Journal of Pathology and Translational Medicine

In Joon Choi

31 Articles

Giant Cell Tumor of the Larynx: Report of a case.: Soya Paik, Yoon Mee Jeen, Woo Ick Yang, In Joon Choi, Young Ho Kim; Korean J Pathol. 1997;31(1):75-78.

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Abstract PDF: Giant cell tumor arising in the osteocartilaginous tissue of the larynx is extremely rare. The few reported cases have all occurred in men older than 20 years and the site of origin has been exclusively localized to the thyroid and cricoid cartilages that are known to undergo enchondral ossification. The formation of giant cell tumor in larynx is thought to be related to this enchondral ossification process. We report a case of giant cell tumor arising in the thyroid cartilage of a 39 year old man. CT scan of the neck revealed a well defined mass of soft tissue density replacing the right thyroid cartilage. Grossly the tumor was well demarcated with a distinctive pushing margin except for the area bordering the submucosa of the larynx where it showed focally an infiltrative pattern of growth. Microscopically multinucleated giant cells were found dispersed regularly among the spindle cells. Although mitoses were frequently noted in the spindle cells there was no atypicality or pleomorphism. Total laryngectomy was performed without further treatment. Postoperative follow up for 6 months has proved the patient to be alive and well without recurrence.

A Morphometric Study of Glomerular Dimensions in Relation to Glomerular Location, Age and Sex in Koreans.: Hyun Hee Lee, Hyeon Joo Lee, In Joon Choi; Korean J Pathol. 1996;30(4):328-339.

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Abstract PDF: As measurement of glomerular size in the assessment of several renal diseases becomes increasingly important, it has become necessary to devise rapid simple methods for the assessment of glomerular size and to have on hand reference ranges. A few reports on glomerular size have been published in Western literature, but their body builds are different from Koreans. In this study, 100 glomeruli(50 glomeruli each from the outer cortical and the juxtamedullary area) were measured in sections taken from 74 kidneys(ages 3 days~73 years) obtained from autopsy utilizing the semi-automatic image analyser. The percentage of glomerular sclerosis was measured based on its location. The sphere diameter, maximum diameter, area and sphere volume of non-sclerotic glomeruli were measured and evaluated with respect to age, sex and the location of the glomeruli. The results were as follows; 1) Mean glomerular dimensions including sphere and maximum diameter, area and sphere volume increased until 40 years of age, then reached a plateau. The percentage of sclerotic glomeruli then increased slowly with age but without statistical significance. 2) The glomerular dimensions and sclerosis showed no significant differences according to sex. 3) Juxtamedullary glomeruli were larger than the outer cortical ones which was statistically significant in age groups of 0~10, 11~20 and 41~50 years. The percentage of sclerotic glomeruli was generally greater in the outer cortex. 4) Differences in the values of glomerular dimensions between outer cortical and juxtamedullary area were similar in all age groups. 5) All parameters of measurement showed consistent and similar trends between the different groups. 6) The measurements of the largest 12 glomeruli out of randomly-selected 50 glomeruli gave similar results when compared with those of 50 glomeruli. It was evident from our results that glomerular size is influenced by age and glomerular location, but not by sex. The method of assessing glomerular size used in this study will not necessarily give the true, absolute value of size but it may be a simple, practical and useful method of comparing glomerular size in different groups of patients.

Interstitial Mononuclear Cell Infiltration and its Phenotypes in IgA Nephropathy.: Hyeon Joo Jeong, Hyunee Yim, Sun Hee Sung, In Joon Choi; Korean J Pathol. 1994;28(5):506-510.

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Abstract PDF: To know the correlation between glomerular and tubulointerstitial lesion and to define the characteristics of interstitial inflammatory cell in IgA nephropathy and classified according to WHO classification and graded tubulointerstitial lesion as mild, moderate and severe. Paraffin-embedded 5u sections were stained with UCHL-l, L26 and CD68 antibodies. More than 20 fields were examined in each case under the high power microscopy and the number of positive cells were counted. There was positive correlation between the severity of glomerular and that of tubulointerstitial lesion. The mostcommoninflammatory cells in the interstitiuin were UCHL-l positive cells followed by CD68 and L26 positive cells. As the WHO grade or tubulointerstitial lesion increased, the numbers of positive cells were increased in all three groups. The proportion of UCHL-1 Positive cells were increased in cases with high WHO grade whereas that of L26 positive cells incases with severe tubulointerstitial lesion Proteinuria was correlated with the degree of inflammatory cell infiltration, especially with that of L26 positive cells.

Immunohistochemical Study on Expression of Extracellular Matrix Components in Glomerular Diseases.: Sun Hee Sung, In Joon Choi; Korean J Pathol. 1994;28(3):288-296.

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Abstract: Most glomerular lesions are associated with qualitative and quantitative alterations of the extracellular matrix components, having relation to progressive glomerular sclerosis. We aimed to investigate the characteristic alteraltions in distribution of extracellular matrix components, such as fibronectin, laminin, collagen type III and IV in human glomerular diseases by immunohistochemical method. The materials included are 3 nephrectomy as normal control, 51 renal biopsies and I autopsy; 3 normal, 5 minimal change disease, 5 minimal change disease with minimal mesangial lgA deposit, 5 benign recurrent hematuria, 10 focal segmental glomerulosclerosis, 15 lgA nephropathy, 10 membranoproliferative glomerulonephritis, 2 diffuse mesangial sclerosis of infancy. Type IV collagen and laminin were present normally in the mesangium, GBM, TBM and interstitial vessels, and were increased at the portion of increased mesangial matrix, of sclerosis and thickened GBM in cases of lgA nephropathy, membranoproliferative glomerulonephritis, focal segmental glomrulosclerosis and diffuse mesangial sclerosis in the proportion to the glomerular damage. Type III collagen was absent in the normal glomeruli, but was detectable focally and segmentally in cases of membranoproliferative glomerulonephritis, IgA nephropathy and focal segmental glomerulosclerosis at the sclerotic portion. Fibronectin was normally detectable mainly in the mesangium, and partly and incompletely in GBM, and was increased at the portion of increased mesangial matrix, sclerosis and thickened GBM in cases of focal segmental glomerulosclerosis, membranoproliferative glomerulonephritis, IgA nephropathy and diffuse mesangial sclerosis, but was diminshed at the old slcerotic portion or global sclerosis. The expression of these antibodies in cases of minimal change disease, minimal change disease with minimal mesangial IgA deposit, benign recurrent hematuria was not different, quantitatively and qualitatively, from that of normal glomeruli. These findings suggest that progressive glomerular sclerosis was due to the increase of extraceuular matrix components such as type IV collagen, laminin, fibronectin and new appearance of type III collagen, and the expression was in proportion to the degree of sclerosis, but had no relation to the disease entity.

Aggressive AngiOmYxoma Occuring in Ischiorectal Fossa: A case report.: Jai Hyang Go, Sun Hee Sung, In Joon Choi; Korean J Pathol. 1994;28(1):99-101.

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Abstract PDF: We report a case of aggressive angiomyxoma in ischiorectal fossa of a 39-year-old women. The tumor is characterized by relatively large size(13 x 11 cm), grossly gelatinous appearance and locally infiltrative nature. Microscopically, it consists of many variable sized blood vessels and spindle or stellate cells widely separated in myxoid or collagenous stroma. Immunohistochemical stains reveal that the tumor cells are strongly positive for actin and desmin. Electron microscopic findings are that of a few cells dispersed in abundant intercellular substance and collagen bundles. These cells form irregular cytoplasmic process without basal lamina and contain endoplasmic reticulum having cistern.

Muscular Hamartoma of the Breast: A case report.: Dong Won Min, Sun Hee Sung, In Joon Choi; Korean J Pathol. 1994;28(1):86-89.

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Abstract PDF: Hamartoma of the breast is relatively rare benign tumor, which is a well-circumscribed mass mainly composed of fibrous stroma, a(tipose tissue, ducts and acini. Muscular hamartoma of the breast is mainly composed of smooth muscle, and is extremely rare because proper smooth muscle is normaly absent in the breast except in the nipple. We describe a rare case of muscular hamartoma of the breast in a 38-year-old woman. This tumor was located in the upper outer quadrant and a 3 x 2.5 x 2 cm sized, well-demarcated but not encapsulated mass, The mass consisted mainly of irregularly arranged smooth muscle bundles in the fibrous stroma with lobular units and admixed fat cells. The origin of smooth muscle in hamartoma is not well known.

The Epidermal Proliferation and the Number of Langerhans Cells in 7, 12-dimethylbenzanthracene Induced Epidermal Changes.: Chang Soon Han, Young Nyun Park, Kwang Gil Lee, In Joon Choi; Korean J Pathol. 1993;27(6):590-604.

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Abstract PDF: Chemically induced epiderml carcinogenesis is usually divided into two stages, the initiation and promotion. The initiation involves conversion of some epidermal cells into latent neoplastic cells and the promotion is proliferation of the transformed cells. As immunosurveillence is thought to be a host defense against tumors, Langerhans cells, being essential in initiation of local cutaneous immunologic reaction, is suggested to be important in the carcingenesis of the epidermis. This study is attempted to investigate the epidermal proliferative changes in mice induced by application of 12-0-tetradecanoy1-phorbol-13-acetate(TPA) on the skin initiated with 7, 12-dimethylbenzanthracene(DMBA) and its relationship with Langerhans cell. Ninty five male inbred BALB/c mice weighing 20~25 g were divided into five groups; the 33 week-group, the 21 week-group, the 12 week-group and the 4 week-group according to the duration of carcinogen application, and the control group. The carcingen was applied with a brush on the dorsal skin of mice after depilation. Ten days after application of 800 nmole DMBA in 0.4 cc acetone, 20 nmole TPA in 0.4 cc acetone was applied twice per week and the control group was applied with the same amount of acetone for 4 weeks. Animals were sacrificed 3 days after the last application of TPA. One hour before sacrifice, bromodeoxyuridine(BrdU) (1 mg/g) was injected via the tail artert for BrdU stain of S phase cells. A strip of dorsal skin was used for hematoxylineosin stain, immunohistochemical stain for BrdU and la antigen of Langerhans cell, and flow cytometry. The results are as follows: 1. Cellular proliferation, hyperkeratosis and dysplasia of the epidermis were increased in relation to duration of carcingen application. Papillomas were developed 12 weeks after application of the carcingen. 2. BrdU labelling and proliferative indices of the 20 weeks' application group were significantly higher than those of the 12 weeks' application group. The number of Langerhans cell was decreased markedly ater 4 week' application of the carcinogen. 3. All epiedrmal lesions including a case of squamous cell carcinoma were diploidy in flow cytometry. It is thought that disturbance of immunosurveillence, caused by depletion of Langerhans cell, may permit proliferation of epidermal cells. Although abnormal quantitative change of nuclear DNA has not occurred even when the epidermal proliferative activity and dysplastic change were increased markedly, it is thought that the occurrence of structural change of chromosome is remained to be clarified.

Histopathologic Studies of Muscle and Peripheral Nerve Following Ingestion of L-tryptophan in Rats.: Tae Sik Yoon, Tai Seung Kim, In Joon Choi, Jung Soon Shin; Korean J Pathol. 1993;27(4):318-327.

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Abstract PDF: The eosinophilia-myalgia syndrome associated with ingestion of L-tryptophan in man is defined by the CDC(1989) as follows: 1) eosinophil count more than 1,000 cells per microliter; 2) generalized myaligia(at some point during the course of illness) of severity sufficient to affect a patient's ability to pursue his or her usual daily activities; 3) no evidence of any infection(e.g., trichinosis) or neoplasm that would explain either the eosinophila or the myalgia. The pathologic findings of the eosinophilia-myalgia syndrome varies according to the degree of severity and types of inflammatory cells in the skeletal muscle. In order to simulate this syndrome in animals and further determine its histopathogenesis, L-tryptophan was administered to rats in the laboratory at various doses(25 mg/kg, 50 mg/kg, 150 mg/kg) over a set period of time. In this study, positive histopathologic findings were designated according to the inflammatory cell infiltration of the epimysium and epineurium. Most of the pathologic findings in the positive group were that of inflammatory cell infiltration composed mainly of eosinophils in the epimysial, epineurial connective and surrounding adipose tissues. Only a few necrotic muscle fibers were seen, and there was absence of any evidence of inflammatory cell inflitration in endoneurium or axonal degenerations. Of 59 rats which were given L-tryptophan, 27 rats(45.8%) met the criteria and were designated as belongintg to the positive group. Only 2 rats ingested with L-tryptophan(150 mg/kg) for 2 months and 4 months showed an eosinophil count more than 1,000 cells/microliter. The eosinophil count in the positive group showed significantly different levels when compared to the the negative group and control group. On the other hand, there were no significant differences in the electrodiagnostic study and serum CK, SGOT, SGPT level between the positive, negative and control groups. In summary, histopathologic findings similar to the eosinophilia-myalgia syndrome were inducible in rats followign the administration of L-tryptophan.

A Morphological Study of the Pulmonary Endothelium and Neuroendocrine Cells in Monocrotaline-Induced Pulmonary Arterial Hypertension.: Woo Ick Yang, Sang Ho Cho, In Joon Choi, Yoo Bock Lee; Korean J Pathol. 1992;26(6):582-592.

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Abstract PDF: To investigate the mechanism of monocrotaline-induced pulmonary arterial hypertension, authors performed immunohistochemical study using antibody to von Willebrand factor(vWF), cell kinetic study using 5-bromodeoxyuridine and ultrastructural study after single subcutaneous injection of monocrotaline(MCT) to Wistar rats. The results of this study demonstrated that the expression of vWF by pulmonary endothelial cells was markedly increased from day 3 until 2 months after MCT injection. The labeling index of pulmonary microvessel endothelium began to increase after six days and was maximal on the third weeks, and thereafter it remained slightly increased above basal level. Electron microscopic study revealed attachment of inflammatory cells an platelets to endothelium from 6 hours and degranulation of attached platelets 24 hours after MCT injection. Evidences of endothelial injury began to appear from 12 hours after MCT injection. Evidences of endothelial injury began to appear from 12 hours and was maximal after 48 hours. From the third day, ultrastructural change of cell regeneration and hypertrophy began to appear and was continuosly observed until 2 months. In addition, we evaluated the changes in the number of pulmonary neuroendocrine cells using antibody to gastrin releasing peptide but it demonstrated no change until 2 months suggesting no role of neuroendocrine cells in the development of pulmonary hypertension of Wistar rats at early stage. In conclusion, the results indicate that pulmonary hypertension by MCT injection is due to increased vascular resistance caused by vasoconstriction and hyperplasia of endothelium with musculariz ation of the pulmonary arterioles induced by endothelial dysfunction and some biologic substances released form endothelium and platelets.

Basaloid-Squamous Carcinoma of the Esophagus: A case report.: Tae Jung Jang, In Joon Choi; Korean J Pathol. 1992;26(1):96-98.

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Abstract PDF: Basaloid-squamous carcinoma of the esophagus is rare and similiar to the solid type of adenoid cystic carcinoma of the salivary gland. The origin of this tumor is unknown. The tumor was located in the lower third of the esophagus. The case of basaloid-squamous carcinoma consisted of submucosal tumor showing carcinoma with a basaloid pattern and focal squamous differentiation associated with squamous cell carcinoma or carcinoma in situ of the esophageal mucosa. A few submucosal tumor cells were positive for cytokeratin.

Distribution of S-100 Protein Positive Dendritic Cell and its Correlation with Degree of Malignancy in Gastric Carcinoma.: Tae Jung Jang, Woo Ick Yang, Chan Il Park, In Joon Choi; Korean J Pathol. 1991;25(4):327-337.

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Abstract PDF: The present study was performed in order to investigate the correlation among the number of T zone histiocytes, the clinicopathologic parameters and the patient's survival. The subjects in this study were 131 advanced gastric carcinomas including 86 follow-up cases and 41 early gastric carcinomas. The infiltration of T zone histiocytes into tumor tissues was investigated using the immunohistochemical method with andti s-100 protein, nd the data obtained were evaluated statistically. T zone histiocytes were scattered among the cancer cells and in areas formed clusters within the cancer stroma. These cells were abundantly present in tumor tissues and around lymphoid follicles but were rarely seen in surrounding normal stomach tissue. Analysis of the number of T zone histiocytes showed no correlation between the number of T zone histiocytes and the clinicopathologic features except the degree of lymphocytic infiltration within the advanced and the early gastric carcinomas. Survival of the patients with a marked infiltration of T zone histiocytes in stage III was longer than that with mild infiltration of T zone histiocytes, but there was no statistical significance(P value=0.084). Multivariate regressio analysis revealed that the depth of invasion(P value=0.0074) and the lymphocytic infiltration(P value=0.0152) were the important prognostic factors. The results indicate that good prognosis is expected in cases with less deep invasion and high lymphocytic infiltration, and that the number of T zone histiocytes is in proportio to the degree of lymphocyte infiltration within the tumor, although not directly correlated with the patient's survival.

The Effect of Common Bile Duct Ligation on Liver Morphology and Coper Metabolism in Rat.: Kyoung Sook Kim, Chanil Park, Jang Whan Cho, In Joon Choi, Yoo Bock Lee; Korean J Pathol. 1990;24(4):402-411.

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Abstract PDF: To clarity the effect of biliary obliteration on copper metabolism of rat liver and on the hepatic morphology, 0.5% cuppuric sulfate was administered intraperitoneally for 42 days following ligation of the common bile duct (CBD) of Sprague-Dawley rats. The blood copper concentration, the hepatic copper content and the accumulation patterns of copper and copper binding protein in the liver were examined and compared with those of the simple CBD ligation group and the simple copper over loaded group. CBD ligation induced marked proliferation of bile ductular structures which, after expanding the portal tracts, invaded and divided the hepatic lobules. There was, however, no excess fibosis beyond what needed to support the new ductules. The blood copper concentration and the hepatic copper content were increased by copper overload with or without CBD ligation, particularly incases with CBD ligation. Liver cell necrosis did not occur by the overloaded copper alone in rats. The hepatic copper and copper binding protein were accumulated at periportal liver cells in the group of coppe overload after CBD ligatio, whereas they began to appear at perivenular hepatocytes in the simple copper overloaded group. In conclusion, it is suggested that CBD ligation does not induce excess fibrosis or liver cirrhosis in rat as far as during our experimental period, but affect significantly on copper metabolism by intrahepatic redistribution of the copper and the copper binding proteins.

A Pathological Review of Pleural Effusion by Immunocytochemical Methods.: Dong Hwan Shin, Hee Jeong Ahn, Woo Ick Yang, In Joon Choi; Korean J Pathol. 1990;24(4):476-481.

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Abstract PDF: An unequivocal diagnosis of mesothelioma during life, on the basis of limited biopsy tissue or cytological specimens, is frequently difficult and requires distinction from inflammatory mesothelial hyperplasia on the one hand and secondary neoplasms, especially adenocarcinoma on the other. Although some studies have produced conflicting results, it is generally believed that immunohistochemical methods can aid in this distinction. To obtain comparable and reproducible results, 23 metastatic carcinoma of the pleura and 2 unequivocal malignant epiehtlial mesotheliomas were studied by the peroxidase-antiperoxedase method on paraffin-embedded cell blocks, and commercially available antibodies to carcinoembryonic antigen (CEA), keratin and epithelial membrane antigen (EMA) were used. Nineteen metastaic adenocarcinoma (73%) and two mesotheliomas (100%) reacted with keratin and EMA antibodies. Nineteen matastatic adenocarcinomas (73%) reacted with EMA antibodies. Nineteen metastatic adenocarcinoma (73%) reacted with CEA antibody; no mesotheliomas stained for CEA. Two cases of reactive mesothlial hyperplasia showed positive for keratin, but negative reaction for EMA and CEA. Noen of the antibodies used in this study was specific for mesothelioma, but CEA was found to be the most useful marker for differentiating between mesothelioma and metastatic carcinoma.

A Pathological Study of Renal Cell Carcinoma.: Kwang Hwa Park, Dong Hwan Shin, In Joon Choi; Korean J Pathol. 1989;23(3):322-330.

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Abstract PDF: The most common malignant renal neoplasm is renal cell carcinoma. It is estimated that renal cell carcinoma accounts for 1% of all primary malignancies in Korea. Rell cell carcinoma presents diverse clinical courses with gross, histopathologic features. It has been known to be very difficult tumor to predict its clinical prognosis. In Korea, many studies have been reported concerning the clinical aspects of renal cell carcinoma. However, pathological studies of renal cell carcinoma are very few even though studies of nuclear grade have been attempted recently. We reviewed 93 cases of renal cell carcinoma examined in the period from 1978 to 1987 in the department of pathology, Yonsei university college of medicine, Yongdong Severance hospital, Wonju college of medicine and analyzed the histopathologic classification, including nuclear grade according to the Fuhrman's method. We abtained the following results by studying the relationship of the factors which had been known as correlated with the prognosis. 1) The ages of patients ranged from 9 to 74 years with a peak in the 6th decade. 2) The most common symptoms of the patients were hematuria, mass and pain, in that oder, and 7 patients complained to specific symptoms. The incidentally found cases characterized stage I, nuclear grade 2 small tumor size (not more than 4 cm) and clear cell type. 3) The renal cell carcinoma was more frequently located in the left kidney than the right by a ratio of 1.25 : 1. The incidence of intrarenal location was divided to the upper pole, 40% : mid portion, 29% : lower pole, 23% : diffuse involvement, 8%. The tumor shoing diffuse growth pattern had a large size, high nuclear grade and mixed cells. 4) The tumor size averaged 8 cm and there was no significant relationship between the size and stage. Seven cases of neoplasms not more than 3 cm were seen, of which 2 cases revealed an outcome of distant metastasis. 5) The histological pattern showed major solid, 53% : tubular, 11% : mixed, 18% : papillary, 9% and sarcomatoid type 9%. The sarcomatoid type was characterized by grade 4, a larger size(more than 10 cm), advanced stage. 6) There was no special relationship between the stage and grade but mostly grade 2 occupied the stage I. 7) The clear cell type was predominantly noted at grade 2 (65%), at the stage I (63%), granular or mixed cell type at grade 3 (87%), 4 (70%). According to these results, the tumors showing a sarcomatoid histologic pattern, diffuse growth pattern had unfavorable prognostic factors, and are thus estimated to have a poor prognosis. But the case which were incidentally found have favorable prognostic factors and probably a better prognosis. The tumor size alone can not exactly predict the metastasis and is not correlated with the stage. Small renal cell neoplasm (not more than 3 cm) generally has unfavorable prognostic factors and should be considered potentially malignant. The high grade frequently has granular cytoplasm. This represents the relationship between grade and cytoplasm, poor prognosis in the granular cell than the clear. The renal cell carcinoma shows variable prognosis and thus the prognosis should be estimated by all the factors. Nuclear grade can be used as one of the useful prognostic factors.

Clinicopathologic Study of the Endometrium of Dysfunctional Uterine Bleeding.: Nam Hoon Cho, Chan Il Park, In Joon Choi; Korean J Pathol. 1989;23(1):65-74.

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Abstract PDF: One of the most common symptoms in gynecologic disorders is an abnormal utirine bleeding, of which dysfuncyional uterine bleeding (DUB) is frequently encountered. DUB is defined as an endocrinologic imbalance of the axis of hypothalamus-pituitary-ovary-endometrium without organic diseases such as a neoplasm, and inflammation, a pregnancy, a trauma, Although the correct diagnosis of DUB depends on various assessements such as a menstrual cycle, basal body temperature, endocrine assay, vaginal cytology and endometrial histology, in many circumstances pathologist have only the endometrial histology with trivial clinical information to make a diagnosis. Therefore, the present study was aimed at assessing the pattern of the endometrium as precisely as possible. The histologic pattern was classified according to the Handrickson and kempson classification (1980). The authors also attempted to correlate the non-neoplastic metaplasia with the endometrial histology. The material consisted of 447 cases of endometrial curettage specimens diagnosed clinically as DUB during recent 4 years. The histologic examination was carried out through the routine formalin fixed-paraffin embedding method, followed by hematoxylin-eosin staining in routine and other special staining as required. The following results were obtained; 1) The pattern of the endometrium in DUB was predominently the proliferative type (239 cases, 65.55%). Of these 293 cases, 144 were of the abnormal proliferatrive phase, and particulary most were the disordered proliferative phase. The remaining 154 cases (34.45%) were found to have secretory endometrium, of which 50 cases belonged to the abnormal secretory type. Most of the cases shewing abnormal secretory patterns appeared dyssynchronous or underdeveloped. 2) Of the 361 patients with DUB for whom the clinical records were available, 197 (54.57%) were non-ovulatory and 118 (32.69%) were ovulatory. 3) Non-neoplasic metaplasia was found in 87 cases, of which ciliiated and papillary types were most common. The endometrium was of the proliferative phase in 73.56% of the cases with metaplasia, and the disordered proliferative pattern showed a particular correlation with the metaplasia (44 cases). 4) Among 63 postmenopausal DUB patients, 52 (82.53%) appeared to have the proliferative endometrium, and in particular 23 (36.51%) had the disordered proliferative endometrium.

Histopathological Studies of 300 Cases of Non-Hodgkin's Lymphoma in Korean Patients.: Hee Jeong Ahn, Soon Hee Jung, Hyen Joo Jeong, Dong Hwan Shin, Kwang Gil Lee, In Joon Choi; Korean J Pathol. 1988;22(3):222-231.

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Abstract PDF: Non-Hodgkin's malignant lymphoma is a relatively frequent lymphoreticular malignancy, and has been reported to constitute up to 5.2% of all malignant tumors in Korean patients. Various morphologic classifications of non-Hodgkin's lymphoma have been proposed, and among them, the Rappaport's classification has been most widely accepted. In 1982, a National Cancer Institute sponsored study on classification led to the creation of the Working Formulation in an attempt to resolve the controversy anddebate regarding the various classifications of non-Hodgkin's lymphoma. Angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis are lymphoreticular proliferative disorders which have reported to transform to malignant lymphoma. The purpose of the present study is to reclassify non-Hodgkin's lymphomas according to the Working Formulation and to investigate the histopathological and immunocytochemical characteristics of angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis. This study reviewed 300 cases of nodal and extranodal non-Hodgkin's lymphoma, 26 cases of polymorphic reticulosis, and 7 cases of angioimmunoblastic lymphadenopathy with dysproteinemia examined in the Departments of Pathology, Yonsei University College of Medicine, Youngdong Severance Hospital and Yonsei University Wonju College of Medicine from January 1977 to December 1986. In non-Hodgkin's lymphoma, each case was classified according to the Working Formulation and the Rappaport classification. All angioimmunoblastic lymphadenopathy with dysproteinemia and polymorphic reticulosis cases were subjected to histopathological analysis and a review of the clinical records. Immunocytochemical studies were done using kappa and lambda chains for B-cell markers and alpha-1-antichymotrypsin for histiocytic marker. The results obtained were as follows; 1) Among 300 cases of non-Hodgkin's lymphoma, the primarily involved tumor sites were the lymph nodes (141 cases), the gastrointestinal tract (67 cases), and the tonsils (32 cases) in descending order of frequency. 2) Using the Working Formulation, intermediategrade lymphomas occurred in 66.4% of the patients, and the most common subtype was "diffuse, large cell" (32.7%). By the Rappaport classification, 3 patients had nodular lymphomas, and "diffuse, histiocytic" was the most common subtype. 3) Infarction was present in 32 cases in which the "diffuse, lagre cell" type was most frequently associated. 4) In immunoperoxidase stains of 7 cases of angioimmunoblastic lymphadenopathy with dysproteinemia, proliferating immunoblasts revealed a polyclonal positivity for kappa and lambda chains. Atypical reticulocytes present in 26 cases of polymorphic reticulosis revealed a negativity for kappa, lambda and alpha-1-antichymotrypsin.

Congenital Acute Myelocytic Leukemia: An autopsy case.: Kyu Rae Kim, Eun Kyoung Han, In Joon Choi, Chang Hyun Yang, Kir Young Kim; Korean J Pathol. 1988;22(3):308-316.

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Abstract PDF: Leukemia is a rare disease in the newborn infant. We have presented an autopsy case of congenital acute myelocytic leukemia in a female neonate and discussecd with review of literature. At birth, she was relatively in good health with 4.2 kg in body weight except a large cephalhematoma on left parietal scalp and multiple subcutaneous nodules with ecchymosis on entire body surface. Hemoglobin concentration was 12.0 gm/, Hct 34.6% and erythrocyte count was 2.24 millions. Of 212,400 leukocytes/mm2, 47% were myeloblast. Biopsy of skin nodules reveal leukemia cutis, which disappear dramatically with anticancer drug. The infant was expired 12 days after admission due to intracerebral hemorrhage and acute renal failure.

Histochemical and Immunohistochemical Properties of Endometrial and Endocervical Adenocarcinoma.: Kyu Rae Kim, In Joon Choi; Korean J Pathol. 1988;22(3):259-267.

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Abstract PDF: The histologic differentiation of endometrial and endocervical adenocarcinomas is a common diagnostic problum of clinical importance, because the staging, treatment and prognosis of these lesions are quite different. First, we examined the distribution of acid mucin in endometrial and endocervical adenocarcinoma (23 cases and 25 cases repectively), but distinguishing differences between endometrial and endocervical adenocarcinoma, especially of endometrioid type, were not observed. Secondly, the distribution of low-molecular weight cytokeratin, vimentin and carcino-embryonic antigen (CEA) by immunohistochemistry were examined in formalin-fixed tissues. CEA was present in 88% of endocervical adenocarcinomas and 34.8% of endometrial adenocarcinoma. vimentin was found in 91.3% of endometrial adenocarcinomas, in contrast with only in 16% of endocervical adenocarcinomas. This study showed that the presence of vimentin in neoplastic glands, in which CEA is negative, may be helpful in the differential diagnosis of endometrial from endocervical adenocarcinomas.

Hyperkeratosis of Renal Pelvis and Ureter: A case report.: Mi Kyung Lee, Hyeon Joo Jeong, In Joon Choi; Korean J Pathol. 1987;21(4):298-302.

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Abstract PDF: Hyperkeratosis of the renal pelvis and ureter is a rare condition and is explained by the metaplastic change from transitional to cornified squamous epithelium. This lesion is frequently associated with, and perhaps caused by chronic urinary infection, but potentially premalignant, accompaning with carcinoma in about 10 to 20 per cent of the cases at the time of diagnosis. A case of hyperkeratosis of renal pelvis & ureter which was clinically suspected of carcinoma in a 49-year old woman with a long history of chronic pyelonephritis is presented with review of literature.

Histopathological and Immunohistochemical Studies of Primary Gastrointestinal Lymphomas in Korean Patients.: Soon Hee Jung, Hyen Joo Jeong, Woo Hee Jung, Tai Seung Kim, In Joon Choi; Korean J Pathol. 1987;21(3):153-167.

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Abstract PDF: The present study is aimed to investigate the clinical and pathologic features of GI lymphomas and the immunocytochemical characteristics, using 71 cases of primary GI lymphomas examined at the Department of Pathology, Yonsei University College of Medicine, Youngdong Serverance Hospital and Yonsei University Wonju College of Medicine from January, 1976 to December, 1985. Results obtained were as follows: 1) Sixty eight cases were Non-Hodgkin's lymphoma and 3 Hodgkin's lymphoma. Surgical resection was done in 58 patients and surgical biopsy in 13. 2) The primary sites of the tumors were stomach, small intestine, ileocecal area and large intestine in a descending order of frequency. 3) The mean age at the time of diagnosis was 45 years. The tumor of the small intestine was generally detected in the younger age and that of the large intestine in the older age. The overall male to female ratio was 1.9 : 1. 4) Abdominal pain was the most common presenting symptom irrespective of the sites of the tumor. Duration of the symptoms were evenly distributed from hours to 12 monthes. 5) The size of the tumors was less than 10 cm in the largest dimension in most of the cases (79.3%). The gross types of the GI lymphomas were ulcerative (27.6%), polypoid (20.7%), multinodulated (17.2%) and diffuse thickening. The rate of lymph node involvement was 44.4% in tumors confined to the serosa, while 82.6% in tumors with serosal penetrations. 6) Classification of 68 cases of Non-Hodgkin's lymphoma according to Working Formulation revealed 50 cases of intermediate grade, 13 cases of high grade and 5 cases of low grade. According to Rappaport classification, all were diffuse types, among which diffuse histiocytic type was the most common. According to Lukes-Collins classification, 60 cases were B cell types, 4 cases genuine histiocytes types and 3 cases T cell types. Most of the gastric and intestinal lymphomas belonged to the follicular center cell (small and large cleaved, large cleaved) types. 7) Immunoperoxidase stains were done in 55 cases of malignant lymphomas. Thirty (65.9%) of 47 B cell lymphomas revealed a positivity for B cell markers. Twenty three (48.9%) of them showed a monoclonality, in which kappa/IgG pattern was most frequently demonstrated. Four cases of true histiocytic lymphomas were positive for alpha-1-antichymotrypsin and lysozyme, the former of which was seemed to be a more sensitive marker for histiocytic differentiation. An attempt was made to evaluate the significance of the degree of reactive histiocytic infiltrates within the lymphoma in relation to the progosis, but correlation could not be made because of the limited cases.

A Histopathologic, Histochemical and Immunocytochemical Study of Cardiac Myxoma.: Dong Hwan Shin, Hee Jeong Ahn, In Joon Choi; Korean J Pathol. 1987;21(2):75-81.

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Abstract PDF: The immunoreactivities of surgically removed 16 cardiac myxomas were studies for factor VIII-related Ag (F VIII-RA), Ulex europaeus agglutinin I (UEA-I) and desmin alpha1-antichymotrypsin, and this study was accompained by a clinicopathologic review. More than 50% of the patients with cardiac myxomas were in their fourth and fifth decades, and cardiac myxomas were much more common in women than in men. All but on occurred in the left atrium, and the majority were attached to the atrial septum, usually in the region corresponding to the fossa ovalis. In one case, an atrial myxoma recurred 37 months after the initial excision. Microscopically, the myxomas contained a myxoid matrix composed of acid mucopolysaccharides within which were embedded polygonal cells. The cells forming both the surface and complicated vascular like channels throuhout the myxoid stroma tested positive for F VIII-RA and UEA-I. The outer cell layers of the complex vascular structures demonstrated variable staining for F VIII-RA, while isolated bundles of smooth muscle cells were present and stained for desmin. A small number of the so-called myxoma cells, immunoreactive for alpha1-antichymotrypsin which were not laden with hemosiderin pigment but were similar to histiocytes, were present particularly around the areas of hemorrhage. These findings support the current view that cellular and histologic heterogeneity arose from the divergent differentiation of multipotential mesenchymal cells. In particular, it remains to be confirmed by further study whether or not true histiocytic differentiation occurs.

Seborrheic Keratosis: A Clinical and Histopathological Study.: Sung Ku Ahn, Dong Hwan Shin, Kwang Gil Lee, In Joon Choi; Korean J Pathol. 1986;20(4):484-490.

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Abstract PDF: A total of 127 cases of seborrheic keratosis examind at the Dept. of Pathology, Yonsei University School of Medicine during 1980~1986 was reviewed. The results were as follow; 1) Sex distribution showed without preponderance with male; Female ratio of 1.05:1. 2) Age distrubution were 10~19 years 0.8%, 20~29 years 4.7%, 30~39 years 14.2%, 40-49 years 25.2%, 50~59 years 29.1%, 60~69 years 17.3%, 70~79 years 6.3% and neck (3.7%). 3) The most common site was face (44.8%), followed by trunk (29.8), lower extremities (10.4%), scalp (6.7%) and neck (3.7%). 4) The clinical diagnoses were sebrorrheic keratosis (47%), nevus (15.4%), verruca (12%), malignant melanoma (7.7%), actinic keratosis (3.4%), pyogenic granuloma (2.6%), mass (2.6%), basal cell epithelioma (0.9%), corn (0.9%), leproy (0.9%), and angiokeratoma (0.9%). 5) The distributions of the light microscopic diagnosis were acanthotic 52 cases (42.9%), hyperkeratotic 33 cases (30%), irritated 17 cases (13.4%), adenoid 15 cases (11.8%), clonal 3 cases (2.4%), melanoacanthoma 1 case (0.8%) and mixed 6 cases (4.7%). 6) The lesions measured from 0.2 cm to 3 cm in maximum diameter and its color was light brown to black with sharply demarcated papule, pladque or nodule.

Ameloblastoma Arising in Odontogenic Cysts: Report of 5 Cases and its Histologic Characteristics.: Jin Kim, In Joon Choi; Korean J Pathol. 1986;20(4):435-441.

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Abstract PDF: Five cases of ameloblastoma considered to be originated from the wall of the odontogenic cysts are reported. Histologic characteristics and diagnostic criteria are aimed to study in differentiation of ameloblastoma arising in odontogenic cysts from odontogenic cysts accompanying with reactive epithelial proliferation, and the literature is reviewed. This study can propose that the ameloblastic change and downward growth of epithelial cells lining the cysts are the most important and characteristic findings of the ameloblastoma derived from odontogenic cysts. In addition, the intraluminal proliferation of epithelial cells in plexiform pattern is also significant.

Clinical and Pathological Analysis of Germ cell Tumors.: You Bong Song, Kyu Rae Kim, In Joon Choi; Korean J Pathol. 1986;20(3):295-304.

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Abstract PDF: The germ cells first appear from the primitive streak, the splanchnopleure and the allantoic membrane of the embry and they migrate toward the gonadal ridge. It can happen, however, that some of these germ cells may not migrate to the gonadal ridge and may remain at ectopic sites such as the mediastium, the central nervous system, the sacrococcygeal region and the retroperitoneum. Therefore, germ cell tumors can arise from these ectopic sites and according to their totipotentiality of differentiating into embryonic and extraembryonic tissues, such as chorionic tissues and yolk sac, they can develop into various tumors. Generally, the sites in which these tumors are frequently found are the gonads, the sacrococcygeal region, the mediastinum, the retroperitoneum and the intracranial region. The aim of this study was to organize and report the data found on these tumors in the records of 412 patients whose tumor specimens were examined in the Department of Pathology of the Yonsei University, college of Medicine within the 10 year period, 1976~1985. The findings are as follows: 1) In total 412 cases, the ratio of benign to malignant tumors was 5.8:1. 2) Germ cell tumors occur commonly in the ovary (326 cases: 78.6%). It's incidence was followed by the descending order, in the mediastinum (26 cases: 6.3%), testis (23 cases: 5.6%), central nervous system (15 cases: 3.6%), sacrococcygeal region (11 cases: 2.7%) and retroperitoneal space (7 cases: 1.7%). Also, 2 were found in the intraorbital region and 1 each in the pericardium and the kidney. 3) In extragonadal sites, female were much more common and the sex ratio (M:F) showed 1:10 in sacrococcygeal region. 1:2.5 in retroperitoneum and 1:2.3 in mediastinum. 4) Mature teratoma was found most commonly (85.4%). It's incidence was followed by in descending order, seminoma (including dysgerminoma and germinoma) (6.8%), embryonal carcinoma (2.9%), endodermal sinus tumor (2.0%), immature teratoma (1.7%) and mixed forms (1.2%). 5) Benign teratoma takes up mostly at ovary, retroperitoneal space, sacrococcygeal region and mediastinum by 93.3%, 100.0%, 81.8%, 80.9%, respectively. But in testis and intracranial region, malignancy were more common. 6) Embryonal carcinoma and endodermal sinus tumor occured at similar aged group and each was distributed 41.7% and 62.5% respectively at first decade. 87.5% of dysgerminoma occured at 11~30 aged group, 91.7% of germinoma at 11~20 aged group, 67% mature teratoma at 20~40 aged group, 75% of seminoma at 31~50 aged group, so age distribution showed embryonal carcinoma, endodermal sinus tumor, dysgerminoma/germinoma, mature teratoma and seminoma, in increasing order. 7) In 352 cases of mature teratoma, 347 cases (98.6%) were cystic type and 5 cases (1.4%) were solid type. In 7 cases of immature teratoma, 5 cases (71.4%) were solid and 2 cases (28.6%) were cystic. 8) The incidence of bilaterality were 10.2% in mature teratoma, 12.5% in dysgerminoma and 16.7% in seminoma. 9) When the corredation of the tumor markers, alphafetoprotein and human chorionic gonadotropin, with malignancy was checked in 12 out of 28 cases of tumor of the testis. Either alpha fetoprotein of human chorionic gonadotropin was found to be elevated in 3 cases (75%) in which metastasis was already present at the time of diagnosis, where in 8 cases in which neither marker was elevated, metastasis was found to be present in only 1 (12.8%).

Immunohistochemistry of Fibrohistiocytic Tumor and Malignant Soft Tissue Tumor Simulating Malignant Fibrous Histiocytoma.: Young Bae Kim, Hyeon Joo Jeong, In Joon Choi; Korean J Pathol. 1986;20(1):1-11.

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Abstract PDF: Soft tissue tumor is defined as a tumor occurring in voluntary muscles, fat, fibrous tissue, along with the vessels serving these tissue and peripheral nervous system. It is difficult to make a diagnosis by conventional microscopic observation because of their pleuripotentiality and similar growth characteristics. Although their morphological findings of tumors are similar to one another, their clinical courses, treatment and prognosis are different. So early, correct diagnosis and proper treatment are neccessary. The present study is aimed to evaluate a value of immunoperoxidase staining to make definite diagnosis of soft tissue tumors and its application to surgical pathology. The material consisted of 106 cases of fibrohistiocytic tumors and malignant soft tissue tumors which are morphologically similar to malignant fibrohistiocytic tumors for 5 years period lasting from 1980 to 1984 at the Department of Pathology, Yonsei University College of Medicine. After the classificationof fibrohistiocytic tumors by the Enzinger (1983), clinical finndings were reviewed and peroxidase antiperoxidase(PAP) method with alpha1-antichymotrypsin was done in 15 cases of all fibrohistiocytic tumors. Other soft tissue tumors which were difficult to differentiate from MFH by light microscopic observation were liposarcoma, rhabdomyosarcoma, fibrosarcoma and malignant schwannoma. These 21 cases of tumors including MFH were stained with PAP method for alpha1-antichymotrypsin, S-100 protein and myoglobin.
Results
obtained were as follows: 1) The cases on study consisted of 19 cases of malignant fibrous histiocytoma, 2 dermatofibrosarcoma protuberans, 45 fibrohistiocytic tumors and 11 other benign fibrohistiocytic tumors. 2) The male to female ratio was 1 : 1.8 in benign and intermediate group of fibrohistiocytic tumor, but 2.2 : 1 in malignant histiocytic tumor. 3) Most cases of benign fibrohistiocytic tumors were occurred in 4th and 5th decade of life. Intermediate and malignant fibrohistiocytic tumors were mostly found in late adult life and their mean age was 43.6 year. 4) The most common sites were trunk and both extrimities in benign fibrohistiocytic tumors(88.9%), but head, neck and lower extremities in MFH (78.9%). Two cases of dermatofibrosarcoma protuberans were occurred in turnk and upper extremity. 5) The PAP stain for alpha1-antichymotrypsin was done in 15 cases of 77 fibrohistiocytic tumors which included MFH, dermatofibrosarcoma protuberans, xanthoma, xanthofibroma, dermatofibroma showed variable degree of positivity to alpha1-antichymotrypsin. The positivity of alpha1-antichymotrypsin revealed no significant difference according to differentiation of the tumors, such as benign, intermediate and malignant. 6) The PAP stain for alpha1-antichymotrypsin revealed diffuse positivity in all cases of MFH and also in a case of malignant schwannoma, fibrosarcoma, liposarcoma and rhabdomyosarcoma, but myoglobin and S-100 protein were negative. In three cases of leiomyosarcoma, two of rhabdomyosarcoma and three of malignant schwannoma, alpha1-antichymotrypsin, S-100 protein and myoglobin were negative, although a few positive tumor cells were present, which may the considered as metatypci differentiation. Another possibility of this discordance was loss of antigenicity by improper procedure of paraffin embedding and poor differentiation of tumor cells. In summary, PAP method for specific tumor marker is important for proper diagnosis of soft tissue tumors, and application to surgical pathology.

Congenital Cystic Adenomatoid Malformation of the Lung: A report of 3 cases.: Kyi Beom Lee, Woo Hee Jung, In Joon Choi; Korean J Cytopathol. 1985;19(4):431-437.

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Abstract PDF: Congenital cystic adenomatoid malformation of the lung is a rare form of congenital cystic disease of the lung and associated with developmental arrest of bronchioles in embryonic life. We report 3 cases of congenital cystic adenomatoid malformation which are classified as type I, II and III according to the morphological classification by Stocker et al. The first case was a 6-year-old female with a mass in the lower lobe of the right lung. The mass was composed of several cysts which were filled with inflammatory exudate and lined by ciliated pseudostratified columnar epithelium (type I + II). The second case was a 4-year-old female with a mass in the middle lobe of the right lung. It was composed of numerous small cysts which were uniform sized and contained inflammatory exudate. These were lined by ciliated columnar and pseudostratified columnar epithelium (type II). The third case was a stillborn female at 27 weeks of gestation. There was generalized edema and severe ascites. The left lower lobe consisted of an ill-defined solid area and small cysts. The solid lesion was composed of bronchiole-sized cysts lined by non-ciliated cuboidal epithelium (type II + III).

Histopathologic Study of the Mediastinal Tumors and Tumor-like Condition.: Kyu Rae Kim, Kwang Kil Lee, In Joon Choi; Korean J Cytopathol. 1985;19(4):413-419.

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Abstract PDF: Mediastinum is bounded by sternum, vertebra, 1st rib, and diaphragm externally, and by pleural cavity internally and includes important structures such as great vessels, nerves, thymus and many lymph nodes. Primary and metastatic cancers, cysts and inflammatory lesions can develop in this region, and the tumor developing in the mediastinum has a tendency to developed in a specific area of mediastinum depending on the histologic type. Therefore the developing site of tumor and the clinical findings are very important in diagnosing the tumor of the mediastinum. We studied not only the characteristics of mediastinal tumor and tumorlike conditions but the histologic classification and frequency of mass to a specific area and then observed if there is any information that could help in diagnosis of the lesion of the mediastinum. Results obtained were as follows: 1) Of the 95 cases of mediastinal lesion which excludes inflammatory process, there were 70 cases (73.5%) of primary tumors, 13 cases (13.1%) of metastatic tumors and 12 cases (12.6%) of tumor-like conditions. 2) Of the 70 cases of primary tumor, 54 cases (76.8%) were benign, 13 cases (20%) were malignant and 3 cases were unclassified or unidentified tumor with the overall 3.8:1 prevalence rate of benign tumor compared to malignancy. 3) Histologic classification of the 70 cases of primary tumor showed 27 cases (28.4%) of germ cell tumor, 22 cases (23.2%) of neurogenic tumor, 7 cases (7.4%) of thymoma, 6 cases (6.3%) of lymphoma and 5 cases (5.3%) of soft tissue tumors with the highest frequency of germ cell tumor. Germ cell tumor and neurogenic tumor exceeded to 50% of total primary mediastinal tumor. 4) Male to female prevalence rate showed that benigh tumor had a high frequency in female with the the ratio of 1:1.4. But malignant tumor showed much higher frequency in male with the ratio of 4.2:1. 5) Anterior mediastinum had germ cell tumor, thymoma and lymphoma in order of frequency. Metastatic tumor was the most common in superior mediastinum. Superior mediastinum had germ cell tumor and neurogenic tumor with about the equal number, and soft tissue tumor was also developed. Middle mediastinal tumor was less common in number compared to other portions of mediastinum but the majority of tumors developed was developmental cysts and metastatic tumors. And the majority of neurogenic tumors occured at the posterior mediastinum. 6) Mass sized 5-10 cm in diameter were about 55.7% of all tumor, 2.5-5 cm and 10-15 cm were 20% respectively. But the mass sized smaller than 2.5 cm and larger than 15 cm were about 5% respectively. And the malignant tumors have more larger size than benign tumors. 7) Patient with benigh tumor had no symptoms at all or some complaints of chest tightness, dyspnea, chest pain, shoulder pain and dysphagia. In addition to above symptoms, patient with malignant tumor complained of systemic symptoms such as weight loss and fever.

A Pathologic and Immunopathologic Study of Behcet's Syndrome.: Hyeon Joo Jeong, In Joon Choi; Korean J Cytopathol. 1985;19(3):374-376.

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Abstract PDF: The pathologic and immunopathologic findings of 15 skin biopsies of Behcet's syndrome were studied to investigate the pathogenetic mechanism of this syndrome. The age range was 28 to 50 years; male to female ratio was 1 : 1.2. Ulceration with acute necrotizing and chronic nonspecific inflammation was present in most cases with leukocytoclastic vasculitis and perivascular lymphohistiocytic, plasmocytic infiltrations. Eight of 15 cases showed C3 deposit in the walls of venules and capillaries, one of them was associated with IgM and fibrinogen deposits. With these findings humoral factor seemed to play a main role in the pathogenesis of vasculitis observed in Behcet's syndrome, but the possibility of other mechanisms operative in complex pattern was also considered.

Clear Cell Sarcoma of Tendons and Aponeuroses: A case report with electron microscopic examination.: Woo Hee Jung, Kyu Rae Kim, In Joon Choi; Korean J Cytopathol. 1985;19(2):244-249.

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Abstract PDF: Clear cell sarcoma of tendons and aponeuroses is the term coined by Enzinger in 1965 to describe a rare but unique type of soft tisse neoplasm whose cells characteristically have the capacity to produce melanin. The authors experienced a case of 64-year old female who presented with a 6x5x4 cm sized mass deeply seated in the left popliteal fossa. The mass was firm and multinodular, and on cut section revealed patches of brown black pigmentation. Histologically the tumor was composed of round to fusiform cells with clear or pale eosinophilic cytoplasm that contained small amounts of glycogen, separated into compact nests or short fascicles by delicate septa of fibrous tissue. The brown black pigment seen in tumor cells and stroma was proven to be melanin by special stain, and ultrastructural examination showed melanosomes in varying stages of development dispersed freely in the cytoplasm or in the lysosomes. These findings strongly support the view that clear cell sarcoma is a tumor of neural crest origin rather than of tenosynovial mesenchyme origin, and is a soft tissue variant of malignant melanoma.

Frozen Section: Indications, limitations, and accuracy.: Hyeon Joo Jeong, Kwang Kil Lee, In Joon Choi; Korean J Cytopathol. 1985;19(1):45-50.

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Abstract PDF: The rapid frozen section method is a means of intraoperative pathological diagnosis, first introduced by Welch in 1891 and developed as a diagnostic tool by Cullen, Wilson, MacCarty et al. This method serves useful purposes, such as determining the malignancy or benignancy of a suspected lesion, determining the adequacy of a biopsy of a suspected lesion, confirming the presence or absence of metatasis, and identifying small structures. But it bears many disadvantages, the most of which is the danger of incorrect diagnosis. We studied the indications, the limitations and the accuracy of the frozen section method and the materials studied was total cases of frozen section during recent 5 years. The ovarall accuracy of the frozen section diagnosis of 1,603 cases was 96.2% with 0.3% of false positive, 3.5% of false negative and 2.8% of incorrect histological diagnoses or grading errors the tissues submitted for frozen section were lymph node, breast, gastrointestinal tract and soft tissue in decreasing order of frequency. The false positive cases were four in number, while the false negative cases were 53, one third of which were the misdiagnoses of the presence of ganglion cells in Hirschsprung's disease.

Gastric Tuberculosis Associated with Gastric Carcinoma: A case report.: Kyoung Sook Kim, Kwang Gil Lee, In Joon Choi; Korean J Cytopathol. 1985;19(1):92-96.

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Abstract PDF: The tuberculosis of the stomach is very rare disease and its association with gastric carcinoma is more so. The diagnosis of gastric tuberculosis is usually made on the histological basis not clinical findings. This case of gastric tuberculosis was found incidentally after the subtotal gastrectomy performed under the impression of stomach cancer. There was an ill-defined ulcerative lesion at the lesser curvature. Microscopically, poorly differentiated adenocarcinoma extended to the serosa and typical tuberculous granulomas were found in the lesion of stomach and regional lymph nodes. Acid-fast bacilli were demonstrated by Ziehl-Neelsen stain in the granuloms of the regional lymph nodes, and a case of gastric carcinoma is presented here and briefly reviewed with the literature.

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