Journal of Yeungnam Medical Science

Case report

Primary diffuse large B-cell lymphoma of the vulva: a case report: Sun Yeon Kim, Ju Hwan Koo, Juhun Lee, Yu Jin Koo, Mi Jin Gu, Dae Hyung Lee; J Yeungnam Med Sci. 2023;40(Suppl):S87-S92. Published online April 25, 2023; DOI: https://doi.org/10.12701/jyms.2023.00108

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Abstract PDF: Diffuse large B-cell lymphoma (DLBCL) is a subtype of non-Hodgkin lymphoma (NHL) and is estimated to account for approximately 30% of all NHL cases. NHL can also occur in the female genital tract and accounts for approximately 1.5% of all NHL cases. Many doctors have difficulty diagnosing or treating vulvar DLBCL because of its very low prevalence. A 55-year-old woman presented with a solid mass on the right side of the vulva. No significantly enlarged lymph nodes were observed in the inguinal region. She underwent excisional biopsy at our institution. DLBCL was diagnosed based on histological examination. According to the Hans algorithm, the lesion was diagnosed as a non-germinal center B-cell-like subtype. The patient was referred to a hematologic oncologist. The disease stage was classified as IE according to the Ann Arbor staging classification. The patient received four cycles of chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone and localized radiation therapy with 36 Gy in 20 fractions. She showed complete remission and maintained this status on the latest computed tomography scan. Gynecologists should rule out lymphoma in patients presenting with a vulvar mass.

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Extraspinal sacrococcygeal myxopapillary ependymoma in a teenager: Minchong Kim, Mi Jin Gu; J Yeungnam Med Sci. 2023;40(4):454-456. Published online September 2, 2022; DOI: https://doi.org/10.12701/jyms.2022.00367

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Case reports

Hemophagocytic lymphohistiocytosis with recurrent Kikuchi-Fujimoto disease: Sang Min Lee, Young Tae Lim, Kyung Mi Jang, Mi Jin Gu, Jong Ho Lee, Jae Min Lee; Yeungnam Univ J Med. 2021;38(3):245-250. Published online November 11, 2020; DOI: https://doi.org/10.12701/yujm.2020.00654

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Abstract PDF

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limiting lymphadenitis. It is a benign disease mainly characterized by high fever, lymph node swelling, and leukopenia. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease with clinical symptoms similar to those of KFD, but it requires a significantly more aggressive treatment. A 19-year-old Korean male patient was hospitalized for fever and cervical lymphadenopathy. Variable-sized lymph node enlargements with slightly necrotic lesions were detected on computed tomography. Biopsy specimen from a cervical lymph node showed necrotizing lymphadenitis with HLH. Bone marrow aspiration showed hemophagocytic histiocytosis. The clinical symptoms and the results of the laboratory test and bone marrow aspiration met the diagnostic criteria for HLH. The patient was diagnosed with macrophage activation syndrome—HLH, a secondary HLH associated with KFD. He was treated with dexamethasone (10 mg/m2/day) without immunosuppressive therapy or etoposide-based chemotherapy. The fever disappeared within a day, and other symptoms such as lymphadenopathy, ascites, and pleural effusion improved. Dexamethasone was reduced from day 2 of hospitalization and was tapered over 8 weeks. The patient was discharged on day 6 with continuation of dexamethasone. The patient had no recurrence at the 18-month follow-up.

Citations

Citations to this article as recorded by

Histiocytic necrotizing lymphadenitis with hemophagocytic lymphohistiocytosis in adults: A single‐center analysis of 5 cases
Qingqing Chen, Jing Zhang, Huijun Huang, Tonglu Qiu, Ze Jin, Yu Shi, Huayuan Zhu, Lei Fan, Jianyong Li, Wenyu Shi, Yi Miao
Immunity, Inflammation and Disease.2024;[Epub] CrossRef
A young Saudi female with combined hemophagocytic lympho-histiocytosis and Kikuchi’s disease: A case report
Kamal Al-Zahrani, Batol Gasmelseed, Hesham Waaer Shadi, Rehab Y AL-Ansari
SAGE Open Medical Case Reports.2023; 11: 2050313X2311543. CrossRef
Cefalea y fiebre: no todo es lo que parece
María Pilar Iranzo-Alcolea, Carmen Ariño-Palao, Grisell Starita-Fajardo, Andrés González-García, Cecilia Suárez-Carantoña
Revista Española de Casos Clínicos en Medicina Interna.2023; 8(2): 105. CrossRef
Kikuchi–Fujimoto disease: literature review and report of four cases
V. G. Potapenko, V. V. Baykov, А. Yu. Markova, N. B. Mikhailova, A. S. Ter‑Grigoryan, Yu. А. Krivolapov
Oncohematology.2022; 17(4): 48. CrossRef

Synchronous ileal inflammatory fibroid polyp and Meckel’s diverticulum found during laparoscopic surgery for adult intussusception: Sung Il Kang, Mi Jin Gu; Yeungnam Univ J Med. 2020;37(3):226-229. Published online December 18, 2019; DOI: https://doi.org/10.12701/yujm.2019.00388

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Abstract PDF

We present a rare case of synchronous ileal inflammatory fibroid polyp and Meckel’s diverticulum detected during laparoscopic surgery for adult intussusception. A 48-year-old woman presented with sudden onset of severe abdominal pain. Abdominal computed tomography revealed a segment of ileocecal intussusception. Thus, laparoscopic exploration was performed, which revealed an ileal mass with an outpouching closed luminal structure in the distal ileum. Two abnormal structures were resected via mini-laparotomy, and the patient was discharged without postoperative complications. Histopathological examination confirmed an ileal inflammatory fibroid polyp and Meckel’s diverticulum with ectopic pancreatic tissue.

Citations

Citations to this article as recorded by

Intestinal intussusception of Meckel’s diverticulum, a case report and literature review of the last five years
Dora Sandoval Schaedlich, Pedro Custodio de Mello Borges, Arnaldo Lacombe, Renato Alonso Moron
einstein (São Paulo).2023;[Epub] CrossRef
A Rare Cause of Colonic Obstruction: Inflammatory Fibroid Polyp
Sevinc Dagistanli, Nermin Gunduz, Osman Sibic, Suleyman Sonmez
Cureus.2022;[Epub] CrossRef
Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction
Claudio Guerci, Francesco Colombo, Gloria Goi, Pietro Zerbi, Barbara Pirrò, Piergiorgio Danelli
Frontiers in Surgery.2022;[Epub] CrossRef
Adult intussusception: a challenge to laparoscopic surgery?
Mingze Sun, Zhongmin Li, Zhenbo Shu, Qi Wu, Xue Liu
PeerJ.2022; 10: e14495. CrossRef
Adult Jejuno-jejunal intussusception due to inflammatory fibroid polyp
Yi-Kai Kao, Jian-Han Chen
Medicine.2020; 99(36): e22080. CrossRef

Case Reports

A Case of Gastric Lipoma with Upper Gastrointestinal Bleeding.: Min Geun Gu, Kook Hyun Kim, Byung Sam Park, Sung Yun Jung, Yo Han Jeong, Dong Won Lee, Hyeong Chan Shin, Mi Jin Gu; Yeungnam Univ J Med. 2013;30(2):132-135. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.132

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Abstract PDF: Gastric lipoma is a typical benign submucosal tumor that is usually asymptomatic and is generally detected incidentally when performing gastroscopy. However, depending on its size and location, an atypical gastrointestinal lipoma can cause abdominal pain, diarrhea, constipation, intestinal obstruction, intussuception and life-threatening gastrointestinal bleeding. We report herein a case of gastric lipoma with bleeding in a 43-year-old man. The gastroscopy showed a 4x4 cm ulcero-fungating submucosal mass at the anterior wall of the gastric antrum. Laparoscopic gastric wedge resection was performed and the lesion was diagnosed as gastric lipoma.

A Case of Pseudolymphomatous IgG4-Related Disease Involving the Maxilla.: Min Jung Kim, Seung Il Bae, Hoon Tae Kim, Young Hoon Hong, Hyun Je Kim, Choong Ki Lee, Mi Jin Gu; Yeungnam Univ J Med. 2013;30(2):128-131. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.128

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Abstract PDF: Immunoglobulin G4 (IgG4)-related disease is an inflammatory condition characterized by IgG4 positive plasma cell infiltration. It can affect any organ in the body and mainly involves the pancreas, liver, biliary tracts, orbits, salivary glands and lymph nodes. It can manifest as an inflammatory pseudotumor. Pseudolymphoma as an inflammatory pseudotumor is a group of benign tumors that exhibit histological and clinical features suggestive of malignant lymphoma. Studies on IgG4-related disease are rarely reported, and no case of the disease that involved the maxillary bone and adjacent soft tissue, except for the skin, has been reported. Therefore, we report herein a case of pseudolymphomatous IgG4-related disease that involved the maxilla, with a literature review.

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.

Original Article

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.

Case Report

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.

Original Article

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.

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