저자들은 조영증강 복부 전산화단층촬영과 혈관조영술로 급성췌장염이 동반된 췌장의 동정맥 기형을 진단하였고 수술적 절제로 치료된 45세 남성의 예를 경험하였다. 췌장의 동정맥 기형은 매우 드문 질환이며 췌장염이 동반된 것은 더 드물다고 알려져 있다. 그러나 췌장의 동정맥 기형도 급성췌장염의 한가지 원인이 될 수 있음을 고려해야 한다.

Mucous retention cyst (MRC) is not uncommon in the pathology of maxillary sinus, which should be differentially diagnosed from chronic maxillary sinusitis. The main stream of diagnosis usually depends on the clinical symptoms and radiological findings. Thus it was sometimes puzzling to confirm the histological features of mucous retention phenomenon in the antral mucosa, when the specimen was from a limited portion or much degenerated by inflammatory reaction. This study aims to define the histopathological features of MRC through reevaluation of MRCs (n=19) and maxillary sinusitis (n=65) diagnosed previously. The present study classified three types of MRC, i.e., an extravasation type, a luminal retention type, and a mixed type of MRC. The extravasation type MRC showed clear pseudocyst cavity under sinus mucosa with infiltration of foamy macrophage, and the luminal retention type MRC showed mucous retention in the luminal cavity of maxillary sinus accompanied with inflammatory reaction, and the mixed type MRC showed the both features of extravasation and luminal retention type MRCs. Resultantly, among nineteen cases of MRC only three cases belonged to the extravasation type MRC, eleven cases belonged to luminal retention type MRC, and three cases belonged to mixed type MRC, while two cases were turned out to be postoperative residual cysts of maxillary sinus. The MRCs examined in this study showed different pathological features from ordinary maxillary sinusitis, exhibiting the typical mucin retention phenomenon of extravasation type or luminal retention type with relatively mild inflammatory reaction with infiltration of mucin-pooled macrophages. However, the luminal retention type MRC was predominant among the MRCs (11/17, 64.7%) and each of the extravasation and mixed type MRCs was only three cases out of 17 MRCs (17.6%). The extravasation type MRC characteristically produces a pseudocyst by the overexpressions of matrix metalloprotease-3 (MMP-3) and connective tissue growth factor (CTGF). Because not only the pathogenetic mechanism but also the prognosis of MRC is different from chronic maxillary sinusitis, we suggest that the MRC of maxillary sinus should be classified into extravasation, luminal retention, and mixed types in the histological observations in addition to the clinical and radiological informations.