Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies

( Gi Tark Noh ),( Kyoung Ju Lee ),( Hee Jung Sohn ),( Kyung Han Lee ),( Won Seok Heo ),( Byung Sung Koh ),( Un Mi Han ),( Young A Bae ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.1

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies

Noh, Gi Tark,Lee, Kyoung Ju,Sohn, Hee Jung,Lee, Kyung Han,Heo, Won Seok,Koh, Byung Sung,Han, Un Mi,Bae, Young A Yeungnam University College of Medicine 2016 Yeungnam University Journal of Medicine Vol.33 No.1

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta- stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Poster Session : PS 1252 ; Pulmonology : A Case of Pulmonary Epithelioid Hemangioendothelioma Misconceived as Pulmonary Metastasis of other Malignancies

( Gi Tark Noh ),( Kyoung Ju Lee ),( Eun Mee Han ),( Hee Jung Sohn ),( Young A Bae ),( Hye In Lim ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Pulmonary epithelioid hemangioendothelioma (PEH) is rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) scans of PEH characteristically demonstrate multiple, bilateral, small nodules 1-2 cm in size, presence as a solitary lung mass is uncommon. The radiographic pattern in PEH may mimic pulmonary metastasis. We reported a case of PEH in patient with colon cancer and breast cancer which was misconceived as pulmonary metastasis. Case: A 63-year old woman who suffered constipation for about 2 weeks, visited our hospital. The colonoscopy showed a large mass with obstruction on hepatic fiexure. The histological diagnosis was adenocarcinoma of ascending colon. Multiple nodules in both lungs and breast nodules were noted on a chest CT. A core biopsy of breast nodule was performed and a diagnosis of invasive ductal carcinoma of left breast was made. Pulmonary nodules seen on chest CT was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed for diagnosis. The pathologic examination of the pulmonary nodule revealed sclerotic and hypocellular with hyalinization. The tumor cells were round with abundant eosinophilic cytoplasm and intracytoplasmic vacuolization. Immuohistochemical analysis revealed that the tumor cells were positive for endothelial marker (CD31, CD34). As a result of the examination, the patient was diagnosed with PEH. Conclusion: Radiologic features of PEH are dif. cult to distinguish from lung metastasis. We report a rare case of PEH in a patient with primary malignancy of colon and breast.

The Efficacy and Safety of GCWB104 (Flos Lonicera Extract) in Functional Dyspepsia: A Single-Center, Randomized, Double-Blind, Placebo-Controlled Study

Yonghoon Choi,Nayoung Kim,Gi Tark Noh,Ju Yup Lee,Dong Ho Lee 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.1

Background/Aims: The Flos Lonicera extract GCWB104 has been shown to have significant protective effects against gastritis and gastric ulcers in vivo. The aim of this study was to investigate the efficacy and safety of GCWB104 in subjects with functional dyspepsia (FD). Methods: In this single-center, double-blind, randomized clinical trial, 92 subjects diagnosed with FD using the Rome III criteria were allocated to either the test group (300 mg of GCWB104, containing 125 mg of Flos Lonicera extract, twice daily) or the placebo group (300 mg placebo, twice daily). The total score improvement on the Gastrointestinal Symptom Rating Scale (GSRS) for individual symptoms, changes in antioxidant levels, changes in dyspepsia-related quality of life according to the Nepean Dyspepsia Index (NDI), and adverse effects were compared before and after 8 weeks of treatment. Results: The differences in total GSRS scores and score improvements after 8 weeks of treatment were significant between the GCWB104 and control groups (p=0.0452 and p=0.0486, respectively). Thirteen of 15 individual symptoms on the GSRS improved in the GCWB104 group, while six symptoms improved in the control group. In addition, statistically significant changes in rumbling, loose stool, and stool urgency were observed in the GCWB104 group. Blood 8-hydroxy-2’-deoxyguanosine (8-OHdG) levels, known as antioxidants, showed significant reductions after 8 weeks of administration of GCWB104. There were no adverse events related to treatment with GCWB104. Conclusions: GCWB104 safely contributed to improvements in mild to moderate FD and irritable bowel syndrome symptoms. Antioxidant effects of GCWB104 were also suggested (Clinicaltrials.gov number NCT04008901).

Poster Session:PS 1138;Gastroenterology (Liver):A Case of Intrahepatic Plexiform Neurofi broma Presenting with Esophageal Varices

( Kyung Han Lee ),( Sun Hong Yoo ),( Gi Tark Noh ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Neurofi bromatosis(NF) is an autosomal dominant disorder, the cardinal feature of which is the development of multiple peripheral nerve sheath tumors called neurofi bromas. Two distinctive forms are recognized. NF1 is characterized by cafe aulait macules and neurofi bromas, and NF2 is characterized by eight nerve tumors. In NF1, neurofi bromas can occur anywhere in the body, usually involving the head, neck, pelvis, and extremities. However, visceral involvement is rare, and intrahepatic involvement is even less common. Case report: A 49-year-old man, with underlying problems of NF1, got an endoscopy for the purpose of screening. The endoscopy showed grade II esophageal varices. For the evaluation of portal hypertension, he got abdominal sonography, and it showed mixed echoic mass on S2. Liver magnetic resonance image showed plexiform neurofi - broma with low signal intensity(SI) on T1-weighted and high SI on T2-weighted images, and the extensive tumor involved lesser sac, portal hilum and celiac trunk. Although only standard treatment was complete surgical resection, the plexiform neurofi broma was not resectable due to the infi ltrative nature of the tumor. We started beta-blocker to control of portal hypertension. Conclusion: Plexiform neurofi bromatosis with involvement of liver and portal vein can cause portal hypertension and its associated complications. Here, we report a rare case of intrahepatic plexiform neurofi broma accompanied by esophageal varices.

A case of portal hypertension by presumed as plexiform neurofibroma at the hepatic hilum

( Kyung Han Lee ),( Sun Hong Yoo ),( Gi Tark Noh ),( Won Suk Heo ),( Byung Seong Ko ),( Jung Ah Chio ),( Hyo Jin Cho ),( Jin Young Choi ),( Hee Jun Kim ),( Won Sohn ),( Sang Jong Park ),( Young Min Pa 대한간학회 2016 Clinical and Molecular Hepatology(대한간학회지) Vol.22 No.2

Neurofibromas can occur anywhere in the body, but they usually involve the head, neck, pelvis, and extremities. Abdominal visceral involvement is rare, and intrahepatic involvement is even less common. We describe a patient who suffered from plexiform neurofibromatosis with liver involvement. A 49-year-old man, who had previously been diagnosed with neurofibromatosis, underwent esophagogastroduodenoscopy and abdominal ultrasonography for screening purposes. Esophagogastroduodenoscopy showed grade 2 esophageal varices and abdominal ultrasonography showed conglomerated nodules with echogenic appearances in the perihepatic space. Magnetic resonance imaging showed presumed plexiform neurofibroma involving the lesser sac and hepatic hilum and encasing the common hepatic artery celiac trunk and superior mesenteric artery left portal triad. We report an unusual case of portal hypertension attributed to the compressive narrowing of the portal vein by presumed as plexiform neurofibroma at the lesser sac and hepatic hilum. (Clin Mol Hepatol 2016;22:276-280)

복부 결핵으로 발현된 후천성 면역 결핍증 1예

고병성,김상중,유경화,이경한,노기탁,허원석 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.3

The incidence of tuberculosis (TB) had gradually been declining all over the world, but in recent years, TB has been increasing due to the spread of the human immunodeficiency virus (HIV). When immune-suppression status deteriorates further, extrapulmonary TB generally appears more often. Abdominal TB is one type of extra-pulmonary TB, which may involve the gastrointestinal tract, peritoneum, lymph nodes or solid viscera. We encountered a case who had initially been diagnosed as having abdominal TB, had progressed to acute respiratory distress syndrome and was eventually confirmed as having developed acquired immune deficiency syndrome. In cases of coinfection of TB and HIV, it is reported that immunological responses become poor and complications with higher morbidity frequently occur. Therefore, the Korean guidelines for TB should be revised to ensure whether HIV infection exists in TB patients.