Journal of Pathology and Translational Medicine

Jin Haeng Chung

19 Articles

Loss of PTEN Expression is an Independent Poor Prognostic Factor in Non-small Cell Lung Cancer.: Seol Bong Yoo, Xianhua Xu, Hyun Ju Lee, Sanghoon Jheon, Choon Taek Lee, Gheeyoung Choe, Jin Haeng Chung; Korean J Pathol. 2011;45(4):329-335.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.329

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BACKGROUND
Alterations in the phosphatase and tensin homolog (PTEN) are correlated with tumor progression. Downregulation of PTEN is related to drug resistance of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the prognostic significance of PTEN in patients with NSCLC and its correlation with EGFR.
METHODS
Two hundred eighty eight surgically resected NSCLC samples, including 168 adenocarcinomas (ADCs), 99 squamous cell carcinomas (SCCs) and 21 other NSCLCs were analyzed for the PTEN. The results were correlated with other clinicopathological variables including EGFR amplification and mutation.
RESULTS
Loss of PTEN was detected in 42.4% of NSCLCs, specifically 28.6% of ADCs, 66.7% of SCCs, and 38.1% of others. Loss of PTEN was significantly associated with SCC, smoking, male gender, and higher stage. In a multivariate analysis, loss of PTEN was significantly associated with short progression-free survival (p=0.037). No association between PTEN and EGFR was observed.
CONCLUSIONS
These results suggest that loss of PTEN results in shorter progression-free survival in patients with NSCLC, and loss of PTEN is more associated with SCC, smoking, male gender, and higher T stage by the 7th tumor, node and metastasis staging system but not EGFR status.

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Molecular mechanisms underlying the regulation of tumour suppressor genes in lung cancer
Jia Yee Lee, Richie R. Bhandare, Sai H.S. Boddu, Afzal B. Shaik, Lakshmana Prabu Saktivel, Gaurav Gupta, Poonam Negi, Muna Barakat, Sachin Kumar Singh, Kamal Dua, Dinesh Kumar Chellappan
Biomedicine & Pharmacotherapy.2024; 173: 116275. CrossRef
Alterations in the PI3K Pathway Drive Resistance to MET Inhibitors in NSCLC Harboring MET Exon 14 Skipping Mutations
Philippe Jamme, Marie Fernandes, Marie-Christine Copin, Clotilde Descarpentries, Fabienne Escande, Angela Morabito, Valérie Grégoire, Matthieu Jamme, Simon Baldacci, David Tulasne, Zoulika Kherrouche, Alexis B. Cortot
Journal of Thoracic Oncology.2020; 15(5): 741. CrossRef
PTEN Tumor-Suppressor: The Dam of Stemness in Cancer
Francesca Luongo, Francesca Colonna, Federica Calapà, Sara Vitale, Micol E. Fiori, Ruggero De Maria
Cancers.2019; 11(8): 1076. CrossRef
PTEN in Lung Cancer: Dealing with the Problem, Building on New Knowledge and Turning the Game Around
Anastasios Gkountakos, Giulia Sartori, Italia Falcone, Geny Piro, Ludovica Ciuffreda, Carmine Carbone, Giampaolo Tortora, Aldo Scarpa, Emilio Bria, Michele Milella, Rafael Rosell, Vincenzo Corbo, Sara Pilotto
Cancers.2019; 11(8): 1141. CrossRef
PTEN expression is a prognostic marker for patients with non-small cell lung cancer: a systematic review and meta-analysis of the literature
Jian Xiao, Cheng-Ping Hu, Bi-Xiu He, Xi Chen, Xiao-Xiao Lu, Ming-Xuan Xie, Wei Li, Shu-Ya He, Shao-Jin You, Qiong Chen
Oncotarget.2016; 7(36): 57832. CrossRef
Alteration of the E-cadherin/β-Catenin Complex Predicts Poor Response to Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor (EGFR-TKI) Treatment
Seol Bong Yoo, Yu Jung Kim, Hyojin Kim, Yan Jin, Ping-Li Sun, Sanghoon Jheon, Jong Seok Lee, Jin-Haeng Chung
Annals of Surgical Oncology.2013; 20(S3): 545. CrossRef
High concordance of EGFR mutation status between histologic and corresponding cytologic specimens of lung adenocarcinomas
Ping‐Li Sun, Yan Jin, Hyojin Kim, Choon‐Taek Lee, Sanghoon Jheon, Jin‐Haeng Chung
Cancer Cytopathology.2013; 121(6): 311. CrossRef
Impact of HER2 and PTEN Simultaneous Deregulation in Non-small Cell Lung Carcinoma: Correlation with Biological Behavior
Ioannis Panagiotou, Stavros N. Georgiannos, Evangelos Tsiambas, Andreas Karameris, Marios Konstantinou, Andreas C. Lazaris, Nikolaos Kavantzas, George Vilaras, Efstratios Patsouris
Asian Pacific Journal of Cancer Prevention.2012; 13(12): 6311. CrossRef
Expression of the Mammalian Target of Rapamycin Pathway Markers in Lung Adenocarcinoma and Squamous Cell Carcinoma
Hyun-Soo Kim, Gou Young Kim, Sung-Jig Lim, Youn Wha Kim
Pathobiology.2012; 79(2): 84. CrossRef

ERCC1 Predicts a Poorer Platinum-based Chemotherapy Outcome but a Better Outcome for Uracil-Tegafur in the Resected Stage I-II NSCLC.: Han Suk Ryu, Xianhua Xu, Hyojin Kim, Jong Suk Lee, Sanghoon Jheon, Jin Haeng Chung; Korean J Pathol. 2011;45(1):45-52.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.45

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Abstract PDF: BACKGROUND
The role of excision repair cross-complementation group 1 (ERCC1) has been controversial in non-small cell lung cancer (NSCLC) patients who received adjuvant chemotherapy with a platinum agent. We investigated ERCC1 expression in stage I-II NSCLC to clarify its significance for adjuvant chemotherapy.
METHODS
The ERCC1 expression profile was evaluated by immunohistochemistry and compared according to adjuvant chemotherapeutic agents in 146 patients who underwent surgical resection for stage I-II NSCLC. The patients were divided into 3 groups; adjuvant chemotherapy with a platinum based agent (18.5%, 27/146); adjuvant chemotherapy with uracil-tegafur (UFT) (40.4%, 59/146); surgery-alone (41.1%, 60/146).
RESULTS
Nuclear ERCC1 expression was detected in 71.9% (105/146) of NSCLC and was significantly associated with a shortened survival period in the group 1 patients who received the platinum based regimen after surgery. The group 2 patients who received UFT showed the longest survival period, followed by the surgery-alone group (overall survival, p=0.049; disease-free survival [DFS], p<0.001).
CONCLUSIONS
These results suggest that stage I-II NSCLC patients with ERCC1 expression experience a shorter DFS period with adjuvant chemotherapy with a platinum based regimen and may benefit from adjuvant chemotherapy with UFT, instead of platinum after surgery.

Malignant Mesothelioma in Body Fluids: with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma.: Jin Ho Paik, Jin Haeng Chung, Baek Hui Kim, Gheeyoung Choe; Korean J Pathol. 2009;43(5):458-466.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.458

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Abstract PDF: BACKGROUND
Malignant mesothelioma (MM) is a rare malignant neoplasm occurring in pleura, pericardium, and peritoneum. The differential diagnosis between MM and metastatic adenocarcinoma (MA) causes diagnostic, staging, and therapeutic dilemmas. Herein, we investigated characteristic cytologic features of MM.
METHODS
Cytologic specimens of MM (n=10), MA (n=25), and reactive mesothelial hyperplasia (n=10) were retrieved and reviewed from archival materials in the Department of Pathology, Seoul National University Bundang Hospital from May 2003 to July 2008.
RESULTS
MM showed tumor cell clusters and singly scattered malignant tumor cells forming single cell populations with sparse reactive benign mesothelial cells. In contrast, MA showed distinct two cell populations of tumor cell clusters and scattered reactive mesothelial cells. Furthermore, MM frequently exhibited a characteristic long chain-like arrangement (hand-in-hand appearance) and intercellular windows, which were rarely evident in MA. Variable nuclear size, relatively consistent nuclear-cytoplasmic ratio, bior multi-nucleation, and lacy cytoplasmic borders were also frequently observed in MM.
CONCLUSIONS
Differential diagnosis of MM from MA in body fluids is possible based on meticulous examination of certain cytologic parameters, which could have significant implications in staging and treatment.

Differential Expression of Glut1 in Pulmonary Neuroendocrine Tumors: Correlation with Histological Grade.: Hyun Ju Lee, Seol Bong Yoo, Won Woo Lee, Doo Hyun Chung, Jeong Wook Seo, Jin Haeng Chung; Korean J Pathol. 2009;43(3):201-205.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.201

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Abstract PDF

BACKGROUND
Increased glucose uptake, a process that is mediated by glucose transporter (Glut1) proteins, is an important metabolic feature in a variety of cancer cells. The overexpression of Glut1 in human cancers is known to be related to a variety of histopathological parameters, including histological grade, proliferation rate, and lymphatic invasion. The principal objective of this study was to evaluate Glut1 expression in the spectrum of pulmonary neuroendocrine (NE) tumors including typical carcinoid tumor (TC), atypical carcinoid tumor (AC), large cell neuroendocrine carcinoma (LCNEC), and small cell carcinoma (SCC), and to characterize the relationship between Glut1 expression and the histologic grade of NE tumors.
METHODS
19 TC, 7 AC, 13 LCNEC, and 6 SCC patients were included in this study. The percentages of Glut1-positive tumor cells in these patients were determined. For statistical analysis, Glut1 expression was subdivided into a Glut1-low expression group (0-30%) and a Glut1-high expression group (31-90%).
RESULTS
In our subgroup analyses, the histological grade of pulmonary neuroendocrine (NE) tumors was significantly correlated with Glut1 expression; TC (n=19, 3.6+/-4.2%), AC (n=7, 20.0+/-4.9%), LCNEC (n=13, 60.0+/-21.1%), and SCC (n=6, 74.2+/-16.9%). Glut1-high expression was significantly associated with high-grade NE tumors such as LCNEC and SCC (n=19, 62.6+/-21.0%) (p=0.000).
CONCLUSIONS
The results of this study appear to indicate that Glut1 overexpression is a consistent feature of high-grade NE lung tumors.

Citations

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GLUT1: A novel tool reflecting proliferative activity of lung neuroendocrine tumors?
Nazim Benzerdjeb, Pascal Berna, Henri Sevestre
Pathology International.2017; 67(1): 32. CrossRef
Oncocytic carcinoid tumor of the lung with intense F-18 fluorodeoxyglucose (FDG) uptake in positron emission tomography–computed tomography (PET/CT)
Yuki Tanabe, Yoshifumi Sugawara, Rieko Nishimura, Kohei Hosokawa, Makoto Kajihara, Teruhiko Shimizu, Tadaaki Takahashi, Shinya Sakai, Shigeki Sawada, Motohiro Yamashita, Haruhiko Ohtani
Annals of Nuclear Medicine.2013; 27(8): 781. CrossRef

Pathological Analysis of 1,000 Cases of Transrectal Ultrasoundguided Systematic Prostate Biopsy: Establishment of New Sample Processing Method and Diagnostic Utility of Immunohistochemistry.: Chang Lim Hyun, Hee Eun Lee, Haeryung Kim, Hye Seung Lee, So Yeon Park, Jin Haeng Chung, Gheeyoung Choe; Korean J Pathol. 2006;40(6):406-419.

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Abstract PDF: BACKGROUND
We developed a new processing method for extended prostate needle biopsy, and evaluated diagnostic utility of routine immunohistochemistry in 1,000 consecutive unselected cases of transrectal ultrasound-guided systematic prostate biopsy.
METHODS
Four to five biopsy cores were embedded in one paraffin block. All the biopsy cores were immunohistochemically stained with basal cell markers.
RESULTS
The new sample processing method was technically perfect for making a diagnosis from extended prostate needle biopsy. Among 1,000 cases, there were 323 cases (32.3%) of adenocarcinoma, 5 cases of other malignant tumors, 9 cases of high-grade prostatic intraepithelial neoplasia without a carcinoma, and only 8 cases of atypical small acinar proliferation. Among the 323 cases of adenocarcinoma, there were 38 cases (11.8%) of microcarcinomas <0.1 cm and 101 cases (31.3%) of small adenocarcinomas <0.3 cm in length. In the needle biopsy specimens, 59 cases (18.3%) were classified as clinically insignificant carcinomas. Among them, 37 cases underwent radical prostatectomy, which turned out to be clinically significant carcinomas in 24 cases (64.9%).
CONCLUSIONS
Routinely performed immunohistochemistry combined with the new sample processing method is very effective for detecting microscopic carcinoma foci as well as differentiating carcinoma from benign conditions mimicking cancer.

Immunohistochemical Characteristics of Kaposi Sarcoma and its Mimicries.: Kyoung Bun Lee, Hye Seung Lee, Hee Eun Lee, So Yeon Park, Jin Haeng Chung, Gheeyoung Choe, Woo Ho Kim, Kye Yong Song; Korean J Pathol. 2006;40(5):361-367.

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Abstract PDF: BACKGROUND
The differential diagnosis of Kaposi sarcoma includes many disease that range from benign disease to malignant tumors. However, little information is available about the immunohistochemical characteristics of Kaposi sarcoma.
METHODS
The expressions of 13 various proteins (HHV-8 LNA-1, Ki-67, bcl-2, p53, CD31, CD34, factor VIII, D2-40, vimentin, SMA, S-100, EMA, and c-kit) were evaluated immunohistochemically in 49 vascular tumors including 16 Kaposi sarcomas, 8 angiosarcomas, 2 hemangioendotheliomas, and 23 benign vascular tumors with using the tissue array method.
RESULTS
All 16 cases of Kaposi sarcoma showed nuclear staining for HHV-8 LNA-1, whereas all the cases of angiosarcoma and benign vascular lesions were negative for HHV-8 LNA-1 (p<0.001). All Kaposi sarcoma were positive for D2-40, which is a marker of lymphatic differentiation, but 25% of the benign vascular lesions and 30.4% of the angiosarcoma were positive for D2-40 (p<0.001). The mean proliferation index as assessed by Ki-67 immunostaining revealed no difference between the benign and malignant vascular lesions (p>0.05). No Kaposi sarcoma showed a bcl-2 expression, but 62.5% of the angiosarcomas and 21.7% of the benign vascular tumors had bcl-2 expressions (p=0.005).
CONCLUSIONS
Immunohistochemical detection of HHV-8 LNA-1 and D2-40 are useful tools to differentiate Kaposi sarcoma from other vascular tumors.

Cytologic Findings of Chordoma in Fine Needle Aspiration Cytology.: Han Suk Ryu, Min Suk Kim, Hwa Jung Ha, Jung Soon Kim, Myung Soon Shin, Sunhoo Park, Jin Haeng Chung, Jae Soo Koh, Seung Sook Lee; Korean J Cytopathol. 2004;15(1):45-51.

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Abstract PDF: It is important to recognize the pathognomonic cytologic findings of chordoma, because of overlapping cytologic features between chordoma, chondrosarcoma, myxofibrillary ependymoma, and metastatic adenocarcinoma. We reviewed the cytomorphologic features of 5 cases of chordoma diagnosed by fine needle aspiration cytology at Korean Cancer Center Hospital from 1987 to 2003. Clinical and radiographic findings of each case were reviewed. Four males and one female (29-54 years) had tumors involving the sacrum. Pain was the presenting symptom in 4 cases. The three cases showed moderate to high cellularity. In all cases, typical physaliferous cells with or without cytoplasmic processes were noted. In two cases, the background was myxoid with single scattered cells. Cell clusters showing cord-like arrangement were occasionally seen. The single or clustered cells showed mild cellular pleomorphism with slightly increased nuclear/cytoplasmic ratio. Mitotic figures were not seen. In our review, the recognition of physaliferous cells is the most important feature to diagnose chordoma and to differentiate it from other lesions mimicking chordoma.

Fine Needle Aspiration Cytologic Features of Follicular Lymphoma.: Jin Haeng Chung, Hwa Jeong Ha, Sun Hoo Park, Jae Soo Koh, Min Suk Kim, Seung Sook Lee, Kyung Ja Cho; Korean J Cytopathol. 2002;13(2):60-65.

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Abstract PDF: The accuracy of fine needle aspiration cytology(FNAC) for the diagnosis of follicular lymphoma was investigated by a review of 13 FNAC specimens from 10 patients. All patients included in this study were confirmed by surgical biopsy preceded by FNAC. Three aspirates were unsatisfactory because of scanty cellularity. Among the remaining 10 cases, 5(50%) were diagnosed as lymphoma, 3(30%) as reactive hyperplasia, one(10%) as metastatic small cell carcinoma, and one(10%) as granulomatous inflammation. Cytologic distinction between follicular lymphoma and reactive hyperplasia is very difficult with cytomorphology alone. Compared to reactive hyperplasia, the characteristic cytologic features such as relatively homogeneous cellular constituent, paucity of tingible body macrophages and lymphohistiocytic aggregates, and less mitotic activity in follicular lymphoma are important findings to prevent false negative diagnosis. In addition, lymphoglandular bodies are useful in distinguishing malignant epithelial tumor from lymphoid lesion.

Cytologic Findings of Primary Small Cell Carcinoma of the Urinary Bladder: A case report.: Mi Seon Kwon, Geung Hwan Ahn, Jin Haeng Chung, Seung Sook Lee, Jae Soo Koh; Korean J Cytopathol. 2001;12(2):121-126.

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Abstract PDF: Primary small cell carcinoma of the urinary bladder is a rare malignant tumor. A more rapidly fatal course may be seen in advanced stages of small cell carcinoma as compared to similar stages of urothelial carcinoma. It is very important to recognize this distinct form of bladder cancer by urinary cytology. The differential diagnosis of small cell carcinoma of the urinary bladder includes metastatic small cell carcinoma, urothelial carcinoma, and primary or secondary malignant lymphoma. This article highlights the urinary cytologic diagnosis of a case of primary small cell carcinoma. A 59-year-old male presented with gross hematuria for five months. Urinary cytology showed high cellularity consisting of tiny monotonous tumor cells in the necrotic background. The tumor cells occurred predominantly singly, but a few in clusters. The cytoplasm was so scanty that only a very narrow rim of it was seen. The nuclei were oval or round and had finely stippled chromatin. Rarely, the nuclei contain visible nucleoli. Frequently cell molding was noted in clusters. Many single cells demonstrated nuclear pyknosis or karyorrhexis. The histologic findings of transurethral resection and partial cystectomy specimen were those of small cell carcinoma. Cytologic distinction may be very difficult but careful attention to clinical features and cellualr details can classify these neoplasms correctly.

Fine Needle Aspiration Cytology of Primary Malignant Lymphoma of the Thyroid Gland: A Case Report.: Mi Seon Kwon, Seung Sook Lee, Jae Soo Koh, Jin Haeng Chung, Kyo Young Lee; Korean J Cytopathol. 2001;12(1):67-71.

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Abstract: Primary malignant lymphoma of the thyroid gland is uncommon malignancies. Its fine needle aspiration cytology (FNAC) findings are rarely described in the literature. This article highlights the FNAC diagnosis of primary malignant lymphoma of the thyroid gland. A 70-year-old female presented with a rapidly enlarging thyroid mass of five months' duration. FNAC smears showed low cellularity consisting of predominantly atypical enlarged lymphoid cells admixed with a few small lymphocytes, plasma cells, and oncocytic cells. Some disrupted lymphoid cells were also present. The tumor cells infiltrated into the thyroid follicular epithelium forming lymphoepithelial lesion. The cytologic appearance showed a diffuse mixture of cell types with only a few small, mature lymphocytes and many enlarged lymphoid cells. The enlarged lymphoid cells were atypical and pleomorphic with nuclear clefting and irregularities. Grossly, the left lobe of the thyroid was nearly replaced by a diffuse firm to soft solid mass with smooth tan fish-flesh homogeneous cut surface. Histological diagnosis was diffuse large B-cell lymphoma with areas of marginal zone B-cell lymphoma of MALT type.

Intrauterine Infection as a Cause of the Neonatal Pulmonary Injury and Bronchopulmonary Dysplasia.: Jin Haeng Chung, Jeong Wook Seo; Korean J Pathol. 2000;34(6):431-436.

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Abstract PDF: The pathogenetic role of intrauterine infection to the neonatal pulmonary injury and bronchopulmonary dysplasia was assessed by studying the interleukin-6 (IL-6) level in the umbilical cord blood and the early morphologic changes of the neonatal lung. Patients were grouped into bronchopulmonary dysplasia (4 cases), chorioamnionitis without chronic lung injury (4 cases), and 6 cases without morphologic evidence of chronic lung injury or placental inflammation. IL-6 level of umbilical cord blood was higher in babies with bronchopulmonary dysplasia (17.7 pg/ml) compared to those with chorioamnionitis (4.7 pg/ml) or those with morphologically normal lung and placenta (6.2 pg/ml). Morphologic parameters of neonatal pulmonary injury were hyaline membrane, terminal bronchiole inflammation, terminal bronchiole regeneration, alveolar collapse and fibroblastic proliferation. Bronchiolar regeneration was the most peculiar feature seen in the lung with bronchopulmonary dysplasia. Alveolar collapse and interstitial fibroblastic reaction were commonly seen in bronchopulmonary dysplasia. The postnatal age at death was higher in those with bronchopulmonary dysplasia, although the occurrence of the morphologic changes was related with the chronicity of those lesions. These findings suggest that intrauterine infection is an aggravating factor for the neonatal pulmonary injury and bronchopulmonary dysplasia, although the early stage of the lung injury is not a definitive indicator for the progressive pulmonary damage leading to the bronchopulmonary dysplasia.

Fine Needle Aspiration Cytology of Metastatic Epithelial-Myoepithelial Carcinoma of the Scalp: A Case Report .: Mi Seon Kwon, Seung Sook Lee, Jae Soo Koh, Jin Haeng Chung; Korean J Cytopathol. 2000;11(2):93-97.

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Abstract PDF: Epithelial-myoepithelial carcinoma is an uncommon, low grade malignant epithelial neoplasm and metastasis is exceedingly rare. This article highlights the fine needle aspiration cytology(FNAC) of a case of metastatic epithelial-myoepithelial carcinoma of the scalp. A 51-year-old female presented with the left parietotemporal scalp mass two months after the left parotidectomy for epithelial-myoepithelial carcinoma. FNAC from the scalp mass showed a biphasic population of ductal epithelial and myoepithelial origin. These epithelial aggregates were numerous and formed a distinct three dimensional architecture in the background of numerous naked nuclei. The three dimensional architectures were predominantly composed of tightly cohesive eosinophilic ductular epithelial cells which tended to aggregate, overlap, and form tubules. Clear myoepithelial cells in three dimensional tissue fragment were inapparent and a few were attached to the periphery of the fragments. A few myoepithelial cells with clear abundant vaculoated cytoplasm were found in the foamy background. The cytological diagnosis was metastatic epithelial-myoepithelial carcinoma. The histologic findings of the scalp mass were those of typical epithelial-myoepithelial carcinoma. Cytologic distinction of epithelial-myoepithleial carcinoma, pleomorphic adenoma, and adenoid cystic carcinoma may be very difficult but careful attention to clinical features and cellualr details can classify these neoplasms correctly.

Intraductal Cystic Hypersecretory Carcinoma of the Breast: A case report.: Jin Haeng Chung, Seung Sook Lee, Jae Soo Koh, Kyung Ja Cho, Jong Inn Lee; Korean J Pathol. 1999;33(2):137-140.

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Abstract: The cystic hypersecretory duct carcinoma of the breast was first described in 1984 by Rosen and Scott and warrants separate discussion because of its unusual pathological features. It is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma or mucocele-like tumor. We present a case report of intraductal cystic hypersecretory carcinoma of the breast with hormone receptor and oncogene study. The histologic differential diagnosis, with an emphasis on benign lesions that may have a predominant cystic component, is also discussed.

Comparison of Qualified Diagnosis of "Atypical Squamous Cells of Undetermined Significance" with Subsequent Biopsy .: Jae Soo Koh, Jin Haeng Chung, Seung Sook Lee, Kyung Ja Cho; Korean J Cytopathol. 1999;10(1):1-5.

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Abstract PDF: To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squa mous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75% in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant asso ciations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.

Image Standardization and Determination of Gray Level Threshold in the Assessment of the Myocardial Fibrosis by the Computerized Image Analysis.: Nam Young Lee, Young Sik Park, Jin Haeng Chung, Jeong Wook Seo; Korean J Pathol. 1998;32(7):494-503.

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Abstract: The computerized image analysis is a useful tool for the quantitative assessment of histopathologic findings. In contrast to the usual microscopic examination by pathologists, the computerization should be accompanied with the standardization process of the image. We developed an algorithm to standardize images and to determine the optimal gray level threshold, using a myocardial fibrosis model. Sirius red staining was more convenient for the image analysis than Masson's trichrome staining because of a better contrast with the surrounding structures. To get an optimal measurement, light intensity was standardized at each of the fibrosis, myocardium and background. In this study, the most promising method to determine the degree of fibrosis was that of revising the background without tissue to a gray level of 200, obtaining a green component of the color image, revising the myocardial fiber to 163, and defining a partial ratio as fibrosis index when the gray level threshold was 120. These threshold levels and parameters were determined after drawing the binarization index curves according to the change of the gray level threshold and by the morphological examination of the actual binarization figures overlaid to the original color image. Through these processes we could get a consistent result on the myocardial fibrosis and we expect a similar principle applies when we analyze color images in the histopathologic quantitation by computerized image analysis.

Antibiotics-associated Pseudomembranous Colitis: A Clinico-Pathologic Analysis with Special Reference to Non-pseudomembranous Mucosal Change.: Jin Haeng Chung, Yong Il Kim; Korean J Pathol. 1997;31(4):308-313.

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Abstract PDF: The presence of volcano-shaped pseudomembrane(PM) formations above the inflamed mucosa has been referred to as the unique biopsy criterion of the pseudomembranous colitis, but PM might be lost during the bowel preparation, and such loss leads pathologists to erroneous interpretations of the endoscopic biopsy specimens. The purpose of this paper is to identify the additional diagnostic clue other than PM among various histologic features in pseudomembranous colitis. We reviewed sigmoidoscopic biopsy specimens from 13 cases of antibiotics-associated pseudomembranous colitis which was confirmed to reveal characteristic PM by endoscopy aside from the clinical history of antibiotics administration. The cases were divided into two groups: the presence of PM (n=7) and its absence (n=6). Both groups showed basically identical histology, which included features of glandular distension, epithelial necrosis, crypt abscess, regenerative glands and mucous plug within the necrotic/dilated glands. Mucous plugs within the necrotic/ dilated glands were found in all cases and seemed to be the most characteristic microscopic feature. Ten cases of resected chronic ulcerative colitis in the active stage were compared for a differential diagnosis of crypt abscess-associated mucosal change. None of them revealed necrotic gland with mucous plugs, although crypt abscess formation was common in both conditions. We conclude that presence of mucous plugs in the dilated/necrotic glands is a useful diagnostic clue even though the biopsy specimens fail to demonstrate PM.

Congenital Anomalies Observed by Autopsies at the Seoul National University Children's Hospital.: Jin Haeng Chung, Jeong Wook Seo, Chong Jai Kim, Chul Woo Kim, Je G Chi; Korean J Pathol. 1997;31(2):93-99.

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Abstract PDF: A retrospective analysis was performed on the 968 cases of fetal or pediatric autopsies over five year period (1990-1994), at the Seoul National University Children's Hospital. Age/mode distribution of cases were artificial abortus(30.6%), spontaneous abortus(12.0%), stillbirth(21.9%), neonates(29%), infants(2.8%) and children(0.9%). Male/female ratio was 1.21. Overall incidence of congenital anomalies was 60.8% and 34.0% of all cases had anomalies involving multiple organ systems. Percentage of cases with any anomaly was 71.6% in artificial abortus, 35.3% in spontaneous abortus, 59% in still births, 65.5% in neonates and 38.9% in infant and children. Common organ systems involved were the cardiovascular system (39.0%), musculoskeletal system (23.6%), nervous system (22.6%), gastrointestinal system (19.9%), and urinary system (14.6%). From these results, we found that the congenital anomalies were most significant diseases of the perinatal period and the cardiovascular anomalies were the most common anomalies of them.

Leydig Cell Tumor of the Ovary: Report of a case.: Jin Haeng Chung, Kyu Rae Kim, Young Hyeh Ko; Korean J Pathol. 1996;30(11):1050-1052.

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Abstract PDF: Leydig cell tumor of the ovary is a very rare tumor which usually occurs in the postmenopausal age, and which is frequently associated with virilization. It has been classified as a lipid cell tumor due to the presence of intracytoplasmic lipids. However, since up to 25% of these tumors contain little or no lipid, the new term "steroid cell tumor" is proposed for this type of neoplasm. We report a case of Leydig cell tumor of the ovary in a 16 year old girl. The patient exhibited recently recognized hirsuitism and secondary amenorrhea. Physical examination revealed moderate obesity with moderate amounts of coarse hair over the whole body and a deepening of the voice. Testosterone and dehydroepiandrosterone sulfate levels were markedly elevated in the peripheral blood. Pelvic ultrasonography revealed a right ovarian tumor. The resected ovary showed a well demarcated, golden yellow to orange colored solid mass, measuring 7 cm on the cut surface. Microscopically, the tumor was composed of solid and diffuse sheets of tumor cells having abundant eosinophilic cytoplasm, and large round nuclei with frequent crystalloids of Reinke in the cytoplasm. To our knowledge this is the first case of Leydig cell tumor of the ovary in a young girl in the Korean literature.

Benign Lymphoepithelial Cyst: A case report.: Jin Haeng Chung, Gyeong Hoon Kang, Je G Chi; Korean J Pathol. 1996;30(6):551-553.

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Abstract PDF: An intraparotid benign lymphoepithelial cyst is a rare disease characterized by unilateral painless swelling of parotid region. The histogenesis is controversial. Surgical excision is recommended for diagnosis and curative treatment. We present a case of benign lymphoepithelial cyst arising in a patient with neurofibromatosis. A 46-year-old woman presented with a slowly growing multilocular cystic mass in the left cheek. The cystic mass measured 4 cm in maximal outer diameter and the cystic wall was thick and yellowish pale to gray, soft with well circumscribed margin. Microscopically, the multilocular cyst was lined by stratified squamous epithelium for the most part and underlying lymphoid tissue aggregates with follicles and sharply demarcated from adjacent salivary parenchyma which is of normal appearance and without lymphoid aggregates. Since this lesion is absolutely benign, it is important to separate this benign cyst from cystic salivary gland tumors.

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