Mucinous Adenocarcinoma in a Horseshoe Kidney

한만훈,남성철,김법완,윤길숙 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.1

We report here on a case of mucinous adenocarcinoma that probably originated in the renal pelvis of a horseshoe kidney. A 61-year-old woman presented with a palpable mass in the left upper quadrant of the abdomen, and this mass had been present for several months. Computed tomography (CT) revealed a left renal pelvic tumor in the horseshoe kidney. Grossly, a 10×9×8 cm unilocular cystic mass filled with chocolate colored mucinous fluid was seen. A connection between the cystic mass and the renal pelvis was demonstrated on retrograde pyelography. Microscopically, the cyst contained anaplastic columnar mucosecretory epithelial cells. Some atypical cell clusters were freely floating in the mucinous lakes. The histopathological findings were consistent with mucinous adenocarcinoma. In addition, glandular metaplasia was noted in the cystic wall. Immunohistochemical assessment of the pelvic adenocarcinoma revealed the positive expressions of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) and a weak positive expression of cytokeratin 7 (CK7). We report here on a case of mucinous adenocarcinoma that probably originated in the renal pelvis of a horseshoe kidney. A 61-year-old woman presented with a palpable mass in the left upper quadrant of the abdomen, and this mass had been present for several months. Computed tomography (CT) revealed a left renal pelvic tumor in the horseshoe kidney. Grossly, a 10×9×8 cm unilocular cystic mass filled with chocolate colored mucinous fluid was seen. A connection between the cystic mass and the renal pelvis was demonstrated on retrograde pyelography. Microscopically, the cyst contained anaplastic columnar mucosecretory epithelial cells. Some atypical cell clusters were freely floating in the mucinous lakes. The histopathological findings were consistent with mucinous adenocarcinoma. In addition, glandular metaplasia was noted in the cystic wall. Immunohistochemical assessment of the pelvic adenocarcinoma revealed the positive expressions of carcinoembryonic antigen (CEA) and cytokeratin 20 (CK20) and a weak positive expression of cytokeratin 7 (CK7).

다수의 경부림프절과 연부조직을 동시에 침범한 두피의 랑게르한스세포육종 1예

한만훈 ( Man-hoon Han ),김준영 ( Jun Young Kim ),이원주 ( Weon Ju Lee ),이석종 ( Seok-jong Lee ) 대한피부과학회 2019 대한피부과학회지 Vol.57 No.9

Currently, the World Health Organization classifies Langerhans cell tumors into Langerhans cell histiocytosis and Langerhans cell sarcoma (LCS). LCS is a neoplastic proliferation of Langerhans cells showing malignant cytological features and aggressive clinical behavior with grave prognosis. Only a few cases have been reported in the available literature; therefore, to date, no definitive treatment has been established. A 64-year-old woman presented with a 1-year history of an asymptomatic, slow-growing erythematous nodule measuring 0.7 cm on her scalp. The patient also reported a 3-month history of a painful swelling on the right side of her neck. Histopathological examination of a scalp biopsy specimen revealed sheets of atypical cells with hyperchromatic nucleoli and clear cytoplasm. Immunohistochemical studies revealed malignant cells positive for CD1a, CD31, CD68, and S-100 expression. Additionally, positron emission tomography-computed tomography and fine-needle aspiration revealed LCS of the cervical lymph nodes and surrounding soft tissue. We recommended surgical excision and adjunctive chemotherapy; however, the patient refused treatment and died of the disease 28 months later. (Korean J Dermatol 2019;57(9):538∼543)

급속소퇴성 선천혈관종 5예

한만훈 ( Man-hoon Han ),정호윤 ( Ho Yun Chung ),이종민 ( Jong Min Lee ),허승 ( Seung Huh ),김준영 ( Jun Young Kim ),이원주 ( Weon Ju Lee ),이석종 ( Seok-jong Lee ) 대한피부과학회 2019 大韓皮膚科學會誌 Vol.57 No.9

Rapidly involuting congenital hemangioma (RICH), a subtype of congenital hemangioma (CH), is fully developed at birth and undergoes rapid involution by 6-14 months of age. Clinically, this vascular lesion differs from both non-involuting CH and infantile hemangiomas. It is important to distinguish between this rare condition and other vascular lesions to ensure appropriate management (active intervention vs. non-intervention). We describe 5 patients diagnosed with RICH based on clinicopathological and/or imaging studies. Three patients showed red-stippled bluish to purplish tense plaques and two showed slightly depressed red-stippled hypopigmented rubbery patches at their initial visit. Spontaneous involution commenced shortly after birth, and complete involution occurred by 16.0±9.9 months of age. Doppler ultrasonography and magnetic resonance imaging were performed for further evaluation. Histopathological examination revealed vascular lobules of various sizes without true arteriovenous microfistulae, and thickened intra- and interlobular vessels were prominent with glucose transporter isoform-1 protein negativity. (Korean J Dermatol 2019;57(9):532∼537)

수류탄 폭발사의 사례에 대한 사건의 재구성

최민성,한만훈,최정우,이종규,곽병혁 대한법의학회 2010 대한법의학회지 Vol.34 No.1

The death caused by a hand grenade detonation is extremely uncommon and specialized event in Korea cause that it used in military fields, and these cases are only investigated by CIC (Criminal Investigation Command) of ROK Army. The hand grenade is small, light weighted anti-human explosive, so it uses widely than other explosive objects. The morphological characteristics seeing in victim by hand grenade detonation are very variable according to position, distance of explosion, type of grenade, environmental effects, and so many others. We performed retrospective analysis of 23 cases of death by hand grenade in ROK Army from 1990 to 2008. These cases are classified by direction and position of wounds, injuries of external and internal organs. Most of all are contact or near contact range detonation, and the focus of detonation is suggested anterior chest wall mostly. Amputations or critical wounds are mostly located on hand, arm, anterior chest, but wounds of dorsal portion is relatively rare. Most of all are suggested to detonate grenade in standing or straightened-arm position. Internal organ damages, such as hemothorax, hemoperitoneum,hemopericardium by detonation pressure or penetration by fragments, are seen in 75% cases of all, and the organs are mostly heart, lung and other hollow organs. External examination may fail to show fatal external damage or wound. The data of this analysis would be used as adjunctive and objective examples of investigation of death by hand grenade in Korea. 저자들은 지금까지의 수류탄 폭발사에서 나타나는 중요소견들을 고찰, 정리하는 것이 향후 객관적이고 정확한 법의 감정을 위해 도움을 줄 것으로 생각하여 1990년 3월부터 2008년6월까지 219개월동안 발생한 수류탄 폭발사의 법의 부검 및검안사례 23예에 대하여 재분류 및 분석하였다. 1. 대부분의 폭발은 근접 혹은 근거리폭발이었고, 폭발중심의 대부분이 흉복부 전면부로 추정되고 배부손상의 수가적으며 신체결손과 치명상의 위치는 대부분이 수부와 팔,전흉복부에 집중되어 있음을 볼 수 있다. 2. 폭발 당시 서있는 자세, 혹은 양팔을 앞으로 쭉 편 자세가많을 것으로 추정된다. 3. 75%에서 내부실질장기의 손상이 있으며 폐, 심장 소화기장관 등 중요장기의 손상이 많이 관찰되었고 손상은 파편창과 폭발압력에 의한 혈흉, 혈복강, 혈심낭 등이 주로 나타났다. 4. 사망자의 계급은 대부분 병사이며 입대 후 1년 내의 병사들이 많았다. 5. 외표상 눈에 띄는 치명적 손상이 없거나 적은 경우도 있다. 결론적으로 수류탄 폭발사의 부검은 외표소견 및 외상의 분포양상도 중요하나 내부장기의 소견도 역시 중요하다고 할 수있으며, 매우 다양한 소견을 보이므로 향후 전향적인 연구가 필요할 것으로 생각된다. 또한 매우 드물게 발생하는 사건이므로 앞으로도 더 많은 데이터들이 축적되어야 할 것이다. 추가적으로 수류탄 폭발사의 법의 감정시 방사선 촬영을 필수적으로 시행하여야 할 것이고 화약검사 등 기타 부가적인 검사도가능한 시행하여야 할 것이다.

대장 내시경 생검으로 진단된 분선충증- 2예 보고 -

남상철,한만훈,김영수,금윤섭,서인수,배한익 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.5

Strongyloides stercoralis is an intestinal nematode that is able to infect the host tissue and persist for many years through autoinfection, and it causes life-threatening hyperinfection in immunocompromised hosts. We report here on two cases of strongyloidiasis that were diagnosed by colonoscopic biopsy. One case was a 73-year-old woman who was hospitalized with complaints of melena. She was being treated with corticosteroid due to her asthma and rheumatoid arthritis. The other case was a 63-year-old man who suffered with abdominal discomfort and severe loss of body weight (18 kg) for 2 months. In both cases, colonoscopic examination revealed polyps and petechiae at the entire colon. Microscopically, a small illdefined granuloma with a longitudinally sectioned parasite was seen on the colonoscopic biopsy. Endoscopic examination was done after suspecting parasitic infestation. The gastric and duodenal mucosa showed numerous cross sections of adult worms, eggs and larvae that were developing in crypts. Even if such a patient is in an asymptomatic state, this illness must be treated due to the potential for fatal autoinfection.

Rectal Invasion by Prostatic Adenocarcinoma That Was Initially Diagnosed in a Rectal Polyp on Colonoscopy

윤길숙,한만훈,서안나 대한병리학회 2019 Journal of Pathology and Translational Medicine Vol.53 No.4

Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is extremely rare. We present a case of rectal invasion by prostatic adenocarcinoma that was initially diagnosed from a rectal polyp biopsied on colonoscopy in a 69-year-old Korean man. He presented with dull anal pain and voiding discomfort for several days. Computed tomography revealed either prostatic adenocarcinoma with rectal invasion or rectal adenocarcinoma with prostatic invasion. His tumor marker profile showed normal prostate specific antigen (PSA) level and significantly elevated carcinoembryonic antigen level. Colonoscopy was performed, and a specimen was obtained from a round, 1.5 cm, sessile polyp that was 1.5 cm above the anal verge. Microscopically, glandular tumor structures infiltrated into the rectal mucosa and submucosa. Immunohistochemically, the tumor cells showed alpha-methylacyl-CoA-racemase positivity, PSA positivity, and caudal-related homeobox 2 negativity. The final diagnosis of the rectal polyp was consistent with prostatic adenocarcinoma. Here, we present a rare case that could have been misdiagnosed as rectal adenocarcinoma.

건선양 발진과 과호산구성증후군이 동반된 IgG4 연관질환 1예

박한기,한만훈,이상진 대한 소아알레르기 호흡기학회 2020 Allergy Asthma & Respiratory Disease Vol.8 No.1

Immunoglobulin (Ig) G4-related disease (IgG4-RD) is newly recognized immune-mediated and fibroinflammatory conditions with various organ involvements. Any organs can be involved, but the pancreas, salivary gland, lymph nodes, and orbit are known to be commonly involved organs. A 54-year-old man presented with complaint of psoriasis like skin rash developed 4 years prior to admission. Although he had been treated for skin rash, the extent of skin lesions increased as well as hypereosinophilia, and multiple lymphadenopathies were newly developed. The patient was diagnosed with IgG4-RD by serum IgG4 levels and histologic examination of the inguinal lymph node. One month after treatment with steroid and azathioprine, his skin rash and lymphadenopathies resolved with improvement and eosinophil count was within the normal range. We herein report a case of a IgG4-RD patient associated with psoriasis-like skin rash and hypereosinophilic syndrome. .

Sudden Child Death due to Thrombotic Giant Coronary Artery Aneurysms Complicated by Atypical Kawasaki Disease: An Autopsy Case

김동자,한만훈,이상한 대한병리학회 2018 Journal of Pathology and Translational Medicine Vol.52 No.4

고환의 장성 낭종

남상철,한만훈,예석준,권태균,김법완,윤길숙 대한병리학회 2007 Journal of Pathology and Translational Medicine Vol.41 No.4

We present a rare case of an enterogenous cyst of the testis in a 21-year-old man. On ultrasonography, an ovoid hypoechoic solid mass (2×2×1.5 cm) was confined to the right testis. The left testis and bilateral epididymis were within normal limits. Grossly, the tumor was a unilocular cystic mass, without a solid component. Microscopically, the cystic mass was composed of mucin-secreting simple columnar epithelial lining cells, lamina propria and a well-differentiated muscularis propria. There was no evidence of any germ cell derivatives or neoplasia in the cystic mass and in the surrounding testicular parenchyma. Immunohistochemistry showed a positive reaction for cytokeratin and the epithelial membrane antigen in the epithelial lining; in addition, it was positive for smooth muscle actin in the well-differentiated muscularis propria.

A Case of Multiple Necrotic Dyskeratotic Cells within the Upper Epidermis and Horny Layer Revealing Persistent Papules and Plaques of Adult-Onset Still’s Disease

하대룡,하기웅,한만훈,이석종 대한피부과학회 2023 Annals of Dermatology Vol.35 No.-

It is important to differentiate violaceous to dusky red papules and plaques that widely persist on the trunk and extremities because there are dermatoses that could be fatal, such as lupus erythematosus, dermatomyositis, drug eruptions, and graft-versus-host disease. Dyskeratotic cells only in the upper epidermis and horny layer are not well known, but it is a distinctive histopathological pattern of atypical type of rash of adult-onset Still’s disease (AOSD). AOSD rash is a transient salmon-colored rash that occurs and disappears with fever; however, an atypical type of rash called “persistent dermal plaque” or “persistent pruritic eruptions” has also been reported. It occurs and persists even after fever subsides. Herein, we describe a case with necrotic dyskeratotic cells in the upper epidermis and horny layer without AOSD symptoms lasting for five years.