The Cytology of a Cellular Variant of Cerebellar Hemangioblastoma in Squash Preparation: Pitfalls in Diagnosis

서연림,오영륜,Suh, Yeon-Lim,Oh, Young-Lyun The Korean Society for Cytopathology 2006 대한세포병리학회지 Vol.17 No.2

Due to its nuclear pleomorphism, knowledge regarding the cytological findings of cerebellar hemangioblastoma can lead to misdiagnosis when using squash specimens, which in other circumstances serves as a useful adjunct in the diagnosis of brain tumors on frozen section. We recently experienced the cytological findings of a cellular variant of cerebellar hemangioblastoma in a 51-year-old man. Squash specimens revealed scattered single tumor cells, with pleomorphic nuclei and cytoplasmic vacuoles, on a hemorrhagic background. The cellular clusters were composed of spindle-shaped endothelial cellsin addition to densely clustered stromal cells. Intranuclear inclusions were frequently seen. The nuclear pleomorphism, bubbly cytoplasmic vacuoles and presence of intranuclear inclusions, seen in the squash specimen, may increase the difficulty of frozen section diagnosis of cerebellar hemangioblastoma. Awareness of the cytologicalfindings of hemangioblastoma is needed to avoid the pitfalls in the intraoperative diagnosis of cerebellar hemangioblastomas.

Ito 저색소증

이근수,장홍준,서연림,안규중,김종민,이종주 ( Geun Soo Lee,Hong Zoon Jang,Yeon Lim Suh,Kyu Joong Ahn,Jong Min Kim,Chong Ju Lee ) 대한피부과학회 1990 대한피부과학회지 Vol.28 No.5

A Case of Hypomelanosis of lto Geun Soo Lee, M.D., Hong Zoon Jang, M.D., Yeon Lim Suh*, M.D., Kyu Joong Ahn, M.Dl., Jong Min Kim, M.D., Chong Ju Lee, M.D. Departments of Dermatology and Pathology*, Clooege of Medicine, Hallym University Seoul, Korea We report a case of hypomelansis of Ito developed in a 6-year-old male patient. He had numberous bizarre, hypopigmented streaky macules on the left side of the chest, and upper arm. The histopathologi findings demonstrated that hypopigmented areas contained slightly decreased basal pigmentation with decreased content of intracellualr melanin in keratinocytes and melanocytes and revealed neither inflammatory changes nor dropping of melanin granule into the dermis. The electron microscopic finding showed decreased number of melanosomes, incomplete melaniztion, and cytoplasmic vacuoles in keratinocytes and melanocytes. Extra-cutaneous alterations were not found.

소아의 수부골에 전이된 신장의 투명세포육종 -1례 보고-

심종섭,김지형,서연림,Shim, Jong-Sup,Kim, Jee-Hyoung,Suh, Yeon-Lim 대한근골격종양학회 1998 대한골관절종양학회지 Vol.4 No.2

Clear cell sarcoma of the kidney (CCSK) is a rare malignant tumor of the renal origin in childhood, distinguished from Wilms tumor by its pathologic and clinical features. Bone metastasis is one of the characteristic clinical features. The common site of metastasis of the clear cell Sarcoma of the kidney is axial skeleton including skull, spines, ribs and femur. A cases of clear cell Sarcoma of the kidney presented to us, which solely metastasized to the hand bones without metastasizing to any other tissues including axial skeleton. We report this case with review of literatures.

A Case of Cerebral Metastasis from Malignant Fibrous Histiocytoma

강관수,이정일,서연림,Kang, Kwan-Soo,Lee, Jung-Il,Suh, Yeon Lim The Korean Neurosurgical Society 2001 Journal of Korean neurosurgical society Vol.30 No.11

뇌로 전이한 악성 섬유성 조직구종 1례를 문헌 고찰과 함께 보고하고자 한다. 환자는 62세 남자로 다발성 전이성 뇌종양 의증하에 개두술 및 종양 제거술을 시행받았다. 술전 검사상 두개강외 원발 부위를 의심할만한 병변은 발견하지 못하였다. 수술과 전뇌 방사선 치료후 6개월째에 성장하는 우측 견부 종양이 발견되어 적출술을 시행하였다. 뇌와 견부 조직 표본에서 악성 섬유성 조직 세포종에 부합되는 일치된 병리 소견을 보였으나 GFAP-양성 세포들은 뇌병변의 조직 표본에서만 발견되었다. 이후에 발생한 척추 등의 골격계 전이성 병변에 대하여서는 고식적 방사선 치료를 행하였다. 최초 진단 후 12개월째 우측 견부 종양이 재발하여 항암 화학 치료 중이다. 이 증례에서 특이한 점은 원발 부위 발견전 전이성 뇌종양이 진단된 것인데, 악성 섬유성 조직구종으로부터 뇌로 전이한 경우가 드물거니와 특히 원발부위가 확인되기 전에 뇌로 전이한 병변이 먼저 발견된 경우는 보고된 바가 없다. 또 하나의 중요한 소견은 GFAP 발현이 뇌병변에서만 나타나며 원발부위인 견부 종양에서는 관찰되지 않은 점이다. 원발성 두개강내 악성 섬유성 조직구종에서 GFAP-양성 세포의 존재는 중요한 조직학적 특성의 하나로 알려져 있으나, 본 증례의 소견은 원발성 두개강내 악성 섬유성 조직구종에 존재하는 GFAP-양성 세포들도 악성 섬유성 조직구종에 의해 이차적으로 생성된 비종양성 성상 세포들이라는 가설을 뒷받침하고 있다. This is a rare case of cerebral metastasis from malignant fibrous histiocytoma(MFH) of the soft tissue. A 62-year-old man underwent craniotomy for resection of multiple intracerebral masses under the impression of metastatic brain tumor with unknown primary site. Preoperative investigation failed to detect any extracranial lesion. At six months after the operation and whole brain radiotherapy, right shoulder mass was detected to grow and excised. Specimen from the brain and shoulder lesions revealed identical pathological findings of malignant fibrous histiocytoma except existence of glial fibrillary acidic protein(GFAP)-positive cells only in brain lesions. Palliative radiotherapy was performed for subsequently developing metastatic lesions in skeletal system. At twelve months after initial diagnosis recurrent lesion at right shoulder was detected and chemotherapy is given. This case is unique because metastatic brain lesion from MFH is rare and also cerebral metastasis as an initial manifestaion of MFH has not been reported before. Another important finding is that there was expression of GFAP only in brain lesions but not in extracranial primary site lesion. Although the presence of GFAP-positive cells is thought as one of characteristic histological findings of primary intracrainal MFH, our observation supports the hypothesis that GFAP-positive cells in primary intracranial MFH may be nonneoplastic astrocytes secondarily involved by MFH.

Mansonian schistosomiasis in rectum

So Dug LIM(임소덕),Yeon-Lim SUH(서연림),Je G CHI(지제근),Sung-Tae HONG(홍성태),Soon-Hyung LEE(이순형) 대한기생충학열대의학회 1995 The Korean Journal of Parasitology Vol.33 No.4

소아에서 발생한 삼차신경초종

김명훈,신형진,남도현,서연림,김종현,Kim, Myoung-Hoon,Shin, Hyung-Jin,Nam, Do-Hyun,Suh, Yeon-Lim,Kim, Jong Hyun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Trigeminal schwannoma is an uncommon intracranial tumor and constitutes less than 0.08-8% of all intracranial schwannoma. Trigeminal shchwannoma is even rarer in childhood and only 11 cases of trigeminal schwannoma under the age of 14 have been reported including our case. We experienced a case of trigeminal schwannoma in a 9 year-old girl without the stigmata of neurofibromatosis. She presented with a 2 week-history of right abducens nerve palsy. Magnetic resonance image demonstrated a dumbbell-shaped tumor extending into right middle and posterior fossas with a size of $60{\times}45{\times}35mm$. The tumor was successfully removed by right transzygomatic subtemporal extradural approach. Pathologic examination of the mass revealed typical features of schwannoma.

간세포암의 DNA 함량분석의 임상적 의의

서병조(Byung Jo Suh),왕희정(Hee Jung Wang),서연림(Yeon Lim Suh),이혁상(Hyucksang Lee) 대한외과학회 1994 Annals of Surgical Treatment and Research Vol.46 No.3

안와 내에 발생한 원발성 편평상피세포암 1예

최다예,이정혜,안정현,서연림,우경인,김윤덕,Da Ye Choi,MD,Jung Hye Lee,MD,Jung Hyun Ahn,MD,Yeon Lim Suh,MD,PhD,Kyung In Woo,MD,PhD,Yoon Duck Kim,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.8

Purpose: Normal squamous cells do not exist in the orbit. Therefore squamous cell carcinoma of the orbit is rare and usually arises as a secondary tumor from distant metastasis or local invasion. The authors herein describe the first case of primary squamous cell carcinoma of the orbit in Korea. Case summary: A 74-year-old female presented with a 2-month history of left upper eyelid swelling and ocular pain. On physical examination, a round, firm, fixed and tender mass was palpable in the superomedial side of the left orbit. Magnetic resonance imaging (MRI) showed 21 mm x 15 mm x 20 mm-sized irregular soft tissue mass with indistinct margin and peripheral enhancement in the superomedial portion of the left orbit, and incisional biopsy of the mass was performed. Histopathological examination showed clusters of squamous cells with polymorphic nuclei and interspersed keratin pearls, consistent with findings of well-differentiated squamous cell carcinoma. Despite extensive systemic work-up, there was no sign of extraorbital malignancy. The patient received left exenteration and adjuvant radiation therapy. Ten months after enucleation, a 12 mm x 14 mm sized firm mass developed on the left forehead, and excisional biopsy and frontalis rotational flap reconstruction were performed. Histopathological examination of the mass was consistent with well-differentiated squamous cell carcinoma. The patient remained alive 17 months after diagnosis without evidence of local recurrence or distant metastasis. Conclusions: Primary squamous cell carcinoma should be considered in the differential diagnosis of acutely progressing tumors of the orbit. J Korean Ophthalmol Soc 2014;55(8):1224-1228

만삭 임신과 동반된 역형성 성상세포종 1예

신수경 ( Su Kyong Shin ),서연림 ( Yeon Lim Suh ),최원준 ( Won Jun Choi ),이순애 ( Soon Ae Lee ),이종학 ( Jong Hak Lee ),백원영 ( Won Young Paik ) 대한주산의학회 2002 大韓周産醫學會雜誌 Vol.13 No.3

일반적으로 성상세포종은 주로 20~40대에 나타나는 종양으로 두개강내 종양의 약 12%를 차지하나 악성이며 예후가 불량한 역형성 성상세포종은 흔하지 않다. 임신과 동반되는 성상세포종은 매우 드문 것으로 알려져 있어 국내외적으로 보고된 예가 매우 드물다. 저자들은 임신 34주 4일의 산모에서 좌측 전두엽 역형성 성상세포종을 진단하였으며 임신 38주 1일에 제왕절개 분만을 하였고 분만 후 2개월째에 부분 종양절제술을 시행하고 방사선 치료와 항암 치료를 시행한 1예를 경험하였기에 보고하는 바이다. Intracranial astrocytoma is often discovered in third-fifth decade and occupies about 12% of the intracranial tumor patients. The concurrence of tumors of the brain and pregnancy is uncommon, moreover, astrocytoma of the brain in term pregnancy is very rare. Generally, astrocytoma is divided into six subgroups. Among them anaplastic astrocytoma is thought to be a malignant brain tumor. In the management of patients with brain tumor complicating pregnancy, judgments with regard to the optimal time for neurologic studies and operation and the mode of delivery are frequently difficult and occasionally controversial. We experienced a case of anaplastic astrocytoma of left frontal lobe, which was diagnosed by MR imaging at the third trimester of pregnancy. We report the case with a brief review of literature.

눈꺼풀에 발생한 에크린 관암 1예

김태협,이정혜,안정현,우경인,서연림,김윤덕,Tae Hyup Kim,Jung Hye Lee,Jung Hyun Ahn,Kyung In Woo,Yeon Lim Suh,Yoon Duck Kim 대한안과학회 2013 대한안과학회지 Vol.54 No.4

Purpose: Eccrine ductal carcinoma is an extremely rare tumor that arises in the eccrine sweat glands. The authors of the present study describe a case of an eyelid mass diagnosed as eccrine ductal carcinoma. Case summary: A 74-year-old woman visited our institute with a 3-month history of a mass in the left medial canthus. The lesion appeared as a solitary nodule with central ulceration. A magnetic resonance imaging (MRI) of the orbit showed a relatively well enhanced 0.8 cm x 0.8 cm-sized ovoid soft tissue mass. A mass excision was performed under frozen section control. The tumor was completely excised with margin clearance and medial canthal reconstruction was performed. Histopathological examination revealed a tumor composed of numerous duct-like structures lined with pleomorphic cuboidal epithelium that was diagnosed as eccrine ductal carcinoma of the eyelid. Conclusions: This is the first description of eccrine ductal carcinoma in a patient in Korea. The possibility of the eccrine ductal carcinoma should be considered in the differential diagnosis in an elderly patient with an eyelid mass.