• Title/Summary/Keyword: internal features

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Metastatic tumors to the pancreas: Balancing clinical impression with cytology findings

  • Mohamed A. Abdallah;Kimberlee Bohy;Ashwani Singal;Chencheng Xie;Bhaveshkumar Patel;Morgan E. Nelson;Jonathan Bleeker;Ryan Askeland;Ammar Abdullah;Khalil Aloreidi;Muslim Atiq
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.91-97
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    • 2022
  • Backgrounds/Aims: Metastatic lesions of the pancreas (PMET) account for 1%-5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods: Patients who underwent EUS-FNA at a community referral center between 2011-2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results: A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions: PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.

Clinical Features of Cholestatic Hepatitis (담즙정체성 간염의 임상적 양상)

  • Choi, Sun-Taek;Eun, Jong-Ryul;Lim, Song-Woo;Kim, Bong-Jun;Lee, Heoon-Ju;Gu, Mi-Jin;Choi, Joon-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.18 no.1
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    • pp.51-58
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    • 2001
  • Background: Cholestatic hepatitis is failure of bile to reach the duodenum with hepatocellular damage and no demonstable obstruction of the major bile ducts. The prognosis is usually good with recovery in less than 4 weeks after withdrawal of the offending drug. However, a prolonged course lasting over 3 months is possible and, in rare cases, progression to ductopenia with development of a vanishing bile duct syndrome occurs. A differential diagnosis with other causes of Chronic liver disease is needed. Materials and Methods: From January 1991 through January 2000, 14 patients diagnosed as cholestatic hepatitis by liver biopsy were included. The possible causative drug, clinical features, laboratory findings, and progression of cholestatic hepatitis were evaluated. The semiquantitative study of liver lesions was performed by two independent observers. Results: Causes of cholestatic hepatitis are 5 cases of oriental medicine, 3 cases of anti-tuberculosis medication, 1 case of ticlopidine and antibiotics and 4 cases of unknown causes. The clinical features of cholestatic hepatitis were jaundice, itching, urine color change, and general weakness. During 6 to 30 months, LFT of 5 patients showed prolonged elevation. Elevated total cholesterol ${\geq}$250 mg/dL in 6 patients, pheripheral blood eosinophilia in 5 patients, auto-antibody positive in 6 patients were observed respectively. The biopsies showed intralobular bilirubinostasis with a mixed portal inflammatory infiltration. Conclusion: In cholestatic hepatitis, durations of abnormal LFT are variable regardless of causative drugs. If cholestatic hepatitis progresses toward chronic course, viral hepatitis, primary biliary cirrhosis, and autoimmune hepatitis should be differentially diagnosed and sequential liver biopsies are needed.

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Intrathoracic Desmoid Tumor Presenting as Multiple Lung Nodules 13 Years after Previous Resection of Abdominal Wall Desmoid Tumor

  • Koo, Gun woo;Chung, Sung Jun;Kwak, Joo Hee;Oh, Chang Kyo;Park, Dong Won;Kwak, Hyeon Jung;Moon, Ji-Yong;Kim, Sang-Heon;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Oh, Young-Ha;Pyo, Ju Yeon;Kim, Tae-Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.267-271
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    • 2015
  • Desmoid tumors are rare soft tissue tumors considered to have locally infiltrative features without distant metastasis until now. Although they are most commonly intraabdominal, very few cases have extra-abdominal locations. The origin of intrathoracic desmoid tumors is predominantly the chest wall with occasional involvement of pleura. True intrathoracic primary desmoid tumors with no involvement of the chest wall or pleura are extremely rare. We recently experienced a case of true intrathoracic desmoid tumor presenting as multiple lung nodules at 13 years after resection of a previous intraabdominal desmoid tumor.

A Case of Giant Cell Tumor Originated from Right Second Rib (늑골에 발생한 골거세포종 1예)

  • Hong, Seok-Cheol;Han, Pyo-Seong;Kim, Nam-Jae;Kim, Ju-Ock;Kim, Sam-Yong;Lim, Seung-Pyung;Song, Kyu-Sang;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.2
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    • pp.172-175
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    • 1992
  • Giant cell tumor is the second most common benign tumor of the bone. But, the incidence in the ribs is rare. Clinical features of giant cell tumor may vary markedly from latent to very aggressive. Recently, we experienced clinically aggressive form of giant cell tumor in the right 2nd rib and report this case with reviewing the articles of giant cell tumor.

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A Case of Metastatic Endobronchial Melanoma from an Unknown Primary Site

  • Lee, Jae-Hee;Lee, Shin-Yup;Cha, Seung-Ick;Ahn, Byeong-Cheol;Park, Jae-Yong;Jung, Tae-Hoon;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.169-172
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    • 2012
  • Melanoma can occur as a metastasis within subcutaneous tissue, lymph nodes, or viscera without a detectable primary tumor. Among patients with metastatic melanoma of unknown primary lesion, those with endobronchial metastasis are exceedingly rare. Herein we report a case of an endobronchial and pulmonary metastasis in a patient with melanoma originating from an unknown primary site. The patient without a previous history of melanoma presented with blood-tinged sputum. Fiberoptic bronchoscopy revealed a black polypoid tumor obstructing the posterior basal segmental bronchus of the right lower lobe. A final diagnosis of the malignant melanoma was made based on an immunohistochemical study of the bronchoscopic biopsy specimen. Skin, ophthalmic, oral, and nasal examinations failed to identify occult primary lesions. Subsequent evaluation including positron emission tomography/computed tomography scans did not uncover any abnormalities other than the metastatic pulmonary melanoma. We also describe the characteristic bronchoscopic features of melanoma.

A Case of Primary Hemangiopericytoma of the Lung (폐의 원발성 혈관주위세포종 1예)

  • Kim, Dae-Young;Lee, Dong-Lyeol;Lee, Kyu-Hwan;Jo, Jin-Hoon;Kim, Kang-Hee;Kim, Ho-Kyun;Kim, Hye-Suk;Yoon, Sun-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.111-116
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    • 1999
  • Primary hemangiopericytomas of the lung are uncommon sarcomas that arise from pericytes that surround the basement membrane of capillaries and small venules within the lung parenchyma. The presenting symptoms and signs depend on the location of the tumor and radiologic features are not diagnostic. The behavior of pulmonary hemangiopericytomas is difficult to predict and all tumors should be considered potentially malignant. Wide surgical excision remains the mainstay of treatment. We report a case of primary hemangiopericytoma of the lung with a brief review of literature.

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A Case of Pseudolymphomatous IgG4-Related Disease Involving the Maxilla (상악골 침범으로 나타난 거짓림프종양 IgG4 연관병증 1예)

  • Kim, Min-Jung;Bae, Seung-Il;Kim, Hoon-Tae;Hong, Young-Hoon;Kim, Hyun-Je;Lee, Choong-Ki;Gu, Mi Jin
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.128-131
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    • 2013
  • Immunoglobulin G4 (IgG4)-related disease is an inflammatory condition characterized by IgG4 positive plasma cell infiltration. It can affect any organ in the body and mainly involves the pancreas, liver, biliary tracts, orbits, salivary glands and lymph nodes. It can manifest as an inflammatory pseudotumor. Pseudolymphoma as an inflammatory pseudotumor is a group of benign tumors that exhibit histological and clinical features suggestive of malignant lymphoma. Studies on IgG4-related disease are rarely reported, and no case of the disease that involved the maxillary bone and adjacent soft tissue, except for the skin, has been reported. Therefore, we report herein a case of pseudolymphomatous IgG4-related disease that involved the maxilla, with a literature review.

Comparison of digitized radiographic alveolar features with age (연령 변화에 따른 치조골의 디지탈 방사선학적 특성비교)

  • Lee Keon Il
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.27 no.1
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    • pp.17-24
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    • 1997
  • The purpose of the present study was to use digital profile image features and digital image analysis of fixed-dimension bone regions, extracted from standardized periapical radiographs of the maxilla, to determine whether differences exist in alveolar bone of younger women(mean age: 59.23±7.34 years) and just menopaused women(mean age: 59.23±7.34). Periapical films were used from two groups of 20 randomly selected women. None of the subjects had a remarkable medical history. To simplify protocol, we chose one interproximal bone area between the maxillary right canine and lateral incisor for study. Ech film was digitized into a 1312 x 1024 pixel x 8 bit depth matrix by means of a Nikon 35 mm film scanner(LS-35lOAF, Japan) with fixed gain and internal dark current correction to maintain constant illumination. The scanner was interfaced to a Macintosh LC III computer(Apple Computer, Charlotte, N.C.). Area and profile orientation were selected with a NIMH Image 1.37(NIH Research Services Branch, Bethesda, Md.). Histogram features were extracted from each profile and area. The results of this study indicate that mean pixel intensities didn't differ significantly between two groups and there was a high correlarion-coefficient between digitized radiographic profile features and area features.

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A Clinical Study of One Patient Suffering Anorexia Nervosa-like Symptoms (신경성 식욕부진 유사 환자 1례에 대한 증례보고)

  • Kim, Jong-Won;Shim, Jae-Chul;Kim, Min-Sang;Oh, Byeong-Yeol;Lee, Ji- Young;Jo, Hyun-Kyung;Chai, Young;Kim, Yoon-Sik;Seol, In-Chan;Yu, Byeong-Chan
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.655-661
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    • 2004
  • Anorexia nervosa is a serious, often chronic, and life-threatening eating disorder defined by a refusal to maintain minimal body weight (within 15% of an individual s normal weight). Other essential features of this disorder include an intense fear of gaining weight, a distorted body image, and amenorrhea(absence of at least three consecutive menstrual cycles when they are otherwise expected to occur). With anorexia nervosa, the nails and hair become brittle, and the skin may become dry and yellow. In addition to depression, hypothermia, lanugo, nausea, vomiting, anxiety and dehydration from sweating can appear. Starvation, weight loss, and related medical complications are quite serious and can result in death. Recently one patient was admitted with anorexia nervosa-like symptoms. The patient is a 18-year-old girl with complaints of weight loss, amenorrhea, anorexia, nausea, vomiting, tremor, and sweating. After treatment through oriental medicine for 2 weeks, most of the symptoms improved. Therefore, this application of oriental medicine is reported with a plea for further investigation.

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Endobronchial Metastasis of Extrapulmonary Malignancies (폐외 악성 종양의 기관지내 전이)

  • Kim, Do-Hoon;Park, Moo-Suk;Chung, Jae-Ho;Cheong, Jae-Hee;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Kim, Young-Sam
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.285-293
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    • 2002
  • Background : The lung is the most common site for a metastasis of extrapulmonary malignant tumors. however, reports on an endobronchial metastasis are rare. An endobronchial metastasis is defined as a documented extrapulmonary neoplasms metastatic to the segmental or more proximal central bronchus within a bronchoscopically visible range. The purpose of this study was to define the clinical characteristics of an endobronchial metastasis of extrapulmonary malignancies. Materials and Methods : The clinical features and treatment outcomes of 27 endobronchial metastatic cancer cases were reviewed from June, 1991 to May, 2001 in the Severance Hospital. Results : The patients' age ranged from 18 to 75. There were 17 men and 10 women. The primary tumors included the colorectum in 7, the uterine cervix in 4, the stomach and the breast in 3 patients each, and an osteosarcoma in 2 patients. The main complaint of most patients was coughing and a chest X-ray revealed a hilar mass, a parenchymal, and an atelectasis. The mean recurrence interval time was 45.5 months. The median and mean survival times were 10 and 12.3 months, respectively. Conclusion : An endobronchial metastasis is an ominous finding, and is associated with advanced-stage diseases. It requires differential diagnosis with a primary bronchogenic carcinoma. If atypical clinical features are present or an atypical cell type is discovered by a biopsy of the lesion in the lung mass, the appropriate diagnostic studies should be undertaken.