Journal of Yeungnam Medical Science

Joon Hyuk Choi

30 Articles

Pancreatic metastasis from malignant phyllodes tumor of the breast: Seung Eun Lee, Young Kyung Bae, Joon Hyuk Choi; Yeungnam Univ J Med. 2021;38(1):78-82. Published online November 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00759

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Pancreatic metastasis from malignant phyllodes tumor (PT) of the breast is rare, and only a few cases have been reported in the literature. Here, we report a case of pancreatic metastasis from malignant PT of the breast in a 48-year-old woman. She had had three episodes of recurrence of malignant PT in her right breast. She presented with epigastric pain for 2 months. Computed tomography and magnetic resonance imaging revealed a 6 cm-sized, well-defined, heterogeneous mass with peripheral enhancement in the body of the pancreas. Endoscopic ultrasonography-guided fine-needle aspiration was performed, and the pathologic report suggested spindle cell mesenchymal neoplasm. Subsequently, surgical excision was performed, and the mass was confirmed as a metastatic malignant PT. The imaging findings are discussed and the literature is briefly reviewed in this report.

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Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor
Ruijing Liu, Jingli Xue, Wen Liu, Beibei Jiang, Fuyun Shi, Zhenzheng Wang, Peifeng Li
Frontiers in Medicine.2023;[Epub] CrossRef
Diagnostic approach to fibroepithelial tumors of the breast
Frances Tresserra, María Angeles Martinez-Lanao, Melissa Fernandez-Acevedo, Cristina Castellet, Sonia Baulies
Revista de Senología y Patología Mamaria.2022; 35: S22. CrossRef

Anti-nuclear antibody-negative immunoglobulin G4-associated autoimmune hepatitis mimicking lymphoproliferative disorders: Min Kyu Kang, Jung Gil Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2020;37(2):136-140. Published online March 24, 2020; DOI: https://doi.org/10.12701/yujm.2020.00066

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Immunoglobulin G4 (IgG4)-associated autoimmune hepatitis (AIH) is a very rare subtype of autoimmune hepatitis and characterized by marked elevated serum IgG and hepatic infiltration of IgG4-expressing plasma cells. Pathologic confirmation of hepatic IgG4-expressing plasma cells is usually required for the final diagnosis of IgG4-associated AIH. Herein, we report the case of a 47-year-old female diagnosed with autoantibody-negative IgG4-associated AIH mimicking lymphoproliferative disorders.

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Hepatic Involvement of Diffuse Large B-Cell Lymphoma Mimicking Antinuclear Antibody-Negative Autoimmune Hepatitis Diagnosed by Liver Biopsy
Euna Lee, Min-Kyu Kang, Gabin Moon, Mi-Jin Gu
Medicina.2022; 59(1): 77. CrossRef
Immunoglobulin G4 (IgG4)‐related autoimmune hepatitis and IgG4‐hepatopathy: A histopathological and clinical perspective
Atsushi Tanaka, Kenji Notohara
Hepatology Research.2021; 51(8): 850. CrossRef

First step to international journal by indexing PMC and DOAJ: Joon Hyuk Choi; Yeungnam Univ J Med. 2020;37(1):1-1. Published online December 18, 2019; DOI: https://doi.org/10.12701/yujm.2019.00395

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Imatinib-induced hepatitis treated by corticosteroids in a patient with metastatic gastrointestinal stromal tumor: Min Kyu Kang, Heon Ju Lee, Joon Hyuk Choi; Yeungnam Univ J Med. 2019;36(2):155-158. Published online January 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00115

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Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.

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Antioxidant-Based Preventive Effect of Phytochemicals on Anticancer Drug-Induced Hepatotoxicity
Ji Eon Park, Chi-Hoon Ahn, Hyo-Jung Lee, Deok Yong Sim, Su Yeon Park, Bonglee Kim, Bum Sang Shim, Dae Young Lee, Sung-Hoon Kim
Antioxidants & Redox Signaling.2023; 38(16-18): 1101. CrossRef

Superficial malignant peripheral nerve sheath tumor from recurrent neurofibroma in the abdominal wall of a patient without neurofibromatosis type 1: Chang Yeon Jung, Jung Min Bae, Joon Hyuk Choi, Ki Hoon Jung; Yeungnam Univ J Med. 2019;36(1):63-66. Published online December 20, 2018; DOI: https://doi.org/10.12701/yujm.2019.00031

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Malignant peripheral nerve sheath tumor (MPNST) is rare, accounting for 5–10% of all soft tissue sarcomas. MPNST is characteristically aggressive and has a poor prognosis. Fifty percent of patients with MPNST have neurofibromatosis type 1 (NF1). NF-associated MPNST (NF-MPNST) occurs more often at younger ages than sporadic MPNST (sMPNST), but the survival difference is controversial. Superficial MPNST from a recurrent neurofibroma is extremely rare and only a limited number of cases have been reported in the literature. Herein, we report an unusual case of superficial MPNST from a recurrent neurofibroma in a patient without NF1.

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Sporadic neurofibroma of transverse colon in a patient without neurofibromatosis type 1: A case report
Toru Imagami, Saburo Sugita, Takaya Nagasaki, Masahiro Kimura, Keisuke Ito, Shingo Inaguma
International Journal of Surgery Case Reports.2020; 71: 19. CrossRef

Immune thrombocytopenia associated with sarcoidosis.: Da Eun Jeong, Min Kyoung Kim, Sung Ae Koh, Kyoung Hee Lee, Joon Hyuk Choi, Young Hoon Hong, Jae Ho Cho, Eun Ju Goo, Myung Soo Hyun; Yeungnam Univ J Med. 2015;32(1):26-30. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.26

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Abstract PDF: Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

Recurrent acinic cell carcinoma in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy.: Sung Yun Jung, Dong Won Lee, Min Geun Gu, Tae Hun Kwon, Sung Ae Ko, Joon Hyuk Choi, Jang Won Sohn, Myung Soo Hyun; Yeungnam Univ J Med. 2014;31(1):33-37. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.33

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Abstract PDF: Acinic cell carcinoma (ACC) is an uncommon malignant tumor of the salivary glands that is difficult to diagnose. It grows slowly and shows distant metastasis rarely. We experienced a case of recurrent ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. The 29-year-old man had been suffering from severe multiple bones and joints pain for 2 months. Ten years earlier, he underwent superficial parotidectomy due to a right subauricular mass. The mass was diagnosed with ACC. After surgery, the tumor recurred twice. Then the patient was diagnosed with cardiac metastasis via positron emission tomography-computed tomography and trans-thoracic echocardiography. He also had hypertrophic osteoarthropathy with multiple bone metastasis. He was given palliative radiotherapy and conservative treatment. ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy has not yet been reported in literature. From this case, it is recommended to evaluate multiple distant metastasis in the ACC of the parotid gland when joint and bone pain are present.

A Case of Type 1 Neurofibromatosis Associated with Multiple Metastatic Gastrointestinal Stromal Tumors.: Hyo Jin Jang, Sung Ae Koh, Da Eun Jeong, Ji Yoon Jung, Eun Ju Goo, Kyoung Hee Lee, Joon Hyuk Choi, Myung Soo Hyun; Yeungnam Univ J Med. 2013;30(2):105-108. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.105

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Abstract PDF: Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeungnam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.

Combined Hepatocellular-Cholangiocarcinoma: Recent Progress in Pathology and Classification.: Joon Hyuk Choi; Yeungnam Univ J Med. 2011;28(1):1-12. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.1

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Primary liver carcinomas have been classified into hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma (CHC). CHC is a tumor containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma. It forms a small but significant proportion of primary liver carcinomas. The origin and pathogenesis of CHC have not been well established. According to the 2010 WHO classification, CHCs are categorized into 2 groups: the classical type and a subtype with stem cell features. This review describes recent progress in pathology and classification of CHC.

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Synchronous Double Primary Hepatic Cancer: Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma
Jin Ok Kim, Dae Won Jun, Kiseok Jang
The Korean Journal of Gastroenterology.2013; 62(2): 135. CrossRef

Angioleiomyoma of the Nasal Septum: A Case Report.: Joon Hyuk Choi, Jun Mo Kim, Yong Dae Kim; Yeungnam Univ J Med. 2008;25(2):154-159. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.154

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Angioleiomyoma of the sinonasal tract is a rare benign tumor. We report a case of angioleiomyoma of the nasal septum in a 51-year-old woman who complained of frequent epistaxis for 3 months. Surgicalexcision was performed. The excised specimen was 0.7 x 0.5 x 0.4 cm in size, well circumscribed, grayish white, rubbery, and soft. Histological examination showed thick-walled blood vessels and smooth muscle cell proliferation. No nuclear atypia or mitoses were present.

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A Case of Leiomyoma of the Nasal Septum
Sung Jae Heo, Jin Hyun Ryu, Jung Soo Kim
Journal of Clinical Otolaryngology Head and Neck Surgery.2016; 27(1): 133. CrossRef
A Case of Vascular Leiomyoma in Nasal Cavity: Case Report and Literature Review
Sung Won Yoon, Min Joon Park, Eun Mee Han, Jung Hyeob Sohn
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2015; 58(2): 138. CrossRef
A Case of Angioleiomyoma of the Nasal Septum
Won Il Park, Ji Sung Shim, Junbum Joo, Ju Eun Cho
Journal of Clinical Otolaryngology Head and Neck Surgery.2013; 24(2): 247. CrossRef

Black Pigmentation of Terminal Ileum after Long Term Ingestion of Charcoal: Jun Young Lee, Sung Bum Kim, Sang Hoon Lee, Hee Jung Moon, Jae Won Choi, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim, Joon Hyuk Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S623-626. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S623

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Abstract PDF: Isolated pigmentation of the terminal ileum is rare incidental finding when performing a colonoscopic examination. The common substances that cause gastrointestinal pigmentations are lipofuscin, iron sulphide(FeS), hemosiderin, and other exogenous materials such as silicates and titanium. In most cases, pigmentation of the terminal ileum has no subjective symptoms, so it is found in autopsy or incidental colonoscopic examination. The cause of pigmentation has not been clearly identified. We experienced a case of pigmentation of terminal ileum associated with long term charcoal ingestion. This finding supports that the source of ileal pigmentation is ingested material.

Cystic Dystrophy in Heterotopic Pancreas of Duodenal Wall －A Case Report－: Mi Jin Gu, Won Kyu Park, Yeung Kyong Bae, Jae Ho Cho, Jay Chun Chang, Jae Woon Kim, Kil Ho Cho, Mi Soo Hwang, Bok Hwan Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S647-651. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S647

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Abstract PDF: Cystic dystrophy is an uncommon, benign poorly understood disease. It is characterized by the development of cysts in heterotopic pancreatic tissue. A 57-year-old-man was hospitalized for abdominal pain for a week. He is a heavy alcohol drinker. There was a cyst at second portion of duodenum on CT. Under the impression of peptic ulcer perforation, Whipple’s operation was performed. Grossly, a cystic space, measuring 3.0 cm in diameter, was noted within the thickened duodenal wall. Microscopically, the cyst was lined by columnar epithelium and granulation tissue and embedded in ectopic pancreatic tissue. The adjacent pancreatic tissue showed focal chronic pancreatitis.

Supratentorial Leptomeningeal Hemangioblstoma －Case Report－: Han Won Jang, Woo Mok Byun, Jae Kyo Lee, Jae Ho Cho, Kil Ho Cho, Mi Soo Hwang, Bok Hwan Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S770-774. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S770

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Hemangioblastoma is a benign tumor that most commonly occurs in the cerebellum and associated with von Hippel-Lindau (VHL) disease. Supratentorial hemanigoblastomas are exceptionally rare. We describe the magnetic resonance imaging (MRI) and histopathologic findings of a supratentorial leptomeningeal hemangioblastoma.

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Sporadic supratentorial hemangioblastoma with meningeal affection: A case report and literature review
Juan Francisco Sánchez-Ortega, Marta Claramonte, Mónica Martín, Juan Calatayud-Pérez
Surgical Neurology International.2021; 12: 394. CrossRef
Supratentorial hemangioblastomas in von Hippel–Lindau wild-type patients – case series and literature review
Luís Rocha, Carolina Noronha, Ricardo Taipa, Joaquim Reis, Mário Gomes, Ernesto Carvalho
International Journal of Neuroscience.2018; 128(3): 295. CrossRef
Meningeal Supratentorial Hemangioblastoma in a Patient with Von Hippel-Lindau Disease Mimicking Angioblastic Menigioma
Hoon Kim, Ik-Seong Park, Kwang Wook Jo
Journal of Korean Neurosurgical Society.2013; 54(5): 415. CrossRef
Supratentorial hemangioblastoma: clinical features, prognosis, and predictive value of location for von Hippel-Lindau disease
S. A. Mills, M. C. Oh, M. J. Rutkowski, M. E. Sughrue, I. J. Barani, A. T. Parsa
Neuro-Oncology.2012; 14(8): 1097. CrossRef

Angiomatoid Fibrous Histiocytoma: A Case Report.: Joon Hyuk Choi, Woo Jung Sung, Nam Hyuk Lee; Yeungnam Univ J Med. 2007;24(2):315-321. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.315

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Angiomatoid fibrous histiocytoma is a rare soft tissue tumor that generally affects children and young adults. We report a case of angiomatoid fibrous histiocytoma in an 11-year-old boy who complained of a back mass for 3 years. Surgical excision was performed. The excised specimen showed a 4.0 x 3.6 x 3.0 cm, well circumscribed, grayish white tumor, with multicystic changes. Histological examination showed proliferation of spindle or round shaped tumor cells. There was a dense fibrous pseudocapsule with prominent chronic inflammatory cell infiltrates.

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Imaging of childhood angiomatoid fibrous histiocytoma with pathological correlation
Ali Yikilmaz, Bo-Yee Ngan, Oscar M. Navarro
Pediatric Radiology.2015; 45(12): 1796. CrossRef

A Case of Glycogen Storage Disease with Hypertrophic Cardiomyopathy.: Dong Hee Kim, Sang Wook Kang, Won Jong Park, Kyoung Ae Jang, Joon Hyuk Choi, Woong Kim, Sang Hee LEE, Geu Ru Hong; Yeungnam Univ J Med. 2006;23(2):252-257. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.252

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Abstract PDF: Glycogen storage diseases are a heterogeneous group of metabolic disorder affecting multiple organ system: liver, skeletal muscle, heart and brain. Clinical features include: short status, hepatomegaly, hypoglycemia, dyslipidemia and rare involvement of the myocardium except in the case of type III, glycogen storage diseases with hypertrophic cardiomyopathy in adult, which is extremely rare. We treated a case of hypertrophic cardiomyopathy with hepatomegaly that was unknown etiology. The patient was diagnosed as having glycogen storage disease. This 46-year old women was transferred with dyspnea on exertion and abnormal LFTs. She was diagnosed with hypertrophic cardiomyopathy by echocardiography but there was no specific cause for hypertrophic cardiomyopathy. A liver biopsy was performed. The result showed glycogen storage disease possible type III, IV or IX. In conclusion, patients with hypertrophic cardiomyopathy of unknown etiology and abnormal LFTs should be evaluated for glycogen storage disease.

Desmoplastic Small Round Cell Tumor: A Case Report.: Joon Hyuk Choi, Sung Soo Yun, Jay Chun Chang; Yeungnam Univ J Med. 2006;23(1):90-95. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.90

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Abstract PDF: Desmoplastic small round cell tumor (DSRCT) is a rare and highly malignant mesenchymal tumor found in the abdominal cavity. It mainly affects young male patients. We report a case of DSRCT that occurred in the abdominal cavity of a 50-year-old man. The tumor was characterized by small round tumor cells with irregular nests in the prominent desmoplastic stroma. The tumor cells showed immunoreactivity for epithelial membrane antigen, desmin, vimentin, and neuron specific enolase.

A Case of Granulation Tissue of the Tongue in Infant.: Hee Jung Lee, Eun Sil Yun, Joon Hyuk Choi, Kwang Hae Choi; Yeungnam Univ J Med. 2005;22(2):247-252. Published online December 31, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.2.247

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Abstract PDF: Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out. Sometimes, tongue lesions are present with dyspnea, dysphagia, dysarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of the tongue in 4 month old female patient. Swallowing difficulty and respiratory distress symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination. After excision of tongue mass, she had no problem with swallowing and breathing.

Ewing's Sarcoma of the Calcaneus: A Case Report.: Joon Hyuk Choi, Ji Hyun Yeo, Mi Jin Kim, Duck Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 2004;21(2):256-261. Published online December 31, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.2.256

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Ewing's sarcoma is rarely found occurs in the bones of the hands and feet. We report a case of Ewing's sarcoma of the left calcaneus in a 15-year-old girl who complained of left heel pain and swelling. An open biopsy was performed and histological examination showed the proliferation of uniform small round cells. Immunohistochemical staining for CD99 showed diffuse strong positivity in the cytoplasmic membrane of the tumor cells. After preoperative chemotherapy, a below knee amputation was performed.

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Diagnoses, treatment, and oncologic outcomes in patients with calcaneal malignances: Case series, systematic literature review, and pooled cohort analysis
Erik T. Newman, Eveline A. J. van Rein, Nina Theyskens, Marco L. Ferrone, John E. Ready, Kevin A. Raskin, Santiago A. Lozano Calderon
Journal of Surgical Oncology.2020; 122(8): 1731. CrossRef

Calcifying Aponeurotic Fibroma: A Case Report.: Joon Hyuk Choi, Jae Sung Seo, Kil Ho Cho; Yeungnam Univ J Med. 2003;20(2):223-228. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.223

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Calcifying aponeurotic fibroma is a rare benign soft tissue tumor that usually involves distal extremities in children and adolescents, especially the hands and feet. We report a case of calcifying aponeurotic fibroma arising in a 14-year-old boy who complained of right thumb mass. Surgical excision was performed. The resected specimen showed a 2.0x1.5 cm grayish white, fibrotic tissue. Histologic examination showed proliferation of fibroblastic cells with infiltrative growth pattern. Foci of calcification and chondroid differentiation were present.

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Calcifying Aponeurotic Fibroma of the Elbow - A Case Report -
Mee-Hye Oh, Eun Ah Jung, Ji Hye Lee, Hyun Deuk Cho, Jong Kyu Han, Yong-Koo Park
The Korean Journal of Pathology.2009; 43(1): 75. CrossRef

A Case of Infected Huge Lymphangioma in Pelvic cavity.: Woo Seok Choi, Seong Ho Lee, Seok Young Chung, Phil Hyun Song, Un Gi Baek, Chul Kyu Cho, Tong Choon Park, Joon Hyuk Choi; Yeungnam Univ J Med. 2002;19(1):63-67. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.63

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Abstract PDF: Lymphangioma is a benign tumor resulted from abnormal communication between large dermal lymphatic channels and central lymphatic system. The tumor is encountered more often in the neck and axilla and less often in mediastinum, omentum, retroperitoneum, and scrotum. It rarely developed at urogenital system, and there has been no previous description of lymphangioma involving the bladder wall in Korea. We report a case of 35-year-old female with infected huge lymphagioma arising from pelvic cavity and involving bladder wall.

Clinical Features of Cholestatic Hepatitis.: Sun Taek Choi, Jong Ryul Eun, Song Woo Lim, Bong Jun Kim, Heoon Ju Lee, Mi Jin Gu, Joon Hyuk Choi; Yeungnam Univ J Med. 2001;18(1):51-58. Published online June 30, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.1.51

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Abstract PDF: BACKGROUND
Cholestatic hepatitis is failure of bile to reach the duodenum with hepatocellular damage and no demonstable obstruction of the major bile ducts. The prognosis of usually good with recovery in less than 4 weeks after withdrawal of the offending drug. However, a prolonged causes of Chronic liver disease is needed. MATERIALS AND METHODS: From January 1991 through January 2000, 14 patients diagnosed as cholestatic hepatitis by liver biopsy were included. The possible causative drug, clinical features, laboatory findings, and progression of cholestatic hepatitis were evaluated. The semiquantitative study of liver lesions was performed by two independent observers. RESULTS: Causes of cholestatic hepatitis are 5 cases of oriental medicine, 3 cases of anti-tuberculosis medication, 1 case of ticlopidine and antibiotics and 4 cases of unknown causes. The clinical features of cholestatic hepatitis were jaundice, itching, urine color change, and general weakness. During 6 to 50 months, LFT of 5 patients showed prolonged elevation. Elevated total cholesterol > or =250 mg/dL in 6 patients, pheripheral blood eosinophilia in 5 patients, auto-antibody positive in 6 patients were observed respectively. The biopsies showed intralobular bilirubinostasis with a mixed portal inflammatory infiltration. CONCLUSION: In chlestatic hepatitis, durations of abnormal LET are variable regardless of causative drugs. If chlestatic hepatitis progresses toward chronic course, viral hepatitis, primary biliary cirrhosis, and autoimmune hepatitis should be differentially diagnosed and sequential liver biopsies are needed.

Mesenchymal Chondrosarcoma: 3 Cases Report.: Mi Jin Gu, Young Kyong Bae, Joon Hyuk Choi, Mi Jin Kim, Won Hee Choi, Duk Seop Shin, Jang Soo Suh; Yeungnam Univ J Med. 2000;17(1):87-92. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.87

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Abstract PDF: Mesenchymal chondrosarcoma is a rare malignant tumor of skeletal and extraskeletal origin, and which shows aggressive local behavior as well as a high metastatic potential. We report 3 cases of mesenchymal chondrosarcoma. Two cases were male and one was female. The ages ranged from 25 to 32 years(mean: 28 years). Tissue was obtained by wide excision in two patients, and incisional biopsy in one. The mass locaterd in the rib(case 1), orbital floor(case 2), and abdominal wall(case 3). Roentgenographically, the tumor resembles ordinary chondrosarcoma, showing osteolytic and obstructive appearance with stippled calcification. Grossly, the tumor was lobulating, solid fish-fleshy like mass with calcification and ossification. Histologically, the tumor shows characteristic bimorphic pattern composed of islands of well differentiated hyaline cartilage admixed with a cellular area of undifferentiated small cells. The small cells usually displayed a hemangiopericytoid or an alveolar pattern.

Chordoma: A Clinicopathologic Review of 4 Cases.: Joon Hyuk Choi, Young Kyung Bae, Mi Jin Kim, Duk Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 1999;16(2):369-375. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.369

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Abstract PDF: Chordoma is a slow-growing malignant neoplasm arising from the remnants of the primitive notochord. It accounts for 1 to 4% of all malignant bone tumors. It occurs exclusively along the spinal axis. Authors experienced four cases of chordoma occurred in the sacrococcygeal region. There were two male and two female patients, with a mean age of 63.5 years(range. 57~75 years). Tissue was obtained by wide excision in two patients, by incisional biopsy in one patient and by needle biopsy in the other. Adjuvant radiation theraphy was performed on all the patients after their biopsy. The mean diameter of the tumors was 7.6cm(range, 5.5 to 13.0cm). Grossly, tumor was multilobulated, soft and myxoid gelatinous mass. Microscopically, the tumor showed lobulated feature divided by fibrous septa within it. There were physaliphorous cells with vacuolated bubbly cytoplasm. And small uniform, round, and non-vacuolated tumor cells were also present. On immunohistochemical stain, all the cases were immunoreactive for cytokeratin, epithelial membrane antigen(EMA) and vimentin, respectively. One of the 4 cases was positive for S-100 protein. All the cases were negative for CEA.

Clear cell sarcoma: 1 case report.: Joon Hyuk Choi, Hae Jeong Choi, Mi Jin Kim, Duk Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 1999;16(1):108-113. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.108

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Abstract PDF: Clear cell sarcoma is a rare soft tissue sarcoma that occurs tendons and aponeuroses, usually of the lower extremities in young adult. The exact histogenesis is not definitely established, We experienced a case of 58 year-old female who presented with a 3.2x2.2cm sized mass located in the subcutaneous tissue on the left lower thigh. The mass was well circumscribed and grayish firm. Two small satellite nodules were also seen. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm and separated into compact nests or short fascicles by delicated fibrous septa. The melanin pigments and hemosiderin were seen. Tumor cells showed positive reaction for S-100 protein and HMB-45. The ultrastructural examination showed abundant mitochondria and melanosomes.

A Clinicopathologic Review of Eight Cases of Chondroblastoma.: Joon Hyuk Choi, Hae Jeong Choi, Mi Jin Ku, Dae Hong Suh, Duk Seop Shin, Kil Ho Cho; Yeungnam Univ J Med. 1998;15(2):359-370. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.359

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Abstract PDF: Eight cases of chondroblastoma were studied by analyzing the clinical and pathologic findings. The age of eight cases ranged from 17 to 38 years old(median age, 22.7 years old). The tumors developed in the femur (3 cases), patella (2 cases), tibia( 1 case), fibula (1 case), and ulna (1 case). The mean diameter of tumors was 4.0 cm (range, 1.5 to 8.0 cm). Grossly, tumors showed grayish brown solid area with foci of secondary aneurysmal bone cyst. Histologically, the tumor cells were round or polygonal in shape with nuclear groove. And there were chondroid differentiation(7 cases), mitosis(3 cases), calcific deposits(3 cases), secondary aneurysmal bone cyst(4 cases), hemosiderin deposits(4 cases), necrosis(3 cases), vascular invasion(1 caes) and foamy histiocytes and cholesterol cleft(1 cases). All cases showed no metastasis to lymph node and distant organ. Seven cases (87.5 %) were immunoreactive for S-100 protein. None were immunoreactive for cytokeratin.

A Clinicopathological Study of Solid and Papillary Neoplasm of Pancreas.: Joon Hyuk Choi, Mi Jin Gu, Hong Jin Kim; Yeungnam Univ J Med. 1998;15(1):36-46. Published online June 30, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.1.36

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Abstract PDF: Solid and papillary epithelial neoplasm of pancreas is a rare tumor, usually affecting young women, and its histogenesis is still controversial. This study was performed to define the clinicopathologic features and cellular origin of this tumor. Eight female cases of solid and papillary epithelial neoplasm of pancreas were studied by analyzing the clinicopathologic findings and immunohistochemical and electron-microscopic findings. The age of eight cases ranged from 21 to 54 years (mean, 34 years). The tumors developed in the tail (4 cases), body-tail (2 cases), body (1 case) and head (1 case). The mean diameter of tumors was 9.3 cm (range, 5.5 to 13 cm). Tumors showed solid, cystic and hemorrhagic areas. Histologically, the tumor cells were uniformly round or polygonal in shape, and formed solid sheets and papillary pattern. On the immunohistochemical stain, 8 cases (100%) were immunoreactive for alpha1-antitrypsin, 7 cases (87.5%) for cytokeratin, 7 cases (87.5%) for progesterone receptor, 6 cases (75%) for vimentin, and 1 case (12.5%) for synaptophysin, respectively. None of them were immunoreactive for estrogen receptor. Electron microscopic examination showed many mitochondria, annulate lamellae and canaliculi-like gap. These findings suggest that solid and papillary epithelial tumor of pancreas possibly originates from totipotential stem cells.

Expression of Oncogene Product in the Colorectal Carcinoma.: Young Ran Shim, Woo Young Jang, Kyoung Chan Choi, Joon Hyuk Choi, Won Hee Choi, Min Chul Shim; Yeungnam Univ J Med. 1995;12(2):210-225. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.210

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Abstract PDF: The expression of p62"' and p2l can be seen in many solid tumor, but the pattern and incidence of expression were different according to organ, countries, and examiners, thus it is not definitely defined. Total 67 colorectal carcinoma in paraffin sections are analysed by immunohistochemically for evaluation of the p62and p21- expression according to the age, sex, chief complaints, location, differentiation, modified Dukes stage, using the specific monoclonal antibodies. The results were summarized as follows : The age of patients ranged from 32 years to 82 years. The mean age was 57.6 years. The expression of p 62y' and p21 was not correlated with age. Male was 29 cases(43.3%) and female was 38 cases(56.7%). The male to female ratio was 1:1.31. The and 95.0% in moderately differentiated adenocarcinoma, 90.0% and 90.0% in poorly differentiated <,;, adenocarcmoma, 100.0% and 100.0% in mucinous carcinoma. The positive rate of p62!and and p2l' was 94.1% and 88.2% in Dukes stage B,, 96.0% and 96.0% in Dukes stage B,, 100.0% and 100.0% in Dukes stage C,, 100.0% and 88.9% in Dukes stage C, and 100.0% and 100. o% in Dukes stage D. The expression of p62 y' in metastatic colorectal carcinoma showed diffuse and strongly positive reaction than primary colorectal carcinoma. The expression of p21 in primary colorectal carcinoma showed diffuse and strongly positive reaction than metastatic colorectal carcinoma.

Fine structure and detoxification kinetics in kupffer cells after injection of endotoxin in rats.: Joon Hyuk Choi, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1993;10(2):313-337. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.313

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Abstract PDF: The aim of this study was to clarify the role of Kupffer cells in the mechanism of endotoxin-induced liver injury. The study on fine structure of Kupffer cells was performed after the injection of endotoxin. The endotoxin(Escherichia soli lipopolysaccharide 026: B6, 1.5mg/100 g of body weight) was intraperitoneally injected in Sprague-Dewley rats. Animals were sacrificed at 1/4, 1/2, 1, 2, 4, 8, 16, 24, 72 and 120 hours after the injection of endotoxin. Livers were extirpated and processed to be examined by light and electron microscopy. The results obtained were summerized as follows: Early changes observed in liver after endotoxin injection included the increased number and hypertrophy of Kupffer cells, infiltration of neutrophils and presence of fibrin thrombi within the sinusoids. The coritinuous increase of the Kupffer cells in number with hypertrophy, congestion and infiltration of inflammatory cells within the sinusoids were observed. Hepatocytes showed* fatty change and occasional necrosis. At 72 hours the congestion decreased. At 120 hours the number of Kupffer cells was increased, but the morphology of Kupffer cells became similar to that of the control group. The numbers and sizes of primary and secondary lysosomes and amount of euchromatin of Kupffer cells increased. Swellings and increase in number of mitochondria, Golgi complex, smooth endoplasmic reticulum, rough endoplasmic reticulum were evident. Microthrombi were present within the sinusoids. The swelling of rough endoplasmic reticulum and mitochondria, decrease of glycogen particles, fatty change, hypoxic vacuoles, pyknotic nuclei and occasional necrosis were observed in hepatocytes. At 72 hours the number of secondary lysosomes in Kupffer cells decreased. At 120 hours the morphology of Kupffer cells became similar to that of the control group. According to these results, it was postulated that the endotoxin was initially taken up by pinocytosis into Kupffer cells and degraded in secondary lysosomes of activated Kupffer cells. Kupffer cells may play an important role in the defense mechanism of liver during endotoxemia. The dysfunction of Kupffer cells and ischemia by sinusoidal microthrombi may cause liver injury.

Three Cases of Primary Adenosquamous Carcinoma of Stomach.: Joon Hyuk Choi, Mi Jin Kim, Hae Joo Nam, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1988;5(2):189-193. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.189

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Abstract PDF: Adenosquamous carcinoma of stomach is a mixed glandular-epidermoid tumor where both components are neoplastic. Its incidence is extremely rare. The five theories on the origin of squamous components are 1) island of ectopic squamous epithelium in the gastric mucosa, 2) squamous metaplasia of gastric epithelium, 3) squamous differentiation in a preexisting adenocarcinoma, 4) endothelial cell differentiated toward squamous elements, and 5) totipotential undifferentiated cells of the gastric mucosa. We experienced three cases of adenosquamous carcinoma. Case 1 was a 71-year-old female patient; an ulcerative lesion was present in the pylorus, measuring 5 cm in diameter. Case 2 was a 57-year-old male patient; an ulcerative lesion is present in the pylorus, measuring 6 cm in diameter. Case 3 was a 58-year-old female patient; an ulcerative lesion was present in the body and fundus, measuring 10 cm in diameter. Microscopic examination revealed a mixed malignant squamous and adenomatous component.

Clinical and Histopathological Studies on Carcinoma of the Uterine Cervix in Taegu.: Joon Hyuk Choi, Won Hee Choi, Suk Jae Hong, Tae Sook Lee; Yeungnam Univ J Med. 1988;5(2):121-128. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.121

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Abstract PDF: Clinical and histopathological studies were made on 202 cases of malignancy of cervix, that were visited to the Department of Obstetrics and Gynecology, Yeungnam University Hospital, during 5 years from 1983 to 1987. The results were summarized as follows. 1. Malignancies of the uterine cervix were 10% of total female malignancies. 2. Among 202 cases, 195 cases (96.5%) were squamous cell carcinoma, in which 60 cases (30.0%) of carcinoma in situ, 9 cases (4%) of microinvasive, and 126 cases (62.5%) of invasive carcinoma were included. 3. The average age of the patients with squamous cell carcinoma was 49.4 years old; In case of carcinoma in situ, it was 43.8, microinvasive, 40.0, invasive 52.1 years old. 4. Clinical symptoms of the patient with squamous cell carcinoma in order of frequency were as follows; vaginal bleeding (47.5%), abnormal cytology (15.4%), and abnormal vaginal discharge (9.4%). 5. Duration of the chief complaints was most commonly less than 6 months (73.2%), and the average duration was 3.8 months. 6. The most common age of marriage was between 19 to 22 years old (46.5%). The average was 21.5 years old. 7. The gravity was 51.5% in 5-8 times, and average 6.2 times. The parity was 61.9% in 1-4 times, and average 3.9 times. 8. The subdivision of 126 cases of invasive carcinoma was made according to FIGO stage classification, stage I, 40 cases (31.8%), stage II, 54 cases(42.9%), stage III, 11 cases (8.7%), and stage IV, 8 cases (6.3%). 9. The histologic subtypes of invasive squamous cell carcinoma were distributed as follows; large cell keratinizing type, 25 cases (19.8%), large cell nonkeratinizing type, 101 cases (80.2%). 10. In the cytologic diagnosis, class I was 2 cases (1.9%), class II was 16 cases (15.1%), class III was 33 cases (31.1%), class IV was 31 cases (29.3%), class V was 24 cases (24.6%). 11. The frequency of lymph node metastasis was 7.5% in stage I, and 11.1% in stage II.

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