74 year old man presented with generalized lymphadenopathy with hepatosplenomegaly. Lymph node biopsy revealed angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) and most areas of lymph node were replaced with large atypical lymphocytes which were revealed to be T cells by immunohistochemistry. All together, the patient was diagnosed as AILD-like T cell lymphoma with bone marrow involvement. The patient presented monoclonal gammopathy (IgG lambda) without any evidence of plasma cell dyscrasia or secondary amyloidosis. After three cycles of combination chemotherapy including cyclophosphamide, prednisone, vincristine and doxorubicin, the patient achieved partial remission with decreased level of serum and urine monoclonal protein.

A Case of Bronchial Mucoepidermoid Carcinoma Associated with Adeonocarcinoma / 결핵

Mucoepidermoid carcinoma was initially recognized as occurring only in the salivary gland and only later was it appreciated that it occurred in the bronchus and trachea as well. Mucoepidermoid carcinoma of bronchial gland origin is extremely rare, and little is known about their natural history. This carcinoma is derived from the minor salivary gland of the proximal tracheobronchial tree and it is divided into low-grade and high-grade by gross, histologic, and ultrastructural criteria. Also Its clinical and biologic behaviors are closely related with histologic grade of carcinoma. We have experienced a rare case of bronchial mucoepidermoid carcinoma associated with adenocarinoma which obstructed the left main bronchus and was successfully removed by the pneumonectomy.

A Case of Biphasic Pulmonary Blastoma / 결핵

Pulmonary blastoma is a primary lung tumor consisting of a mixture of immature embryonal-like mensenchymal and epithelial components and in some areas resemble embryonal lung tissue of up to 3-4 months gestational age. The tumor was first described in 1945 by Barrett and Barnard and again in 1952 by Barmard, who named it an embryoma of the lung which resembled fetal lung histologically, with glandular structures lined by non-ciliated epithelium and a surrounding stroma resembling mesenchyme. In 1961 Spencer renamed them Pulmonary blastoma as he believed they represented neoplasms similar in pathogenesis to nephroblastoma. The prognosis of these tumors is poor, and the clinical course is not readily predicted from histological appearance. Untill now, more than one hundred cases have been reported in the literature in the word and there is no report in Korea. We report a case of biphasic pulmonary blastoma, which ruptured spontaneously, in a 31-year-old young man who was presented as sharp pain under the right subscapular area.

A Case of Biphasic Pulmonary Blastoma / 결핵

Pulmonary blastoma is a primary lung tumor consisting of a mixture of immature embryonal-like mensenchymal and epithelial components and in some areas resemble embryonal lung tissue of up to 3-4 months gestational age. The tumor was first described in 1945 by Barrett and Barnard and again in 1952 by Barmard, who named it an embryoma of the lung which resembled fetal lung histologically, with glandular structures lined by non-ciliated epithelium and a surrounding stroma resembling mesenchyme. In 1961 Spencer renamed them Pulmonary blastoma as he believed they represented neoplasms similar in pathogenesis to nephroblastoma. The prognosis of these tumors is poor, and the clinical course is not readily predicted from histological appearance. Untill now, more than one hundred cases have been reported in the literature in the word and there is no report in Korea. We report a case of biphasic pulmonary blastoma, which ruptured spontaneously, in a 31-year-old young man who was presented as sharp pain under the right subscapular area.

Histopathological Changes of the Renal Arterial Wall After Bipolar Coagulation in Experimental Rat Models

The bipolar coagulator has been frequently used in reducing the size of aneurismal neck or dissecting the aneurismal sac. However the effects of bipolar current on the wall of vessels have not been adequately documented. The author studied the histopathological changes of the renal arterial wall after bipolar coagulation. Thirty one Sprague-Dawley strain rats of both sexes and of various age were used. Under penthobarbital anesthesia, the left renal artery was coagulated with bipolar forcep just distal to it's origin from the aorta. The rats were divided into two groups:Group A was coagulated for two seconds:Group B for one second. The coagulation sites of vessels were examined grossly and microscopically in three and six months, respectively. The results were summarized as followings: 1) In both three and six months groups:the internal elastic membrane and elastic fibers were destructed, fragmented and thinned;the medial smooth muscle cells were damaged and decreased in number. 2) While the endothelial cells were severely desquamated and scattered in three months group, but there was an evidence of partial regeneration of endothelium and reduction of inflammatory reaction in six months group. Fibrosis was more augmented in six month group than three month group. 3) Between group A and B, There weemed to be no definite discrepancy in histopathological findings. 4) Pseudoaneurysms were developed in 72.2% of three months group and in 61.5% of six months group, but there was no significant statistical difference in the rate of pseudoaneurysm formation between the two groups(p>0.05, chi2=0.393). 5) Above findings suggest that the pseudoaneurysm which might be produced by bipolar coagulation of vessels in the neurosurgical operation, would be progressed to the true aneurysm if continuous hemodynamic factors are exerted upon the pseudoaneurysm. Therefore, it is desirable that the bipolar current should be used very catiously during the surgery of cerebrovascular disease.

Pathologic Study on Congenital Pseudarthrosis of the Tibia / 대한정형외과학회잡지

No abstract available in English.

Osteonecrosis of the Femoral Head Associated with Polyvinylpyrrolidone Storage / 대한정형외과학회잡지

Eighteen cases of osteonecrosis of the femoral head associated with macromolecular polyvinylpyrrolidone (PVP) deposition were analysed on the basis of clinical, radiologic and pathologic features. The cases were observed during 8 years period from January, 1974 to December, 1981. The pathogenesis of the osteonecrosis of the femoral head due to PVP storage in reticuloendothelial system were discussed in detail. Parenteral administration of high-molecular PVP in repeated, long duration led to osteonecrosis of the femoral head. Storage of PVP in the histiocytes of the bone marrow resulted in osteonecrosis of the femoral head followed by microciculation disturbance. PVP-induced osteonecrosis were manifested as multiple foci of necrosis involving not only the femoral head, other long bones around joints, but also the visceral reticuloendo-thelial system characterized by infiltrates of histiocytes laden with PVP. The patients with PVP induced osteonecrosis complianed multiple joint pain in their early course of the disease. On roentgenogram, osteonecrosis were often noted in the hip, shoulder, knee, and ankle in order or frequency. Foamy histiocytes laden with PVP were characteristic on hematoxylin-eosin stain diagnostic on Weigert's elastica, phosphotungstic acid hematoxylin, and Congo red stains. As far as rationale of the treatment concerning a number of staging systems for Osteonecrosis, the choice of surgical procedures were similar to those given by W.F. Enneking et al. In the series, we have performed two hips in total surface replacement, 26 hips in total hip replacement mostly for 3rd generation-configuration of Charnley prosthesis. In addition, one case for free vascularized fibula graft and trans-trochanteric rotational osteotomy after Sugioka were also included for this study. The result of treatment was rather optimistic. However, complications have occured in 4 hips of 3 patients which required removal of whole prosthetic components. Therefore, we underwent revisional surgery in three out of four hips subsequently during the short post-poerative follow-up. These will be published in the future.

Primary Malignant Fibrous Histiocytoma in the Long Bones: 2 Cases / 대한정형외과학회잡지

Malignant fibrous histiocytama is currently defined as a malignant primary bone tumor, and that may contain fibromatoua, xanthomatous, or histiocytic elementa, varing widely in the degree of anaplasia that is present. The principal lesions to be considered in the differential diagnoais of malignant fibrous histiocytoma are osteogenic sarcoma and fibrosarcoma. Malignant fibrous histiocytoma is more sensitive to chemotherapeutic ageata than are osteosarcama and fibrosarcama. In this paper 2 cases sre reported, including the one in which the tumor arose in a midahaft of the femur and the other one arosein the upper metaphyseal portion of the tibla.

Block Resection of the Chordoma in Sacrococcygeal Region: A Case Report / 대한정형외과학회잡지

Chordomas are maligaant tumors which arise in the remnants of the embryonic notochord, and exhibit a definite predilection for the extremes of the spinal axis, the great majority arising either in the basioccipital or in the sacrococcy geal regions. Particularly, complete surgical removal is almost impossible, therefore, local recurrence after the surgical removal of this tumor is common or rule. This report describes a csse of chordoma arising sacrococcygeal region treated with block resection.