Kikuchi-Fujimoto disease is a rare disease first described in 1972 by Kikuchi and Fujimoto et al. The disease is described as a benign and unusual self-limiting histiocytic necrotizing lymphadenitis of unknown origin, which is characterized histologically by necrotic foci surrounded by histiocytic aggregates. is usually manifested with lymphadenopathy and high fever. This disease mostly affects young Asian women between 20 and 30 years of age and has rarely been reported in children. Main symptoms are indolent or light tender, enlarged lymph nodes in the neck area. The correct diagnosis requires the histologic examination of the lymph node. Kikuchi-Fujimoto disease is easily confused histologically and clinically with lymphoma and systemic lupus erythematosis histologically and clinically. Although it is an uncommon cause of fever of unknown origin, early recognition of KFD is very important and will minimize potentially harmful and unnecessary evaluations and treatments. We reported a case, a 23-year old man who had Kikuchi-Fujimoto disease with a literature review.
Background: Canine malignant lymphoma is classified into B- or T-cell origin, as in the human case. Due to differences in prognosis, a suitable method needs to be developed for lineage identification. Aims: To determine the accuracy of immunophenotypic and molecular information between three methods: immunocytochemistry (ICC), immunohistochemistry (IHC) and heteroduplex polymerase chain reaction for antigen receptor rearrangements (hPARR) in spontaneous canine lymphomas. Materials and Methods: Peripheral blood, fine needle aspiration and tissue biopsies from enlarged peripheral lymph nodes prior to treatment of 28 multicentric lymphoma patients were collected. Cytopathology and histopathology were examined and classified using the updated Kiel and WHO classifications, respectively. Anti-Pax5 and anti-CD3 antibodies as B- and T-cell markers were applied for immunophenotyping by ICC and IHC. Neoplastic lymphocytes from lymph node and white blood cell pellets from peripheral blood were evaluated by hPARR. Results: In this study, low grade B-cell lymphoma accounted for 25% (7/28), high grade B-cell lymphoma for 64.3% (18/28) and high grade T-cell lymphoma for 10.7% (3/28). According to the WHO classification, 50% of all cases were classified as diffuse large B-cell lymphoma. In addition, ICC showed concordant results with IHC; all B-cell lymphomas showed Pax5+/CD3, and all T-cell lymphomas exhibited Pax5-/CD3+. In contrast to hPARR, 12 B-cell lymphomas featured the IgH gene; seven presented the $TCR{\gamma}$ gene; five cases showed both IgH and $TCR{\gamma}$ genes, and one case were indeterminate. Three T-cell lymphomas showed the $TCR{\gamma}$ gene. The percentage agreement between hPARR and ICC/IHC was 60%. Conclusions: Immunophenotyping should not rely on a single method. ICC or IHC with hPARR should be used concurrently for immunophenotypic diagnosis in canine lymphomas.
Kim, Hee Kyoo;Ha, Seung In;Kim, Yu Ri;Park, Chan Bog;Oak, Chul Ho;Jang, Tae Won;Jung, Maan Hong;Oh, Kyung Seung;Chun, Bong Kwon;Lee, Min Ki;Park, Soon Kew
Tuberculosis and Respiratory Diseases
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v.56
no.5
/
pp.505-513
/
2004
Background : In lung cancer patients, the presence of metastatic neck nodes is a crucial indicator of inoperabilty. So thorough physical examination of neck is always mandatory, but sometimes those are hardly palpable even by the skillful hand. Ultrasonography is a useful diagnostic method in detection of small impalpable lymph nodes and in guidance of fine needle aspiration biopsy. In this study we evaluated the clinical usefulness of ultrasonography(USG) and ultrasound-guided fine needle aspiration cytology(US-FNA) in lung cancer patients without palpable neck nodes. Methods and Materials : From Sep 2002 to Sep 2003, 36 non-small cell lung cancer patients (20 adenocarcinoma, 16 squamous cell cancer) and 10 small cell lung cancer patients without palpable neck nodes on physical examiation were enrolled. patients who had contralateral mediastinal nodal enlargement(>1cm) on chest CT were excluded. After the routine check of USG on the neck, US-FNA was done in cases with enlarged neck nodes (${\geq}5mm$ in the short axis). The presence of enlarged lymph node on USG, and of malignant cells on cytology were evaluated by the histological type and the patients' clinical stage of lung cancer. Results : Among 36 non-small lung cell cancer patients, 14 (38.8%) had enlarged neck nodes on USG, and 5 of 10 small cell lung carcinoma patients. The mean diameter of the neck nodes was 9.8 mm (range, 7-12 mm). US-FNA of 14 non-small cell lung cancer patients revealed tumor cells in eight patients (57.1%). In 5 small cell lung cancer pateints, tumor cells were found in all cases. By the result of US-FNA, the clinical stage of 8 out of 36 (22.2%) non-small cell lung cancer patients had changed, including two cases of shift from the operable IIIa to the inoperable IIIb. In small cell lung cancer patients their clinical stage was not changed after US-FNA, but their pathological diagnosis was easily done in two cases, in whom endobronchial lesions were not found on bronchoscopy. Conclusions : USG and US-FNA of neck node seem to be safe, sensitive and cost-effective diagnostic tools in the evaluation of lung cancer patients without palpable neck nodes.
A calf suffering from diarrhea was admitted to the Animal and Plant Quarantine Agency for diagnostic evaluation. Postmortem examination revealed that the mesenteric lymph node was enlarged and small intestine wall was thin. Microscopically, a large number of small round organisms were attached to the small intestine villi. Villous atrophy and proprial neutrophil infiltration were also observed. Based on modified Ziehl-Neelsen staining, electron microscopy, and ELISA results, the calf was diagnosed with fatal cryptosporidiosis.
A six year old female Shih Tzu was euthanized after having about 2 months history of weakness and convulsion with hypoglycemia. On ultrasonography, several masses in variable sizes were noted in the liver and fine needle aspiration cytology revealed probable neoplasm of pancreatic origin. On necropsy, numerous round firm tan nodules with central depression were noted in the liver and heart. Mesenteric lymph node was enlarged and fused with presumable pancreatic tissue. Based on the histopathology and immunohistochemistry, the tumor was confirmed as malignant metastatic insulinoma.
An 8-year-old spayed female domestic shorthair cat was presented with a chief complaint of chronic nasal discharge and dyspnea. Physical examination revealed pyohemorrhagic nasal discharge, inspiratory dyspnea and stertor, and an enlarged right mandibular lymph node. Abnormalities of blood works and serum chemistry included mildly increased hematocrit, and globulin concentration. Serologic tests for FeLV and FIV, and a panel of polymerase chain reaction tests for Chlamydophila felis, Feline Calicivirus, Herpesvirus, Bordetella, Mycoplasma felis, and H1N1 influenza was all negative. Only radiographic finding showed increasing soft tissue density in the right nasal cavity and computed tomography disclosed soft tissue/fluid opacification in the right nasal cavity, paranasal sinus, and pharyinx along with slight deviation to the right of the osseous nasal septum. Focal lysis of ventral nasal septum was also suspected in CT scan. Cytological evaluation of fine needle aspirate smears of the enlarged mandibular lymph nodes revealed numerous fungal yeasts having variably thick capsule both extracellularly and intracellularly with low numbers of macrophages. Some yeasts showed narrow based budding, which was a consistent finding with Cryptococcus organisms. Serum protein electrophoresis was a polyclonal consistent with chronic infection and serum was submitted for a fungal serology panel test. In serologic tests Cryptococcus antigen titer was 1 : 32,768. In vitro culture was unsuccessful. Treatment was initiated with administration of fluconazole, clindamycin, and tocopherol. Clinical signs resolved within 3 days after the initial treatment. The cat was discharged and scheduled for periodic evaluation and continued therapy, but was lost to follow-up thereafter.
This is a report on four cases of the lobar emphysema due to proximal bronchial obstruction in the Department of Thoracic Surgery, Hanyang University Hospital, during the period of three and half years from 1972 to 1975. First case, a two years old male child was referred to our Department with the lobar emphysema of the lower lobe of the right lung with pneumonia. This emphysema was developed after aspiration of a piece of peanut. Bronchoscopy revealed that the bronchus of the right lower lobe was obstructed with the foreign body, however removal of the peanut through bronchoscope was not attempted because of corruption and softening of the peanut. The removal of the peanut by bronchotomy was performed after subsiding of acute phase of pulmonary infection. Postoperative course was uneventful and the emphysema was disappeared. Second case, a twenty months old female baby was referred to our Department with lobar emphysema of the lower lobe of the left lung. The emphysema was suddenly developed with coughing and dyspneic symptoms and the diagnosis was made roentgenologically. She gave a history of reccurrent infections of the respiratory tract after birth. Bronchoscopy showed an obstruction of the left main bronchus with the growing of fibrinous tissue on the bronchial mucosa. The protruded tissue in the left main bronchus taken out about O.8ml with biopsy forceps for histological examination. After this procedure, the emphysema of the left lung was disappeared. Histological finding was reported to be a chronic inflammatory granulation tissue. Third case, a two and half years old male child was referred to our Department with roentgenological lobar emphysema. Two weeks prior to admission he had an episode of sudden onset of coughing attack with dyspnea. Bronchoscopy revealed that the bronchus of the left lower lobe was obstructed with a mass which was strongly suspected of a neoplastic tissue. At operation, there was found a perforation of enlarged tuberculous lymph node in the bronchus of the left lower lobe and protrusion of granulation tissue into the bronchus. Ruptured orifice on themembranous wall of the left lower lobe bronchus was closed with interrupted suture after the" removal of a perforated tuberculous lymph node. Postoperative course was uneventful and antituberculous chemotherapy was given. Fourth case, a 47 years old man was admitted to our Department with the complaint of severe dyspnea of few months duration. Twenty years ago, he had a history of lung tuberculosis and was treated for many years. X-ray examination including tomography and bronchography revealed that the upper lobe of the right lung was destroyed with cavities, the lower lobe was completely shrunk, and the right middle lobe was strongly overdistended with narrowing bronchial trees. Differential bronchospirometry and lung scanning confirmed that the respiratory function of the affected lung was impaired almost totally. The value of the right lung was calculated on 6% of oxygen uptake, 1% of Minute volume, and 32% of vital capacity. The right pneumonectomy was performed under the careful consideration of anesthetic and surgical procedures. Postoperative course was uneventful and the respiratory function was improved nearly to the normal level.evel.
Kim, Kang San;Hwang, Hyung Sik;Kwon, Heum Dai;Moon, Seung Myung;Oh, Suk Jun;Choi, Sun Kil
Journal of Trauma and Injury
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v.20
no.1
/
pp.52-56
/
2007
Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.
Kwang Hyun Chung;Jin Myung Park;Jae Min Lee;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
Journal of Digestive Cancer Research
/
v.1
no.2
/
pp.104-107
/
2013
Gallbladder (GB) cancer is highly malignant neoplasm found in advanced stage and chemotherapy commonly plays a palliative role in GB cancer. We report a case of unresectable GB cancer treated with chemotherapy followed by extended cholecystectomy. Fifty-six-year-old male visited our hospital with weight loss and dyspnea on exertion. Computed tomography detected pulmonary embolism and diffuse GB wall thickening with para-aortic lymph node enlargement. The length of common channel was 23mm at magnetic resonance cholangiopancreatography which stands for anomalous union of the pancreaticobiliary duct. Anticoagulation was started for pulmonary embolism. GB wall mass was regarded as unresectable GB cancer with distant lymph node metastasis. Gemcitabine and cisplatin combination chemotherapy was carried out for 6 cycles. Primary tumor was stationary but multiple enlarged lymphnodes were almost completely disappeared. Extended cholecystectomy with hepaticojejunostomy was performed. Post-operative tumor stage was T3N1 (stage IIIB) and R0 resection was achieved. After operation he has no evidence of disease recurrence for 6 months.
Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
Journal of Gastric Cancer
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v.7
no.2
/
pp.97-101
/
2007
We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.
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