• Title/Summary/Keyword: pathological lesion

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Rare Form of Schwannoma as a Purely Hemorrhagic Cystic Tumor Located in an Intermuscular Plane

  • Lim, Joo Hee;Shim, Jae-Chan;Yoon, Byung-Ho;Kang, Yun Kyung;Lee, Kyoung Eun;Kim, Ho Kyun;Lee, Ghi Jai;Suh, Jung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.1
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    • pp.38-42
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    • 2017
  • Schwannomas are mostly solid tumors, some of which may contain cystic degenerations or hemorrhages. However, a schwannoma seen as a purely hemorrhagic cystic tumor is very rare. A 63-year-old woman was referred to the hospital due to a slow-growing mass (present for about 5 years) on her right thigh. She complained about vague pain but without neurologic symptoms such as numbness or tingling sensations. MR images showed an oval lesion with defined margins surrounded by the rectus femoris, vastus lateral, and the vastus intermedius. It was characterized as a multilocular cystic lesion composed of hemorrhagic fluid. In addition, the benign hemorrhagic cystic lesion was differentially diagnosed by radiological techniques as a hemorrhagic ganglion cyst. The lesion was surgically excised and, based on pathological features, was diagnosed as being a schwannoma. We report a purely hemorrhagic cystic schwannoma located in an intermuscular plane.

Pathological observation of porcine respiratory disease in slaughter pigs (도축돈에 대한 호흡기 질병의 병리학적 조사)

  • Kim, Nam-Hee;Hwang, Weon-Moo;Lee, Jung-Goo;Lee, Sung-Mo;Yang, Don-Sik;Lee, Chang-Hee;Kim, Sung-Jae;Han, Jeong-Hee
    • Korean Journal of Veterinary Service
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    • v.34 no.4
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    • pp.389-395
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    • 2011
  • The aims of this study were to assess the lung lesions and to compare gross observations with histopathological findings in the lungs of slaughter pigs. During August of 2010 through July of 2011, the 1,200 lung samples were randomly collected from slaughtered pigs in Korea. We examined prevalence of lung lesions and classified the lung lesion according to the severity of lung lesions. For the comparison of gross lesions with histopathological findings, BALT hyperplasia was also examined. Among the tested samples, 1,100 (91.7%) had pneumonic lung lesions. In the seasonal prevalence of pneumonic lung lesions, spring was the highest followed by winter, summer and autumn, respectively. The mean pneumonic score ($mean{\pm}SD$) was $21.37{\pm}17.87$ and the highest gross lesion according to stages was 11~20% (27.2%, 326/1,200). The prevalence of pleuritis was 7.0% and the highest prevalence was determined in summer. In severity, the lungs collected in this study were frequently in chronic stage (36.4%, 437/1,200), and it was shown that BALT hyperplasia was more extensive in chronic lesion. In this study, the prevalence of pneumonic lung lesions showed a high side and appeared particularly high in the spring. Severity of lung lesion was the most prevalent chronic lesions which were consistent with histopathologic findings.

Histological Observation of Osteochondrosis Dissecans Occurred in Mandibular Condyle (하악과두에 생긴 박리성 뼈연골증의 조직학적 관찰)

  • Choung, Pill Hoon;Kim, Soung Min;Lee, Suk Keun
    • The Korean Journal of Oral and Maxillofacial Pathology
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    • v.42 no.5
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    • pp.145-152
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    • 2018
  • A 57 years old female complained of severe pain on the right temporomandibular joint (TMJ) area. Her right condyle had been partly resected under surgical operation 13 years ago due to condyle hypertrophy, thereafter she felt dull pain on TMJ area and recently the lesion became severely swelled and painful leading to cancer phobia. The present radiological views showed slightly enlarged and sclerosed condyle with increased radiopacity, but its articular sliding function was almost disable during mouth opening. The patient's TMJ lesion was carefully managed with conservative physiotherapy and pain treatment. The microsection of condyle head obtained from the previous operation was re-evaluated histologically, and it was finally diagnosed as osteochondrosis dissecans (OCD), exhibiting hyperplastic proliferation of cartilage in condyle head and marked vascular dilatation in epiphyseal zone. This abnormal cartilage tissue was distinguishable from normal cartilage tissue found in the peripheral cartilaginous cap of the same microsection. The involved cartilage cap showed thick hypertrophic chondrocyte zone with horizontal and vertical clefts accompanying diffuse hyaline degeneration. The superficial fibrous zone of cartilage cap was thickened and frequently peeled off, while lower hypertrophic zone of cartilage cap was highly cellular and proliferative. Consequently, the endochondral ossification became aberrant and resulted pre-mature apoptosis of many hypertrophic chondrocytes, followed by diffuse and mild inflammatory reaction in the underlying marrow tissue. Therefore, it was suggested that this hypertrophic condyle lesion, OCD, be differentiated depending on radiological and histological features from ordinary condyle hyperplasia, osteochondroma, and osteoarthritis, and that the pathological confirmation of OCD may provide a reliable modality for dental and medical treatment of chronic and painful TMJ lesion.

A Case of Adenocarcinoma Presenting a Solitary Pulmonary Nodule that Grows Slowly Over 10 Years (10년간 크기가 서서히 증가한 고립성 폐결절이 선암으로 진단된 1예)

  • Kwon, Ki Du;Kim, Ji Hyeong;Kim, Dae Yong;Choi, Moon Han;Choi, Jae Huk;Shin, Dong Won;Choi, Jong Hyo;Yi, Sul Hee;Yun, Jin A;Choi, Jae Sung;Na, Ju Ok;Seo, Ki Hyun;Kim, Yong Hoon;Oh, Mi Hae
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.318-323
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    • 2008
  • It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.

Retrospective Evaluation of Discrepancies between Radiological and Pathological Size of Hepatocellular Carcinoma Masses

  • Tian, Fei;Wu, Jian-Xiong;Rong, Wei-Qi;Wang, Li-Ming;Wu, Fan;Yu, Wei-Bo;An, Song-Lin;Liu, Fa-Qiang;Feng, Li;Liu, Yun-He
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9487-9494
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    • 2014
  • Background: The size of a hepatic neoplasm is critical for staging, prognosis and selection of appropriate treatment. Our study aimed to compare the radiological size of solid hepatocellular carcinoma (HCC) masses on magnetic resonance imaging (MRI) with the pathological size in a Chinese population, and to elucidate discrepancies. Materials and Methods: A total of 178 consecutive patients diagnosed with HCC who underwent curative hepatic resection after enhanced MRI between July 2010 and October 2013 were retrospectively identified and analyzed. Pathological data of the whole removed tumors wereassessed and differences between radiological and pathological tumor size were identified. All patients were restaged using a modified Tumor-Node-Metastasis (TNM) staging system postoperatively according to the maximum diameter alteration. The lesions were classified as hypo-staged, iso-staged or hyper-staged for qualitative assessment. In the quantitative analysis, the relative pre and postoperative tumor size contrast ratio ($%{\Delta}size$) was also computed according to size intervals. In addition, the relationship between radiological and pathological tumor diameter variation and histologic grade was analyzed. Results: Pathological examination showed 85 (47.8%) patients were overestimated, 82 (46.1%) patients underestimated, while accurate measurement by MRI was found in 11 (6.2%) patients. Among the total subjects, 14 (7.9%) patients were hypo-staged and 15 (8.4%) were hyper-staged post-operatively. Accuracy of MRI for calculation and characterized staging was related to the lesion size, ranging from 83.1% to 87.4% (<2cm to ${\geq}5cm$, p=0.328) and from 62.5% to 89.1% (cT1 to cT4, p=0.006), respectively. Overall, MRI misjudged pathological size by 6.0 mm (p=0.588 ), and the greatest difference was observed in tumors <2cm (3.6 mm, $%{\Delta}size=16.9%$, p=0.028). No statistically significant difference was observed for moderately differentiated HCC (5.5mm, p=0.781). However, for well differentiated and poorly differentiated cases, radiographic tumor maximum diameter was significantly larger than the pathological maximum diameter by 3.15 mm and underestimated by 4.51 mm, respectively (p=0.034 and 0.020). Conclusions: A preoperative HCC tumor size measurement using MRI can provide relatively acceptable accuracy but may give rise to discrepancy in tumors in a certain size range or histologic grade. In pathological well differentiated subjects, the pathological tumor size was significantly overestimated, but underestimated in poorly differentiated HCC. The difference between radiological and pathological tumor size was greatest for tumors <2 cm. For some HCC patients, the size difference may have implications for the decision of resection, transplantation, ablation, or arterially directed therapy, and should be considered in staging or selecting the appropriate treatment tactics.

Outcomes of Local Excision for Early Rectal Cancer: a 6-year Experience from the Largest University Hospital in Thailand

  • Lohsiriwat, Varut;Anubhonganant, Worabhong;Prapasrivorakul, Siriluck;Iramaneerat, Cherdsak;Riansuwan, Woramin;Boonnuch, Wiroon;Lohsiriwat, Darin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5141-5144
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    • 2013
  • Background: This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. Materials and Methods: We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. Results: This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Conclusions: Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.

Intracranial Pial Arteriovenous Fistulas

  • Lee, Ji-Yeoun;Son, Young-Je;Kim, Jeong-Eun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.101-104
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    • 2008
  • Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion that has only recently been recognized as a distinct pathological entity. A 41-year-old woman (Patient 1) presented with the sudden development of an altered mental state. Brain CT showed an acute subdural hematoma. A red sylvian vein was found intraoperatively. A pial AVF was revealed on postoperative angiography, and surgical disconnection of the AVF was performed. A 10-year-old boy (Patient 2) presented with a 10-day history of paraparesis and urinary incontinence. Brain, spinal MRI and angiography revealed an intracranial pial AVF and a spinal perimedullary AVF. Endovascular embolization was performed for both lesions. The AVFs were completely obliterated in both patients. On follow-up, patient 1 reported having no difficulty in performing activities of daily living. Patient 2 is currently able to walk without assistance and voids into a diaper. Intracranial pial AVF is a rare disease entity that can be treated with surgical disconnection or endovascular embolization. It is important for the appropriate treatment strategy to be selected on the basis of patient-specific and lesion-specific factors in order to achieve good outcomes.

Recurrent Intramedullary Neurenteric Cyst of the Spine - Case Report - (척수 수질내에 재발한 신경장관성 낭종 - 증례보고 -)

  • Rhee, Jong Joo;Ra, Young Shin;Khang, Shin Kwang;Roh, Sung Woo;Rhim, Seung Chul
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1422-1426
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    • 2001
  • Neurenteric cysts are developmental cysts derived from embryonic endodermal layers. Fewer than 100 have been reported in which there were no associated bone or soft-tissue malformations and only six among those cases showed intramedullary location in the literatures. The authors report a 16-year-old young man with a thoracic intramedullary neurenteric cyst which presented with symptoms of axillary pain and paraparesis. The magnetic resonance imaging showed intramedullary mass extended from level of T3 to T7. There was no associated bone or soft-tissue anomaly. This cyst was partially excised and marupialized into subarachnoid space. The pathological findings were compatible with neurenteric cyst. Nine months later, the cyst recurred and at second operation, cyst wall was removed completely.

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Clinical and bacteriological studies on infectious atrophic rhinitis of swine (돼지 전염성 위축성 비염의 임상학적 및 세균학적 연구)

  • Kim, Bong-hwan;Tak, Ryun-bin;Cho, Gil-jae;Jang, Hee-kyung
    • Korean Journal of Veterinary Research
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    • v.31 no.4
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    • pp.457-469
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    • 1991
  • Clinical and bacteriological observations on infectious atrophic rhinitis of swine were conducted in order to obtain some basic information for the clinical and immnnological control of the disease prevailing in the republic. Samples were collected from nasal cavities of 135 4~12 week old pigs from 12 herds and from turbinates of 199 slaughtering pigs from 14 swine herds to investigate the prevalence of Bordetella bronchiseptica and/or Pasteurella multocida in the nasal cavities of the pigs. On the examination of nasal swabs by cultural techniques and of gross lesion of snouts of slaughtering pigs, all the swine herds investigated were found to be affected by atrophic rhinitis and a total of 84 B bronchiseptica and 139 P multocida cultures were isolated from the nasal cavities of the pigs. Of the 199 slaughtering pigs, some 48% revealed gross pathological lesion typical of atrophic rhinitis and the prevalence of B bronchiseptica and P multocida were 27.6% and 46.7%, respectively. Biochemical properties, antimicrobial susceptibilities, serological characteristics and toxigenicity of the isolates of B bronchiseptica and P multocida were investigated.

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Foraminal Synovial Cyst Associated with Ankylosing Spondylitis

  • Kim, Heyun-Sung;Ju, Chang-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.54-56
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    • 2011
  • Ankylosing spondylitis (AS) is frequently associated with inflammatory lesions of the spine and continuous fatigue stress fractures; however, an association with an intraspinal synovial cyst has not been previously reported. A 55-year-old man with a five year history of AS who presented with back pain and a right radiculopathy was admitted to the hospital. Five years previously, he underwent a percutaneous vertebroplasty for an osteoporotic L1 compression fracture, and was diagnosed with AS at that time. Plain radiographs showed aggravated kyphosis and a stress fracture through the ossified posterior element, below the prior vertebroplasty. Magnetic resonance images revealed a right foraminal cystic lesion at the L2-L3 level with effacement of the nerve root. A 1.6 cm cystic lesion that appeared to arise from the L2-L3 facet joint without direct communication was excised from the L2-L3 foramen. Pathological examination confirmed synovial cyst. The patient's symptoms resolved immediately after surgery except for a mild dysesthesia of the right leg. We report herein a rare case of foraminal synovial cyst associated with AS accompanying posterior element fracture with a review of literature.