• Title/Summary/Keyword: misdiagnosis

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Malignant Melanoma of the Foot (족부의 악성 흑색종)

  • Moon, Sung-Hoon;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.18-23
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    • 2006
  • Purpose: We reviewed the clinical finding of malignant melanoma of the foot in korean because it's advanced stage and extended lesion at diagnosis. Materials and Methods: Retrospective study was enforced about the 11 cases who has diagnosed to malignant melanoma of the foot from February 1995 to March 2004. The mean follow up period was 61 months. In this study we used age, sex, site, depth, histology, clinical stage, precursor lesion, misdiagnosis, interval to diagnosis, survival time, survival. Results: Average age was 58 years and number of female was six. Common site of involvement were heel of plantar surface (6 cases) and subungual area (2 cases). Depths of involvement were 0.3 to 10 mm, most common histological type was acral lentiginous melanoma (7 cases), stage 5 according to classification of Clark were 5 cases and stage 2 or more according to clinical staging were 8 cases. precursor lesion were benign melanocytic nevi (2 cases) and ill defined (9 cases). Chief complaint were increasing of size, color change, pain and ulceration. Conclusion: Malignant melanoma of the foot usually arise at nonvisible area and is easy to be misdiagnosed or delayed treatment. So it is hard to early diagnosis and have poor prognosis. So we need education and effort to early detection and diagnosis.

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Fine Needle Aspiration Cytology of Metastatic Melanoma in the Breast - A Case Report - (유방에 전이한 악성 흑색종의 세침흡인 세포학적 소견 - 1예 보고 -)

  • Oh, Young-Lyun;Ko, Young-Hyeh
    • The Korean Journal of Cytopathology
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    • v.9 no.1
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    • pp.111-115
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    • 1998
  • Although the characteristic cytologic features of melanoma have been well described the diagnosis of metastatic melanoma by fine needle aspiration cytology (FNAC) may be difficult in the case of amelanotic melanoma and in the absence of awareness of clinical history. Furthermore, when the breast is the site of initial presentation, it could simulate a primary breast carcinoma leading to misdiagnosis. The recognition of metastatic malignant melanoma in FNAC material is essential to avoid an unnecessary mastectomy and to ensure appropriate chemotherapy. We experienced a case of metastatic melanoma of breast which presented as solitary breast mass in a 56-year-old woman. She had a history of surgical excision of right foot for melanoma one year ago. The cytologic smears were composed of noncohesive epithelioid cells with round or eccentric nuclei, bi-or multi-nucleation, prominent nucleoli, fine chromatin, and intranuclear inclusions. The cytoplasm of tumor cells had scanty melanin pigment but were diffusely positive for S-100 protein.

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Fine Needle Aspiration Cytology of Inflammatory Myofibroblastic Tumor in Mesentery - A Case Report - (장간막에서 발생한 염증성 근섬유모세포종의 세침흡인 세포학적 소견 - 1예 보고 -)

  • Son, Hyun-Jin;Kim, Joo-Heon;Moon, Woo-Sung;Choi, Ho-Yeul;Kang, Myoung-Jae
    • The Korean Journal of Cytopathology
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    • v.11 no.1
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    • pp.35-39
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    • 2000
  • Since inflammatory myofibroblastic turner was initially recognized in the lung, this tumor has been described in other extrapulmonary sites. In spite of relatively uniform histologic findings in various organs, a rarity in extrapulmonary sites and highly vascular characteristics frequently lead to a misdiagnosis in preoperative radiology and fine needle aspiration cytology. We present a case of inflammatory myofibroblastic tumor occurring in the mesentery of a 4-month-old girl. Fine needle aspiration cytology smear disclosed characteristic spindle cells intermixed with prominent mature plasma cells and lymphocytes. According to the immunohistochemical staining, we recognized that the intervening spindle cells are myofibroblasts which have reactivity for the both actin and vimentin.

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Fine Needle Aspiration Cytology of Solitary Fibrous Tumor of the Pleura - Report of a case misdiagnosed as adenocarcinoma of lung - (흉막에 발생한 고립 섬유성 종양의 세침흡인 세포학적 소견 - 폐의 선암종으로 오진한 1예 보고 -)

  • Choi, Yoon-La;Oh, Young-Lyun;Lee, Mee-Sook;Han, Jung-Ho;Ahn, Geung-Hwan
    • The Korean Journal of Cytopathology
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    • v.12 no.2
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    • pp.111-115
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    • 2001
  • Solitary fibrous tumor on the pleura is rare but should be included in the differential diagnosis on a peripheral pulmonary nodule. Cytologic features of solitary fibrous tumor of the pleura is not familar to the pathologist and may be misdiagnosed as malignancy. We report fine needle aspiration cytologic(FNAC) findings of a case of solitary fibrous tumor misdiagnosed as adenocarcinoma in a 48-year-old woman. The FNAC displayed a mixture of bland-looking spindle cells and clusters of epithelioid cells, which have hyperchromatic nuclei with prominent nucleoli. The helpful finding to distinguish It from other circumscribed benign and malignant lesions is the presence of fibromyxoid matrix admixed with blood vessels and thin collagen fibers. Familiarity with these features is essential to avoid misdiagnosis and overtreatment.

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Submasseteric Abscess (깨물근하 농양)

  • Ha, Young In;Park, Eun Soo
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.799-802
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    • 2007
  • Purpose: The masserteric space is an important tissue compartment of the face, but a disease in it is difficult to diagnose and treat. The submasseteric abscess is located between the masseter muscle and mandibular ramus with different appearances such as sepsis, infection, or tumor. Especially the common misdiagnosis of submasseteric abscess is acute or chronic parotitis. The purpose of this report is to pay special attention to the possible diagnosis of submasseteric abscess for the symptoms of unilateral cheek swelling and tenderness that accompany marked trismus. Methods: A 11-year-old boy came to our hospital because of facial swelling, tenderness, and trismus in a history of left cheek swelling and toothache. We diagnosed his case as submasseteric abscess by CT scan and surgical intervention was performed. Under general anesthesia, the abscess was opened by the intraoral incision and considerably massive pus was drained. Results: Swelling, tenderness, and trismus became to subside during postoperative 10 days and general condition and vital signs became stable. After 6 months, CT scan showed that both masseteric muscles were symmetric and there was no periosteal reaction of the mandible. Conclusion: In conclusion, submasseteric abscess is a rare infection with the symptoms of cheek tenderness and marked trismus. A detailed medical history and clinical examination of a patient as well as computed tomography(CT) are important tools in the accurate diagnosis and efficient treatment of the submasseteric abscess. Adequate drainage, removal of cause, and antibiotic infusion are the management of choice.

Acute Abdominal Pain in Children (급성 복통)

  • Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup2
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    • pp.11-18
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    • 2008
  • We often have difficulties in the diagnosis of acute abdominal pain in children because they are unable to adequately express the characteristics of their pain. With a good understanding of the etiologies of abdominal pain associated with ages, we should create a diagnostic approach based on the location of the pain. First, we must differentiate the surgical abdomen from the non-surgical acute abdomen. Then, we have to identify whether the pain originating from intestinal obstruction, ulcerative diseases, or hepatobiliary dysfunction. It is important to interview and examine the patient serially until the patient completely improves. These attitudes will reduce the patient's pain caused by delayed diagnosis and unavoidable misdiagnosis. Finally, the new insight for the appropriate use of analgesics against acute abdominal pain in children is now needed by the pediatrician.

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Subungual Exostosis (족지에 발생한 조갑하 외골증)

  • Song, Kwang-Soon;Kang, Chul-Hyung;Min, Byung-Woo;Park, Jong-Wan
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.106-110
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    • 1996
  • A subungual exostosis is an uncommon benign osteochondral lesion that appears as a painful nodule. Histologically, the tumors consist of a proliferating fibrocartilaginous cap that merged into mature trabecular bone at its base. From 1989 through 1991, 5 patients with subungual exostosis were treated. Three of them had exostosis on the great toe. There were three girls and two boys. The average age of the patients was 10.6 years. All of patients were treated by local excision. Two cases of our patients treated with an incomplete excision were recurred within 3 months after the original procedure. Lack of awareness of unusual lesion can cause initial misdiagnosis in many cases. We considered that a complete excision of the lesion is important for preventing the recurrence, and it should be confirmed with intraoperative radiographs.

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The Fate of Neglected Vascular Injury of the Hand in Acute Hand Injuries (급성 수부 손상에서 간과된 혈관성 손상을 가진 수부의 운명)

  • Kim, Tae-Bum;Lee, Yong-Jig;Lee, Young-Keun;Woo, Sang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.30-38
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    • 2007
  • In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-to-end artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.

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Comparison of Images Using Optimized Grid and Images Using Grid Supperession Software in the Diagnosis of Micro Lesions (미세병변 진단에서 Optimized Grid을 사용한 영상과 Grid Supperession Software를 사용한 영상의 비교분석)

  • Lee, Sang-Ho
    • Journal of radiological science and technology
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    • v.41 no.2
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    • pp.149-155
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    • 2018
  • Quantitative analysis was performed to confirm that moire artifact was removed without loss of image when using grid suppression software in the diagnosis of micro lesions. we showed that grid suppression images can be morphologically different from original images as they are significantly lower than those of the optimized grid in the similarity analysis with reference images in mammographic phantom images. We were confirmed that images of microcalcification with smaller signal than noise were lost because the pixel values of all lesions increased significantly after the grid suppression, The change in contrast using the NORMI 13 X-ray test phantom was reduced to 30% of the reference image, This result was significantly lower than the 90% when using the optimized grid. In conclusion, the use of grid suppression software in clinical images should be carefully considered because of the possibility of misdiagnosis due to micro lesion loss and morphological changes.

Abnormal insertion of the anterior horn of medial meniscus to misdiagnosis to horizontal tear - A case report - (횡 파열로 오인하게 하는 내측 반월상 연골 전각부의 비정상적 삽입 - 증례 보고 -)

  • Kim, Dong-Hee;Gwark, Ji-Yong;Park, Jin-Seung;Hwang, Sun-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.124-128
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    • 2011
  • Many types of meniscal anomalies have been reported. The authors encountered one case of anomalous insertion of the anterior horn of the medial meniscus to the anterior horn of the lateral meniscus, which ran up along the course of the transverse ligament. This anomalous band was detected in MRI of the knee as a horizontal tear of anterior horn of the lateral meniscus but found during the operation as a anomalous insertion of the anterior horn of the medial meniscus. We report the case with a review of the literature.

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