Journal of Pathology and Translational Medicine

Chan Kwon Jung

18 Articles

Application of Bethesda System for Reporting Thyroid Aspiration Cytology.: Kyungji Lee, Chan Kwon Jung, Kyo Young Lee, Ja Seong Bae, Dong Jun Lim, So Lyung Jung; Korean J Pathol. 2010;44(5):521-527.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.521

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BACKGROUND
The Bethesda classification system for reporting on thyroid fine-needle aspiration (FNA) cytology was recently proposed by the National Cancer Institute, USA. We aimed to report our experience with applying this system for thyroid FNA, with a focus on comparing it with the four categorical system.
METHODS
We retrospectively reviewed the 4,966 thyroid FNAs that were performed at the Seoul St. Mary's Hospital between October 2008 and September 2009. All the FNAs were classified according to the Bethesda system and the four tier system.
RESULTS
The cytologic diagnoses of the Bethesda system included 10.0% unsatisfactory, 67.7% benign, 3.1% atypia of undetermined significance, 0.6% follicular neoplasm, 0.5% follicular neoplasm, Hurthle cell type, 5.1% suspicious for malignancy and 13.0% malignancy. Using four tier system, 10.1%, 67.6%, 9.3%, and 13% were diagnosed as unsatisfactory, negative for malignancy, atypical cells and malignancy, respectively. Of the 4,966 nodules, 905 were histologically confirmed. The specificity of the Bethesda system and the four tier system for diagnosing malignancy was 99.6% and 82.6%, respectively.
CONCLUSIONS
The Bethesda system can classify indeterminate thyroid nodules into more detailed categories and provide clinicians with useful information for management.

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The Bethesda System for Reporting Thyroid Cytopathology: Validating at Tribhuvan University Teaching Hospital
Kunjan Acharya, Shreya Shrivastav, Prashant Triipathi, Bigyan Raj Gyawali, Bijaya Kharel, Dharma Kanta Baskota, Pallavi Sinha
International Archives of Otorhinolaryngology.2022; 26(01): e097. CrossRef
Ultrasound-guided fine needle aspiration cytology and ultrasound examination of thyroid nodules in the UAE: A comparison
Suhail Al-Salam, Charu Sharma, Maysam T. Abu Sa’a, Bachar Afandi, Khaled M. Aldahmani, Alia Al Dhaheri, Hayat Yahya, Duha Al Naqbi, Esraa Al Zuraiqi, Baraa Kamal Mohamed, Shamsa Ahmed Almansoori, Meera Al Zaabi, Aysha Al Derei, Amal Al Shamsi, Juma Al Kaa
PLOS ONE.2021; 16(4): e0247807. CrossRef
Subclassification of the Bethesda Category III (AUS/FLUS): A study of thyroid FNA cytology based on ThinPrep slides from the National Cancer Center in China
Huan Zhao, HuiQin Guo, LinLin Zhao, Jian Cao, Yue Sun, Cong Wang, ZhiHui Zhang
Cancer Cytopathology.2021; 129(8): 642. CrossRef
McGill Thyroid Nodule Score in Differentiating Thyroid Nodules in Total Thyroidectomy Cases of Indeterminate Nodules
Hadi A Al-Hakami, Reem Al-Mohammadi, Rami Al-Mutairi, Haya Al-Subaie, Mohammed A Al Garni
Indian Journal of Surgical Oncology.2020; 11(2): 268. CrossRef
Fine-needle aspiration cytology of nodular thyroid lesions: A 1-year experience of the thyroid cytopathology in a large regional and a University Hospital, with histological correlation
Kaumudi Konkay, Radhika Kottu, Mutheeswaraiah Yootla, Narendra Hulikal
Thyroid Research and Practice.2019; 16(2): 60. CrossRef
Reproducibility of atypia of undetermined significance/follicular lesion of undetermined significance category using the bethesda system for reporting thyroid cytology when reviewing slides from different institutions: A study of interobserver variability
Vijayalakshmi Padmanabhan, Carrie B Marshall, Guliz Akdas Barkan, Mohiedean Ghofrani, Alice Laser, Idris Tolgay Ocal, Charles David Sturgis, Rhona Souers, Daniel F.I Kurtycz
Diagnostic Cytopathology.2017; 45(5): 399. CrossRef
The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists
Mimi Kim, Hyo Jin Park, Hye Sook Min, Hyeong Ju Kwon, Chan Kwon Jung, Seoung Wan Chae, Hyun Ju Yoo, Yoo Duk Choi, Mi Ja Lee, Jeong Ja Kwak, Dong Eun Song, Dong Hoon Kim, Hye Kyung Lee, Ji Yeon Kim, Sook Hee Hong, Jang Sihn Sohn, Hyun Seung Lee, So Yeon Pa
Journal of Pathology and Translational Medicine.2017; 51(4): 410. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
Bethesda System for Reporting Thyroid Cytopathology: A three-year study at a tertiary care referral center in Saudi Arabia
Mohamed Abdulaziz Al Dawish, Asirvatham Alwin Robert, Aljuboury Muna, Alkharashi Eyad, Abdullah Al Ghamdi, Khalid Al Hajeri, Mohammed A Thabet, Rim Braham
World Journal of Clinical Oncology.2017; 8(2): 151. CrossRef
Thyroid Fine-Needle Aspiration Cytology Practice in Korea
Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang
Journal of Pathology and Translational Medicine.2017; 51(6): 521. CrossRef
Malignancy Risk for Fine-Needle Aspiration of Thyroid Nodules according to the Bethesda System for Reporting Thyroid Cytopathology, at King Abdul-Aziz, National Guard Hospital
Omimah Abdullah
Journal of Otolaryngology-ENT Research.2017;[Epub] CrossRef
The Bethesda System for Reporting Thyroid Fine-Needle Aspiration Cytology: A Kuwaiti Experience - A Cytohistopathological Study of 374 Cases
Kusum Kapila, Laila Qadan, Rola H. Ali, Mohammed Jaragh, Sara S. George, Bahiya E. Haji
Acta Cytologica.2015; 59(2): 133. CrossRef
Review of the Bethesda System for Reporting Thyroid Cytopathology: A Local Study in Bohol Island, Philippines
Annette L. Salillas, Faye Candice S. Sun, Emelisa G. Almocera
Acta Cytologica.2015; 59(1): 77. CrossRef
The role of core needle biopsy in the preoperative diagnosis of follicular neoplasm of the thyroid
Hye Sook Min, Ji‐Hoon Kim, Inseon Ryoo, So Lyung Jung, Chan Kwon Jung
APMIS.2014; 122(10): 993. CrossRef
Incidence and Malignancy Rates of Diagnoses in the Bethesda System for Reporting Thyroid Aspiration Cytology: An Institutional Experience
Ji Hye Park, Sun Och Yoon, Eun Ju Son, Hye Min Kim, Ji Hae Nahm, SoonWon Hong
Korean Journal of Pathology.2014; 48(2): 133. CrossRef
Thyroid “Atypia of undetermined significance” with nuclear atypia has high rates of malignancy and BRAF mutation
Hyo Jin Park, Jae Hoon Moon, Cha Kyong Yom, Kyu Hyung Kim, June Young Choi, Sang Il Choi, Soon‐Hyun Ahn, Woo‐Jin Jeong, Won Woo Lee, So Yeon Park
Cancer Cytopathology.2014; 122(7): 512. CrossRef
Molecular Genotyping of Follicular Variant of Papillary Thyroid Carcinoma Correlates with Diagnostic Category of Fine-Needle Aspiration Cytology: Values of RAS Mutation Testing
Sang Ryung Lee, Chan Kwon Jung, Tae Eun Kim, Ja Seong Bae, So Lyung Jung, Yeong Jin Choi, Chang Suk Kang
Thyroid.2013; 23(11): 1416. CrossRef
Fine Needle Aspiration Cytology of Thyroid Follicular Neoplasm: Cytohistologic Correlation and Accuracy
Changyoung Yoo, Hyun Joo Choi, Soyoung Im, Ji Han Jung, Kiouk Min, Chang Suk Kang, Young-Jin Suh
Korean Journal of Pathology.2013; 47(1): 61. CrossRef
Diagnostic Dilemma of a Follicular Lesions/Neoplasm in Thyroid Fine Needle Aspiration Cytology
Chan Kwon Jung
Journal of Korean Thyroid Association.2012; 5(2): 104. CrossRef
Review of atypical cytology of thyroid nodule according to the Bethesda system and its beneficial effect in the surgical treatment of papillary carcinoma
Yoo Seung Chung, Changyoung Yoo, Ji Han Jung, Hyun Joo Choi, Young-Jin Suh
Journal of the Korean Surgical Society.2011; 81(2): 75. CrossRef

Prognostic Significance of Glycolytic Metabolic Change Related to HIF-1alpha in Oral Squamous Cell Carcinomas.: Sook Hee Hong, Sang Young Roh, Yoon Ho Ko, Hye Sung Won, Myung Ah Lee, In Sook Woo, Jae Ho Byun, Jin Hyoung Kang, Young Seon Hong, Chan Kwon Jung, Yeon Sil Kim, Young Hoon Ju, Min Sik Kim; Korean J Pathol. 2010;44(4):360-369.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.4.360

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Abstract PDF

BACKGROUND
Growing tumors adapt to a hypoxic environment and increase anaerobic glycolysis. This metabolic switch is related to aggressive behavior. We investigated the relationship between glycolytic metabolism biomarkers associated with hypoxia-inducible factor (HIF)-1alpha and prognosis.
METHODS
We performed immunohistochemical staining of HIF-1alpha, pyruvate dehydrogenase kinase (PDK) 1 and lactate dehydrogenase (LDH) 5 in 74 patients with oral squamous cell carcinoma (SCC) who had received curative radical resection.
RESULTS
High reactivity of HIF-1alpha, PDK 1 and LDH 5 was observed in 29 (39.2%), 32 (43.2%) and 54 (73.0%) patients, respectively. Expression levels of the three biomarkers were significantly correlated. All three markers were highly expressed in 16 (21.6%) patients. Elevated expression of the three markers was associated with increased invasiveness (p = 0.043) and recurrence (p = 0.017) of tumors. In survival analysis, upregulation of the three markers was additionally associated with shorter disease free survival (DFS, p = 0.001) and overall survival (OS, p = 0.002). High expression of all three markers was a strong independent prognostic factor for DFS (p = 0.030) and OS (p = 0.026).
CONCLUSIONS
Oral SCC with altered glycolytic metabolism exhibits a more invasive and aggressive phenotype. Our results indicate that glycolytic metabolism biomarkers related to HIF-1alpha may be independent prognostic factors in patients with oral SCC.

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Glucose transporter 1 (GLUT1) of anaerobic glycolysis as predictive and prognostic values in neoadjuvant chemoradiotherapy and laparoscopic surgery for locally advanced rectal cancer
Byoung Yong Shim, Ji-Han Jung, Kang-Moon Lee, Hyung-Jin Kim, Sook Hee Hong, Sung Hwan Kim, Der Sheng Sun, Hyeon-Min Cho
International Journal of Colorectal Disease.2013; 28(3): 375. CrossRef

Clinicopathologic Significances of EGFR Expression at Invasive Front of Colorectal Cancer.: Yeo Ju Kang, Chan Kwon Jung, Yeong Jin Choi, Kyo Young Lee, Hyung Jin Kim, Won Kyung Kang, Seong Taek Oh; Korean J Pathol. 2010;44(1):16-21.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.16

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Abstract PDF: BACKGROUND
Epidermal growth factor receptor (EGFR) is frequently expressed in the invasive front of colorectal cancer (CRC), but its clinicopathologic significance remains unclear. We investigated the clinical value of the EGFR expression at the invasive front of CRC.
METHODS
We performed an immunohistochemical analysis in order to examine the expression and distribution of EGFR in 214 cases of CRC. The EGFR status was considered positive when > or =1% of the tumor cells had membranous staining.
RESULTS
Overall, an EGFR expression was observed in 144 (67%) cases and it had no significant relationship with the clinicopathologic parameters. However, an EGFR expression at the invasive front was correlated with lymphatic invasion, lymph node metastasis and a high level of serum carcinoembryonic antigen (p = 0.028, p = 0.043, and p = 0.045, respectively). For the budding-positive CRCs liver metastases were found in the cases with an EGFR expression at the budding, but no liver metastasis occurred in the EGFR negative cases at the budding (p = 0.030).
CONCLUSIONS
An EGFR expression at the invasive front has clinicopathologic significances in patients with CRC. An EGFR expression at tumor cell budding is a pathologic marker that suggests the high potential for liver metastasis in CRC.

Comparison of Clinical Efficacy between an HPV DNA Chip and a Hybrid-Capture II Assay in a Patient with Abnormal Colposcopic Findings.: Tae Jung Kim, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Young Jin Choi, Kyo Young Lee, Jong Sup Park; Korean J Cytopathol. 2008;19(2):119-125.; DOI: https://doi.org/10.3338/kjc.2008.19.2.119

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Abstract PDF

This study was performed to compare the efficacy between a DNA chip method and a Hybrid-Capture II assay (HC-II) for detecting human papillomavirus in patients with intraepithelial lesions of the uterine cervix. From May, 2005, to June, 2006, 192 patients with abnormal colposcopic findings received cervical cytology, HC-II and HPV DNA chip tests, and colposcopic biopsy or conization. We compared the results of HC-II and HPV DNA chip in conjunction with liquid based cervical cytology (LBCC) and confirmed the results of biopsy or conization. The sensitivity of the HPV DNA chip test was higher than HC-II or LBCC. The HPV DNA chip in conjunction with LBCC showed higher sensitivity than any single method and higher sensitivity than HC-II with LBCC. We confirmed that the HPV DNA chip test was more sensitive for detecting HPV in cervical lesions than HC-II, and that it would provide more useful clinical information about HPV type and its multiple infections.

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Comparison of Analytical and Clinical Performance of HPV 9G DNA Chip, PANArray HPV Genotyping Chip, and Hybrid-Capture II Assay in Cervicovaginal Swabs
Ho Young Jung, Hye Seung Han, Hyo Bin Kim, Seo Young Oh, Sun-Joo Lee, Wook Youn Kim
Journal of Pathology and Translational Medicine.2016; 50(2): 138. CrossRef

Expression of Survivin According to Malignant Progression of Breast Lesions.: Hyun Joo Choi, Ji Han Jung, Chan Kwon Jung, Jinyoung Yoo, Eun Jung Lee, Chang Suk Kang, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(4):238-243.

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Abstract PDF: BACKGROUND
The aim of this study was to examine the survivin expression pattern in benign lesions, atypical ductal hyperplasias (ADH), ductal carcinomas in situ (DCIS) and in invasive carcinomas of the breast and to evaluate the effect of expression of this marker on the malignant progression of breast cancers. In addition, the relationship between the expression of the marker and the clinicopathological characteristics for invasive carcinomas were investigated.
METHODS
Immunohistochemical staining using a tissue microarray method for survivin was performed for 103 benign lesions, 30 ADHs, 26 DCISs and 116 invasive carcinomas.
RESULTS
The expression of cytoplasmic survivin was higher for invasive carcinomas than for ADHs and DCISs (p<0.05). For breast invasive carcinomas, expression of cytoplasmic survivin significantly correlated with tumor size, lymph node metastasis and stage (p<0.05).
CONCLUSIONS
These results suggest that overexpression of cytoplasmic survivin may be involved in the development of the late stage of breast malignancy, especially invasiveness. In breast invasive carcinomas, expression of survivin may be a useful indicator for the evaluation of patient prognosis.

Concurrence of Spatially Separated Medullary Carcinoma and Papillary Carcinoma of the Thyroid Gland: A Report of Three Cases.: Changyoung Yoo, Chan Kwon Jung, Hyeok Sang Kwon, Sung Hun Kim, Min Sik Kim, Seung Nam Kim, Kyo Young Lee; Korean J Pathol. 2007;41(3):207-212.

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Abstract PDF: Although medullary thyroid carcinoma (MTC) may coexist with papillary thyroid carcinoma (PTC) as a collision tumor within the same nodule or as two or more spatially separated tumors, these two carcinomas rarely coexist. We encountered three cases of sporadic MTCs spatially separated from PTCs, which occurred concurrently, either within the same thyroid lobe or in different thyroid lobes. In each of the cases the patients underwent total thyroidectomy and neck dissection. PTC metastases of the lymph node were observed in two of the cases and MTC metastasis of the lymph node was observed in one case. Among the multiple thyroid nodules affected by both MTCs and PTCs, only the dominant nodules had spread to the lymph nodes. Because MTC has a different clinical significance from PTC, in patients with multiple thyroid nodules, appropriate diagnostic approaches, such as fine needle aspiration of all possible nodules and measurement of serum calcitonin level, should be performed.

Mucin Phenotype and CDX2 Expression as Prognostic Factors in Gastric Carcinomas.: Chan Kwon Jung, Kyo Young Song, Gyeongsin Park, Cho Hyun Park, Myeong Gyu Choi, Young Seon Hong, Kyo Young Lee; Korean J Pathol. 2007;41(3):139-148.

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Abstract PDF: Background
: Mucin phenotypic markers and CDX2 are widely expressed in gastric carcinomas, however, recent studies have produced conflicting results regarding whether the expression patterns of these markers have clinicopathologic significance.
Methods
: We examined samples from 217 gastric carcinoma patients immunohistochemically to determine if the expression of mucin phenotypic markers and CDX2 was correlated with postoperative survival and other clinicopathologic factors.
Results
: All tumors were phenotypically classified as gastric (type G, 81 cases), gastric and intestinal mixed (type GI, 55 cases), intestinal (type I, 43 cases), or unclassified (type U, 38 cases). The occurrence of type G and GI tumors was positively correlated with tumor progression whereas that of type U tumors was negatively correlated with tumor progression. CDX2 expression was correlated with type I tumors. Tumors that expressed MUC5AC or MUC6 had a better prognosis than those that did not. When the relationship between phenotype and prognosis was considered, type GI had the best prognosis, followed by type G, then type U.
Conclusions
: The mucin phenotypic markers may be useful for predicting tumor progression and survival in patients with gastric carcinomas. Additionally, CDX2 may play an important role in gastric carcinogenesis of type I tumors.

The Expression of Telomerase Reverse Transcriptase Protein is an Independent Prognostic Marker in Early Stage Non-Small Cell Lung Carcinomas.: Ji Han Jung, Chan Kwon Jung, Ahwon Lee, Gyeongsin Park, Jinyoung Yoo, Kyo Young Lee; Korean J Pathol. 2007;41(2):95-102.

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Abstract PDF: BACKGROUND
The catalytic subunit of telomerase, hTERT (telomerase reverse transcriptase), is one of the most important components of telomerase, and performs a pivotal role in the mechanism underlying the regulation of telomerase activity in cellular immortalization and carcinogenesis. The principal objective of this study was to investigate hTERT expression in patients with non-small cell lung carcinomas (NSCLCs), and to evaluate its clinical significance and association with the expression of p16 and p53.
METHODS
Using tissue microarray, the protein expression profiles of hTERT, p16 and p53 were investigated via immunohistochemistry in 167 samples of NSCLCs.
RESULTS
Expression was observed in 54.5% (91/167) of the tumors, which were predominantly squamous cell carcinomas. Patients evidencing hTERT expression in their tumors exhibited significantly poorer survival rates than did patients without hTERT expression in early-stage NSCLCs (p=0.0125). According to the results of our Cox regression analysis, hTERT expression proved to be an independent prognostic factor (p=0.006), particularly for squamous cell carcinomas (p=0.019). hTERT expression was not correlated with p16 expression, but was rather associated with the expression of p53 (p=0.002).
CONCLUSIONS
Our results show that hTERT may perform a function in the progression of NSCLC, and that its detection may be useful in predicting the prognosis of NSCLC patients in the early stages of the disease, as well as in the development of a targeted therapy in these tumors.

Expression of p73 in Non-small Cell Lung Carcinomas.: Ji Han Jung, Gyeongsin Park, Chan Kwon Jung, Hyun Joo Choi, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(2):109-115.

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Abstract PDF: BACKGROUND
The p73 is a recently identified homologue of the tumor suppressor gene, p53, and it has been found to induce apoptosis and inhibit cell proliferation. However, its role in the development of tumors is unclear. This study examined the expression of p73 in patients with non-small cell lung carcinomas (NSCLCs) to determine its clinical significance and association with the expressions of p53, pRb, and mdm2.
METHODS
A total of 183 NSCLCs were analyzed immunohistochemically using a tissue microarray.
RESULTS
The p73 protein was expressed in the cell nuclei in 156 (85.2%) out of the 183 cases. There was no correlation between the p73 expression and the clinicopathological variables. However, there was a correlation between the p73 expression and the mdm2 and pRb expressions. Multivariate Cox survival analysis identified tumor size and lymph node metastasis to be independent prognostic factors, but the p73 expression was not found to be associated with the patients' survival.
CONCLUSIONS
p73 is commonly expressed in NSCLC and it might, in conjunction with pRb and mdm2, be involved in the development of these tumors.

A Comparision of Surepath(TM) Liquid-Based Smear with a Conventional Smear for Cervicovaginal Cytology-with Reference to a Histological Diagnosis.: Kyung Chul Lee, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Yeong Jin Choi, Jong Sup Park, Kyo Young Lee; Korean J Cytopathol. 2007;18(1):20-28.

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Abstract PDF: This study was performed to compare Surepath(TM) liquid-based smear and a conventional cervicovaginal smear with reference to a histological diagnosis. A hybrid capture test (HCII) was also performed and analyzed. We collected matched cases for cervicovaginal cytology- histology: 207 cases for conventional cytology (CC) and 199 cases for liquid-based cytology (LBC). HCII was performed in 254 patients. When a cytological diagnosis of ASCUS or above (ASCUS+) is classified as positive and a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 91.7% and 75.9%, respectively and the sensitivity and specificity for CC was 62.6% and 96.1%, respectively. When a cytological and histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 77.5 and 96.6%, respectively and the sensitivity and specificity for CC was 49.7% and 100%, respectively. When a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for HCII was 78.9% and 78.1%, respectively. The concordance ratio between the cytological and histological diagnosis was 80.4% (kappa=76.0) for LBC and 56.5% (kappa=55.1) for CC. LBC is more sensitive and less specific then CC, as a cytological cutoff level of ASCUS, but more sensitive and equally specific, as a cytological cutoff level LSIL or HSIL. LBC is more reliable with a high concordance ratio between the cytological and histological diagnosis.

Evaluation for Cytopreservability of Manual Liquid-Based Cytology Liqui-PREP(TM) and its Application to Cerebrospinal Fluid Cytology: Comparative Study with Cytospin.: Gyeongsin Park, Kyungji Lee, Chan Kwon Jung, Dae Hyoung Lee, Bin Cho, Youn Soo Lee, Sang In Shim, Kyo Young Lee, Chang Suk Kang; Korean J Cytopathol. 2007;18(1):46-54.

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Abstract PDF: Cerebrospinal fluid (CSF) cytology is an effective tool for evaluating diseases involving the central nervous system, but his technique is usually limited by its low cellularity and poor cellular preservation. Here we compared the manual liquid-base Liqui-PREPTM (LP) to the cytospin (CS) with using a mononuclear cell suspension and we applied both methods to the CSFs of pediatric leukemia patients. The cytopresevability, in terms of cell yield and cell size, and the clinical efficacy were evaluated. When 2000 and 4000 mononuclear cells were applied, LP was superior to CS for the cell yield, 16.8% vs 1.7% (P=0.001) and 26.2% vs 3.5% (P=0.002), respectively. The mean size of the smeared cells was 10.60 micrometer in the CS, 5.01 micrometer in the LP and 6.50 micrometer in the direct smear (DS), and the size ratio was 1.7 (CS to DS), 0.8(LP to DS) and 2.1 (CS to LP), respectively. As compared to the cells in the DS, the cells in the CS were significantly enlarged, but those in the LP were slightly shrunken. Upon application to 109 CSF samples, 4 were diagnosed as positive for leukemia (positive), 4 had atypical cells and 101 were negative by CS; 6 were positive, one had atypical cells and 102 were negative by LP. For six cases, in which 4 were positive for leukemia and 2 of 4 had atypical cells by CS, they were positive by LP and they were also confirmed as positive according to the follow-up study. Three cases diagnosed as atypical cells (two by CS and one by LP), were confirmed as negative. In conclusion, these results suggest that LP is superior to CS for the cytopresevability and for rendering a definite diagnosis of cerebrospinal fluid.

Expressions of Cyclin E-pathway Proteins (cyclinE, cdk2, p21, p27, p57) and Their Prognostic Significance in Non-small Cell Lung Carcinomas.: Ji Han Jung, Gyeongsin Park, Myung Ah Lee, Jae Ho Byun, Chan Kwon Jung, Heejeong Lee, Kyo Young Lee, Sang In Shim, Chang Suk Kang; Korean J Pathol. 2006;40(1):24-31.

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Abstract PDF: BACKGROUND
The aberrant expression of cyclins, cdk and cdk inhibitor has been shown to be involved in oncogenic transformation. The aim of this study was to investigate the expression of the cyclin E-pathway proteins (cyclin E, cdk2, p21, p27, p57) in human non-small cell lung carcinomas (NSCLC) and also to evaluate the clinical significance of these expressions.
METHODS
A total of 203 consecutive patients with completely resected pathological stage I-III NSCLC were retrospectively reviewed. The expressions of cyclin E, cdk2, p21, p27 and, p57 was examined by performing immunohistochemistry with using the tissue microarray method.
RESULTS
In the total cases, the expression levels of cyclin E, cdk2, p21, p27 and p57 were 39.9% (81/203), 48.3% (98/203), 68.0% (138/203), 32.5% (66/203) and 2.7% (5/203), respectively. The overexpression of cyclin E and cdk2 was significantly and inversely correlated with the histologic differentiation in the adenocarcinoma (p<0.05), but not in the squamous cell carcinoma. Among the clinicopathologic factors, the stage and lymph node metastasis were associated with overall survival (p<0.05). Among these proteins, the negative expression of p21 was significantly correlated with a shortened survival rate (p<0.05).
CONCLUSIONS
These data suggest that the overexpression of cyclin E and cdk2 and the loss of p21 and p27 are associated with tumor progression in NSCLC. The aberrant expression of p21 is correlated with a poor prognosis. Therefore the immunohistochemical analysis of this protein as well as the clinical stage and, lymph node metastasis may be useful tools for evaluating the prognosis of NSCLC patients.

Fine Needle Aspiration Cytology of the Warthin's Tumor Misinterpretated as Squamous Cell Carcinoma: A Case Report.: Kyungji Lee, Chan Kwon Jung, Ahwon Lee, Kyo Young Lee, Chang Suk Kang; Korean J Cytopathol. 2005;16(2):106-109.

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Abstract PDF: We report a case of Warthin's tumor of the parotid gland in a 53?year?old man, which is incorrectly diagnosed as squamous cell carcinoma. Fine needle aspiration cytology(FNAC) smear obtained from the right parotid gland revealed scattered epithelial cell clusters or nests in a diffuse inflammatory and necrotic background. Some epithelial cells had squamoid appearance showing variable sized bizarre shaped nuclei. They had abundant of dense eosinophilic keratinized cytoplasm. Occasionally, parakeratotic cells were also present. These cytologic findings with significant atypia and necrotic background made diagnosis as squamous cell carcinoma. But, the resection specimen from this patient showed classic Warthin's tumor in addition to abundant areas of inflammation and squamous metaplasia. Metaplastic or infarcted Warthin's tumor in the salivary gland may be confused with false positive diagnosis of malignancy on FNAC. Therefore, cytopathologist should have adequate awareness of potential of erroneous diagnosis in FNAC of Warthin's tumor.

Dendriform Pulmonary Ossification: A case report.: Chan Kwon Jung, Kyo Young Lee, Chang Suk Kang, Sang In Shim, Byung Kee Kim; Korean J Pathol. 2000;34(11):950-952.

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Abstract PDF: The dendriform pulmonary ossification (DPO) is a rare condition of unknown origin in which branching mature bony spicules, usually containing marrow, are found within the alveolar septa. DPO manifests slow progression over many years or may remain unchanged; spontaneous regression has not been recorded. Most patients have no symptoms directly attributed to the ossification, although they may have symptoms due to the underlying fibrotic process. We experienced a case of DPO in 38 year-old-man who presented with cough and sputum for a month. The chest X-ray showed marked coarsened interstitial lung markings in both lungs, especially in the lower lobes. Open lung biopsy was done. Grossly, there were significant dendriform osseous structures. Histologically, branching arrays of mature bone were found in the interstitium and occasionally in alveolar spaces. Some bony trabeculae contained fatty or cellular marrow. The alveolar septa showed fibrous thickening with chronic inflammation. The transition between fibrosis and bone tissue was observed. Our case suggests that dendriform pulmonary ossification may be a rare special manifestation of chronic fibrosing interstitial inflammation of the lung. Osseous structures seem to derive from metaplastic bone formation in the vicinity of undergoing fibrous process.

Myofibrosarcoma of the Breast: A case report .: Chan Kwon Jung, Kyo Young Lee, Chang Suk Kang, Sang In Shim, Byung Kee Kim; Korean J Pathol. 2000;34(1):96-98.

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Abstract PDF: Myofibrosarcoma of the breast is a rare malignant mesenchymal tumor that has been reported in only four well documented cases so far. We report a case of myofibrosarcoma of the breast in an 88-year-old man who complained of a palpable mass for 1 year. Microscopically, the tumor consisted mainly of spindled cells, arranged in irregular fascicles and embedded in broad bands of dense hyalinized collagen. It showed ill-defined border infiltrating the adjacent adipose tissue, moderate cellular pleomorphism, and high mitotic rate (8~9/10 HPF). Immunohistochemical study confirmed myofibroblastic differentiation of the tumor cells with diffuse strong reaction for vimentin, smooth muscle actin, and fibronectin.

Primitive Neuroectodermal Tumor of the Ovary: A case report .: Chan Kwon Jung, Eun Sun Jung, Youn Soo Lee, Byung Kee Kim, Sun Moo Kim; Korean J Pathol. 1999;33(8):631-635.

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Abstract PDF: Primitive neuroectodermal tumors (PNET) of the ovary are rare tumors with an exclusive or almost exclusive malignant neuroectodermal composition, and are generally regarded as a monodermal expression of an ovarian teratoma. The tumors are basically identical with the lesions of the same name occuring typically in the central nervous system of children. These tumors consist chiefly of undifferentiated small cells resembling neuroblasts. There are also mature, well- differentiated neuroectodermal cells, such as astrocytes and ependymal cells. We report a case of ovarian PNET with glial and neuroblastic differentiation and focal teratomatous foci of non-neural tissue in a 17-year-old female.

Fine Needle Aspiration Cytology of Small Cell Carcinoma of the Parotid Gland: A Case Report .: Chan Kwon Jung, Eun Sun Jung, Youn Soo Lee, Sun Moo Kim, Byung Kee Kim; Korean J Cytopathol. 1999;10(2):163-167.

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Abstract PDF: Primary small cell carcinoma of the salivary gland is a rare neoplasm that accounts for approximately 1.8% of all primary major salivary gland malignancies. Because of its rarity, it is difficult to diagnose small cell carcinoma of the parotid gland by fine needle aspiration cytology(FNAC). We experienced a case of primary small cell carcinoma of the parotid gland in a 72-year-old woman who presented with two palpable masses of the left infraauricular and ocular regions of two to three month's duration, respectively. Aspirate smears from the left infraauricular area were highly cellular on necrotic and lymphocytic background and showed individually dispersed cells or three-dimensional clusters of small cells. The tumor cells were round to oval with a very high nucleocytoplasmic ratio. Nuclei were about two times the size of lymphocytes and had uniformly dispersed but hyperchromatic to pyknotic chromatin. Nucleoli were occasionally visible but were generally inconspicuous. Numerous mitotic figures were detected. The clusters of these small tumor cells exhibited angular nuclear molding, irregular nuclear outlines, and occasionally rosette like arrangement. The tumor was confirmed by histology and immunohistochemistry.

Serratia marcescens Skin Abscess.: Chan Kwon Jung, Young Shin Kim, Kyo Young Lee, Kyungja Han, Chang Suk Kang, Sang In Shim, Jun Young Lee, Baik Kee Cho; Korean J Pathol. 1998;32(11):1032-1034.

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Abstract: Serratia marcescens is the most important member of the genus Serratia and causes opportunistic infections, particularly pneumonia and septicemia in patients with malignancy, renal failure (acute and chronic), and diabetes mellitus. The most common portals of entry are known to be, in descending order, lung, genitourinary tract, intravenous line, gastrointestinal tract, and skin. S. marcescens rarely causes skin infection because it does not normally colonize human skin. Only six cases of S. marcescens cellulitis were reported. Five of them were immunocompromised patients. We have experienced a case of skin abscess caused by S. marcescens, which was found in a 59-year-old woman. She was undergoing prior antibiotic treatment after insulinoma surgery. S. marcescens was isolated from the skin abscess as a sole organism. She was treated with appropriate antibiotics that exhibited sensitivities for the organism and cured without any complication. The authors report a case of S. marcescens infection on the skin of a 59-year-old woman and review the literature concerning this organism as a causative agent.

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