Journal of Pathology and Translational Medicine

Sook Hee Hong

32 Articles

WHO Classification of Malignant Lymphomas in Korea: Report of the Third Nationwide Study.: Jin Man Kim, Young Hyeh Ko, Seung Sook Lee, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2011;45(3):254-260.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.254

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BACKGROUND
The aim of study was to determine the relative frequency of malignant lymphoma according to World Health Organization (WHO) classification in Korea.
METHODS
A total of 3,998 cases diagnosed at 31 institutes between 2005 and 2006 were enrolled. Information including age, gender, pathologic diagnosis, site of involvement and immunophenotypes were obtained.
RESULTS
The relative frequency of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) was 95.4% and 4.6%, respectively. B-cell lymphomas accounted for 77.6% of all NHL, while T/natural killer (T/NK)-cell lymphomas accounted for 22.4%. The most frequent subtypes of NHL were diffuse large B-cell lymphoma (42.7%), extranodal marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue (19.0%), NK/T-cell lymphoma (6.3%) and peripheral T-cell lymphoma (PTCL), unspecified (6.3%), in decreasing order. The relative frequency of HL was nodular sclerosis (47.4%), mixed cellularity (30.6%), and nodular lymphocyte predominant (12.1%) subtypes. Compared with a previous study in 1998, increase in gastric MZBCL and nodular sclerosis HL, and slight decrease of follicular lymphoma, PTCL, and NK/T-cell lymphoma were observed.
CONCLUSIONS
Korea had lower rates of HL and follicular lymphoma, and higher rates of extranodal NHL, extranodal MZBCL, and NK/T-cell lymphoma of nasal type compared with Western countries. Changes in the relative frequency of lymphoma subtypes are likely ascribed to refined diagnostic criteria and a change in national health care policy.

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

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Abstract PDF

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

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

Korean Pediatric/Adolescent Lymphoma: Incidence and Pathologic Characteristics.: Seung Sook Lee, Jin Man Kim, Young Hyeh Ko, Jooryung Huh, Chang Suk Kang, Chul Woo Kim, Yun Kyung Kang, Jai Hyang Go, Min Kyung Kim, Wan Seop Kim, Yoon Jung Kim, Hyun Jung Kim, Hee Kyung Kim, Jong Hee Nam, Hyung Bae Moon, Chan Kum Park, Tae In Park, Young Ha Oh, Dong Wha Lee, Jong Sil Lee, Juhie Lee, Hyekyung Lee, Sung Chul Lim, Kyu Yun Jang, Hee Kyung Chang, Yoon Kyung Jeon, Hye Ra Jung, Min Sun Cho, Hee Jeong Cha, Suk Jin Choi, Jae Ho Han, Sook Hee Hong, Insun Kim; Korean J Pathol. 2010;44(2):117-124.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.117

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Abstract PDF

BACKGROUND
The Hematopathology Study Group of the Korean Society of Pathologists conducted a nation-wide retrospective analysis of Korean pediatric lymphoma, to provide pathologic data on pediatric/adolescent lymphoma subtypes and features.
METHODS
All lymphoma cases of all age groups were collected during a recent 2 year-period (2005-2006) from 32 institutes in Korea. Among 3,686 lymphoma patients, 142 who were age 18 or less were classified according to the World Health Organization (WHO) classification.
RESULTS
Among 142 pediatric/adolescent lymphoma patients, Hodgkin lymphoma accounted for 21 (14.8%) and non-Hodgkin lymphoma (NHL) for 121 (85.2%). Hodgkin lymphoma appears to be more common in the pediatric/adolescent age group than in the all-ages group (14.8% vs 4.4%). T- and natural killer cell-NHL was more common in the pediatric/adolescent age group than in the all ages group (46.3% vs 22%). The majority of Korean pediatric/adolescent NHL cases was composed of Burkitt lymphoma, T- or B-lymphoblastic lymphoma, anaplastic large-cell lymphoma, and diffuse large B-cell lymphoma. For lymphoma patients under the age of 6 years, most had B-lymphoblastic or Burkitt lymphoma, which commonly presented at extranodal sites.
CONCLUSIONS
The distribution of lymphoma subtypes in the pediatric/adolescent age group is quite different from the distribution of adults, but it was quite similar to distribution in Western countries.

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A Case of Nasal Type Extranodal NK/T Cell Lymphoma Incidentally Detected in a Child
Ha Jin Oh, Sang Hyun Park, Hae In Jang, Dong Hoon Lee, Yoo Duk Choi, Hee Jo Baek, Hoon Kook
Clinical Pediatric Hematology-Oncology.2015; 22(1): 76. CrossRef

Subcellular Localization of p27(kip1) in Breast Cancer and Its Prognostic Significance.: Sook Hee Hong, Dae Choel Kim, Se Heon Cho, Young Seoub Hong; Korean J Pathol. 2006;40(3):185-192.

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Abstract PDF: BACKGROUND
p27 is a member of the cyclin-dependent kinase (CDK) inhibitors that arrest the progression of the cell cycle; thus, it acts as a tumor suppressor gene. The loss or decrease of p27 protein is frequently seen and this has an independent prognostic potential for many human cancers. p27 is functionally inactivated through accelerated proteolysis and cytoplasmic sequestration. Cytoplasmic mislocalization of p27 by abnormal phosphorylation in the tumor cells doesn't allow it to bind and inhibit nuclear cyclin/CDK targets.
METHODS
We examined the p27 protein expression in 86 cases of invasive ductal carcinoma of the breast via immunohistochemical staining to evaluate the subcellular localization of p27 and its relationship with the clinicopathologic features and the prognostic factors.
RESULTS
The nuclear expression of p27 was noted in 48.9% of the tumors, a combined nuclear and cytoplasmic expression was noted in 20.9%, a cytoplasmic expression was noted in 12.8%, and a negative expression was noted in 17.4%. The decreased nuclear expression and/or cytoplasmic mislocalization of p27 were statistically correlated with the nuclear grade (p=0.001), histologic grade (p=0.036), tumor size (p=0.033), lymph node metastasis (p=0.043), ER (p=0.001), and PR (p=0.001) status, while they were not correlated with patient age, stage, HER2, p53, and Ki67.
CONCLUSIONS
The breast tumors showing both decreased nuclear expression and cytoplasmic mislocalization of p27 are associated with a deranged cell cycle via functional inactivation and also with poor prognostic factors. It is expected that p27 can be a promising anticancer target molecule for the treatment of breast cancer.

Angioleiomyoma of the Nasal Cavity: A Case Report.: Su Jin Kim, Sook Hee Hong, Mee Sook Roh; Korean J Pathol. 2004;38(3):181-183.

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Abstract PDF: Angioleiomyoma of the sinonasal area is an extremely rare benign neoplasm. To the best of our knowledge, only 26 cases have been described. Here, we report a case of angioleiomyoma arising in the nasal cavity of a 60-year-old woman. Microscopically, the tumor consisted of proliferating smooth muscle cells punctuated with thick-walled vessels with slit-like lumina. The tumor was negative for estrogen and progesterone receptor by immunohistochemical study. Further studies are needed to clarify whether the growth of this tumor is sex steroid-dependent.

Prevalence of Human Papillomavirus Infection in Women in South Korea: Incidence of Positive HPV DNA and anti-VLPs in Residents of Busan City.: Sook Hee Hong, Duk Hee Lee, Hai Rim Shin; Korean J Cytopathol. 2004;15(1):17-27.

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Abstract PDF: To investigate a population-based survey of the prevalence of human papillomavirus (HPV) infection in South Korea, we performed Papanicolaou smears and tests for HPV DNA and anti-HPV antibody detection in 909 sexually active general women (age range; 20-74 years, median 44 years) who were randomly selected residents from S district of Busan City. The presence of DNA of 36 different HPV types was detected by means of a GP 5+/6+ primer-mediated PCR enzyme immunoassay in cervical exfoliated cells, and IgG antibodies against L1 virus-like particles (anti-VLPs) of 5 HPV types 16, 18, 31, 33, and 58 were tested by means of enzyme linked immunoassay. The incidence of cytologic abnormality was 5.2% in Pap smear. The positive rate of HPV DNA was 10.4%, high in young women younger than 35 years old and proportionally increased according to the cytologic grades. The most often found HPV type was HPV 70, followed by HPV 16 and 33, and high-risk HPV types were more frequent in women younger than 35 years old. The most common HPV type in abnormal cytologic smears was HPV 16, followed by HPV 58 and 66. Anti-VLPs was positive in 19.7% and the frequent anti-VLPs type was against HPV 18, followed by HPV 31 and 16. The concordance between the markers for each specific HPV type was noted in 10 women and HPV 16 was the most frequent one. The incidence of multiple HPV infection was 18.9% and that of multiple anti-VLPs antibodies was 31%. Among 103 self-reported virgins, 4.9% had anti-VLP antibodies.

Expression of pRb, p16, Cyclin D1 and Cyclin E in Infiltrating Duct Carcinoma of the Breast.: Hea Kyoung Hur, Mee Sook Roh, Jin Sook Jeong, Seo Hee Rha, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 2001;35(5):416-423.

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Abstract PDF: BACKGROUND
Inactivation of the retinoblastoma protein (pRb) is a mechanism by which tumor cells can subdue normal growth control. Among the molecules involved in control of pRb phosphorylation, cyclin D1 and cyclin E have been found to be deregulated and overexpressed in various types of cancers.
METHODS
Immunohistochemical stains for pRb, p16, cyclin D1 and cyclin E were performed in 73 cases of infiltrating duct carcinomas of the breast. In addition to analysis of their expression rates, the relationships between their expressions and the clinicopathologic parameters were evaluated.
RESULTS
pRb, p16, cyclin D1 and cyclin E were positive in 64.7% (44 out of 68 cases), 24.6% (15 out of 61 cases), 43.8% (32 out of 73 cases) and 61.6% (45 out of 73 cases), respectively. Their expression rates were not significantly associated with clinicopathologic prognostic factors. 33 out of 38 cases with p16-negative reactions were pRb positive, while 10 out of 15 cases with pRb-negative reactions were p16 positive. There was a significant inverse relationship between pRb and p16 expressions (P<0.005). 25 out of 32 cases with cyclin E-positive reactions were cyclin D1-positive, and 25 out of 45 cases with cyclin D1-positive reactions were cyclin E-positive. A statistically significant association was observed between cyclin D1 and cyclin E expressions (P<0.05).
CONCLUSIONS
The main mechanism during tumorigenesis of breast carcinoma depends on the cyclin D1/p16/pRb pathway, but cyclin E might play a role in the absence of cyclin D1. The inverse correlation between the pRb and p16 expressions may represent one of the important mechanisms in tumorigenesis, as well.

Primary Carcinosarcoma of the Skin.: Mee Sook Roh, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 2001;35(5):444-446.

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Abstract PDF: Carcinosarcoma is a biphasic tumor composed of intimately admixed malignant epithelial and mesenchymal components. Primary cutaneous cases are extremely rare; there are with only 18 cases documented in English literature to date. We present a case of a 55-year-old woman with a primary carcinosarcoma of the scalp. Histologically, the lesion consisted of an undifferentiated spindle cell sarcomatous component admixed with a resembling malignant tumor with eccrine differentiation. Immunohistochemistry showed the epithelial component to express cytokeratin and EMA and lack of vimentin expression. In the sarcomatous component, the staining pattern demonstrated the reverse. The patient received adjuvant radiotherapy; but one month later a recurring nodule developed at this site, and two months later, metastasis to the neck lymph node developed. There is no evidence of recurrence or metastasis after 25 months of follow-up.

Imprint Cytologic Feature of Pleuropulmonary Blastoma: A Case Report .: Mee Sook Roh, Ji Young Seo, Gi Yeong Huh, Pill Jo Choi, Sook Hee Hong, Jin Sook Jeong; Korean J Cytopathol. 2001;12(1):39-43.

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Abstract PDF: Pleuropulmonary blastoma (PPB) is an unusual intrathoracic blastoma presenting in childhood and characterized by a biphasic neoplastic population of undifferentiated, small round blastemal cells and larger spindle-shaped sarcomatous cells with entrapped benign epithelial-lined structures. We experienced the cytologic features of PPB in imprint smear from the pleural-based huge mass of the middle lobe of the right lung in a 4-year-old boy. The smears showed high cellularity composed of small ovoid blastemal elements and scattered spindle mesenchymal tumor cells. Lobectomy and pathologic investigation confirmed the diagnosis. PPB seems to be a tumor in which accurate diagnosis may be achieved by cytology if appropriate clinical information were given. Timely and accurate diagnosis of PPB by cytology paves the way for attempting preoperative treatment in future cases.

Rosai-Dorfman Disease of the Nose and Salivary Gland: A case report.: Mee Sook Roh, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1999;33(12):1203-1206.

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Abstract PDF: Rosai-Dorfman disease (RDD) is a rare type of benign histiocytosis characterized histologically by intracellular engulfment of lymphocytes. Extranodal RDD may occur as a part of generalized process involving lymph nodes or may involve extranodal sites independent of the lymph node status. We have experienced a case of extranodal Rosai-Dorfman disease of the nose as an initial lesion prior to nodal involvement. The patient was a 20-year-old woman who complained of nasal obstruction for 4 years, remotely, and left submandibular mass for 3 months, recently. Histologically, the lesion taken from nasal cavity, submandibular gland and left upper jugular lymph node all showed an heavy infiltrate consisted of plasma cells, lymphocytes and sheets of macrophages with abundant pale cytoplasm, which replaced organ architecture. The associated focal fibrosis made it difficult to differentiate from inflammatory pseudotumor. Some macrophages demonstrated phagocytosis of lymphocytes, plasma cells and occasionally neutrophils. The macrophages were strongly positive for S-100 protein.

Immunohistochemical Findings in 10 Cases of Inflammatory Myofibroblastic Tumor.: Soo Jin Jung, Mi Seon Kang, Chang Hoon Lee, Sook Hee Hong, Hye Kyoung Yoon; Korean J Pathol. 1999;33(9):717-722.

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Abstract PDF: A wide range of denomination has been used for inflammatory myofibroblastic tumor (IMT). IMT is not entirely homogeneous, even though it shows some overlapping histologic features such as haphazard proliferation of spindle cell and polymorphic chronic inflammatory cell infiltraion. The spindle cell is considered to be of myofibroblastic origin but follicular dendritic cell origin was reported recently. IMT is known as nonneoplastic, aberrant inflammatory response. However, IMT could show local invasion, recurrence, vascular invasion, and malignant transformation, and clonal characteristics and aneuploidy of IMT support the hypothesis that IMT may be a neoplastic process. In order to define the nature of spindle cell of IMT, immunohistochemical stains for smooth muscle actin (SMA), vimentin (VMT), lysozyme, S-100 protein, cytokeratin, CD21 were done. Additional immunohistochemical stains for MIB-1 for proliferating activity and LMP (latent membrane protein) for Epstein-Barr virus (EBV) were done. IMTs were composed of each 2 cases from lung, liver and lymph node and one case from common bile duct, maxillary sinus, bladder and thigh, and were histologically subclassified according to Coffin et al. Nine cases (90%) were positive for SMA and VMT, but no correlation between SMA and VMT immunoreactivity and histologic types was identified. Five cases (50%) were positive for lysozyme and S-100 protein, and histologic type III was negative for lysozyme and S-100 protein, and immunoreactivity for S-100 protein was different according to the histologic subtypes. All 11 cases were negative for CD21 and EBV LMP. MIB-1 labelling index was less than 1% in all cases. In summary, the spindle cell is regarded as myofibroblastic origin rather than follicular dendritic cell origin. Relationship with EBV is not clear, and negligible MIB-1 reaction suggests that IMT might have a good prognosis.

Expression of E-cadherin and p53 Proteins in Gastric Adenocarcinoma.: Sook Hee Hong, Mee Sook Roh; Korean J Pathol. 1999;33(2):80-87.

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Abstract: The gastric carcinoma shows various molecular and genetic alterations in its development and progression. There are evidences that the changes of the expression of cell adhesion molecules affect the morphogenesis of the tumor as well as the tumor progression and metastasis. The purpose of this study is the evaluation of the expression pattern of a cell adhesion molecule, E-cadherin, and a tumor suppression gene, p53, by immunohistochemical stain and the relationship of their expressions with clinicopathologic findings in gastric adenocarcinoma tissue. The E-cadherin expression was absent or reduced in 93 cases (73.2%) and p53 was positive in 98 cases (77.2%) of 127 gastric adenocarcinomas. The frequency of reduced E-cadherin expression was significantly higher in poorly differentiated adenocarcinomas (p=0.04) and in diffuse type (p=0.01), but that of p53 positivity was not significantly correlated with tumor differentiation. Both proteins showed no correlation with depth of invasion, lymph node and distant metastasis, and tumor stage. There was no correlation between E-cadherin and p53 expression. This study indicates that the altered expressions of E-cadherin and p53 are associated with the development of intestinal and diffuse types of gastric adenocarcinoma and the differentiation of the gastric adenocarcinoma is affected by cell adhesion mediated by E-cadherin, but the modes of tumor progression and metastasis are not affected by E-cadherin and p53.

Alterations of the Mucin Glycoprotein Expression and Their Relationship with the Pathologic Prognostic Factors in Gastric Carcinoma.: Mee Sook Roh, Gi Yeong Huh, Sook Hee Hong; Korean J Pathol. 1999;33(1):15-24.

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Abstract: Alterations of the mucin-type glycoproteins may contribute to changes in cancer cell growth regulation, immune regulation, and cellular adhesion, which in turn may influence the invasive and metastatic capabilities of the cancer. Many of the cancer-associated antigens such as mucin antigens have been identified recently and alterations in the glycosylation of the mucins have been described in the cancer. Immunohistochemical studies of 3 antigens associated with alteration of the mucin glycoprotein (MUC1, MUC2, STn) were done to evaluate their relationship with known pathologic prognostic factors and their usefulness in assessment of the progression of gastric carcinoma in 127 gastric carcinoma tissues. The MUC1 was detected in 57 (44.9%), MUC2 in 76 (59.8%) and STn antigen in 77 (60.6%) out of 127 cases of gastric carcinomas. The expression rate of MUC1 was significantly correlated with depth of tumor invasion, lymph node and distant metastases, and advanced tumor stage (p=0.001). The expression rate of MUC2 was not significantly correlated with pathologic findings and known prognostic factors. The STn antigen was significantly associated with incidence of lymph node metastasis (p=0.02). The coexpression of both MUC1 and MUC2 or MUC1 and STn was more frequent in tumors with deep invasion, lymph node metastasis and advanced tumor stage than one or none expression (p<0.05). These results suggest that the alterations of expression of the mucin proteins, especially MUC1 and carbohydrate antigen (STn) are associated with poor biological behavior of the gastric carcinoma.

Expression of Cell Adhesion Molecules -CD44H and CD44v6- in Colorectal Carcinoma.: Dae Cheol Kim, Seo Hee Rha, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1998;32(9):655-662.

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Abstract: During tumor progression, a subset of cells acquires metastatic properties, presumably through a series of genetic alterations. As the result, cells detach from the primary tumor, penetrate the basement membrane and invade the adjacent structures including lymph and blood vessels. Loss of adhesive functions and gain of new adhesive functions are thought to play a crucial role in this metastatic cascade. Since tumor metastasis is the principle cause of death for cancer patients including colon cancer, there is a consensus that a search for tools that allow effective assessment of the metastatic potential of tumors is a prime goal for cancer research. An immunohistochemical study of cell adhesion molecules, CD44H and its variant CD44v6, was done to evaluate their relationship with known prognostic factors related to the progression and metastasis of colorectal carcinoma in 94 cases of colorectal carcinoma tissues. The results were as follows. The CD44H expression was detected in 90 (95.7%) and CD44v6 in 53 (56.4%) out of 94 cases of colorectal carcinoma, and the CD44H was overexpressed in tumor tissue more than in normal mucosa in 62% of the cases. The expression rates of both protein were not significantly correlated with age and sex of the patients, invasion depth, lymph node metastasis, tumor differentiation, and tumor site. The coexpression of CD44H and CD44v6 in tumor was significant (p<0.05). The above results suggest that overexpression of CD44H and loss of function to control the alternative splicing of CD44 mRNA resulting in CD44v6 expression and alteration of adhesive function are closely associated with tumorigenesis of the colorectum.

Expression Pattern of the Rb Protein and its Correlation with Prognosis in Primary Lung Cancer.: Hea Kyoung Hur, Seo Hee Rha, Sook Hee Hong; Korean J Pathol. 1997;31(2):152-161.

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Abstract PDF: An immunohistochemical stain for the Rb tumor suppressor gene product was performed in pathologic specimens from 72 primary lung cancer patients to study the correlation between its expression and histologic type, cancer differentiation, clinical stage and survival rate. The expression of the Rb protein was positive in 34 cases(47.2%) and negative in 38 cases(52.8%). The Rb protein was not expressed in 16 of 42 cases(38.1%) in squamous cell carcinoma, in 17 of 23 cases(73.9%) in adenocarcinoma, in one of three cases(33.3%) in undifferentiated large cell carcinoma, in two of two cases(100%) in small cell carcinoma, in one of one case(100%) in an adenosquamous carcinoma and in one of one case(100%) in an atypical carcinoid. There were significant difference of the Rb protein expression between squamous cell carcinoma and adenocarcinoma(p<0.05). The expression of Rb protein was not correlated with degree of cancer cell differentiation and clinical stage of the lung cancer(p>0.05). The two year survival rate for patients with the Rb positive was 65% compared with 37% for those with the Rb negative which was significant(p<0.05). This result suggests that an altered or the absence of the Rb protein in cancer cells can be a valuable prognostic factor in the lung cancer.

Adenomyoepithelioma of the Breast.: Sang Yong Lee, Hea Kyoung Hur, Dae Cheol Kim, Seo Hee Rha, Sook Hee Hong; Korean J Pathol. 1997;31(1):83-86.

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Abstract PDF: Adenomyoepithelioma is a rare benign tumor which occurs mainly in the skin, salivary gland and very rarely in the breast. Histologically this tumor demonstrates biphasic differentiation of luminal epithelial cells and myoepithelial cells. We report a case of adenomyoepithelioma occuring in the outer lower quadrant of the right breast of a 56-year-old female, confirmed histologically with an aid of immunohistochemistry. This is the first documented report in Korean literature.

Expression Pattern of Tumor Progression and Metastasis-related Gene Proteins - CD44H, CD44v6, erbB-2, and p53 -in Gastric Carcinoma.: Sung Woo Joo, Young Jhoon Chin, Dae Cheol Kim, Gi Yeoung Huh, Sook Hee Hong; Korean J Pathol. 1996;30(9):751-763.

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Abstract PDF: Immunohistochemical studies of the molecules associated with gastric tumor progression and metastasis were done to evaluate their relationship with known prognostic factors and their usefulness in assessment of the progression of gastric carcinoma in 127 gastric carcinoma tissues. The 4 antibodies used in this study were CD44H, CD44v6, erbB-2, and p53. The CD44H expression was detected in 76 (59.8%), CD44v6 in 63 (49.6%), erbB-2 in 18 (14.2%), and mutant p53 in 98 (77.2%) out of 127 cases of gastric carcinomas. There was no significant correlation between the expression rates of each four proteins. The expression rates of all 4 proteins were not significantly correlated with age and sex of the patients and lymph node metastasis, but the correlation between CD44v6 expression and the depth of tumor invasion and tumor stage was significant (p<0.05). These results suggest that CD44v6 is closely associated with tumor invasion, and high levels of CD44H, erbB-2 and p53 are associated with tumorigenesis of the stomach as they are highly expressed in early as well as in advanced gastric carcinomas. The findings also support the conclusion that the loss of control of alternative CD44 mRNA splicing resulted in production of CD44v6 splicing variant in tumor cell facilitates tissue invasion by increased adherence of the tumor cell to an extracellular matrix or by tumor cell migration. It can be expected that CD44v6 overexpression in tumor cells appears to be an important prognostic indicator for gastric tumor progression.

Chromophobe Cell Renal Carcinoma: A report of 3 cases.: Me Sook Roh, Gi Yeong Huh, Seo Hee Rha, Heon Young Kwon, Sook Hee Hong; Korean J Pathol. 1996;30(7):616-622.

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Abstract PDF: Chromophobe cell renal carcinoma is an uncommon variety of renal cell carcinoma first described in humans in 1985 by Thoenes and his colleagues. It is a distinct type of renal cancer presumably derived from the intercalated cells of the collecting duct system and exhibiting a better prognosis than other types of renal cell carcinoma. This type of renal cell carcinoma has not been reported in Korean literature. We experienced three cases of chromophobe cell renal carcinoma from surgical pathology files of Dong-A medical center. The patients were a 65-year-old female, a 54-year-old female, and a 50-year-old male who had 8.2x6 cm, 4x2.5 cm and 4.3x3.2 cm sized, yellowish gray, beige to tan colored masses in the kidneys, respectively. Microscopically, the tumor cells were arranged in sheets or nests with delicate intervening vasculature. The cells were voluminous, uniform in appearance and contained finely reticulated cytoplasms delineated by prominent cell borders. With Hale's iron colloid staining the cytoplasm showed positive reaction; with PAS staining the result was negative. Immunohistochemically, the tumor cells showed positive reaction for cytokeratin but negative for vimentin. Electron microscopy showed numerous small, round to oval cytoplasmic vesicles, 150-300nm in size. All the patients received only radical nephrectomy and survived without evidence of recurrence or metastasis during follow-up intervals ranging from 4 months to 5 years.

Malignant Rhabdoid Tumor of the Kidney in an Adult: A case report.: Sang Yong Lee, Dae Cheol Kim, Seo Hee Rha, Sook Hee Hong; Korean J Pathol. 1996;30(6):539-543.

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Abstract PDF: Malignant rhabdoid tumor is a distinct renal tumor in pediatric age group and extremely rare in adults. It was originally described as a rhabdomyosarcomatoid variant of Wilms' tumor. But subsequent studies failed to confirm myogenous differentiation, so the rhabdoid tumor is now considered to be a distinct and unique disease type of highly malignant renal tumor, histogenetically unrelated to Wilms' tumor. However the histogenesis have not been clearly defined until now. We report a case of malignant rhabdoid tumor of the kidney in a 34-year-old man who represented with a left abdominal mass. Grossly, a large mass occupying most of the left kidney except for a part of upper pole was invading beyond renal capsule and the perirenal soft tissue. It measured 18x14 cm in dimension and was soft, lobulated and yellowish gray with large areas of hemorrhage and necroses. Microscopically, the tumor mass was composed of sheets of round or polygonal neoplastic cells growing in a solid pattern. These tumor cells were medium to large in size with ample cytoplasm containing recognizable eosinophilic inclusion and had an eccentrically located, large nucleus with one or a few prominent nucleoli. Mitotic figures were frequently observed. Ultrastructurally, the tumor cells contained whorled filamentous inclusions corresponding to vimentin, epithelial membrane antigen and cytokeratin in immunostaining.

Angiomyofibroblastoma of the Vulva: A case report.: Mee Sook Roh, Hea Kyoung Hur, Sook Hee Hong, Sang Kap Kim, Young Cheol Baek, Hwa Sook Moon; Korean J Pathol. 1996;30(4):344-346.

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Abstract PDF: Angiomyofibroblastoma is a distinctive, hitherto uncharacterized, benign soft tissue tumor of the vulva with histology similar to an aggressive pelvic angiomyxoma. It can be distinguished from an aggressive angiomyxoma by its circumscribed borders, higher cellularity, more numerous blood vessels, the frequent presence of plump stromal cells, minimal stromal mucin, and rarity of erythrocyte extravasation. We experienced a case of angiomyofibroblastoma of the vulva occurring in a 45-year-old woman. The lesion was a well-defined but not encapsulated mass, 4.5x4.2 cm. Histologically the mass was characterized by alternating hypercellular and hypocellular edematous zones in which abundant blood vessels were irregularly distributed. Immunohistochemically, the spindled, plump spindled, and oval stromal cells were reactive for vimentin and desmin, but not for cytokeratin, or S-100 protein.

Immunohistochemical Study of the Expression of the p53 Protein in Primary Lung Cancer.: Sang Yong Lee, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1996;30(3):218-227.

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Abstract PDF: An immunohistochemical stain for p53 tumor suppressor gene product was performed in 59 primary lung cancers to study the relation between its expression and type of the tumor, degree of tumor differentiation,clinical stage and smoking. The results were as follows: 1. The expression of mutant p53 protein was noted in 28 of 59 cases(47.5%) of primary lung cancers. The p53 protein was expressed in 21 of 35(60%) squamous cell carcinomas, in 6 of 21(28.6%) adenocarcinomas, and 1 of 1(100%) small cell carcinoma. There was a significant difference in expression of p53 among the different histologic types of lung cancer(p<0.05). 2. The incidence of p53 protein expression did not correlate with the degree of tumor cell differentiation or the clinical stage of lung carcinoma(p>0.05). 3. The incidence of p53 protein expression was higher in smokers(current: 75%, former: 46.2%) than in non-smokers(5.6%) and was increased in direct proportion to the pack years. There was a statistically significant correlation between p53 expression and smoking(p<0.05). The mutation of p53 gene may often be an early event in the development of lung cancer and it is suggested that the smoking known as a risk factor for the development of the lung cancer may be associated with the transformation of p53 tumor suppressor gene into mutant p53 gene or oncogene.

Extrarenal Malignant Rhabdoid tumor: A Case Report.: Sang Yong Lee, Dae Cheol Kim, Seo Hee Rha, Sook Hee Hong, Tae Hun Kang, Young Ho Lee, Kyoung Jin Nam, Jin Sook Jeong; Korean J Cytopathol. 1996;7(1):69-74.

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Abstract PDF: Malignant rhabdoid tumor is a distinct renal tumor in the pediatric age group. It was originally described as a rhabdomyosarcomatoid variant of Wilms tumor. However, subsequent studies failed to confirm myogenous differentiation, so it is now considered to be a distinct and unique type of highly malignant tumor, histogenetically unrelated. Although extrarenal forms of this tumor are rare, several examples have been described in other sites, especially the liver, prostate, paravertebral area, urinary bladder and soft tissue. We experienced a case of malignant rhabdiod tumor located in the intraabdominal cavity in a 10 month-old boy. Smear of peritoneal fluid showed round, polygonal and irregular shaped cells with large nuclei, ample cytoplasm containing Jight pink "to purple cytoplasmic inclusions, and one or a few prominent nucleoli. Immunocytochemistry revealed positivity to cytokeratin, epithelial membrane antigen and vimentin, and negativity to desmin and neuron-specific enolase. These distinct cytologic appearance and immunophenotypes were most consistent with a diagnosis of extrarenal malignant rhabdoid tumor. The cytoplasmic inclusions were correlated with eosinophilic inclusions seen in histologic section and electron microscopy confirmed this interpretation, showing filamentous aggregations in the cytoplasms of the tumor cells.

Expression Patterns of Bcl-2 and PCNA in Cervical Intraepithelial Neoplasia.: Mee Sook Roh, Gi Yeung Huh, Sook Hee Hong; Korean J Pathol. 1995;29(6):703-713.

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Abstract PDF: Immunohistochemical stains for bcl-2 oncoprotein and PCNA and examination of the mitosis level were perfon-ned in 76 cases of cervical intraepithelial neoplasia (CIN). We studied the expression pattern of bcl-2 protein according to histologic grades and the function of bcl-2 oncogene associated with cellular proliferation by comparing with PCNA expression and the mitosis level. The results were as follows: 1) Of 76 cervical intraepithelial neoplasias, 23 (30.3%) were CIN I, 23 (30.3%) were CIN II, and 30 (39.4%) were CIN III. 2) Of 23 CIN I cases, grade 0 and 1 mitosis level were seen in 20 (87.0%), PCNA in 16 (69.6%), and bcl-2 in 19 (82.6%) cases, respectively, which indicates that CIN I lesions have a low cellular proliferative activity. 3) Of 30 CIN III cases, grade 2 and 3 mitosis level were noted in 28 (93.3%), PCNA in 25 (83.3%) and bcl-2 in 19 (63.3%) cases, respectively, which indicates that CIN III lesions have a high cellular proliferative activity. The results suggest that progressive increase of dysfunctional proliferative activity and abnormal decrease of cell death result in increased number of neoplastic cells according to CIN grade. Also the expression rate of bcl-2, PCNA and mitosis level were significantly different between CIN I and 111, which suggest that they might be good parameters for classifying CIN into low and high grade and for prediction of the biologic behavior of the CIN lesion.

Elastofibromatous Lesion of the Stomach: A case report.: Mee Sook Roh, Sook Hee Hong; Korean J Pathol. 1995;29(1):103-105.

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Abstract PDF: Elastofibroma is a peculiar tumor-like lesion which manifests as a slowly growing, solid, ill-defined mass of fibroelastic tissue occurring almost exclusively in elderly persons. It has been found in the ,,ubscapular region but rare examples have also been found in other locations. We experienced a case of elastofibromatous lesion of the stomach. The lesion was incidentally found in a 71 -year-old woman during an operation of cholecystectomy due to chronic cholecystitis and choledocholithiasis. The lesion was a relatively well-defined but not encapsulated small nodule, 0.7 cm in diameter, at submucosal layer of gastric pylorus. Histologically the nodular mass consisted of abundant acellular collagen fibers containing numerous elastofibroma fibers.

PCNA Labelling index and AgNORs of Transitional Cell Carcinoma of the Urinary Bladder.: Byung Gon Park, Sang Yong Lee, Mee Sook Roh, Seo Hee Rha, Sook Hee Hong; Korean J Pathol. 1994;28(5):469-477.

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Abstract PDF: Proliferating cell nuclear antigen (PCNA, PC10), an auxillary protein of DNA polymerase, plays a main role in the early stage of DNA Synthesis and is synthesized from Gl phase to s phase of the cell cycle. Nucleolar organizer region (NORs) are DNA loops encoding RNA proteins(AgNORs). To evaluate correlation with PCNA labelling index (LI)and AgNORs according to histological grades and clinical stages of transitional cell carcinoma of the urinary bladder, the authors analysed 54 transitional cell carcinoma using immunohistochemical stain for PCNA and silver stain for AgNORs in paraffin sections. The comparison of PCNA (PC10) LI and clinical stage showed a significant correlation (p<0.05), where as PCNA (PC10) LI according to histologic grade showed no significant correlation. High grade tumors showed increase PCNA LI. Superficial tumors (Ta-Tl) showed significantly lower PCNA LI than muscle invasive tumors (T2-T4)(p<0.05). There was no significant correlation between AgNORs and clinical stage, bur higher stage and higher grade tumors showed increased noubers of AgNORs. These results suggest that PCNA LI has a significant correlation with clinical stages of transitional cell carcinoma of the urinary bladder.

Nesal T-cell Lymphoma associated with Hemophagocytic Syndrome: A case report.: Mee Sook Roh, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1994;28(5):541-543.

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Abstract PDF: Peripheral T-cell lymphoma is the generic group given to a family of tumors composed of neoplastic lymphocytes with phenotypic features of peripheral T-cells. Certain peripheral T-cell lymphomas develop a hemophagocytic syndrome that mimics malignant histiocytosis, both clinically and pathologically. We experienced a case of nasal T-cell lymphoma, histologically mimicking malignant histiocytosis in a 40-year-old male. The chief complaints were nasal obstruction and intermittent mild fever. Mild anemia, elevated SGOT and SGPT, polyclonal gammophthy, and moderate hepatomegaly were present. Two weeks later was present an enlarged cervical lymph node. The biopsied nasal mass showed angiocentric and angiodestructive peripheral T-cell lymphoma withextensive necrosis and marked erythrophagocytosis by non-neoplastic histiocytes. Subsequently, cervical lymph node was biopsied, which showed peripheral T-cell ltmphoma with extensive necrosis and erythrophagocytosis as well. The atypical lymphoid cells revealed pan-T(+), but CD4(-) and CD8(-), whereas the reactive histiocytes showed lysozyme(+), immunohistochemistry.

Congenital Esophageal Stenosis due to Tracheobronchial Remnants: A case report.: Byung Gon Park, Mee Sook Rho, Sang Yong Lee, Seo Hee Rha, Sook Hee Hong; Korean J Pathol. 1994;28(4):442-444.

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Abstract PDF: Congenital esophageal stenosis due to tracheobronchial remnants is one of main forms of congenital esophageal stenosis, and it was first described by Frey and Duschel in l936. An 18-month-old male presented with underdevelopment and dehydration state due to persistent vomiting several times per day since 3 months after his birth. Esophagogram revealed an elongated and diiated esophagus with marked stenosis at distal portion. Partial distal esophagectomy was performed. Histologically, the thickened esophageal wall is composed of tracheobronchial remnants including hyaline cartilages, mucous glands, and ductal structures lined by ciliated respiratory epithelium under stratified squamous mucosa.

Immunohistochemical Study of the Multidrug Resistant(MDR) Gene Expression in Gastric Carcinoma.: Jung Hee Han, Byung Gon Park, Mi Sook Roh, Sook Hee Hong; Korean J Pathol. 1994;28(1):38-48.

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Abstract PDF: We performed immunohistochemical stain of p-glycoprotein using JSB-1 monoclonal antibody to study multidrug resistant(MDR) gene expression in 137 gastric tumor tissues obtained from 87gastric carcinoma patients. The incidence of p-glycoprotein expression was 60 of 87 cases(69%) and it was not correlated with age, sex, depth of tumor invasion, and lymph node metastasis, but was correlated with histologic type of gastric adenocarcinoma. The distribution of p-glycoprotein positive cells in the tumor tissue was diffuse in 34 cases(73.9%) and focal in 12 cases(26.1%), and the dominant staining patterns of p-glycoprotein in the tumor cells were cytoplasmic and golgi staining in 20 cases(43.5%) and 19 cases(41.3%), respectively, and 7 cases(15.2%) showed fine granules in the cytoplasm. The incidence of p-glyco-protein expression in the tumor tissue was higher in A and AB blood type patients who have A antigen than in 0 and B blood type patients. Cytoplasmic staining pattern was dominant in O and B blood types and golgi staining in A and AB blood type patients. Among 27 patients 'who received chemotherapy, partial remission was noted in 9 of 11 p-glyco-protein negative patients(81.8%) and no remission or progression of the tumor was seen in 9 of 16 p-glycoprotein positive patient(56.3%). The p-glycoprotein expression in gastric carcinoma had no direct correlation with known several prognostic factors of the gastric tumor except for histologic type, and it is supposed that p-glycoprotein detection in gastric tumor tissue by immunohisto-chemical stain is a good method for predicting the response of chemotherapy, especially in p-gly-coprotein negative cases.

Hamartoma Arising in the Urinary Bladder: A case report.: Young Bae Kim, Tae Sook Hwang, Byung Gon Park, Jin Sook Jeong, Sook Hee Hong; Korean J Pathol. 1993;27(3):283-286.

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Abstract PDF: Hamartoma of the bladder is quite a rare entity which is composed of a disorderly admixture of mature cellular elements normally present in the urinary bladder. There is a great controversy regarding the pathogenesis of this lesion. Whether it is a true hamartomatous lesion or metaplastic lesion developed secondary to the inflammatory process. Similar or identical lesions has often been given by other names such as florid examples of cystitis glandularis. We prefer to cell florid examples of cystitis glandularis rather than hamartoma when it was occurred in an old age higher then 50th decade. Here we report a case of hamartoma of the urinary bladder in 44 years old man. Cystoscopic examination revealed a papillary polypoid mass which was attached to the fundus of bladder by long stalk. The mass measured 1.5 cm in greatest diameter. It was composed of epithelial nests resembling von Brunn's nest, cystitis glandularis or cystitis cystica dispersed in a stroma rich in smooth muscle and fibrous tissue.

Small Cell Carcinoma of the Ovary: A case report.: Young Bae Kim, Sook Hee Hong, Kyu Rae Kim; Korean J Pathol. 1992;26(4):399-404.

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Abstract PDF: Small cell carcinoma of the ovary is rare malignancy occurring in women under 40 years of age(average, 23 years), which is associated with hypercalcemia in two thirds of cases. Its histogenesis is uncertain, but the possibilities of common epithelial, neuroendocrine, sex cord stromal and germ cell origin are suggested. All reported cases were proved to have rapid fatal course despite various therapy and 5 years suvival rate was only 10%. We report one case of a 20-year old woman with primary small cell carcinoma of the left ovary. The ovary was markedly enlarged and completely replaced by a mass, measuring 21x16x8 cm. Microscopic examination revealed dimorphic population of small and large malignant cell producing immature follicle-like structure which is characteristic of small cell carcinoma of the ovary. These pathological findings were similar to those of granulosa cell tumor, which is required to make differential diagnosis from small cell carcinoma. Immunohistochemical stains for cytokeratin and vimentin were positive, but those for S-100 protein and NSE were negative. One month after the initial operation, the tumor has recurred and the second and the second palliative operation followed by 3 cycles of chemotherapy was done. The patient showed disseminated metastasis at present time.

Hemangiopercytoma of the Meninges: The immunohistochemical study for the relationship between hemangiopericytic meningioma and peripheral hemangiopericytoma.: Sun Hee Yoon, Weon Yeong Choi, Sook Nyo Lee, In Sook Lim, Sook Hee Hong; Korean J Pathol. 1990;24(4):502-508.

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Abstract PDF: Hemangiopericycic maningioma is clinically and pathologically similar to peripheral Hemangiopericytoma and now tends to be terned as hemangiopericytoma of central nervous system. The authors studied 3 cases of hemangiopericytic meningioma obtained from 3 patients, 1 case of meningotheliomatous meningioma, angioblastic meningioma and transitional meningioma, and 2 cases of peripheral hemangiopericytoma, which had operated from November 1988 to May 1989 at the department of neurosurgery, Pusan Inje University Hospital. The authors analysed and compared the immunohistochemical finding and light microscopic apearance. The results obtained were summarized as follows; 1) Classic maningioma (meningotheliomatous meningioma, transitional meningioma and angioblastic meningioma) shows reactivity to both EMA and vimentin. 2) Hemangiopercicytic meningioma and peripheral hemangiopericytoma are reactive only to vimentin, so the two tumors are suggested as same type of tumor. 3) One of 3 cases of hemangiopericytic meningioma shows whorling and interlacing bundles of spindle cells, the peculiar light microscopic features of transitional meningioma, suggesting transitional or mixed form of hemangiopericytic meningioma and transitional meningioma.

Exceptionally Good Lymphocytic Infiltration with Histiocytes and Multinucleated Giant Cells of Stomach Cancer: A case report.: Dongsoo Suk, Sook Hee Hong, Hye Kyung Yoon, Hyung Gin Kang; Korean J Pathol. 1986;20(1):112-115.

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Abstract PDF: Stomach of 34 year old man showed an early stage of the cancer with slight involvement of the superficial part of the inner muscle layer and accompanied with one metastatic lymph node. The cancer is that of medium differentiated adenocarcinoma. There is an heavy infiltration of lymphocytes mixed with histiocytic mononuclear cells and multinucleated giant cells. Some giant cells appear as Langhans' type suggesting phagocytic cells of their origin containing PAS positive materials in the cytoplasma. In other places, they appear as atrophic cancer nests suggesting that these tumor nests were arrested and undergone to regressive cellular process because of the over-whelming immunological pressure by the host.

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