Mixed hepatocellular-cholangiocarcinoma accounts for about 1% of all hepatocellular carcinoma. In many cases, mixed hepatocellular-cholangiocarcinoma has been misdiagnosed as hepatocellular carcinoma or cholangiocarcinoma because of the indistinctive clinical course and radiologic findings. The clinical course and the pathologic characters are not known well, but it resembles the characteristics of hepatocellularcarcinoma rather than cholangiocarcinoma. So mixed hepatocellular-cholangiocarcinoma was classified as a kind of hepatocellular carcinoma. But the growth and dissemination rate is faster than that of hepatocellular carcinoma and the prognosis more poor. So the exact diagnosis is important. Authors experienced a patient who has the mixed hepatocellular-cholangiocarcinoma diagnosed by liver and neck node biopsy in patient who complain-ed abdominal discomfort and palpable mass, so we report the case.

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• A Case of Curative Resection of Advanced Combined Hepatocellular-cholangiocarcinoma after Neoadjuvant Chemotherapy
  Jee Eun Choi, Kyung Hee Kim, Seon A Kim, Jung Hwan Lee, Sang Myung Woo, Sang-Jae Park, Eun Kyung Hong, Woo Jin Lee
  Korean Journal of Pancreas and Biliary Tract.2016; 21(2): 101.     CrossRef

Small cell lung cancer accounts for about 20% of all lung cancers. At the time of diagnosis, the majority of patients already have metastasis. The liver is one of the most common sites of distant metastasis of lung cancer. Small cell lung cancer arises from neuroendocrine cells which produce hormone, hormone producing granules can be seen under electron microscope . A 65-year-old male was admitted to hospital because of jaundice and right upper quadrant pain. The chest roentgenogram and chest computed tomography(CT) scan showed a 3 cm mass in right upper lobe with bilateral mediastinal lymphadenopathy and right pleural effusion. The abdomen CT scan revealed multiple masses in the liver with heterogenous pattern suggesting metastatic orgin. Though the immunohistochemistry and electron miscroscopy, he was diagnosed as metastatic small cell lung cancer of liver. We report a case of the Immunohistochemical and Electron Microscopic Observation of Metastatic Small Cell Lung Cancer of Liver.

Nowadays, upper gastrointestinal endoscopy is very commonly performed procedure as a diagnostic tool or therapeutic purpose. Although perforation rate during diagnostic evaluation has been reported as low about 0.03%, gastrointestinal perforation is a critical problem to the patients owing to significant morbidity and hospital stay. Therefore, all endoscopists should know the risk factors for the perforation and pay attention to avoid this complication. We experienced a case of 66 year-old-male with duodenal microperforation after endoscopic biopsy. During endoscopic examination, a submucosal mass was detected at duodenal second portion and endoscopic biopsy was performed. After this, he complained of severe abdominal pain during colonoscopy. Emergent simple abdomen and abdominal computed tomography revealed multiple free air in retroperitoneal space and duodenal perforation was suspicious. He was treated with primary closure and then recovered completely. Therefore, we report a case with microperforation after endoscopic duodenal biopsy.

Rhodotorula species are emergent opportunistic pathogens, Particularly m mmunocompromised patients. Rhodotorula mucilaginosa was the species most frequently recovered, followed by Rhodotorula glutinis. They have been associated with endocarditis, peritonitis, meningitis and catheter-associated fungemia. We experienced a case of catheter-related blood stream infection by rhodotorula glutinis. He was 46-year old man with decompensated liver cirrhosis. He was admitted for esophageal variceal bleeding. Rhodotorula glutinis was identified on blood culture, and amphotericin B was administered for fungemia treatment.

Acute appendicitis is the one of the most common operative disease in general surgery following by acute cholecystitis and intestinal obstruction, and most of the acute appendicitis is diagnosed at the emergency room.

Especially, because the number of patient who present atypical symptoms of acute appendicitis increases, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease.

We report one case of acute appendicitis diagnosed by colonoscopy performed to evaluate for atypical abdominal pain.