• Title/Summary/Keyword: Clinical and pathologic findings

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Thymic Carcinoma -A Case Rport- (흉선암 1례 보고)

  • 고영호
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.497-501
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    • 1994
  • We have experienced a case of primary thymic carcinoma. A 39 year old female patient admitted with incidentally detected mediastinal mass on chest film.The tumor showed invasion to surrounding tissues and the mediastinal lymphadenopathies were also noted. Invasion to contiguous mediastinal structures made complete surgical extirplation impossible and the biposy findings revealed primary thymic carcinoma. Primary thymic carcinoma is a rare neoplasm originating from the thymic epithelial cells. Clinical behavior of the thymic carcinoma is much different from it`s benign counterpart and several pathologic variants were reported.

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Various Pathologic Conditions of Sinus Tarsi Syndrome Assessed by Imaging and Arthroscopic Findings (영상학적 및 관절경적 소견으로 평가한 족근동 증후군의 다양한 병적 상태)

  • Jeong Jin Park;Seung Jae Cho;Seong Hyeon Jo;Chul Hyun Park
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.60-67
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    • 2024
  • Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

Meningiomas with Rhabdoid or Papillary Components : Prognosis and Comparison with Anaplastic Meningiomas

  • Kim, Jeong-Kwon;Jung, Tae-Young;Jung, Shin;Lee, Kyung-Hwa;Kim, Seul-Kee;Lee, Eun Jung
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.357-362
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    • 2016
  • Papillary and rhabdoid meningiomas are pathologically World Health Organization (WHO) grade III. Any correlation between clinical prognosis and pathologic component is not clear. We analyzed the prognoses of patients with meningiomas with a rhabdoid or papillary component compared to those of patients with anaplastic meningiomas. From 1994 to June 2013, 14 anaplastic meningiomas, 6 meningiomas with a rhabdoid component, and 5 meningiomas with papillary component were pathologically diagnosed. We analyzed magnetic resonance imaging (MRI) findings, extent of removal, adjuvant treatment, progression-free survival (PFS), overall survival (OS), and pathologic features of 14 anaplastic meningiomas (group A), 5 meningiomas with a predominant (${\geq}50%$) papillary or rhabdoid component (group B1), and 6 meningiomas without a predominant (<50%) rhabdoid or papillary component (group B2). Homogeneous enhancement on MRI was associated with improved PFS compared to heterogeneous enhancement (p=0.025). Depending on pathology, the mean PFS was $134.9{\pm}31.6\;months$ for group A, $46.6{\pm}13.4\;months$ for group B1, and $118.7{\pm}19.2\;months$ for group B2. The mean OS was $138.5{\pm}24.6\;months$ for group A and $59.7{\pm}16.8\;months$ for group B1. All recurrent tumors were of the previously diagnosed pathology, except for one tumor from group B1, which recurred as an atypical meningioma without a papillary component. Group B1 tumors showed a more aggressive behavior than group B2 tumors. In group B2 cases, the pathologic findings of non-rhabdoid/papillary portion could be considered for further adjuvant treatment.

Efficacy of Endoscopic Ultrasonography for Prediction of Tumor Depth in Gastric Cancer

  • Park, Ji-Min;Ahn, Chang-Wook;Yi, Xian;Hur, Hoon;Lee, Kee-Myung;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.109-115
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    • 2011
  • Purpose: As the proportion of early gastric cancer (EGC) has recently been increased, minimally invasive treatment is currently accepted as main therapy for EGC. Accurate preoperative staging is very important in determining treatment options. To know the accuracy of endoscopic ultrasonography (EUS), we compared the depth of invasion of the tumor with preoperative EUS and postoperative pathologic findings. Materials and Methods: We retrospectively analyzed 152 patients who underwent EUS before laparoscopic gastrectomy. The preoperative EUS results were compared with the pathological findings. Results: The overall proportion of coincidence for depth of invasion between EUS and pathologic results was 41.4%. Univariate analysis showed that the rate of corrected prediction of EUS for tumor depth significantly decreased for the lesions more than 3cm in diameter (P=0.033), and those with a depressed morphology (P=0.035). In multivariate analysis, the depressed type (P=0.029, OR=2.873) and upper lesion (P=0.035, OR=2.151) was the significantly independent factors influencing the inaccurate prediction of EUS for tumor depth. Conclusions: When we decide the treatment modality considering the clinical depth of invasion by EUS, the possibility of discordance with pathologic results should be considered for the lesions located in the upper third of the stomach and with a depressed morphology.

Spontaneous Perforation of Colon in Previously Healthy Infants and Children: Its Clinical Implication

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.193-198
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    • 2016
  • Purpose: Spontaneous colon perforations are usually encountered as necrotizing enterocolitis in the neonatal period, but occur rarely in infants and children without pathological conditions. This study was conducted to describe its clinical implication beyond the neonatal period. Methods: Cases of spontaneous colon perforation confirmed after the operation were reviewed retrospectively and the clinicopathological characteristics were analyzed. Clinical data were compared according to the presence of pneumoperitoneum as initial findings. Results: Eleven patients were included in the study period and showed a history of hospitalization before transfer due to management for fever, respiratory or gastrointestinal problems. Six patients showed a sudden onset of abdominal distention and only seven patients showed a pneumoperitoneum as initial radiologic findings, however there were no significant clinicopathological differences. Perforation was found evenly in all segments of the colon, most commonly at the sigmoid colon in four cases. There were no specific pathologic or serologic causes of perforation. Conclusion: When previously healthy infants and children manifest a sustained fever with a sudden onset of abdominal distention during management for fever associated with respiratory or gastrointestinal problems, there is a great likelihood of colon perforation with no pathological condition. Prompt surgical management as timely decision-making is necessary in order to achieve a good progress.

The Clinical Study on 39 Cases of Subclinical Hypothyroidism (전현성 갑상선 기능저하증의 임상적 고찰)

  • Yu, Cheol-Jae;Ahn, Weon-Jeon;Lee, Houn-Young;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.1
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    • pp.67-73
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    • 1986
  • Subclinical hypothyroidism can be defined as an asymptomatic state in which a reduction in thyroid activity has been compensated by an increased TSH output to maintain a euthyroid state. We analysed clinical features, laboratory data, and pathologic findings in 3g cases of subclinical hypothyroidism who were diagnosed at the Dept. of Internal Medicine, Chungnam National University Hospital from Aug. 1984 to June, 1985. 1) The age distribution was from sixteen to sixty-nine and mean a9e was 34.8. Peak incidence was in the 4th decade and 3rd, 5th, 6th decade in order. 2) The sex distribution showed female preponderance with a ratio of 18.5 to 1. 3) The major presenting manifestations were nonspecific ones such as fatigue, indigestion, and anorexia. 4) Physical examination revealed diffuse goiter in 47.6%. Major abnormalities were no gross abnormality (30.9%), nodular goiter and facial edema. 5) There was no significant difference of the basal serum $T_3\;and\;T_4$ concentrations between subclinical hypothyroidism and normal controls (p>0.05). 6) The basal serum TSH concentration of subclinical hypothyroidism $(32.61{\pm}14.95{\mu}U/ml)$ was significantly higher than that of normal controls $(3.92{\pm}1.05{\mu}U/ml)$ (p<0.005). 7) Microsomal antibody was detected in 80.6% and thyroglobulin antibody was detected in 30%. 8) The pathologic findings in 26 cases revealed Hashimoto's thyroiditis in 76.9% (lymphocytic type, 34.6%; oxyphilic type, 26.9%; fibrotic type, 15.4%). The others were adenomatous goiter(15.4%), adenomatous carcinoma (3.8%) and subacute thyroiditis(3.8%).

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Hemophagocytic lymphohistiocytosis diagnosed by brain biopsy

  • Ju, Hee Young;Hong, Che Ry;Kim, Sung Jin;Lee, Ji Won;Kim, Hyery;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Chae, Jong-Hee;Phi, Ji Hoon;Cheon, Jung-Eun;Park, Sung-Hye;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.358-361
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    • 2015
  • Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, splenomegaly, jaundice, and pathologic findings of hemophagocytosis in bone marrow or other tissues such as the lymph nodes and liver. Pleocytosis, or the presence of elevated protein levels in cerebrospinal fluid, could be helpful in diagnosing HLH. However, the pathologic diagnosis of the brain is not included in the diagnostic criteria for this condition. In the present report, we describe the case of a patient diagnosed with HLH, in whom the brain pathology, but not the bone marrow pathology, showed hemophagocytosis. As the diagnosis of HLH is difficult in many cases, a high level of suspicion is required. Moreover, the pathologic diagnosis of organs other than the bone marrow, liver, and lymph nodes may be a useful alternative.

Gene Therapy of Inherited Muscle Diseases (유전성 근육질환의 유전자 치료)

  • Shin, Jin-Hong
    • Annals of Clinical Neurophysiology
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    • v.14 no.2
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    • pp.53-58
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    • 2012
  • For the last decades, molecular genetics has achieved great advances that the genes on the list of inherited muscle diseases are piling up. Those diseases of overlapping clinico-pathologic findings are now understood with discrete molecular pathogeneses. We are facing an exciting era that the long-waited gene therapy may eventually come true. Skipping of dystrophin exon 51 is on successful clinical trials, which will benefit about 13% of the children suffering from Duchenne muscular dystrophy. Exon skipping is under active investigation to expand the candidates. Hopefully it may cover majority of Duchenne muscular dystrophy mutations and some of other diseases. Adeno-associated virus is one of the most versatile tools for gene transfer. It may overcome the limitation of exon skipping. Here we review exon skipping technique of Duchenne muscular dystrophy and briefly discuss the other strategies being studied to cure inherited muscle diseases.

Subungual Exostosis of the Foot (족부의 조갑하 외골종)

  • Ahn, Jong-Chul;Shin, Duk-Seop;Shon, Oog-Jin;Choi, Joon-Hyuk
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.56-62
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    • 1999
  • Purpose : This study was conducted to analyze the clinical materials and treatment results of 13 cases of subungual exostosis. Materials and Methods : Thirteen subungual exostoses of the foot treated from January 1991 to December 1997 were studied. We analyzed the clinical data and results of treatment to identify the clinical characteristics of this disease. We investigated the location, shape and relation of exostosis to phalanx with simple x-ray of the foot to identify the radiological characteristics. All the cases were sent to pathologic examination after resection to determine the pathological characteristics. Results : The results of physical examination on presentation were various. Most cases were located at the dorsomedial side of the distal phalanx and were involved in the toe nail. Eleven cases were located at great toes and one each at the 2nd and 3rd toe. Causes of exostosis were not clear, but 2 cases were related to trauma. For the type of exostosis, 7 cases were sessile and 6 were stalk type. On histologic examination, 9 cases showed a cartilaginous portion with overlying proliferating fibrous tissue and underlying bone formation. There was a gradual maturation of spindle cell proliferation from cartilage to cancellous bone. The cartilage was moderately cellular with some pleomorphism, but true anaplasia was not present. Conclusion : The clinical presentation and findings of simple x-rays were most helpful in diagnosing subungual exostosis. Complete excision of the mass achieved complete relief of symptoms and recovery without recurrence in all cases.

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Intraventricular Glioblastoma Multiforme with Previous History of Intracerebral Hemorrhage : A Case Report

  • Kim, Young-Jin;Lee, Sang-Koo;Cho, Maeng-Ki;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.44 no.6
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    • pp.405-408
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    • 2008
  • GBM is the most common primary brain tumor, but intraventricular GBM is rare and only few cases have been reported in the literature. The authors report a case of 64-year-old man who had a remote history of previous periventricular intracerebral hemorrhage. Brain computed tomography (CT) and magnetic resonance (MR) imaging showed an intraventricular lesion with inhomogeneous enhancement, infiltrative borders and necrotic cyst, and obstructive hydrocephalus. The patient underwent surgical removal through transcortical route via the bottom of previous hemorrhage site and the final pathologic diagnosis was GBM. We present a rare case of an intraventricular GBM with detailed clinical course, radiological findings, and pathological findings, and the possible origin of this lesion is discussed.