- Undifferentiated Carcinoma Arising in a Choledochal Cyst: A Case Report.
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Hee Eun Lee, Chang Lim Hyun, You Jeong Lee, Hye Sil Seol, Ja June Jang
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Korean J Pathol. 2006;40(6):461-465.
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- An association between choledochal cyst and carcinoma is well established. Here, we report an extremely rare case of undifferentiated carcinoma exhibiting extensive sarcomatous features arising in a choledochal cyst. The patient in our case had a radiologically confirmed choledochal cyst and anomalous pancreaticobiliary ductal union, and mild wall thickening in the cyst was observed on endoscopic retrograde cholangiopancreatography. The patient underwent common bile duct excision and cholecystectomy. In the choledochal cyst, a nodule measuring 1.5x1 cm was detected. The lesion was composed of atypical, spindle-shaped and large, round pleomorphic tumor cells simulating sarcoma. Neither glandular nor squamous differentiation was observed. These cells were immunoreactive for both vimentin and cytokeratin by immunohistochemistry. These histologic and immunohistochemical findings were consistent with undifferentiated carcinoma, spindle and giant cell type, according to the WHO classification.
- Histological Grading and Staging of Chronic Hepatitis Standardized Guideline Proposed by the Korean Study Group for the Pathology of Digestive Diseases .
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Young Nyun Park, Ho guen Kim, Chae Yoon Chon, Jae Bok Park, Jin Hee Sohn, Seung Ha Yang, Eun Sil Yu, Mi Seon Lee, Ja June Jang, Hee Kyung Chang, Jong Jae Jeong, Dae Young Kang, Yong Il Kim, Chan Il Park
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Korean J Pathol. 1999;33(5):337-346.
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- The terms chronic active hepatitis (CAH), chronic persistent hepatitis (CPH), and chronic lobular hepatitis (CLH) should be discontinued in favor of etiologic terminology.
The activity of necro-inflammation and the degree of fibrosis should be evaluated for grading the severity and for the stage of disease. Members of the Korean Study Group for the Pathology of Digestive Diseases reviewed 30 cases of chronic hepatitis and reached the following consensus: 1) The pathology report of the biopsy samples with features of chronic hepatitis should include the etiology, grade and stage. 2) Grade and stage should be semiquantitatively evaluated as none, minimal, mild, moderate and severe. 3) For grading, lobular activity and periportal activity should be evaluated, separately. 4) To avoid confusion with other grading systems, simple report using descriptive terms rather than numerical records is recommended in daily practice.
Criteria for each grade and stage should be presented and discussed. Histologic grading and staging of chronic hepatitis by new standardized guidelines will give more information about the prognosis as well as the present status of hepatitis. The terms CAH, CPH and CLH may be used in parentheses to facilitate relearning.
- Gastrointestinal Polyposis in Koreans: A Nationwide Survey of Clinicopathologic Analysis of 112 Surgically Resected Cases.
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Mee Soo Chang, Hoguen Kim, Woo Ho Kim, Chan Il Park, Eun Kyung Hong, Han Kyeom Kim, In Soo Suh, Byung Kee Kim, Ja June Jang, Woon Sub Han, Hyung Sik Shin, So Young Jin, Dae Young Kang, Yong Il Kim
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Korean J Pathol. 1998;32(6):404-412.
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Abstract
- Gastrointestinal polyposis (GIP) is a rare disease characterized by formation of the numerous polyps in the gastrointestinal tract and presenting several extraintestinal manifestations. Most of the diseases are transmitted in an autosomal dominant pattern. In Korea, the epidemiological study as well as the pathological analysis of the GIP is not well established. We therefore analysed 38 items of GIP using surgically resected specimens. The materials in this study were collected from the 12 institutions and case reports in Korean literature between 1980 and 1991. The clinicopathologic findings were reevaluated by several members of the study group for gastrointestinal pathology. The results are as follows: (1) A total of 112 cases were included in this study: 83 cases were collected from 12 institutions and 29 cases were collected from Korean literature. The cases were classified as familial adenomatous polyposis (FAP), 59 cases; Gardner's syndrome, 3 cases; juvenile polyposis, 12 cases; Peutz-Jeghers syndrome, 35 cases; multiple colonic adenomas, 3 cases. (2) Among 59 cases of FAP, the range of age at operation was 14 to 61 years, and a family history was positive in 25 cases. The number of polyps in colorectum was 100~8,000. Of the 37 cases in which the examination of polyp density was available, 16 cases (43%) showed the highest density in the rectum and the sigmoid colon. The carcinomatous change within polyp(s) was present in 18 cases (31%), and associated advanced single or multiple colonic carcinomas existed in 37 cases (63%). Twenty-six (45%) tumors out of total 58 carcinomas were in the rectum.
Twenty-five patients were evaluated for the upper gastrointestinal lesions, and 11 patients (44%) had pathologic lesions; multiple fundic gland polyps in 3 cases (12%), gastric and duodenal adenomas in 2 cases (8%), gastric adenomas in 2 cases (8%), duodenal adenomas in 2 cases (8%), gastric carcinoma and adenoma in 1 case (4%), gastric carcinoma in 1 case (4%). (3) Among 3 cases of Gardner's syndrome, the range of age at operation was 25 to 31 years, a family history was identified in 2 cases. One case was associated with an advanced colonic carcinoma and carcinomatous change within polyp. Extra gastrointestinal lesions were sebaceous cyst, epidermal cyst, osteoma and desmoid tumor. (4) Among 12 juvenile polyposis, the range of age at operation was 8 to 51 years and 5 patients had a family history. The carcinomatous change within polyp was found in 2 cases (17%) and associated advanced colonic carcinoma was in 4 cases (33%). The associated different type of polyps was tubular adenomas in 9 cases (75%), hyperplastic polyps in 4 cases (33%) and villous adenomas in 2 cases (17%). (5) Among 35 Peutz-Jeghers syndrome, the range of age at first operation was 6 to 42 years, family history was positive in 11 cases. The carcinomatous change within polyp was found in 1 case (3%), and associated advanced colonic carcinoma in 1 case (3%). The epithelial misplacement was observed in 4 cases (11%), and tubular or villous adenomatous feature in 4 cases (11%). In summary, the most frequent GIP for the surgical resection in Korea is FAP and the FAP is associated with high incidence of coexisting advanced and intramucosal carcinomas.
Hamartomatous polyposis syndromes, such as juvenile polyposis and Peutz-Jeghers syndrome are another frequent disease for the surgical resection and are also associated with an increased risk of cancer.
- The Current Practice of the Autopsy Services and the Autopsy Records at the Seoul National University Hospital.
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Jeong Wook Seo, Yoon Sung Lee, Je Geun Chi, Ghee Young Choe, Soong Deok Lee, Chong Jai Kim, In Ae Park, Woo Ho Kim, Ja June Jang, Chul Woo Kim, Seong Hoe Park, Jung Bin Lee, Hyun Soon Lee, Yong Il Kim, Eui Keun Ham, Sang Kook Lee
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Korean J Pathol. 1998;32(6):453-459.
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Abstract
- This study outlines the current status of the autopsy practice and the medical records for autopsies at the Department of Pathology, Seoul National University Hospital.
Total number of autopsy cases from 1954 to 1995 was 3,131.
Adults aged over 17 were 371 cases and children were 2,515 cases. The demographic data in 245 cases was not available.
The number of adult autopsies and its proportion among total number of autopsies during 10-year periods decreased from 144 cases (40%) during the 10-year-period from 1956 to 52 cases (3%) during the 10-year-period from 1986. The number of children cases during the same period groups increased slightly from 210 cases (58%) to 393 cases (25%). But the number of fetal cases increased rapidly from 7 cases (2%) to 1,146 cases (72%). Among fetal autopsies the proportion of fetuses died earlier than 24 weeks of gestation increased and this figure exceeds that of fetuses that died later than 24 weeks of gestation from 1992. Forty percent of the cases were submitted from the clinical departments of the Seoul National University Hospital but the remainders were referred from 73 hospitals. Final autopsy diagnoses were analysed according to the Korean Standard Classification of Disease (KCD)-3 coding system and by searching key words for all cases. Common diagnoses as coded among cases from 1990 were P9, P0, P2, Q2 and Q0. Common diseases by key words for adult cases were liver disease, tuberculosis and pneumonia.
Common diseases for children cases were pneumonia, hyaline membrane disease, meningitis and tuberculosis. Through this study we could show the importance of autopsy services for fetuses. We could also establish a regular registration system for autopsies at general hospitals.
- Expressions of the Tumor Associated Proteins and Their Correlation with the Pathologic Features in Childhood Hepatoblastoma.
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Han Seong Kim, Hyo Seop Ahn, Kwi Won Park, Ja June Jang
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Korean J Pathol. 1997;31(6):538-545.
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- Hepatoblastoma is a rare malignant liver tumor found in children. Its biological characteristics and prognostic factors have not been well known. We investigated 29 cases of hepatoblastoma, registered in university hospitals in Seoul from 1984 to 1996. By the immunohistochemical method, p53, Waf-1 (p21), bcl-2, heat shock protein 70 (hsp70), c-jun, transforming growth factor-alpha (TGF-alpha) expressions were studied. Those data were compared with clinico-pathologic features; age, sex, tumor size, tumor stage and histologic subtypes. Expression of p53 and bcl-2 were each observed separately in single cases. Expression of c-jun was more frequently noted in patients at higher stages. Expression of TGF-alpha decreased in the order of pure fetal, mixed, embryonal and small cell anaplastic subtypes. Cumulative survival rate was lower in females than in males and in patients with a higher tumor stage.
According to histologic subtypes, survival rates decreased in the order of pure fetal, mixed, embryonal and small cell anaplastic subtypes. Survival rate was lower in patients with c-jun expression. Group of TGF-alpha labelling index under 19 showed a lower survival rate than that over 19. In conclusion, we found that tumor associated proteins, c-jun and TGF-alpha, are closely related to the prognosis of hepatoblastoma but p53 and bcl-2 may not be related to it.
- Grading System for Gastric Epithelial Proliferative Diseases Standardized Guidelines proposed by Korean Study Group for Pathology of Digestive Diseases.
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Hoguen Kim, So Young Jin, Ja June Jang, Woo Ho Kim, Sang Yong Song, Kyu Rae Kim, Eun Sil Yu, Hyung Sik Shin, Han Kyeom Kim, Jin Hee Sohn, Eun Kyung Hong, Youn Wha Kim, Jin Sook Jeong, Chang Jin Kim, Shin Eun Choi, In Suh Park, Chan Il Park, Yong Il Kim
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Korean J Pathol. 1997;31(5):389-400.
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- The assessment of epithelial changes in gastric mucosal biopsies has been one of the major problems caused by inconsistencies in and disagreements about nomenclature and interpretation. To resolve these issues, members of the Study Group for Pathology of Digestive Diseases reviewed microslides of 50 gastric lesions showing varying degrees of mucosal abnormality and reached the following consensus; 1) the proliferating gastric epithelium can be divided into hyperplastic and neoplastic; 2) the term "dysplasia" is reserved for the microscopic epithelial changes that are unequivocally neoplastic; 3) Biopsy specimens can be categorized as regenerative(negative for dysplasia), indefinite(questionable dysplasia), positive(positive for dysplasia) and overt carcinoma; 4) The positive category can be divided into two subgroups, high grade dysplasia and low grade dysplasia. Criteria for each grade are presented and discussed. We offer these guidelines for establishing the correct diagnosis of the gastric mucosal biopsy specimens and for prospective studies.
- Application of the Revised Case Matrix Format to Tutorial in Pathology Teaching: An Interim Approach toward Problem-Based Learning under Traditional Curricular Structure.
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Yong Il Kim, Chong Jai Kim, Gee Young Kim, Chul Woo Kim, Woo Ho Kim, Ja June Jang, Je Geun Chi, Gyeong Hoon Kang, Myeong Cherl Kook, Jung Sun Kim, Tae Sook Kim, Gee Young Kwon, So Dug Lim
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Korean J Pathol. 1996;30(8):570-661.
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- This paper describes a student-centered case study program concerning the tumor pathology course for first year students in medical school under the traditional curricular structure. A traditional, discipline-oriented, lecture-laboratory approach was partly modified by introducing a tutuorial session using a modified case matrix format during the laboratory hours without altering the general scheme of the existing system. Small group tutorial sessions were set with the development of learning objectives emphasizing clinicopathologic reasoning and early exposure to future practical presentation which was followed by the large class session; each tutorial was supplied with a short clinical history, gross kodachrome slides, and microslides. The session for problem identification was replaced by proving a series of instructor-designed questions for both pathology and interdisciplinary correlation during which pedagogical implication was stressed the most. Student's active participation, development of self learning skill and vigorous teaching-learning process among students, and motivation/relevance for forthcoming pathology study were among the benefits conferred by this modification. We conclude that this approach is an interim step to meet the advantages of problem-based learning even in a traditional curricular structure.
- Coexisting Adenocarcinoma and Epithelioid Leiomyosarcoma of Stomach: A case report.
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Jung Youn Kim, Jae Soo Koh, Kyung Ja Cho, Ja June Jang
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Korean J Pathol. 1995;29(4):521-523.
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- We report a case of malignant tumor of the stomach showing both carcinoma and sarcoma components in a 47 year-old woman. The resected stomach revealed two tumors which were in different location. The one mass was a 2 x I cm, poorly demarcated tumor at the body, along the lesser curvature and the other was a 6 x 7 cm, well demarcated polypoid tumor with a central depression at cardia of the posterior stomach wall. The tumor at the body was a poorly differentiated adenocarcinoma which showed strong reactivity for CEA. The tumor at the cardia was composed of epithelioid or spindle shaped cells with abundant eosinophilic cytoplasm and revealed 5-6 mitoses per ten high power field. The tumor at the cardia was diagnosed as epithelioid leiomyosarcoma and showed reactivity for vimentin but none for actin, desmin,keratin, and CEA. This is different from the usual carcinosarcoma.
- Locally Infiltrative Glomus Tumor: A case report.
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Jung Youn Kim, Kyung Ja Cho, Soo Yong Lee, Ja June Jang
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Korean J Pathol. 1994;28(3):325-327.
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- Malignant glomus tumor is a rare neoplasm arising from the glomus body, comprising categories of locally infiltrative glomus tumor, sarcoma arising in benign glomus tumor and de novo glomangiosarcoma. We report one case of locally infiltrative glomus tumor arising in nail bed of the right thumb of a 50 year-old woman. The tumor showed the architectural features of glomus tumor but cytologically bizarre, pleomorphic features without mitosis and infiltrative growth pattern to adjacent connective tissue and nerve. Immunohistochemical results were consistent with glomus tumor. This category of malignant glomus tumor must be distinguished from other round cell tumors because of its good prognosis.
- c-erbB-2 Oncoprotein Overexpression in Breast Cancer.
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Tae Sook Hwang, Kyung Ja Cho, Young Bae Kim, Joo Ryung Huh, Ja June Jang
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Korean J Pathol. 1994;28(1):1-7.
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- c-erbB-2 oncogene is a normal cellular proto-oncogene coding transmembrane glycoprotein structurally similar to the epidermal growth factor receptor. Amplification of this oncogene in a variety of human adenocarcinomas has been reported and is particularly well documented in breast carcinoma. It has been suggested that amplification of this oncogene is indicative of poor prognosis and is valuable only second to the lymph node status. Using immunohistochemical staining for the c-erbB-2 protein, overexpression of this protein was analysed in 228 primary breast cancer specimens and the frequency of overexpression and the relationship between overexpression and the other established prognostic variables are evaluated. Ninty three cases out of 228 cases(40.8%) show postive oncoprotein overexpression and using the chi-squared test for a trend, a significant correlation was found between c-erbB-2 protein staining and the histological grade, lymph node status, and estrogen receptor status(P<0.05). No significant association was found between staining and the patient's age and tumor size. Most of the tumors with histological types known to have good prognosis showed negative expression. Above findings strongly suggest that expression of c-erbB-2 oncogene is another independent indicator of poor prognosis in breast carcinoma.
- Fine Needle Aspiration Cytology of Poorly Differentiated ""Insular Carcinoma"" of the Thyroid: A Case Report.
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Seung Sook Lee, Chang Won Ha, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1994;5(1):35-40.
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- A case of poorly differentiated "insular" carcinoma of the thyroid is presented and discussed with references to the literature. In fine needle aspiration cytology of our case, the aspirates were highly cellular with tumor cells appearing as dispersed isolated cells as well as in dense clusters and syncytial formations. Occasional microfollicles containing colloid were evident. Most of nuclei were fairly uniform with considerable variability and a few showed definite atypical features. Nuclear grooving was additional features. Necrotic debris was not seen. Our cytologic findings were correlated well with histology, confirming typical insular pattern of tumor cells with the presence of occasional pleomorphic cells and papillary carcinoma-like features. With much attention to cytological features of insular carcinoma, it would be possible to diagnose a preoperative suggestive diagnosis, even though not definitive.
- Expression of ras Oncogene Product, MHC class II Antigen and Human Papillomavirus 16/18 DNA in Carcinomas of the Uterine Cervix.
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K J Cho, Ja June Jang
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Korean J Pathol. 1993;27(5):485-490.
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- Immunohistochemical study for ras oncogene product(p21) and MHC class II(HLA-DR) antigen, and in situ hybridization for human papillomavirus(HPV) type 16/18 were performed on 50 squamous cell carcinomas of the uterine cervix. Activated ras and aberrant DR expression were noted in 26 cases(52%) and 11 cases(22%), respectively, without a difference between keratinizing and non-keratinizing types. No direct correlation between ras and DR expression was histologically found. p21 was diffusely distributed with a finely granular pattern in the cytoplasm. Aberrant DR expression was also diffuse, with linear staining along the cell membrane. In situ hybridization revealed HPV type 16/18 DNAs in superficial koilocytotic cells of 4 cases, in which ras or DR expression was not correlated with the presence of HPV DNA.
- Fine needle aspiration cytology of follicular neoplasm of the thyroid.
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Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1993;4(2):105-110.
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- No abstract available.
- Aspiration cytology of pilomatrixoma.
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Jae Soo Koh, Chang Won Ha, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1993;4(1):25-28.
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- No abstract available.
- Effusion cytology of metastatic rhabdomyosarcoma.
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Jae Soo Koh, Chang Won Ha, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1993;4(1):74-76.
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- No abstract available.
- Carcinosarcoma Arising from Mixed Tumor of the Parotid Gland: A case report.
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Jae Soo Koh, Chang Won Ha, Na Hye Myoung, Kyung Ja Cho, Kyung Kyun Oh, Mi Kyung Kim, Ja June Jang
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Korean J Pathol. 1992;26(5):530-532.
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- A case of true malignant mixed tumor of the parotid gland is reported. The tumor, occuring in a 55-year-old man, started to grow rapidly after a long history of parotid mass. Total parotidectomy was carried out and the resected tumor measured 5x4x3 cm with a cut surface showing grayish-white solid and myxoid appearance. Microscopically, the tumor had both carcinomatous and sarcomatous elements, the former consisting of undifferentiated carcinoma with focal areas of ductal differentiation and the latter consisting of pleomorphic sarcoma with chondrosarcomatous differentiation.
A remnant of benign pleomorphic adenoma could also be identified. Immunohistochemical study demonstrated focal cytokeratin reactivity in the carcinoma cells and vimentin in sarcomatous elements. It is assumed from these clinical and histological findings that the tumor had transformed from a pre-existing benign pleomorphic adenoma.
- Oxyphilic Clear Cell Carcinoma of the Ovary: A case report.
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Chang Won Ha, Jae Soo Koh, Na Hye Myoung, Kyung Ja Cho, Sang Yoon Park, Mi Kyung Kim, Ja June Jang
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Korean J Pathol. 1992;26(5):500-503.
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- Oxyphilic clear cell carcinoma of the ovary is a variant of clear cell carcinoma with abundant eosinophilic cytoplasm described by Young & Scully in 1987. Thorough samplin is needed to identify typical foci of clear cell carcinoma for the differential diagnoses from a variety of ovarian tumors with oxyphilic cells. We report a case of oxyphilic clear cell carcinoma in a 65-year-old female patient who presented with vaginal spotting and lower abdominal discomfort. The excised mass was a 10x8x7cm sized, well circumscribe yellowish white solid ovarian tumor. Microscopically, the tumor showed glandular, papillary and alveolar growth patterns composed of cuboidal or hobnail-shaped oxyphilic cells.
- Adenoid Cystic Carcinoma of the Lung: Report of 2 cases.
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Jae Soo Koh, Chang Won Ha, Na Hye Myong, Kyung Ja Cho, Mi Kyung Kim, Ja June Jang
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Korean J Pathol. 1992;26(2):175-179.
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- Adenoid cystic carcinoma of the lung is histologically and ultrastructurally identical to the salivary gland tumor of the same name and is characterized by infiltrative growth, local recurrence, and usually a prolonged clinical course.
We have recently experienced two cases of adenoid cystic carcinoma arising in the lung. Case 1 was a 59 year-old male who presented with cough, fever, and chill of 1.5 months' duration, and case 2 was a 61 year-old male who was incidentally found to have a 3 to 4 cm sized lobulated mass in the right upper lobe. After being worked up, both patients underwent right pneumonectomy. In case 1, a 3x2 cm sized tumor was located in the lower bronchus, partly elevating toward the lumen and partly infiltrating into regional lymph nodes and lung parenchyma showing grayish-white and solid cut surface. Case 2 was a 3.5x3.5 cm sized upper bronchial tumor resembling the former in appearance. Histologically, the tumors were composed of small round hyperchromatic cells, forming solid, cribriform, acinar, or tubular structures. Luminal spaces in tumor cell nests contained PAS-positive mucinous or hyaline material.
Among the tumor cells, scattered islands of normal submucosal gland were noticed.
- Fine needle aspiration cytology of the breast.
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Kyung Ja Cho, Jae Soo Koh, Chang Won Han, Ja June Jang
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Korean J Cytopathol. 1992;3(2):52-59.
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- No abstract available.
- Effusion cytology of multiple myeloma: a case report.
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Jae Soo Koh, Chang Won Ha, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1992;3(2):90-93.
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- No abstract available.
- A case of hepatic actinomycosis disgnosed by fine needle aspiration cytology.
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Chang Won Ha, Jae Soo Koh, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1992;3(2):100-103.
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- No abstract available.
- Effusion cytology of squamous cell carcinoma.
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Na Hye Myong, Jae Soo Ko, Chang Won Ha, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1992;3(1):12-18.
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- No abstract available.
- Fine needle aspiration cytology of secretory carcinoma of the breast: a case report.
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Chang Won Ha, Jae Soo Koh, Na Hye Myong, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1992;3(1):25-29.
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- No abstract available.
- A Histopathological Analysis of 69 Cases of Adenocarcinoma of the Uterine Cervix.
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Na Hye Myong, Chang Won Ha, Kyung Ja Cho, Ja June Jang
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Korean J Pathol. 1991;25(5):427-435.
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- Cervical adenocarcinoma represents approximately 3-6% of the uterine cervical neoplasms. Recently, its relative incidence tends to be increased in contrast to squamous cell carcinoma. Sixty nine cases from 1985 to 1990 diagonsed as adenocarcinoma of the cervix by radical or total hysterectomy were analyzed to know their histopathological characteristics and related prognostic factors. The results wer as follows. (1) The age distribution ranged from 24 to 60 years and the mean age was 44 years and 47 years in adenocarcinoma in situ and invasive adenocarcinoma, respectively. Staging by FIGO classification showed the range from stage 0 to IIb, of which 63.8% was stage Ib. (2) Cases were composed of 7 cases of adenocarcinoma in situ(10%) and 62 cases of invasive adenocarcinomas(90%). The latter included 16 cases of adenosquamous carcinoma and 46 cases of pure adenocarcinoma which showed endocervical, endometrioid, clear cell, minimal deviation adenocarcinoma subtypes. The most frequent subtype was endocervical adenocarcinoma(51%) and the endometrioid subtype showed slightly higher incidence rate(13%) in comparison to the previous studies. (3) Coexistent squamous lesions ranging from mild dysplasia to invasive carcinoma were found in 4 out of 7 cases(57%) of adenocarcinoma in situ and 18 out of 62 cases(29%) of invasive adenocarcinoma. Severe dysplasia and carcinoma in situ comprised most(77%) of them. (4) Analyses of histopathological and clinical characteristics of adenocarcinoma of the uterine cervix revealed positive correlations between tumor size or mucin leakage and depth of invasion. The prognostic factors in relation to lymph node metastasis were considered to be th stage of disease, the size of tumor, mucin leakage in the stroma, and histologic subtypes.
- Adenosquamous Carcinoma of the Stomach: Report of three cases with immunohistochemical study.
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Chang Won Ha, Na Hye Myong, Kyung Ja Cho, Ja June Jang
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Korean J Pathol. 1991;25(4):382-386.
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- Adenosquamous carcinoma originating in the stomach is relatively rare, and the occurrence of such tumor is interesting with respect to its histogenesis. We describe three cases of gastric adenosquamous carcinoma in a 39-year-old man, a 58-year-old woman and a 52-year-old man.
They were grossly classified as Borrmann type III or II, revealing no difference from usual advanced gastric adenocarcinomas. Microscopically three cases showed well or moderately differentiated squamous cell carcinoma component occupying large areas of the tumors. Areas of transition from glandular to squamous epithelium were frequently observed. Metastatic foci in the regional lymph nodes also were consisted of two elements. On immunohistochemical study, CEA immunoreactivity was found not only in adenocarcinoma component but also in squamous cell components, in comparison to cytokeratin which was detected only in squamous areas. The immunohistochemical findings of CEA reactivity in both components, and the presence of microscopic transitional zones support the hypothesis of squamous metaplasia occurring in an already existing adenocarcinoma in the development of adenosquamous carcinoma of the stomach.
- Analytic study of 362 bile cytologic materials.
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Jae Soo Koh, Chang Won Ha, Na Hye Myong, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1991;2(2):73-78.
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- No abstract available.
- Immunohistochemical Observation of Placental Form of Glutathione S-Transferase in Squamous Cell Carcinoma.
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Mi Kyung Kim, Jin Seok Seo, Kye Yong Song, Ja June Jang, Sang Chul Park
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Korean J Pathol. 1990;24(3):190-196.
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- Glutathione S-Transferase (GST) is a conjugation enzyme in the metabolism of exogenous and endogenous lipophilic compounds for their excretion and detoxification. Acidic isozyme of GST, GST-Pi, has been recognized as a preneoplastic marker in the experimental hyperplastic nodules of liver in rats, and GST-Pi is abundant in the squamous cells of the skin, also. This histochemical study was carried out to evaluate the distribution and the relationship between the differentiation status of squamous cells in dysplastic or neoplastic epithelium in various organs. The human placental form of glutathione S-transferase (GST-Pi) were stained immunohistochemically with specific anti GST-Pi rabbit antibody in 23 cases of human squamous cell carcinomas. The patients consisted of 14 cases from the uterine cervix, 3 cases from the esopahgus, 3 cases from the lung and 3 cases from the larynx. The results obtained were as follows; 1. Basal cells in normal mucosa were stained negative for GST-Pi while superficial keratinocytes were stained moderately positive. Basal dysplastic cells were stained negatively or weakly positive.
Carcinoma cells especially large cells either keratinizing or nonkeratinizing were stained moderately to strongly.
Carcinoma cells surrounding keratin pearl were strongly reacted with GST-Pi than other carcinoma cells. 2.
Differentiated cells of squamous cell carcinoma showed moderate to strong positive reaction to GST-Pi staining irrespective of its site of origin. 3. Therefore, Immunohistochemical staining pattern of GST-Pi in various squamous carcinoma cells showed similar immunohistochemical reaction to the GST-pi, which is closely correlated to the degree of differentiation, keratinigation and also suggested that squamous carcinoma cells had abundant GST-Pi related detoxifying system.
- Postirradiation Malignant Mixed Mesodermal Tumor of the Uterus: A case report.
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Na Hye Myong, Kyung Ja Cho, Sang Yoon Park, Ja June Jang
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Korean J Pathol. 1990;24(2):161-165.
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- A case of malignant mixed mesodermal tumor (MMMT) developed after radiation therapy for a uterine cervix cancer is described. The patient was a 62-year-old female at the time of diagnosis of stage Ib squamous cell carcinoma of the cervix and a total of 12,000 rads of x-ray was administered on the pelvic area. Five years later she manifested vaginal spotting and rectal pain. Endometial curettage and biopsy revealed carcinosarcoma. Radical hysterectomy was done and a 5x3x2 cm sized polypoid mass was noted in the uterine cavity. Microscopically, the tumor showed intimate admixture of adenocarcinomatous and sarcomatous areas. The sarcomatous stroma was composed of compactly arranged atypical spindle cells with frequent mitoses, merging into a loosely textured reticular areas and abundant amount of heterologous elements such as skeletal muscle and cartilage. The rhabdomyosarcomatous element was confirmed by PTAH staining and immunohistochemical staining for myoglobin and desmin.
Multiple metastases to the liver, lung, and lymph nodes appeared within one year of total abdominal hysterectomy and bilateral salpingo-oophorectomy. In spite of palliative radiotherapy, she expired one month later.
- Fine Needle Aspiration Cytology of Two Cases of Leiomyosarcoma.
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Chang Won Ha, Na Hye Myong, Kyung Ja Cho, Ja June Jang
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Korean J Cytopathol. 1990;1(2):147-151.
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- Leiomyosarcoma of the soft tissue is a well-defined and characteristic entity histologically, but cytomorphological studes are lacking. A correlative cytological study of 2 cases of leiomyosarcoma is presented. The smears from case 1 were rich in tumor cells and most cells were arranged in large sheets or clusters. The cells showed round to oval nuclei containing fine chromatin and small prominent nucleoli. The smears from case 2 were moderate in cellularity with loose clusters or isolated cells. The characteristic blunt-ended and cigar-shaped nuclei containing coarse chromatin and prominent nucleoli were identified in case 2. Nuclear atypia, prominent nucleoli and high cellularity permit diagnosis of malignancy, although the atypia is generally less pronounced than in the histology. The cytological diagnosis of leiomyosarcoma may be auxiliary in the diagnosis of recurrence or metastasis in the patients with alleged leiomyosarcoma.
- Fine Needle Aspiration Cytology of Myxodi Chondrsarcoma of Pleura: A Case Report.
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Na Hye Myong, Kyung Ja Cho, Ja June Jang, Jae Il Zo, Young Mog Shim
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Korean J Cytopathol. 1990;1(2):152-157.
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- A 70-year-old female who was diagnosed as myxoid chondrosarcoma by fine needle aspiration of a pleural mass is described. She presented with left chest discomfort of 4 months' duration and aggravating dyspnea and chest pain for 2 months. Chest X-ray and CT scan revealed a large lobulated low density mass invading chest wall at the left pleural cavity and massive pleural fluid. Fine needle aspiration was done under the impression of mesothelioma or metastatic cancer. The aspirates from the mass were very cellular and composed of isolated or clustered forms of large plump cells. Abundant cytoplasm was bluish opaque and the margin was rounded in the isolated cells, whereas clustered cells show ill-defined cell borders and aggregating tendency. The nuclei were eccentric, round to ovoid, and had fine chromatin pattern and multiple small nucleoli. Cellular pleomorphism or mitotic figure was not definite. These findings were consistent with cytologic features of chondrosarcoma. Final diagnosis was confirmed as myxoid chondrosarcoma by mediastinoscopic biopsy and the tumor showed strong positivity for S-100 protein.
- Transthoracic Fine Needle Aspiration Cytology: Review of 213 cases.
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Kyung Ja Cho, Na Hye Myong, Ja June Jang, Soo Yil Chin, Ki Hwan Kim, Hong Sik Byun, Duk Lim
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Korean J Pathol. 1989;23(4):455-460.
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Abstract
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- A total of 213 fine needle aspirations from pulmonary lesions in 193 patients performed from January, 1986 to March, 1989 were analyzed. The cytologic diagnoses were unsatisfactory in 10, negative in 60, atypical in 6, suspicious in 11 and malignant in 126 cases. The cytologic types of the malignant cases were 47 squamous cell carcinomas, 40 adenocarcinomas, 10 small cell carcinomas, 6 large cell carcinomas and 10 metastatic tumors. They were verified by the histologic confirmation in 31 cases and by the clinical data in the remainder. There were 5 false-negative cases and none was false-positive, representing 96% sensitivity and 100% specificity. Primary lung cancers were accurately typed in 73% of histologically confirmed case. Cell blocks, prepared in 99 cases, were helpful in tumor typing of 11 cases.
- Fine Needle Aspiration Cytology of Pulmonary Hamartoma: 3 cases.
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Na Hye Myong, Kyung Ja Cho, Ja June Jang
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Korean J Pathol. 1989;23(3):355-358.
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- Fine needle aspiration cytology of three cases of pulmonary hamartoma is presented. Case 1 was in a 67-year-old man with a 7 cm-sized left lung mass. Case 2 and 3 were in 47 and 53 year old females and consisted of 3 cm and 2 cm-sized right lung nodules, respectively. Fine needle aspiration of the masses revealed several fragments of irregularly shaped mature hyaline cartilage or fibromyxoid mesenchyme and sheets of benign epithelial cells in scanty to acellular background. Also scattered were inflammatory cells including lymphocytes, neutrophils and histiocytes and mature fat cells. These features were diagnostic for pulmonary hamartoma and case 1 was histologically confirmed by following surgical excision of the mass. Differential diagnoses about pulmonary hamartoma in the respect of conditions capable of producing cartilage on fine needle aspiration, were discussed.
- A Case of Sacrococcygeal Chordoma Diagnosed by Fine Needle Aspiration Biopsy Cytology.
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Ja June Jang, Kyung Ja Cho, Soo Yong Lee
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Korean J Pathol. 1988;22(3):356-359.
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- A case of sacrococcygeal chordoma diagnosed by fine needle aspiration is presented. This is a case of a 54-year-old woman who came with coccygeal pain of 5-6 months duration.
Aspiration biopsy cytology revealed many nests of cells having abundant bubbly cytoplasm and round to oval variably sized nuclei. The cells had indistinct cytoplasmic borders and many of the cells had cytoplasmic vacuoles. The nuclei had thin regular nuclear membranes, finely granular chromatin and one or two small nucleoli. The cells were generally monotonous, but focally pleomorphic with giant cell formation. Mitotic figures were scanty. The backgroud of the aspirate contained abundant mucinous materal. These findings were typical of those of recorded chordoma cases and the diagnosis was confirmed by a following open biopsy.
The patient received 4,000 rads of neutron radiotherapy and has been well till March '88.
- Fine Needle Aspiration Cytology of Chondrosarcoma.
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Kyung Ja Cho, Ja June Jang, Soo Yong Lee
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Korean J Pathol. 1988;22(3):348-352.
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- Fine needle aspiration cytologic findings of four cases of chondrosarcoma were described. The cases consisted of one primary scapular tumor, two recurrent shoulder masses, and right upper quadrant mass which developed after an A-K amputation for an unknown tumor. The aspirates characteristically revealed cell-rich smears containing clusters and isolated cells having abundant cyanophilic cytoplasm and round to oval or elongated vesicular nuclei.
The cytoplasm was occasionally foamy. The nuclei were usually small but prominent. Nuclear atypism and pleomorphism were frequently associated. The last case showed epithelioid sheets of polygonal cells, possibly representing chondroblasts, and a well differentiated chondroid element. The fine needle aspiration could be a good diagnostic tool for primary, recurrent, and metastatic chondrosarcomas.
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