Journal of Pathology and Translational Medicine

Mee Joo

27 Articles

Diagnostic Utility of AMACR and Claudin-7 for the Classification of Renal Cell Carcinoma.: Sang Hwa Shim, Mee Joo, Han Seong Kim, Sun Hee Chang, Ki Young Kwon; Korean J Pathol. 2010;44(2):155-161.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.155

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Abstract PDF: BACKGROUND
The histologic classification of renal cell carcinoma (RCC) is based on the cytoarchitectural features, yet sometimes this requires correlation with the immunophenotype. Alpha-methylacyl-CoA racemase (AMACR) and claudin-7 have recently been introduced as useful markers that are frequently expressed in papillary RCC (PRCC) and chromophobe RCC (ChRCC), respectively. The aims of this study are to evaluate the expressions of AMACR and claudin-7 in RCCs and to investigate whether they are helpful for making the histological classification of RCCs.
METHODS
Immunohistochemistry for CD10, RCC marker, cytokeratin (CK)7, CD117, AMACR and claudin-7 was performed for 104 RCCs, and these consisted of 54 clear cell RCCs (CCRCC), 26 PRCCs and 24 ChRCCs.
RESULTS
For diagnosing PRCC, the sensitivity and specificity of AMACR were 92.3% and 71.8%, respectively, and using AMACR(+)/CK7(+), the specificity was increased by 23.1% to 94.9%. For diagnosing ChRCC, the sensitivity and specificity of claudin-7 were 91.7% and 78.8%, respectively, and using claudin-7(+)/AMACR(-), the specificity was significantly improved (to 96.3%). For diagnosing CCRCC, CK7(-)/claudin-7(-)/CD117(-) was the most useful immunohistochemical panel (sensitivity, 96.3%; specificity, 98%).
CONCLUSIONS
AMACR and claudin-7 are helpful markers for the histologic classification of RCCs, and their diagnostic utility is strengthened when they are used as an immunohistochemical panel, AMACR(+)/CK7(+) for PRCC, claudin-7(+)/AMACR(-) for ChRCC and CK7(-)/claudin-7(-)/CD117(-) for CCRCC.

A Case of Endocrine Mucin-Producing Sweat Gland Carcinoma Co-existing with Mucinous Carcinoma: A Case Report.: Sunhee Chang, Sang Hwa Shim, Mee Joo, Hanseong Kim, Yong Kyu Kim; Korean J Pathol. 2010;44(1):97-100.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.97

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An endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare skin tumor that most commonly occurs on the eyelids of elderly women. This tumor is morphologically analogous to endocrine ductal carcinoma in situ and solid papillary carcinoma of the breast. We describe one case of a 51-year-old male with an EMPSGC co-existing with mucinous carcinoma of the eyelid. The tumor was composed of dilated ducts with a smooth border and was partially filled with a papillary proliferation. Tumor cells were uniform, small-to-medium in size, and oval-to-polygonal with light eosinophilic cytoplasm. Nuclei were bland with diffusely stippled chromatin and inconspicuous nucleoli. Tumor cells expressed chromogranin, synaptophysin, estrogen and progesterone receptors, cytokeratin 7, and epithelial membrane antigen.

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A Case of Endocrine Mucin-Producing Sweat Gland Carcinoma of the Eyelid
Ji Eon Kang, Sung Eun Kim, Suk-Woo Yang
Journal of the Korean Ophthalmological Society.2023; 64(2): 149. CrossRef
Endocrine mucin-producing sweat gland carcinoma: a systematic review and meta-analysis
Michael H. Froehlich, Keith R. Conti, Ivy I. Norris, Jordan J. Allensworth, Nicole A. Ufkes, Shaun A. Nguyen, Evelyn T. Bruner, Joel Cook, Terry A. Day
Journal of Dermatological Treatment.2022; 33(4): 2182. CrossRef
Next-generation sequencing analysis suggests varied multistep mutational pathogenesis for endocrine mucin-producing sweat gland carcinoma with comments on INSM1 and MUC2 suggesting a conjunctival origin
Joseph G. Mathew, Anita S. Bowman, Jad Saab, Klaus J. Busam, Kishwer Nehal, Melissa Pulitzer
Journal of the American Academy of Dermatology.2022; 86(5): 1072. CrossRef
Endocrine mucin‐producing sweat gland carcinoma and associated primary cutaneous mucinous carcinoma: Review of the literature
Rebecca Tian Mei Au, Manish M. Bundele
Journal of Cutaneous Pathology.2021; 48(9): 1156. CrossRef
An Update on Endocrine Mucin-producing Sweat Gland Carcinoma
Meghana Agni, Meisha L. Raven, Randy C. Bowen, Nora V. Laver, Patricia Chevez-Barrios, Tatyana Milman, Charles G. Eberhart, Steven Couch, Daniel D. Bennett, Daniel M. Albert, R. Nick Hogan, Paul O. Phelps, Hillary Stiefel, Norberto Mancera, Martin Hyrcza,
American Journal of Surgical Pathology.2020; 44(8): 1005. CrossRef
A Case of Endocrine Mucin-Producing Sweat Gland Carcinoma: Is it Still an Under-Recognized Entity?
Khaled A. Murshed, Mohamed Ben-Gashir
Case Reports in Dermatology.2020; 12(3): 255. CrossRef
Endocrine Mucin-Producing Sweat Gland Carcinoma, a Histological Challenge
Mary Anne Brett, Samih Salama, Gabriella Gohla, Salem Alowami
Case Reports in Pathology.2017; 2017: 1. CrossRef
Endocrine mucin‐producing sweat gland carcinoma occurring on extra‐facial site: a case report
Jia‐Huei Tsai, Tzu‐Lin Hsiao, Yi‐Ying Chen, Cheng‐Hsiang Hsiao, Jau‐Yu Liau
Journal of Cutaneous Pathology.2014; 41(6): 544. CrossRef
Endocrine Mucin-Producing Sweat Gland Carcinoma
Catharine A. Dhaliwal, Antonia Torgersen, Jonathan J. Ross, James W. Ironside, Asok Biswas
The American Journal of Dermatopathology.2013; 35(1): 117. CrossRef

Giant Cell Tumor-like Proliferation Associated with Renal Staghorn Calculi: A Case Report.: Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak, Sang Hwa Shim, Sung Yong Cho; Korean J Pathol. 2009;43(2):182-184.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.2.182

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Abstract PDF

A 62-year-old man with left flank pain and hematuria was shown to have a staghorn stone in left renal pelvis. Grossly, renal pelvis and calyces were markedly dilated with cystic and hemorrhagic degeneration and renal parenchyma was atrophied. A tumor-like mass was located in a hemorrhagic cyst of the renal upper pole. This mass consisted of giant cells and stromal cells mimicking a giant cell tumor of bone. This giant cell tumor-like proliferation may represent a response to hemorrhage into a cystic cavity. Recognition of this finding is important to avoid the over-diagnosis of neoplastic lesions.

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Imaged guided surgery during arteriovenous malformation of gastrointestinal stromal tumor using hyperspectral and indocyanine green visualization techniques: A case report
Tristan Wagner, Onur Mustafov, Marielle Hummels, Anders Grabenkamp, Michael N Thomas, Lars Mortimer Schiffmann, Christiane J Bruns, Dirk L Stippel, Roger Wahba
World Journal of Clinical Cases.2023; 11(23): 5530. CrossRef

The Expression of Galectin-3 and Galectin-7 in Epithelial Dysplasia and Adenocarcinoma of the Stomach.: Ji Eun Kwak, Han Seong Kim, Mee Joo, Sun Hee Chang, Sang Hwa Shim, Hye Ran Lee; Korean J Pathol. 2008;42(6):365-372.

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Abstract PDF: BACKGROUND
Galectin-3 and galectin-7 may play roles in human carcinogenesis. The aim of this study was to investigate the expressions of galectin-3 and galectin-7 in gastric dysplasia and adenocarcinoma. METHODS: We examined the expressions of galectin-3, galectin-7, and P53 in nonneoplastic gastric mucosa, gastric epithelial dysplasia (GED), and adenocarcinoma by immunohistochemistry. Twenty cases of nonneoplastic gastric mucosa, 20 cases of low grade GED, 20 cases of high grade GED, 40 cases of early gastric cancer (EGC), and 60 cases of advanced gastric cancer (AGC) are included for study. RESULTS: In the nonneoplastic tissue, only galectin-3 was expressed in the intestinal metaplasia. Galectin-7 was not stained in the nonneoplastic gastric mucosa. Galectin-3 was expressed in 3 cases of low grade GED (15%), 13 cases of high grade GED (65%), 2 cases of EGC (5%), and 5 cases of AGC (8%), respectively. Galectin-7 was expressed in 2 cases of low grade GED (10%), 3 cases of high grade GED (15%), and 4 cases of EGC (10%), respectively. However, it was not expressed in AGC.
CONCLUSIONS
Based on our results, the expressions of galectin-3 and galectin-7 may contribute to the development of gastric epithelial dysplasia and early gastric cancer, rather than contributing to the progression of gastric adenocarcinoma.

Pancreatic Pseudocyst with Splenic Involvement: A Case Report.: Jeong Hwan Chun, Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak, Sang Hwa Shim, Chul Nam Kim, Soon Joo Cha; Korean J Pathol. 2008;42(6):405-408.

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Abstract PDF: There have been a few reported cases of pancreatic pseudocyst with involvement of adjacent structures including the stomach, duodenum, and even the mediastinum. An intrasplenic pancreatic pseudocyst is an uncommon complication of acute or chronic pancreatitis. We report a case of pancreatic pseudocyst with splenic involvement in a 69-year-old man with a review of literatures. Abdominal CT revealed a 4 cm sized cyst at the pancreatic tail which was extending into the splenic hilum and splenic parenchyma. Distal pancreatectomy and splenectomy was performed. Pathologic findings demonstrated a pseudocyst of pancreatic tail which communicated with the infacted splenic parenchyma. Also vasculitis, endothelial hyperplasia and medial calcification of the splenic artery were observed.

A Case Report of Cutaneous Coccidioidomycosis.: Sunhee Chang, Sang Hwa Shim, Ji Eun Kwak, Mee Joo, Hanseong Kim, Hai Jin Park, Yee Gyung Kwak, Je G Chi; Korean J Pathol. 2008;42(4):223-225.

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Abstract PDF: Coccidioidomycosis, which results from inhaling the spores of Coccidioides species, is endemic in the southwestern United States. The primary infection site is the lung, and dissemination of the disease can occur. We report a case of cutaneous coccidioidomycosis in a 79-year-old Korean woman who presented with purpura on both lower extremities, but no pulmonary symptoms and no history of visiting an endemic area. Microscopically, skin biopsy showed multiple aggregates of granulomas in the dermis. Numerous multinucleated giant cells were associated with the granulomas. Mature and immature fungal spherules, which were 20 to 30 micrometer in diameter, were present inside and outside the multinucleated giant cells.

Fibrovascular Polyp of the Hypopharynx: A Case Report.: Sunhee Chang, Sang Hwa Shim, Ji Eun Kwak, Mee Joo, Hanseong Kim, Bum Jo Jung, Joong Wook Shin, See Young Park, Kyung Ja Cho, Je G Chi; Korean J Pathol. 2008;42(4):226-228.

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Abstract PDF: We report here on a case of fibrovascular polyp arising in the hypopharynx of a 62-year-old man. Laryngomicroscopic surgery with laser ablation was performed to excise the mass. Histopathologically, the surface of the polyp was covered with mature squamous epithelium. The polyp showed a characteristic lobular proliferation of mature adipose tissue that was separated by myxoid or collagenous connective tissue. Some scattered skeletal muscle bundles were seen in the central portions of the polyp and these bundles were surrounded by a concentric proliferation of the spindle cells; this was reminiscent of Pacinian corpuscles. Regarding their location and the intermingled pattern of proliferating tissues, it is more plausible that the skeletal muscle is a hamartomatous component rather than entrapped, preexisting tissue.

A Diagnostically Challenging Case of an Infarcted Adenomatoid Tumor of the Epididymis.: Sunhee Chang, Sang Hwa Shim, Ji Eun Kwak, Mee Joo, Hanseong Kim, Je G Chi, Keon cheol Lee; Korean J Pathol. 2008;42(4):229-231.

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Abstract PDF: We describe a case of an infarcted adenomatoid tumor of the epididymis that was challenging to diagnose. A 20-year-old man presented with acute left scrotal pain. He was found to have a 2x1.5x1 cm tumor that was relatively well circumscribed on gross examination. There was a central necrotic area that exhibited gaping spaces and ghost outlines of epithelial cells. The periphery of the necrotic lesion showed focally viable adenomatoid tumor. The majority of the tissue adjacent to the necrosis consisted of granulation tissue, fibroblastic and myofibroblastic proliferation, and neutrophils. The fibroblasts and myofibroblasts showed plump nuclei, often with small nucleoli. No mitotic activity was present. The differential diagnosis for an infarcted adenomatoid tumor includes malignant mesothelioma, inflammatory myofibroblastic tumor, and inflammatory conditions. The key to diagnosing an infarcted adenomatoid tumor is to consider it in the differential diagnosis of any spindle cell tumor with necrosis occurring in the genital tract.

Florid von Brunn Nests of the Urinary Bladder: A Case Report.: Han Seong Kim, Ji Eun Kwak, Sang Hwa Shim, Mee Joo, Sun Hee Chang, Je G Chi, In Rae Cho; Korean J Pathol. 2008;42(3):169-171.

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Abstract PDF: Among benign proliferations of the urinary bladder, von Brunn nests and cystitis cystica et glandularis are common. Sometimes florid proliferation of von Brunn nests makes an intravesical mass, which mimics tumorous lesions. We report here on a case of florid von Brunn nests, occurred in the 34-year-old man with hematuria. Radiological and cystoscopic examinations reveal a polypoid-papillary lesion and transurethral resection was then performed. Pathologically, prominent proliferations of urothelial cell nests were found deep in the lamina propria. Neither significant cytologic atypia nor muscle invasion was noted. Florid von Brunn nests should be considered both clinically and pathologically in the differential diagnosis of a intravesical mass.

Synchronous Development of Gastrointestinal Stromal Tumor and Arteriovenous Malformation in the Jejunum: A Case Report.: Sang Hwa Shim, Yoon Hee Han, Ji Eun Kwak, Sun Hee Chang, Hanseong Kim, Je G Chi, Mee Joo; Korean J Pathol. 2008;42(3):185-188.

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Abstract PDF: Vascular malformations associated with neoplasms are extremely rare. Herein we report an extraordinary coincidence of arteriovenous malformation (AVM) and gastrointestinal stromal tumor (GIST) in the jejunum. A 44-year-old woman presented with melena and anemia. Abdominal computed tomography revealed a highly vascularized, strong early arterial enhancing soft tissue mass in the jejunum, which was confirmed by angiography to be an AVM supplied by the distal jejunal branch of the superior mesenteric artery. An emergency operation was performed due to active gastrointestinal (GI) bleeding. The resected jejunum showed a protruding, mostly solid subserosal mass. The mass was confirmed to be a spindle cell type GIST and was intermingled with the AVM located in the overlying submucosa and muscularis propria. To our knowledge, this is the first reported case of an AVM associated with a GIST. This case masqueraded radiologically as an AVM alone and presented clinically with GI bleeding.

Florid Cystic Endosalpingiosis of the Uterus: A Case Report.: Sang Hwa Shim, Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak; Korean J Pathol. 2008;42(3):189-191.

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Abstract PDF: A 54-year-old woman presented with vaginal bleeding. On gynecologic and radiologic examinations, bilateral cystic ovarian tumors were suspected. A laparoscopic examination revealed multiple cysts involving both the uterine horns and the posterior surface of the uterus. These were removed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Microscopically, multiple cysts were identified in the subserosal layer of the uterus, and they were lined with benign tubal type epithelium surrounded by a smooth muscle wall. These features were consistent with "florid cystic endosalpingiosis". Considering the location of the lesion, the lesion has to be distinguished from other benign cystic lesions of the uterus and adnexa, including multicystic mesothelioma, serous cystadenoma and mucinous cystadenoma. Awareness of this lesion will facilitate a correct diagnosis by both the clinician and pathologist.

Combined Xanthogranulomatous Urachitis and Bullous Cystitis: A Case Report.: Ji Eun Kwak, Han Seong Kim, Mee Joo, Sun Hee Chang, Sang Hwa Shim, Je G Chi, In Rae Cho; Korean J Pathol. 2008;42(1):41-44.

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Abstract PDF: Xanthogranulomatous inflammation of the urachus is a very rare benign chronic inflammatory disease of an unknown etiology. Herein we report a case of a 31-year-old woman who complained of lower abdominal pain and dysuria. Cystoscopy revealed a bullous change at the dome of the urinary bladder. MRI revealed a cystic mass above the bladder dome that extended to the umbilicus. A partial cystectomy with urachal resection was performed. Pathological examination revealed xanthogranulomatous urachitis combined with bullous cystitis.

Cytologic Findings of Fine Needle Aspiration Biopsy of 23 Schwannomas.: Sunhee Chang, Mee Joo, Hanseong Kim; Korean J Cytopathol. 2008;19(1):41-46.; DOI: https://doi.org/10.3338/kjc.2008.19.1.41

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Abstract PDF

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or oval-shaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.

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Multiple Cervical Schwannomas Mimicking Metastatic Lymph Nodes from Papillary Thyroid Cancer
Ji-Sun Kim, Chang-Young Yoo, Rae-Hyung Kim, Jung-Hae Cho
Journal of Korean Thyroid Association.2014; 7(1): 102. CrossRef

Lipomatous Hypertrophy of the Interatrial Septum: A Case Report.: Ji Eun Kwak, Han Seong Kim, Mee Joo, Sun Hee Chang, Sang Hwa Shim, Je G Chi, Wook Sung Kim; Korean J Pathol. 2007;41(3):213-215.

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Abstract PDF: Lipomatous hypertrophy of the interatrial septum is a benign cardiac mass that is characterized by excessive deposition of fat in the interatrial septum. It typically occurs in elderly, obese patients and may cause arrhythmia. We report a case of lipomatous hypertrophy of the interatrial septum. A 45-year-old man was admitted for evaluation of chest discomfort. Transthoracic echocardiography revealed a cardiac mass, which was suspected as a myxoma. A resection of the tumor was performed. Grossly, the mass was 1.3x1.2x0.8 cm, and showed yellow soft consistency and good demarcation. Microscopically, the mass consisted of mature adipose tissue, intermixed cardiac muscle fibers, entrapped nerve fibers and ganglion cells. Lipomatous hypertrophy of the interatrial septum should be differentiated pathologically from tumorous cardiac mass such as lipoma and myxoma.

Expression of c-kit and Cell Cycle Regulators in Non-small Cell Lung Carcinoma.: Sun Hee Chang, Mee Joo, Hanseong Kim; Korean J Pathol. 2006;40(6):427-431.

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Abstract PDF: BACKGROUND
The abnormal expression of c-kit is implicated in the pathogenesis of a variety of solid tumors. The Rb pathway and p53 act as cell cycle regulators. The purpose of this study was to assess the expression of c-kit, Rb, p53, p16 and cyclin D1 and their relationship to clinical and pathological parameters in patients with non-small cell lung carcinomas (NSCLC(s)).
METHODS
Tissue microarrays consisting of 2 mm cores from the corresponding blocks were constructed from 54 NSCLC(s). Immunohistochemical staining for c-kit, Rb, p53, p16 and cyclin D1 was performed. C-kit immunostaining was considered positive if > or =10% of tumor cells were immunoreactive along the membrane and/or in cytoplasm. For Rb, p53, p16 and cyclin D1, tumor cells showing a nuclear staining pattern were interpreted as positive.
RESULTS
We found that c-kit was expressed in 13 (24%) cases, Rb was lost in 39 (72%) cases, p53 was expressed in 28 (52%) cases, p16 was lost in 42 (78%) cases and cyclin D1 was expressed in 33 (61%) cases. The c-kit expression was significantly higher in adenocarcinoma (39%) than in squamous cell carcinoma (8%). We did not find any correlation between c-kit, Rb, p53, p16 and cyclin D1 expression and clinicopathological parameters such as: age, tumor size, lymph node involvement, disease stage and distant metastasis. There was a direct correlation between p53 expression and Rb loss.
CONCLUSIONS
These results suggest that c-kit may be a useful therapeutic target for patients with c-kit positive tumors, and that the disruption of Rb and p53 pathways may play an important role in the development and progression of NSCLC(s).

Propylthiouracil-induced Hepatic Injury: A Case Report.: Ji Eun Kwak, Han Seong Kim, Sun Hee Chang, Mee Joo, Je G Chi, Jin Soo Moon, Jong Guk Lee; Korean J Pathol. 2006;40(4):289-291.

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Abstract PDF: Propylthiouracil (PTU) is one of the most widely used drugs for the treatment of the hyperthyroidism. However the liver damage is a rare adverse effect, which can be fatal. We present a case of PTU-induced hepatitis. A 13-year-old girl was diagnosed as having Graves' disease, for which PTU was administered. Three months after commencing PTU, she developed jaundice accompanied with elevated serum transaminases and total bilirubin levels. The viral markers were all negative. The pathologic findings of the liver biopsy included necrosis of hepatocytes predominantly around the central veins (i.e., zone 3 necrosis) and moderate to severe infiltration of lymphocytes in portal areas. After withdrawal of the PTU, clinical symptoms and liver function test results were improved gradually.

Fine Needle Aspiration Cytology of Periductal Mastitis (Subareolar Abscess) and its Clinical Significance of Cytological Diagnosis.: Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak, Sung Hye Park, Byung Ju Song; Korean J Cytopathol. 2006;17(1):27-31.

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Abstract PDF: Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.

Survivin and Fas Ligand Expressions Are Correlated with Angiolymphatic Tumor Spread in Medullary Thyroid Carcinoma.: Min Kyung Kim, Jin Hee Sohn, Mee Joo, Hanseung Kim, Sung Hye Park, Seong Hoe Park, Eo Jin Kim, Seoung Wan Chae; Korean J Pathol. 2005;39(5):320-325.

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Abstract PDF: BACKGROUND
Medullary thyroid carcinoma (MTC) that originates from C cells comprises about 10% of all the malignant thyroid tumors. Activating mutations of the RET proto-oncogene have been found to be involved in the anti-apoptotic pathway of MTC that harbors the RET mutation. We investigated the correlation between the clinicopathologic parameters and the expressions of survivin, a novel anti-apoptotic molecule, and the other apoptosis-related proteins, and the known prognostic markers.
METHODS
Immunohistochemical staining was performed using antibodies for survivin, Fas, Fas ligand (FasL), bcl-2, calcitonin, CEA and cyclin A in 19 case of MTC; 10 sporadic MTCs, eight multiple endocrine neoplasia (MEN) type 2A MTCs and one familial MTC (FMTC).
RESULTS
Survivin protein expression was found in five cases (26%) and this was correlated with the presence of angiolymphatic tumor emboli (p=0.019). FasL was expressed in 14 cases (74%) and it had correlation with the presence of lymph node metastases (p=0.029). The cyclin A-labeling indices were correlated with local invasiveness (p=0.001).
CONCLUSIONS
Survivin and FasL might be involved in the lymphatic tumor spread of MTC.

Urachal Adenocarcinoma with a Concomitant Urachal Remnant: A Case Report.: Tae Hoon Kim, Mee Joo, Min Kyung Kim, Hanseong Kim, Je G Chi, Jae Y Ro; Korean J Pathol. 2004;38(4):280-283.

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Abstract PDF: Urachal adenocarcinoma is a rare tumor, and it has similarities with nonurachal adenocarcinoma; therefore, it is sometimes difficult to make a diagnosis. We present a typical case of urachal adenocarcinoma that had all the diagnostic criteria including the presence of an urachal remnant. A 65-year-old woman presented with complaints of a painless gross hematuria. Pelvic CT and cystoscopy showed an intraluminal protruding mass centered in the bladder wall. When diagnosed as adenocarcinoma with a signet ring cell component being noted by frozen biopsy, partial cystectomy with resection of the median umbilical ligament and peritoneum was carried out for a suspected urachal adenocarcinoma. The tumor morphology showed as typical mucinous adenocarcinoma. Characteristic tubular structures showing the typical histology of an urachal remnant was found in the perivesical fat. On immunohistochemical staining, the urachal adenocarcinoma showed a pattern similar to colonic adenocarcinoma, while the urachal remnant showed strong positivity for CK7 and Chromogranin A.

Carcinoid Tumor Arising from A Normal Kidney: A Case Report.: Seo Young Sohn, Han seong Kim, Mee Joo, Min Kyung Kim, Sung Hye Park; Korean J Pathol. 2004;38(3):196-199.

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Abstract PDF: Primary carcinoid tumor of the kidney is a very rare disease. Until now, only 41 cases have been reported worldwide, and nine of these arose in a horseshoe kidney. In Korea, 3 cases have been reported to date, and all of these arose in a horseshoe kidney. We present a case of primary carcinoid tumor occurring in a normal kidney of a 45 year old man. A tumor was incidentally found close to the hilum of the left kidney. Histologically, the tumor exhibited trabecular and ribbon-like pattern of cuboidal or columnar cells. Mitotic activity was rarely seen. The tumor cells were positive for synaptophysin and chromogranin A. Numerous dense-core neurosecretary granules were observed by the electron microscopic examination. To our knowledge, the present case is the first report of primary renal carcinoid tumor arising in a normal kidney in Korea.

Squamous Cell Carcinoma Arising from Mature Cystic Teratoma of the Ovary: A report of three cases .: Mee Joo, Han Nae Min, Yun Kyung Kang, Hye Kyung Lee, Young Chae Cho, Eung Soo Lee; Korean J Pathol. 1999;33(12):1211-1215.

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Abstract PDF: Malignant transformation develops in a little less than 2% of mature cystic teratomas. A wide variety of malignant tumors may arise within benign mature cystic teratomas, and the most common of these is squamous cell carcinoma, which account for 75~85%. In general, the tumors are in an advanced stage and the prognosis is poor as most patients die within a year. However, when the tumor is confined to the ovary, they have a good prognosis and the 5-year survival rate is 63~83%. We experienced three cases of squamous cell carcinoma arising in mature cystic teratoma. Two of the carcinomas occurred in postmenopausal women: 58-(case 1) and 66-(case 2) year-old, and were confined to the ovaries. They were alive 37 months and 18 months after the operation, respectively. The third case was a 45-year-old premenopausal woman who had an extraovarian extension of the tumor and early recurrence within two months. Histologically, cases 1 and 3 were conventional well to moderately differentiated squamous cell carcinomas and case 2 showed a well-differentiated squamous cell carcinoma with exuberant proliferating trichilemmal tumor-like areas.

Cryptosporidium Infection of Human Intestine: An Electron Microscopic Observation.: Min Suk Kim, Yun Kyung Kang, Chul Jong Yoon, Mee Joo, Hye Kyung Lee, Jeong Gi Seo, Je G Chi; Korean J Pathol. 1999;33(2):121-127.

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Abstract: Protozoa of the genus Cryptosporidium are small coccidian parasite known to infect the mucosal epithelium of a variety of animals including human, causing fatal course in immunodeficient patients as well as self-limited illness in healthy individuals. Various life cycle stages including trophozoite, meront, merozoite, gametocyte and oocyst in infected mucosa are a diagnostic feature. Electron microscopy (EM) provides sufficient findings for genus and species identification of this parasitic organism. The authors presented scanning and transmission EM findings of Cryptosporidium parvum infection in two children: one with acute lymphoblastic leukemia and the other without any evidence of immune compromise.

Cellular Schwannoma Arising in a Facial Nerve.: Mee Joo, Hye Sung Kim, Yun Kyung Kang, Hye Kyung Lee, Jae Young Park; Korean J Pathol. 1997;31(7):688-691.

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Abstract PDF: Cellular schwaninoma is a variant of schwannoma, which is characterized by predominance of cellular Antoni A area, presence of mitotic activity, nuclear hyperchromasia, pleomorphism, and absence of Verocay body. These pathologic features often prompted a misdiagnosis of malignancy. However, the clinical outcome has indicated the benignity of the tumor. We have experienced a case of cellular schwannoma arising from right facial nerve with right hemifacial weakness and erosion of mastoid process. Grossly, it was a 3.5 x 3 cm sized and relatively well encapsulated mass with yellowish, friable cut surface. Microscopically, cellular growth with moderate cellular pleomorphism and some mitotic activity (5/40 HPFS, up to 2/HPF) were noted. Immunostaining for S-100 protein showed diffuse strong positive reaction.

Congenital Cystic Disease of the Kidney overview and a classification.: Mee Joo, Yeon Mee Kim, Chong Jai Kim, Yeon Lim Suh, Jeong Wook Seo, Je Geun Chi; Korean J Pathol. 1997;31(3):233-243.

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Abstract PDF: The congenital renal cystic disease encompasses a complex group of pathologic and clinical entities. We retrospectively reviewed 42 cases of congenital renal cystic lesions classified into four Potter types in a series of 2,063 consecutive autopsies from 1981 to 1996. According to our study based on morphologic, clinical, genetic features and associated anomalies, type I and III are relatively compatible with Potter's original definition. However, it was reasonable that type II and IV are classified to the same group because of: 1) very similar histologic findings representing dysplastic kidney, 2) many associated anomalies, 3) no evidence of inheritance, and 4) presence of a combined type. Syndrome associated cysts, such as Meckel-Gruber syndrome, were also separately classified. If the dysplastic evidence was insufficient for diagnosis to the dysplastic kidney in type II and IV, then these cases would be better classified into a cystic disease associated with congenital hydronephrosis. We propose a classification of the congenital cystic disease of the kidney to be: 1) dysplastic kidney, 2) cystic disease associated with congenital hydronephrosis, 3) polycystic kidney, and 4) syndromic cystic disease.

Clear Cell Sarcoma of the Kidney: A case in 39 year old man.: Hyun Ju Yoo, Yun Kyung Kang, Mee Joo, Hye Kyung Lee, Dae Woo Kim, Suk San Park; Korean J Pathol. 1996;30(12):1138-1143.

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Abstract PDF: Clear cell sarcoma of kidney(CCSK) is a rare pediatric neoplasm characterized by a predominating component of clear cells, a predilection for metastases to bone, and a poor prognosis. The incidence of CCSK peaks during the 2nd year of life and adult cases are very rare. We report a case of CCSK encountered in the right kidney of a 39-year-old man. Grossly, it was a lobulated mass showing infiltrative margin, measured 7x5.5x5cm and had a homogeneous gray-tan color with a soft, fish-flesh consistency. Microscopically, about half of the tumor revealed the classic pattern of CCSK, having tumor cell cords or nests separated by the characteristic alveolar capillary networks. The tumor cells had clear pale cytoplasm, bland looking round nuclei and inconspicuous nucleoli. The other half showed the epithelioid-trabecular pattern forming pseudorosette or cord-like structures. Immunohistochemically, there was only a focal positive reaction to vimentin. Ultrastructurally, the tumor cells showed the primitive nephrogenic mesenchymal differentiation such as electron lucent cytoplasm, a small amount of organelles, scanty heterochromatin, inconspicuous nucleoli, and a lack of flocculant basal lamina material around the cytoplasmic membrane. We consider that this is a case of CCSK occuring in the oldest patient ever reported, confirmed by both immunohistochemistry and electron microscopy.

Flow Cytometric DNA Analysis in Papillary Carcinoma of Thyroid Gland: comparison with Ki-67 immunohistochemical staining.: Mee Joo, Hye Je Cho; Korean J Pathol. 1996;30(11):959-965.

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Abstract PDF: Nuclear DNA content was measured using a flow cytometric method to analyze 36 paraffin- embedded and 7 fresh tissues of 43 papillary carcinomas of thyroid gland. DNA aneuploidy was found in 3 cases(6.9%) and diploidy in 40 cases(93.1%). But there were no suggestive findings in clinical history, and cytological and morphological features for aneuploidy. In 40 diploid cases, S-phase fraction(SPF) were analyzed with regard to sex, age, tumor size, presence or absence of capsular invasion, lymph node involvement and ground glass nuclei. Among the multiple factors, only the tumor size, especially the larger sized-group(above 2cm in tumor diameter) was found to have a statistically significant higher SPF than the smaller sized-group (p<0.05). And high SPF groups relatively well corresponded to the high risk group. Thirty nine cases of papillary carcinoma have also been evaluated for proliferative activity with Ki-67 monoclonal antibody. The average Ki-67 labeling index was 0.36% in total cases, and that of the aneuploid cases was 0.73%, which was higher than that of the diploid cases(0.33%). So. We think that the low aneuploid rate and low Ki-67 labeling index relatively well represent the usual good clinical course of this tumor and the high SPF is a suggestive finding for a high risk group.

Cytologic Analysis of Metastatic Malignant Tumor in Pleural and Ascitic Fluid.: Mee Joo, Hye Je Cho; Korean J Cytopathol. 1995;6(2):125-132.

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Abstract PDF: Cytodiagnosis of pleural and ascitic fluid is a commonly performed laboratory examination. Especially, positivity for malignant cells in effusion cytology is very effective and also presents the first sign of malignancy in unknown primary site of the tumor. We examined each 34 cases of pleural and ascitic fluid cytologic specimen diagnosed as metastatic tumor, which was selected among 964 pleural fluid cytology cases and 662 ascitic fluid cytology cases from September 1989 to June 1995. Among the ascitic fluid cytology specimens examined, 34 specimens were positive in 29 patients. The most common primary neoplasms were carcinomas of ovary (32%), stomach (32%), colon (6%), breast (3%), pancreas (3%), and lung (3%) and lymphoreticular neoplasms (3%). The metastatic tumor was predominantly adenocarcinoma type in both pleural (82%) and ascitic (91%) fluid. The study of metastatic adenocarcinoma in effusion from lung, ovary, and stomach was undertaken to find distinctive features for the identification of the primary site. The smears of metastatic pulmonary adenocarcinoma had a tendency to show high grade pleomorphism and many large tight cell clusters, whereas that of the ovarian adenocarcinoma showed low grade pleomorphism with abundant intracytoplasmic vacuoles in relatively clear background. That of the stomach revealed the intermediate features.

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