• Title/Summary/Keyword: pathologic diagnosis

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Schwannoma of the Hand: Importance of Differential Diagnosis & Microsurgical Dissection (수부의 신경초종: 감별진단과 미세수술의 중요성)

  • Tark, Kwan-Chul;Koo, Hyun-Kook
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.452-456
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    • 2010
  • Purpose: The schwannoma is a benign peripheral nerve tumor arising from the Schwann cell of the nerve sheath. Only 2-8% of schwannomas arise in the hand and wrist. Misdiagnosis is frequent such as ganglion and neurofibroma. This article documents and clarifies the clinical features of schwannomas arising in the hand and wrist, and emphasizes importance of differential diagnosis and meticulous surgical extirpation under magnification. Methods: The author reviewed clinical features of 15 patients with pathologic final diagnosis of schwannoma developed in hand and wrist during the last 12 years from 1998 through 2009. The review included the sex, age of onset, duration, preoperative diagnosis, location, involved nerve, preoperative symptoms and. Postoperative sequelae after surgical extirpation of the lesion with magnification, or without magnification of the surgical fields. Results: The chief complaints were slow growing firm mass in all patients, and followed by pain in 40%, and paresthesia in 40% respectively. The lesions were developed solitarily in 14 patients (93%). The postoperative pathologic diagnosis and preoperative diagnosis were coincided with only in 6 patients (40%). Other preoperative diagnosis were soft tissue tumor in 4 patient (26.6%), and ganglion in 3 patients (20%), and neurofibroma in 2 patients (13%). In all patients who were undergone surgical excision under the fields of magnification, all symptoms were subsided without any sequelae. Meanwhile muscle weakness, paresthesia, hypoesthesia and /or accidental nerve resection developed after surgical excision with naked eye. Conclusion: Schwannoma in hand most commonly appears as a slow growing solitary mass with pain or paresthesia. The chance of preoperative misdiagnosis was 60% in this series. To provide good prognosis and less sequelae, careful and elaborate diagnostic efforts and meticulous surgical excision under the magnification are necessary in management of schwannoma.

Hemophagocytic lymphohistiocytosis diagnosed by brain biopsy

  • Ju, Hee Young;Hong, Che Ry;Kim, Sung Jin;Lee, Ji Won;Kim, Hyery;Kang, Hyoung Jin;Park, Kyung Duk;Shin, Hee Young;Chae, Jong-Hee;Phi, Ji Hoon;Cheon, Jung-Eun;Park, Sung-Hye;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.358-361
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    • 2015
  • Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, splenomegaly, jaundice, and pathologic findings of hemophagocytosis in bone marrow or other tissues such as the lymph nodes and liver. Pleocytosis, or the presence of elevated protein levels in cerebrospinal fluid, could be helpful in diagnosing HLH. However, the pathologic diagnosis of the brain is not included in the diagnostic criteria for this condition. In the present report, we describe the case of a patient diagnosed with HLH, in whom the brain pathology, but not the bone marrow pathology, showed hemophagocytosis. As the diagnosis of HLH is difficult in many cases, a high level of suspicion is required. Moreover, the pathologic diagnosis of organs other than the bone marrow, liver, and lymph nodes may be a useful alternative.

OSTEOMYELITIS OF THE MANDIBLE ASSOCIATED WITH OSTEOPETROSIS (하악골 골수염이 동반된 전신적 골화석증)

  • Lee, Jong-Ho;Jeong, Jong-Cheol;Seo, Ku-Jong;Jeong, Joong-Jae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.4
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    • pp.269-274
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    • 1992
  • Osteopetrosis is a rare skeletal disease of unknown etiology. Osteomyelitic changes in the jaw bones are frequently seen in this disease, especially in the mandible and may follow upon tooth extraction. A case is reported of a 31-year-old male who was seen because of intraorally exposed bony spicule and chronic dull pain. Radiographic and haematological investigations led to the diagnosis of osteopeirosis with osteomyelitis. The striking radiologic findings were pathologic mandibular fracture and generalized skeletal thickening. The present case could be grouped under the benign form, type II osteopetrosis. With the conservative and minimally invasive modes of treatment including administration of penicillin G sodium, curettage and closed reduction, we could successfully manage the osteomyelitis and pathologic fracture associated osteopetrosis.

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Problems in the Pathologic Diagnosis of Suspected Lung Cancer

  • Soo Han Kim;Mi-Hyun Kim;Min Ki Lee;Jung Seop Eom
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.176-182
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    • 2023
  • Since the introduction of low-dose computed tomography (CT) screening for patients at high risk of lung cancer, the detection rate of suspicious lung cancer has increased. In addition, there have been many advances in therapeutics targeting oncogenic drivers in non-small cell lung cancer. Therefore, accurate pathological diagnosis of lung cancer, including molecular diagnosis, is increasingly important. This review examines the problems in the pathological diagnosis of suspected lung cancer. For successful pathological diagnosis of lung cancer, clinicians should determine the appropriate modality of the diagnostic procedure, considering individual patient characteristics, CT findings, and the possibility of complications. Furthermore, clinicians should make efforts to obtain a sufficient amount of tissue sample using non- or less-invasive procedures for pathological diagnosis and biomarker analysis.

Prevalence of Benign Pulmonary Lesions Excised for Suspicion of Malignancy: Could It Reflect a Quality Management Index of Indeterminate Lung Lesions?

  • Carillo, Gerardo Andres Obeso;Vazquez, Jose Eduardo Rivo;Villar, Alberto Fernandez
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.458-464
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    • 2014
  • Background: The effort to detect lung cancer in ever-earlier stages leads to the identification of an increasing number of patients without preoperative histological diagnosis. The aim of this study is to determine the prevalence and characteristics of benign lesions excised in the context of lung cancer surgery. Methods: We retrospectively analyzed data from 125 surgical procedures. We compared the preoperative clinical or cyto-histological diagnosis with the surgical-pathologic diagnosis in order to identify the percentage of benign lesions excised. Furthermore, other parameters were analyzed, such as age, sex, tumor size, the presence of calcification, and the type of surgery according to subgroup. Results: Of the 125 patients included in the study, 63 (50.4%) had a preoperative histological diagnosis of malignancy, corresponding to 56 cases (44.8%) of primary lung cancer and 7 cases (5.6%) of metastases. The 62 (49.6%) remaining cases without preoperative histological diagnosis were divided among 50 (40%) solitary pulmonary nodules and 12 (9.6%) pulmonary masses. According to the postoperative pathologic examination, we identified 12 (9.6%) benign lesions excised during lung cancer surgery. There were no statistically significant differences by subgroups with respect to age or sex. We found statistically significant evidence regarding the size and wedge resection as the surgical technique of choice for this type of benign lesion. Conclusion: Our study obtained results similar to those published by other groups regarding the resection of benign lesions in lung cancer surgery. This percentage could be a quality management index of indeterminate lung lesions.

Epidemiological investigation of equine hindlimb ataxia with Setaria digitata in South Korea

  • Hwang, Hyeshin;Ro, Younghye;Lee, Hyunkyoung;Kim, Jihyeon;Lee, Kyunghyun;Choi, Eun-Jin;Bae, You-Chan;So, ByungJae;Kwon, Dohoon;Kim, Ho;Lee, Inhyung
    • Journal of Veterinary Science
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    • v.23 no.5
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    • pp.75.1-75.7
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    • 2022
  • Background: Since 2013, the number of requests for diagnosis for horses based on neurological symptoms has increased rapidly in South Korea. The affected horses have commonly exhibited symptoms of acute seasonal hindlimb ataxia. A previous study from 2015-2016 identified Setaria digitata as the causative agent. Objectives: This study is an epidemiological investigation to find out risk factors related to the rapid increase in hindlimb ataxia of horses due to aberrant parasites in South Korea. Methods: An epidemiological investigation was conducted on 155 cohabiting horses in 41 horse ranches where the disease occurred. The surrounding environment was investigated at the disease-causing horse ranches (n = 41) and 20, randomly selected, non-infected ranches. Results: Hindlimb ataxia was confirmed in nine cohabiting horses; this was presumed to be caused by ectopic parasitism. Environments that mosquitoes inhabit, such as paddy fields within 2 km and less than 0.5 km from a river, had the greatest association with disease occurrence. Conclusions: Most horse ranches in South Korea are situated in favorable environments for mosquitoes. Moreover, the number of mosquitoes in the country has increased since 2013 due to climate change. Additional research is required; however, these data show that it is necessary to establish guidelines for the use of anthelmintic agents based on local factors in South Korea and disinfection of the environment to prevent disease outbreaks.

Ultrasonography to the Diagnosis of Dogs with cataracts and retinal detachment (개의 백내장 및 망막박리에서의 초음파 진단)

  • 김종택
    • Journal of Veterinary Clinics
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    • v.14 no.2
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    • pp.235-237
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    • 1997
  • Cataract and Retinal detachment eyes dogs were examined by ultrasonography. Ultrasonography of the immature and mature cataractous eyes showed echographic changes, and cataractous lens increased in thickness. The diagnosis of retinal detachment was made an echodense waving motion structure in the posterior segment was imaged. This investigation will provide basic information for the study of pathologic conditions affecting the eyes of dog using ultrasound unit commonly available to the veterinarian.

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Vocal Fold Leukoplakia: Updates in Diagnosis and Management (성대 백반증의 진단과 치료에 대한 최신 지견)

  • Ji, Jeong-Yeon;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.13-19
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    • 2022
  • Vocal fold leukoplakia poses a challenge to otolaryngologists due to its various spectrum of pathologic diagnosis. The degree of dysplasia is associated with malignancy risk and the new 2017 WHO classification system changed from the 3-tier system to a 2-tier system consisting of low and high grades. Infections including candidiasis, cryptococcosis, and tuberculosis should also be included in the differential diagnosis. Efforts have been made to evaluate risks using endoscopic technologies such as narrow band imaging, and surgery is essential for histopathological diagnosis. Regarding management, it is important to make an accurate diagnosis and find a balance between oncologic safety and functional outcome.

A Clinicopathologic Analysis of Neck Masses (경부 종괴의 임상 및 병리학적 고찰)

  • Km Jeong-Ho;Oh Sang-Hoon;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.51-57
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    • 1997
  • A mass appearing in the anterior or lateral side of neck often can be a diagnostic challenge. Differential diagnosis of the neck mass covers a broad spectrum of diseases and the proper evaluation and management of a neck mass requires an impressive amount of anatomic and pathologic information. Because improper diagnosis and management may convert a potentially curable malignant metastasis into incurable disease, a differential diagnosis must be considered in all patients who present with a neck mass. Authors reviewed 2,148 cases of neck mass who were diagnosed by surgical resection, biopsy or aspiration during the period between October 1982 to December 1993, excluding those with thyroid and parathyroid disease. The evaluated characteristics were age, sex, site of lesion, and pathologic diagnosis. The results were as follows: Of 2,148 cases of neck mass, the overall ratio of benign to malignant tumor was 3 : 1. In 1,603 cases of benign mass lesion, the most common disease was lymphadenitis(non-specific and tuberculosis) showing 53% incidence, the second was salivary gland tumor(13%), and the third was congenital lesion(12%). The minor problems such as lipoma and sebaceous cyst were 21 %. In the age distribution of benign lesion, tuberculous lymphadenitis showed peak incidence in second decade, non-specific lymphadenitis was main disease of childhood, salivary gland tumor was peak in fourth decade, and most of congenital lesions were diagnosed at the age below 15. In 545 malignant tumors, the most common lesion was metastatic cancer to cervical lymph nodes yielding 71 % incidence(head and neck primary 52%, infraclavicular primary 42%, unknown primary 5%), the second common disease was lymphoma(19%), and the third was salivary gland cancer(9%). In the age incidence of malignant tumor, 60% of them developed in the fifth and sixth decade, head and neck primary was more common in the fifth decade than sixth, however lymphoma showed higher incidence in sixth decade. In the analysis of mass location according to lymph node level grouping(I - V), lymphadenitis developed mostly in level V nodes, the next common occurring site was level IV in tuberculous lymphadenitis and level II in non-specific lymphadenitis. The majority of metastatic cancers were found in level IV and III, and common occurring site of lymphoma was in level II and IV. Pathologic diagnosis of neck masses were made by fine needle aspiration cytology 80 cases, incisional biopsy 533 cases, excisional surgery 1,399 cases, and neck dissection 116 cases. For the proper management of neck mass, a proper diagnostic modality should be selected from imaging techniques, cytology, biopsy or neck dissection, with the consideration of patient's age, history and clinical findings. The scapel biopsy could be used freely in the inflammatory disease or inoperable metastatic cancer, but it should be reserved in the curable metastatic cancer or clinically possible malignancy.

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