• Title/Summary/Keyword: Clinical and pathologic findings

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Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality (특발폐섬유증 진단의 최신 지견과 간질성폐이상)

  • Bo Da Nam;Jung Hwa Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.770-790
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    • 2021
  • Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

An Insufficient Preoperative Diagnosis of Borrmann Type 4 Gastric Cancer in Spite of EMR

  • Ahn, Jae-Bong;Ha, Tae-Kyung;Lee, Hang-Rak;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.11 no.1
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    • pp.59-63
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    • 2011
  • Borrmann type 4 gastric cancers are notorious for the difficulty of finding cancer cells in the biopsy samples obtained from gastrofiberscopy. It is important to obtain the biopsy results for making surgical decisions. In cases with Borrmann type 4 gastric cancer, even though the radiological findings (such as an upper gastrointestinal series, abdominal computed tomography and positron emission tomography/computed tomography) or the macroscopic findings of a gastrofiberscopy examination imply a high suspicion of cancer, there can be difficulty in getting the definite pathologic results despite multiple biopsies. In these cases, we have performed endoscopic mucosal resection under gastrofiberscopy as an alternative to simple biopsies. Here we report on a case in which no cancer cells were found even in the endoscopic mucosal resection specimen, but the radiologic evidence and clinical findings were highly suspicious for gastric cancer. The patient finally underwent total gastrectomy with lymph node resection, and she was pathologically diagnosed as having stage IV gastric cancer postoperatively.

Incidental Benign Parotid Lesions on FDG-PET: Prevalence and Clinico-pathologic Findings (FDG-PET 검사시 우연히 발견한 양성 이하선 병변: 유병율과 임상 및 병리 소견)

  • Lim, Il-Han;Lee, Won-Woo;Chung, Jin-Haeng;Park, So-Yeon;Kim, Sang-Hee;Kim, Yu-Kyeong;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.5
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    • pp.359-363
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    • 2007
  • Purpose: Incidental parotid lesions on F-18 FDG-PET can mimic distant metastasis of underlying malignancy. The prevalence and the clinico-pathologic findings of PET positive parotid lesions have not been known. We investigated how often incidental parotid lesions are found on clinical FDG-PET studies and what the clinico-pathologic characteristics of those parotid lesions are in the present study. Materials and Methods: We retrospectively reviewed 3,344 cases of FDG-PET which had been obtained in our hospital from May 2003 to Dec 2006. The indications of FDG-PET were: evaluation of known/suspected cancer (n= 3,212) or screening of cancer in healthy subjects (n=132). Incidental parotid lesion on FDG-PET was defined as an un-expected FDG uptake in one of parotid glands which was not primary target lesion of current FDG-PET. FDG uptake was represented by maximum standardized uptake value (maxSUV). Final diagnosis was made by pathologic analysis or clinical follow-up assessment. Results: Fifteen (0.45% = 15/3,344) incidental parotid lesions were found and they were all benign lesions. The maxSUV ranged from 1.7 to 8.6 (mean${\pm}$s.d. = $3.7{\pm}1.9$). Final diagnoses of the incidental parotid lesions were; Warthin's tumor (n=2), pleomorphic adenoma (n=1), other un-specified benign lesion (n=1), and benign lesions under bases of imaging studies (n=3) and of clinical follow-up (n=8). Conclusion: All of incidentally found parotid lesions in clinical FDG-PET studies were confirmed as benign lesions with prevalence of 0.45%. Close follow up using PET or CT might be a reasonable approach for determining the nature of incidentally found parotid lesions.

Correlation Between Unidentified Bright Objects on Brain Magnetic Resonance Imaging (MRI) and Cerebral Glucose Metabolism in Patients with Neurofibromatosis Type 1

  • Sohn, Young Bae;An, Young Sil;Lee, Su Jin;Choi, Jin Wook;Jeong, Seon-Yong;Kim, Hyon-Ju;Ko, Jung Min
    • Journal of Genetic Medicine
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    • v.9 no.2
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    • pp.84-88
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    • 2012
  • Purpose: Neurofibromatosis type 1 (NF1), which is caused by mutations of the NF1 gene, is the most frequent single gene disorder to affect the nervous system. Unidentified bright objects (UBOs) are commonly observed on brain magnetic resonance imaging (MRI) in patients with NF1. However, their clinical and pathologic significance is not well understood. The purpose of this study was to investigate the correlation between UBOs and cerebral glucose metabolism measured by $^{18}F$-2-Fluoro-2-deoxy-D-glucose ($^{18}F$-FDG) positron emission tomography (PET) in Korean patients with NF1. Materials and Methods: Medical records of 75 patients (34 males and 41 females) with NF1 who underwent brain MRI and PET between 2005 and 2011 were evaluated retrospectively. Clinical data including demographics, neurological symptoms, and brain MRI and PET findings, were reviewed. Results: UBOs were detected in the brain MRI scans of 31 patients (41%). The region most frequently affected by UBOs was the basal ganglia. The most frequent brain PET finding was thalamic glucose hypometabolism (45/75, 60%). Of the 31 patients with UBOs, 26 had thalamic glucose hypometabolism on brain PET, but the other 5 had normal brain PET findings. Conversely, of the 45 patients with thalamic glucose hypometabolism on brain PET, 26 showed UBOs on their brain MRI scans, but 19 had normal findings on brain MRI scans. Conclusion: UBOs on brain MRI scans and thalamic glucose hypometabolism on PET appear to be 2 distinctive features of NF1 rather than correlated symptoms. Because the clinical significance of these abnormal imaging findings remains unclear, a longitudinal follow-up study of changes in clinical manifestations and imaging findings is necessary.

Cerebral Toxoplasmosis Combined with Disseminated Tuberculosis

  • Hwang, Eui-Ho;Ahn, Poong-Gi;Lee, Dong-Min;Kim, Hyeok-Su
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.316-319
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    • 2012
  • A 24-year-old man presented with mental change, fever, abdominal pain, tenderness and palpable mass on the lower abdomen. He was a non-Korean engineer and did not accompany a legal guardian, so medical history taking was difficult due to his mental status. Brain magnetic resonance imaging showed multiple rim-enhanced lesions of the brain, and abdominal computed tomography showed huge paraspinal abscess. Chest X-ray and computed tomography showed poorly defined nodular opacities. We initially thought that this patient was infected with toxoplasmosis with typical cerebral image finding and immunoglobulin laboratory finding of cerebrospinal fluid and serum study. The abdominal abscess was confirmed as tuberculosis through the pathologic finding of caseous necrosis. We used anti-tuberculosis medication and anti-toxoplasmosis medication for almost 4 months, and then his clinical state and radiological findings were considerably improved.

Evaluation of Subcutaneous and Intramuscular Irritation of the Typhoid Vaccine in Rabbits

  • Ihm, Jong-Hee;Che, Jeong-Hwan;Li, Guang-Xun;Kang, Byeong-Cheol
    • Toxicological Research
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    • v.15 no.1
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    • pp.65-68
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    • 1999
  • A newly developed typhoid vaccine was tested for subcutaneous and intramuscular irritationin male Ner Zealand White rabbits. In subcutaneous and intramuscular irritation tests, there were no observed clinical signs, body weight changes and gross pathologic findings at doses of 1 mg/ml and 0.0125 mg/ml during experimental period. However, in positive control (0.75% acetic acid), we could find various lesions that had hemorrhage, necrosis and infiltration of inflammation cells in both subcutaneous and muscular tissues. From these results, we suggest that typhoid vaccine is not irritant in subcutaneous and muscular tissue of rabbits.

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A Case of Thymoma Misdiagnosed as Parathyroid Adenoma on Tc-99m pertechnetate/Tl-201 Subtraction Scintigraphy (Tc-99m pertechnetate/Tl-201 감영 신티그라피에서 부갑상선 선종으로 오인된 흉선종 1예)

  • Chung, Yong-An;Yoo, Ie-Ryung;Kim, Sung-Hoon;Chung, Soo-Kyo;Wang, Young-Pil;Jung, Ji-Han;Lee, Kyo-Young;Kim, Byung-Kee
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.274-279
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    • 2001
  • A large superior mediastinal mass was found incidentally by ultrasonography in a 60-year-old man. There was an abnormal accumulation of Tl-201 in the lower pole of left thyroid gland, extending into left superior mediastinum on Tc-99m pertechnetate/Tl-201 subtraction scan. Laboratory findings relating thyroid and parathyroid were all within normal range. We considered the mass as a non-functioning parathyroid adenoma tentatively. However, subsequent surgery and pathologic examination revealed the mass to be a benign mixed thymoma. We report a case of patient with thymoma showing unusual Tc-99m pertechnetate/Tl-201 subtraction imaging and laboratory findings, and suggest to consider the possibility of other mediastinal tumors rather than parathyroid adenoma.

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Surgical Treatment of Pulmonary Aspergillosis (폐국균증의 외과적 치료)

  • 하종곤
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.41-47
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    • 1991
  • From January, 1980, to August, 1989, 23 patients underwent thoracotomy for treatment of pulmonary aspergillosis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 12 male and 11 female patients ranging from 23 years to 61 years old[mean age, 40.7 years]. The main clinical symptoms were hemoptysis[91.3%], cough[65.2%], chest pain[34.5%]. Sixteen patients[69.6%] had simple aspergilloma and 7[30.4%] had complex aspergilloma. The most common indication for operation was a hemoptysis, indeterminate mass, chronic cough, or obstructed bronchus. Anatomical location of lesion was mainly located upper lobe [82.6%] and most of cases were managed by lobectomy. Postoperative pathologic findings showed that 13 case[56.5%] were combined with tuberculosis, two were combined with bronchiectasis and two were combined with lung tumor, but 6 cases were not combined with other disease. Early complications occurred in 33.5% of patients with simple aspergilloma and in 85.7% of patients with complex aspergilloma. But there was no hospital death.

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Feline panleukopenia virus infection in imported cats

  • Kang, Sang-Chul;Kang, Kyung-Il;Jean, Young-Hwa;Kim, Jae-Hoon
    • Korean Journal of Veterinary Research
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    • v.47 no.4
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    • pp.437-441
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    • 2007
  • The cases of feline panleukopenia virus (FPLV) infection were diagnosed in three imported cats. All cats died within one week after mild emaciation, depression and anorexia. One cat showed yellowish watery diarrhea. At necropsy, all cats had segmental hemorrhage on the serosa and mucosa of the small intestine. Histopathologically, severe diffuse necro-hemorrhagic enteritis was observed in small intestine especially in jejunum and ileum. The crypts of Lieberkuhn were dilated and contained necrotic epithelia. Severely damaged epithelia of crypts were transformed into bizarre shapes. Multifocal lympholysis and lymphoid depletion were found in Peyer's patches and other lymphoid tissues. Direct fluorescent antibody (FA) test revealed the characteristic FPLV antigen in the cytoplasms of crypt epithelial cells. Based on the clinical signs, characteristic pathologic findings and FA test, these cases were diagnosed as FPLV infection. In our best knowledge, this study is the first case report for FPLV infection in imported cats in Korea.

Crosstalk between the Producers and Immune Targets of IL-9

  • Van Anh Do-Thi;Jie-Oh Lee;Hayyoung Lee;Young Sang Kim
    • IMMUNE NETWORK
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    • v.20 no.6
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    • pp.45.1-45.16
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    • 2020
  • IL-9 has been reported to play dual roles in the pathogenesis of autoimmune disorders and cancers. The collaboration of IL-9 with microenvironmental factors including the broader cytokine milieu and other cellular components may provide important keys to explain its conflicting effects in chronic conditions. In this review, we summarize recent findings on the cellular sources of, and immunological responders to IL-9, in order to interpret the role of IL-9 in the regulation of immune responses. This knowledge will provide new perspectives to improve clinical benefits and limit adverse effects of IL-9 when treating pathologic conditions.