• Archives of Plastic Surgery
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• v.35 no.3
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• pp.312-315
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• 2008

Purpose: Amelanotic melanoma represents a melanoma with an absence or a small number of melanin pigments and comprises 2% of all melanomas. These melanomas are frequently misdiagnosed, probably because of its nonspecific clinical features and difficulty in diagnosis, resulting in delayed diagnosis and treatment. We report a patient with amelanotic melanoma, who underwent surgical treatment with sentinel lymph node biopsy using gamma probe. Methods: A 32-year-old female was presented with a slowly growing ill-defined, hypopigmented nonerythematous lesion with nail defect on right index finger tip. Preoperative punch biopsy was performed, showing an amelanotic melanoma. Sentinel lymph node biopsy was done using gamma probe(Crystal probe system, CRYSTAL PHOTONICS GmbH, Germany) and confirmed no evidence of regional lymph node metastases. The patient underwent amputation at the proximal interphalangeal joint. Results: Histopathologic findings showed superficial spreading melanoma. There were no melanin pigments in Hematoxylin & Eosin stain but positive immunohistochemical stainings for S-100 protein and Hmb45, which were consistent with amelanotic melanoma. Patient's postoperative course was uneventful without any complication and had no evidence of recurrence of tumor in 6 months follow-up period. Conclusion: Amelanotic melanoma is extremely rare subtype of malignant melanoma with histopathologic findings of atypical melanocytes without melanin pigments. Early detection is crucial since survival is strongly related to tumor thickness and tissue invasion at the time of diagnosis. Wide excision is the treatment of choice and other conjunctive therapy has not been successful.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.554-559
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• 2007

A 29-year-old female patient presented with exertional dyspnea that she had suffered with for 2 months. The chest X-ray displayed right pleural effusion that was diagnosed as chyle, according to the level of cholesterol and triglyceride in the pleural fluid. VATS (video assisted thoracic surgery) of the right lung was performed on the 7th day of hospitalization for obtaining a lung biopsy and to control the of pneumochylothorax. On the 11th hospitalization day, VATS of left lung was also performed to control the recurrent pneumothorax via pleurodesis. The lung biopsy showed moderate amounts of spindle-shaped and rounded cells (so-called LAM cells), which were reactive to actin and HMB45 (on immunohistochemical stains). We report here on a rare case of lymphangioleiomyomatosis combined with chylothorax and bilateral pneumothroraces.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.533-537
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• 1999

Pulmonary lymphangiomatosis is a very rare pulmonary lesion with an aggressive potential that occurs mainly in newborns, infants and young children of both sexes. It is characterized by pulmonary abnormalities of lymphatic system, showing an increased number of complex anastomosing lymphatic channels in the pleura, in the subpleural interlobular septa, and along the bronchovascular lymphatic route and uniformly fatal. We report a case of lymphangiomatosis behaving like lymphangioleiomyomatosis in a 26-year-old woman.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.357-369
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• 2001

In this present study, the healing process and the recurrence of pigmentation were evaluated clinically and histologically in accordance with the extent and the range of pigmentation after phenol was applied to remove melanin pigmentation in gingiva. Six mongrel dogs were used. The melanin pigmentation in canine gingiva were classified into slight, moderate and severe according to the extent of pigmentation and divided into local and diffuse types according to the range. Following general and local anesthesia, 90% phenol was applied to the pigmented gingiva of the subjects with small cotton balls until the surface was etched to be whitish and was neutralized with small cotton balls soaked by 95% alcohol. The contralateral pigmented gingiva to the one treated with phenol, was treated by surgical deepithelialization. At 1, 3 and 8 weeks, the treated gingiva was examined clinically and evaluated histologically following H-E stain, and HMB 45 stain for melanocyte after biopsy. In the phenol treated sites, epithelium and connective tissue healed normally and there was no pigmentation at 1 week. At 3 weeks of healing, melanin repigmentation was observed in the severe local type and moderate to severe diffuse type. In the surgically deepithelialized sites, healing was delayed, compared to phenol treated sites and the infiltration of the inflammatory cells and congestion in connective tissue was shown at 1 week. At 3 weeks, healing was completed and there was a partial melanin repigmentation. At 8 weeks of healing, the extent and the range of repigmentation were increased in both group according to the extent or range priot to depigmentation procedure. These results suggpriorest that the removal of melanin pigmentation with 90% phenol application result in normal healing process of gingiva. However, in the severe local type and moderate to severe diffuse type, sites treated with phenol showed repigmentation at 3 week, which was earlier than surgical deepithelialized sites. Therefore it is required to select appropriate method according to initial condition of pigmentation.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.13-19
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• 2001

Background : The incidence of malignant melanoma is currently increasing at a rate greater than any other cancer occuring in human. At this time, early diagnosis and surgical excision were the mainstay of treatment for patients with malignant melanoma. We reviewed the results of average 4 years of follow-up after surgical excision of total 16 cases of malignant melanoma since 1985. Materials and Methods : There were 16 patients (mean age 58.5 years, 5 men, 11 women). The site of the primary lesion was foot and toe (6), back (3), hand (2), thigh (2), shoulder (1), lower abdomen (1) and lip (1). The lymph node was involved at 9 patients. The histologic diagnosis was made with H-E, S-100 stain, and HMB-45 stain as a special stain. Results : Histologically, there were Clark's stage I for 3 patients, II in 4, III in 2, IV in 3, and stage V in 4 patients. The wide excision only greater than 2cm margin was performed for 4 patients. The wide excision and lymph node dissection were performed for 4 patients. The amputation was only performed for 3 patients, and the amputation and lymph node dissection were performed for 5 patients. After surgical excision, chemotherapy was done with Taxol for each 2 patients of stage IV and V. After long term follow-up for mean 4 years, 4 patients died related with melanoma, 1 patient was recurred, and 11 patients were cured. Conclusion : The incidence of malignant melanoma was rare in Korea, but early involvement of lymph node at initial diagnosis was found in many cases (9/16, 56%). And then, early detection and appropriated excision as well as careful dissection of adjacent lymph nodes will offer the patient the best chance for cure.