• Journal of Korean Foot and Ankle Society
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• v.23 no.2
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• pp.71-73
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• 2019

Nearly one third of the world's population have active or latent tuberculosis, resulting in 1.5 million deaths annually. Tuberculosis involving the peripheral nerve is difficult to detect. Sural nerve tuberculoma is an extremely rare case of tuberculous involvement of the peripheral nerve that has attracted the attention of physicians. This paper reports a patient with sural nerve tuberculoma. A 58-year-old female patient presented with a palpable mass on the posterolateral calf with progressive tingling sensation on the distal area. The patient had no history of trauma and it was unclear whether the patient had any contact with individuals with active tuberculosis. The histopathologic findings revealed a granuloma-like lesion with caseous necrosis that was compatible with tuberculoma.

• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.73-77
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• 2018

Germinoma is the most common type of intracranial germ cell tumors (GCTs). Pineal gland and suprasellar region are the most frequent sites of central nervous system (CNS) involvement. Intracranial masses caused by Langerhans cell histiocytosis (LCH) mimics features of CNS GCTs. LCH frequently involve spine and is the most common cause of vertebra plana in children. A 15-year-old boy presented with progressing symptoms of polydipsia, polyuria, general headache, nausea and severe back pain. Brain MRI showed brain tumor with simultaneous involvement of suprasellar region and pineal gland. An excisional biopsy of suprasellar mass was done. The pathologic assessment confirmed the diagnosis of germinoma. Patient's treatment continued accordingly. A spine MRI, done due to persistent backache, showed a vertebra plana. We reevaluated the primary diagnosis suspecting LCH. Germinoma of CNS was confirmed and a biopsy of vertebral lesion resulted in hemangioma. Thus we report a case of CNS germinoma with co-occurrence of vertebra plana. We emphasized the importance of histopathologic diagnosis of pineal/suprasellar masses and primary investigation of other CNS regions including spine for possible metastasis or comorbidities.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.65-69
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• 2023

We report a unique case of hemangioma of the nasal cavity in von Hippel-Lindau (VHL) syndrome. A 26-year-old female with VHL syndrome who had previously undergone surgery for pancreatic and adrenal mass presented with a 4-month history of left-sided nasal obstruction. The patient had an expansile mass lesion in the left nasal cavity and an imaging test demonstrated the mass in the left maxillary sinus extending to the nasal cavity. The tumor was removed with an endoscopic prelacrimal recess approach considering the possibility of not only a benign tumor such as hemangioma but also a malignant tumor of the maxillary sinus and histopathologic examination confirmed cavernous hemangioma. This case is the rarely reported manifestation of the paranasal sinus in VHL disease.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.992-998
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• 2004

Background: The decision of staging of esophageal cancer have great effect on the resectability of the lesion and estimation of the patient's prognosis. Today, CT is one of the most popular modality for staging of esophageal cancer. However, it has some limitations because of false-positive or false-negative findings on cancer staging. The purpose of this study was to analyze the efficacy of CT in preoperative staging of esophageal cancer. Material and Method: We retrospectively analysed the difference of staging of esophageal cancer between CT and histopathological findings for the 114 patients with histologically proven esophageal cancer who underwent operation at the department of thoracic and cardiovascular surgery, Chonnam national university hospital, between January 1999 and June 2003. We evaluated the efficacy of chest CT in the staging of esophageal cancer compared to postoperative histopathologic findings by calculating sensitivity, specificity, accuracy, and reproducibility of chest CT to detect abnormality. Result: The reproducibilities between chest CT and histopathologic findings were 0.32 (p<0.01) for primary tumor (T), 0.36 (p<0.01) for lymph node invasion (N), and 0.62 (p<0.01) for distant metastasis (M). The reproducibilities between chest CT and histopathologic findings for lymph node invasion (N) and distant metastasis (M) were superior to that of primary tumor (T). The accuracy of primary tumor (T) was 65.8% and 98.2% in group III and IV, which was significantly higher than that of group I and II (78.9% and 62.3%). In general, specificity of chest CT for TNM staging was superior to sensitivity. Conclusion: In conclusion, preoperative CT scanning can provide important information on lymph node invasion and metastasis of lesion than primary tumor invasion.

• Journal of the korean academy of Pediatric Dentistry
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• v.29 no.3
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• pp.463-468
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• 2002

The unicystic ameloblastoma deserves separate consideration on the basis of its clinical, radiologic, and pathologic features and its response to treatment. It refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst, but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity. The lesion is most commonly found on the mandible posterior area, and often asymptomatic, although large lesions may cause a painless swelling of the jaws. The lesion typically appears as a circumscribed radiolucency that surrounds the crown of an unerupted molar. These are usually considered to be a dentigerous, residual cyst on the relationship of the lesion to teeth in the area. Three histopathologic variants of unicystic ameloblastoma may be seen. 1) Luminal type, 2) Intraluminal type, 3) Mural type. In this case, these tumor was treated as cysts by enucleation with iliac bone graft, and the diagnosis of ameloblastoma is made after microscopic examination of the presumed cyst.

• Journal of Veterinary Clinics
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• v.26 no.1
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• pp.104-108
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• 2009

Global cerebral ischemia occurs commonly in patients who have a variety of clinical conditions including cardiac arrest and shock. Cerebral ischemia results in a rapid depletion of energy stores that triggers resulting in excitotoxic death. Imaging studies of the brain with computed tomography(CT) or magnetic resonance imaging(MRI) are necessary to confirm the clinical neurolocalization, identify any associated mass effect, and rule out other causes of focal brain disorders. Cardiopulmonary arrest was occurred by propofol anesthesia in a 1 year old, intact female Beagle dog. After successful cardiopulmonary resuscitation was performed within 5 minutes, clinical signs such as vocalization, paddling, opisthotonus and seizure were represented. At the 12th day, CT and MRI examinations of the brain were performed to evaluate the brain. After euthanasia, histopathologic examination was performed. On transverse image of CT, lesions appeared as a hypodense in the right dorsal surface of the frontal lobe and level of optic canal, and dorsomedial surface of occipital lobe of cerebrum. No contrast enhancement was represented following intravenous contrast administration. On MR images of brain, the lesions were seen as a hyperintense on T2-weighted(T2W) images and a isointense or mild hypointense on T1-weighted(T1W) images. Hyperintense lesions both T2W and T1W images were observed at the surrounding cerebral sulcus. There was no significant signal changes on contrast T1WI. Histopathologic examination after euthanasia revealed that the lesion was necrosis of the cerebral cortex caused by cerebral ischemia.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5171-5174
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• 2014

Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.248-258
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• 2005

The challenging task of classifying the fibro-osseous(FO) lesions has been previously attempted but only in the past 15 years has the entire spectrum of diversity been appreciated. For the clinicians, it is hard to clearly diagnose the lesions before operations. The purpose of this study was to review the literature about fibro-osseous lesions of the jaws and to analyse our clinical cases. As the results of the review of clinical features, radiography and histopathologic findings of sixteen cases of fibro-osseous lesions, we could elucidate diagnostic aids for treatment of benign FO lesion in jaws. Six patients involving fibrous dysplasia complained the facial swelling and facial asymmetry. The radiographic features of the lesions showed ground-glass radiopacity mostly and the histologic findings showed typically Chinese character-shaped trabeculae without osteoblastic rimming in the fibrous stroma. Six patients with ossifying fibroma were notified as swollen buccal cheek state. Their radiographic findings showed cortical expanded radiolucent lesion with sclerotic defined border, which was contrast to the normal adjacent bone. The lesions showed variant radiolucent lesions. Histological findings were revealed as cellular fibrous stroma with woven bones, variable patterns of calcifications. Three patients with cemental dysplasia didn't have specific complaints. Well circumscribed radiopaque lesions on mandibular molar area were observed. Cementum-like ossicles with fibrous stroma were found on microscopic findings. A osteoblastoma case with jaw pain was found. The radiographic feature was a mottled, dense radiopacity with osteolytic border on mandibular molar area. Under microscopy trabecule of osteoid with vascular network were predominantly found. Numerous osteoblast cells with woven bone were found. These clinical, radiographic and microscopic findings of benign fibrous-osseous lesions would suggest diagnostic criteria for each entity of FO lesions.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.3
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• pp.301-305
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• 2012

The odontoma is a hamartoma of odontogenic origin and consists of enamel, dentin, cementum and pulp tissue. Two types of odonotma are histologically recognized: complex and compound. Odontoma may be the cause of noneruptoin or impaction of teeth, formation of cyst and resorption of adjacent bone. The recommended treatment for an odontoma is conservative surgical excision. No propensity for recurrence has been noted. Peripheral odontoma is relatively rare lesion and shows the histological characteristics of an intraosseous odontoma. This report described a 3-year-old Korean girl with a firm gingival mass in the posterior mandibular area, which had been gradually enlarging over 18months. Radiographic examination showed a radiopaque mass but no evidence of underlying intraosseous lesion. Excisional biopsy was performed for the mass removal and histopathological examination. The result of histopathological study was identified as hamartous supernumerary tooth germ. Based on the clinical presentation, radiographic and histopathologic findings, we concluded that the final diagnosis was peripheral odontoma. For three years after surgery, there is no clinical sign of recurrence.

• Journal of Korean Neurosurgical Society
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• v.29 no.2
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• pp.222-230
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• 2000

Purpose : Resection of the epileptogenic zone in the parietal and occipital lobes may be relevant although only few studies have been reported. Methods : Eight patients with parietal epilepsy and nine patients with occipital epilepsy were included for this study. Preoperatively, all had video-EEG monitoring with extracranial electrodes, MRI, 3D-surface rendering of MRI using Allegro(ISG Technologies Inc., Toronto, Canada), and PET scans. Sixteen patients underwent invasive recording with subdural grid. Eight had parietal resection including the sensory cortex in two. Seven had partial occipital resection. Two underwent total unilateral occipital lobectomy. The extent of the resection was made based mainly on the data of invasive EEG recordings, MRI, and 3D-surface rendering of MRI, not on the intraoperative electrocorticographic findings as usually done. During resection, electrocortical stimulation was performed on the motor cortex and speech area. Results : Out of eight patients with parietal epilepsy, three had sensory aura, two had gustatory aura, and two had visual aura. Six of nine patients with occipital epilepsy had visual auras. All had complex partial seizures with lateralizing signs in 15 patients. Four had quadrantopsia. One had mild right hemiparesis. Abnormality in MRI was noticed in six out of eight parietal epilepsy and in eight out of nine occipital epilepsy. 3D-surface rendering of MRI visualized volumetric abnormality with geometric spatial relationships adjacent to the normal brain, in all of parietal and occipital epilepsy. Surface EEG recording was not reliable in localizing the epileptogenic zone in any patient. The subdural grid electrodes can be implanted on the core of the structural abnormality in 3D-reconstructed brain. Ictal onset zone was localized accurately by subdural grid EEGs in 16 patients. Motor cortex in nine and sensory speech area in two were identified by electrocortical stimulation. Histopathologic findings revealed cortical dysplasia in 10 patients ; tuberous sclerosis was combined in two, hamartoma and ganglioglioma in one each, and subpial gliosis in six. Eleven patients were seizure free at follow-up of 6 months to 37 months(mean 19.7 months) after surgery. Seizures recurred in two and were unchanged in one. Six produced transient sensory loss and one developed hemiparesis and tactile agnosia. One revealed transient apraxia. Two patients with preoperative quadrantopsia developed homonymous hemianopsia. Conclusion : This study suggests that surgical treatment was relevant in parietal and occipital epilepsies with good surgical outcome, without significant neurologic sequelae. Neuroimaging studies including conventional MRI, 3Dsurface rendering of MRI were necessary in identifying the epileptogenic zone. In particular, 3D-surface rendering of MRI was very helpful in presuming the epileptogenic zone in patients with unidentifiable lesion in the conventional MRI, in planning surgical approach to lesions, and also in making a decision of the extent of the epileptogenic zone in patients with identifiable lesion in conventional MRI. Invasive EEG recording with the subdural grid electrodes helped to confirm a core of the epileptogenic zone which was revealed in 3D-surface rendered brain.