Journal of Pathology and Translational Medicine

Sun Hee Chang

19 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 Pancreatitis Presenting with Pancreatic Panniculitis: A Case Report.: Seong Hyun Kim, Sun Hee Chang, Hai Jin Park; Korean J Pathol. 2009;43(6):566-569.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.566

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Pancreatic panniculitis is a rare disease in which necrosis of fat in the panniculus and other distant foci occur in the setting of pancreatic disease. The most common pancreatic disorders associated with pancreatic panniculitis are acute and chronic pancreatitis, especially the alcohol-related types and pancreatic carcinoma. We now report a case of pancreatic panniculitis in which skin eruptions, not abdominal symptoms, were the presenting symptom. A 45-year-old man presented with multiple erythematous tender subcutaneous nodules on the shins, arthralgia of both ankles and swelling of the left foot. He was diagnosed as having pancreatitis 15 months ago. Histopathologic findings of a skin biopsy showed focal fat necrosis with anucleated "ghost-like" fat cells with a thick shadowy wall. Laboratory evaluation revealed an increase in serum amylase and lipase. We diagnosed this patient's problem as pancreatic panniculitis associated with a relapse of pancreatitis.

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Pancreatic Panniculitis in Patients with Chronic Pancreatitis: Case Report and Review of Literature
Eui Joong Kim, Min Su Chu, Ki Chang Sohn, Dong Ho Cho, Ga Hye Na, Haak Cheoul Kim, Eun Young Cho
The Korean Journal of Gastroenterology.2017; 69(1): 83. 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.

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.

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.

Loss of PTEN Expression in Breast Cancers.: Sun Hee Chang, Shi Nae Lee, Min Sun Cho, Heasoo Koo, Woon Sup Han, Seock Ah Im, Byung In Moon, Hyun Suk Suh, Hye Young Choi, Sun Hee Sung; Korean J Pathol. 2005;39(4):236-241.

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Abstract PDF: Background
: PTEN, located on chromosome 10q23.31, is a novel tumor suppressor gene. In the sporadic breast cancers, the incidence of the loss of heterozygosity of PTEN is approximately 10% to 40%, but the incidence of intragenic mutation of PTEN is less than 1%. To as- sess the role of the PTEN in the invasive ductal breast cancer, we studied the frequency of the loss of PTEN expression, its correlation with the commonly used prognostic factors of the breast cancer and with PTEN promoter hypermethylation status. Methods : Immunohistochemical staining with an anti-PTEN protein antibody was performed on the paraffin-embedded breast tissues from 129 women with a diagnosis of invasive ductal carcinoma. Methylation specific PCR was performed to detect hypermethylation in the PTEN gene on the 28 cases with the loss of PTEN expression.
Results
: Sixty-two (48%) of 129 breast tumors had the loss of PTEN expression. The loss of PTEN expression was correlated with lymph node metastasis and stage, and there was a near-significant correlation with the tumor size. PTEN promoter hypermethylation was found in five (18%) out of 28 patients. Conclusion : These results suggest that the loss of PTEN expression might play a role in the progression of the breast cancer and that the aberrant promoter methylation is one of the silencing mechanisms of PTEN.

Warthin-like Tumor Variant of Papillary Thyroid Carcinoma: A Case Report.: Sun Hee Chang, Chang Sig Choi, Yoon Suk Kim; Korean J Pathol. 2004;38(3):200-203.

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Abstract PDF: An unusual oncocytic papillary thyroid carcinoma with abundant lymphoid stroma bearing a resemblance to Warthin? tumor of salivary gland is described. We report a rare case of a Warthin-like tumor variant of papillary thyroid carcinoma in a 41-year-old-woman. Histologically, the tumor was characterized by oncocytic follicular cells showing nuclear features reminiscent of papillary carcinoma and lymphoid rich stroma. The surrounding non-neoplastic thyroid parenchyma showed focal peritumoral lymphocytic thyroiditis.

Expression of Sialosyl Tn Mucin Antigen in Gastric Adenocarcinoma and Its Relationship with Prognostic Factors.: Sun Hee Chang, Ho Jung Kim, Sun Hee Sung, Hea Soo Koo, Woon Sub Han; Korean J Pathol. 1999;33(9):695-701.

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Abstract: Sialosyl Tn mucin antigen (STn) is a carbohydrate antigen of tumor associated mucin formed by the premature 2~6 sialation of N-acetylgalactosamine. STn has been expressed in several tumor types and showed prognostic significance in colonic carcinoma. The authors evaluated the expression of STn immunohistochemically and correlated its expression with clinicopathologic variables in 100 gastric cancers. In early gastric cancer, STn was expressed in 24 cases out of 50 cases (48%). In advanced gastric cancer, STn was expressed in 48 of 50 (96%). The difference in STn expression between advanced gastric cancer and early gastric cancer was statistically significant. The difference in STn expression between tumors with lymph node metastasis and those without lymph node metastasis, between tubular adenocarcinoma and signet ring cell carcinoma, and between intestinal type and diffuse type adenocarcinoma was statistically insignificant in early or advanced gastric adenocarcinoma. These results suggest that the STn expression plays a role in the tumor progression in both early and advanced gastric adenocarcinomas.

Taxol-induced Pathological Findings in Rat Small Intestine.: Sun Hee Chang, Shi Nae Lee, Hee Soo Yoon, Min Sun Cho, Hea Soo Koo, Woon Sup Han; Korean J Pathol. 1997;31(12):1291-1296.

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Abstract PDF: Taxol is an active chemotherapeutic agent against a variety of solid tumors and a potentially useful drug for augmenting the cytotoxic action of radiotherapy against certain cancers. Taxol blocks cells in the mitotic phase of cell cycle. The aim of this study was to define the in vivo response of rapidly dividing cells of the small intestinal mucosa to taxol. We studied the numbers of apoptotic and mitotic cells and the expression of bcl-2 and p53 in rat jejunal crypt cells at 1, 2, 4, 8, 12, 16, and 24 hours and 3 and 5 days after intraperitoneal injection of taxol. Mitosis peaked at 2 and 4 hours and 12 and 16 hours. Apoptosis peaked at 16 hours and returned to normal after five days. The glands in crypts showed marked distortion with atypical lining cells after three days, which returned to normal at 5 days. bcl-2 expression was markedly decreased at 8 to 24 hours and subnormally recovered after three to five days. p53 showed no significant changes throughout. The histopathological changes in small intestine due to taxol were transient with complete recovery. bcl-2 expression was inversely corresponded to numbers of apoptosis. The changes were p53 independent. Further studies to understand the conditions that maximize the cell-cycle modulating effects of taxol cl-may greatly enhance its anti-tumor effectiveness.

Crohn's Disease Involving Small Intestine and Colon: 2 cases report.: Shi Nae Lee, Sun Hee Chang, Hee Soo Yoon, Hea Soo Koo, Ok Kyung Kim, Ryung Ah Lee, Eung Beum Park; Korean J Pathol. 1997;31(4):379-382.

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Abstract PDF: Crohn's disease was originally described as a small bowel disorder and has been known to involve the large bowel in approximately 40% of all cases with or without concomitant ileal component. We describe two cases of Crohn's diseas of small intestine and colon with a summary of differential diagnosis with ulcerative colitis. Both cases were originally diagnosed and treated as ileal tuberculosis. Grossly, there were skip lesions in both cases with prominent pseudopolyps and ulcerations in colon. Also noted were typical serpentine lesions in ileum as well as in colon. Microscopically, transmural inflammation was confirmed and one case showed scattered noncaseating granulomas in the wall. Submucosal edema and fibrosis with thickening of the wall was not prominent in colon. Polymerase chain reaction performed on paraffin block for the demonstration of Mycobacterium tuberculosis in one case showed negative reaction.

Familial Juvenile Polyposis.: Sun Hee Chang, Shi Nae Lee, Hea Soo Koo, Ok Kyung Kim, Sun Sub Jung, Eung Bum Park; Korean J Pathol. 1997;31(2):185-188.

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Abstract PDF: Familial juvenile polyposis is a rare intestinal polyposis characterized by the occurrence of multiple juvenile polyps in the gastrointestinal tract. We report a case of familial juvenile polyposis in a 17-year-old man with a review of the literature. This patient underwent total colectomy due to a 6 years history of rectal bleeding. Grossly, the colon showed 36 variable sized pedunculated polyps, measuring 2.5cm x 2cm from the largest size and 0.2cm x 0.2cm to the smallest size. Histologically, the polyps consisted of cystically dilated glands, lined by normal colonic epithelial cells, scattered in loose, edematous stroma containing inflammatory cell infiltration. There were no areas of tubular adenoma or malignancy in any of the polyp.

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