- Cytologic Features and Distribution of Primary Sites of Malignant Cells in Cerebrospinal Fluid .
-
Yeon Mee Kim, Mi Yeong Jeon, Je Geun Chi
-
Korean J Cytopathol. 2000;11(2):65-73.
-
-
-
 Abstract
 PDF
- Cytologic evaluation of cerebrospinal fluid(CSF) is an effective mean for diagnosing many disorders involving the central nervous systems(CNS). One of the most important reasons for cytologic examination of CSF is to detect metastatic or primary neoplasms of the CNS. We did a retrospective study of 1,438 CSF specimens obtained between 1992 and 1996. A total of 1,205 adult and 233 pediatric CSF specimens from 947 patients were accessed at the Department of Pathology of Seoul National University Hospital and Children's Hospital, respectively. Among 1,438 CSF cytology specimens, 169 cases(11.8%, 77 patients) including 135 adult cases(59 patients) and 34 pediatric cases(18 patients) were positive for malignant cells. Diagnoses included 60 metastatic carcinomas(adult, 60; pediatric, 0); 46 malignant lymphomas(adult, 44; pediatric, 2); 21 leukemias(adult, 20; pediatric, 1); 4 retinoblastomas(adult, 0; pediatric 4); 2 rhabdomyosarcomas(adult, 0; pediatric, 2); 1 multiple myeloma(adult, 1; pediatric, 0), and 35 primary CNS neoplasms(adult, 10; pediatric, 25). The most commonly identified metastatic carcinomas in adults were adenocarcinoma. Their primary sites were the lung, gastrointestinal tract, and breast in order of frequency.
The most common primary CNS neoplasm in children was medulloblastoma.
- Sarcomatoid Renal Cell Carcinoma; Special Reference to its Distinction from Carcinosarcoma.
-
Kee Taek Jang, Yeon Mee Kim, Je Geun Chi
-
Korean J Pathol. 1998;32(5):378-381.
-
-
-
Abstract
- Sarcomatoid renal cell carcinoma is an uncommon tumor that has to be distinguished from renal carcinosarcoma. We have described three cases of sarcomatoid renal cell carcinoma showing different clinical and light microscopic features.
An ultrastructural study of the tumor cells from the sarcomatoid area revealed frequent desmosomal junction, confirming the epithelial nature of the neoplasm. All three cases showed an aggressive clinical course and tended to invade adjacent organs or tissues. We believe that an histological and immunohistochemical examination in conjunction with an electron microscopic examination are necessary to diagnose sarcomatoid renal cell carcinoma.
- 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.
-
-
-
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.
- Histopathological Differences between Silicone Granuloma and Paraffinoma.
-
Yeon Mee Kim, Hye Kyung Lee, Hye Je Cho, Je Geun Cho
-
Korean J Pathol. 1996;30(5):427-436.
-
-
-
Abstract
PDF
- During the past two decades, silicone (polydimethylsiloxane) has become one of the most extensively applied biomaterials.
Although pure silicone is relatively inert and usually causes only minimal tissue reactions, it has been reported to evoke a definite foreign body reaction. We studied five cases of silicone-induced granulomas in various sites; two in the breast, one in the breast and axillary lymph nodes, one in the subcutis of the abdomen, back and extremities and one in the eyeball, to illustrate the salient histopathologic features of reactions to silicone with particular emphasis to its differences from paraffin granuloma. For this, 17 paraffinomas were also studied.
Tissue reaction to silicone liquid and gel was characterized by numerous round to oval empty cystic vacuoles, mild to moderate fat necrosis, foreign body reaction, a variable degree of mononuclear inflammatory cell infiltration and mild focal fibrosis. The cystic spaces were relatively uniform and showed a snow-man like appearance. In contrast to the silicone granulomas, the paraffinomas, also refered to as sclerosing lipogranulomas showed diffuse sclerosis and frequent calcification around the cystic vacuoles. The cystic spaces in paraffinomas were swiss cheese-like configuration, and the content of the cystic spaces was dirty and frequently calcified. However, there were certain similarities between these two types of granulomas particularly in the early phases of the reaction, therefore, the history of silicone injection or implant, is sometimes critical to the diagnosis of silicone granuloma. Despite great technologic advances in the manufacturing of prostheses and medical equipment, droplets and/or particles of silicone still escape into the body tissues in a variety of ways; therefores, the pathologist should always wonder whether the histologic reaction observed is due to silicone or to some other foreign material including paraffin.
- The Studies of bcl-2 Oncoprotein and Epstein-Barr Virus Expression in Malignant Lymphomas: Immunohistochemical and in situ hybridization analysis on 66 cases.
-
Hye Jae Cho, Yeon Mee Kim, Hyun Ju Yoo, Jong Eun Joo
-
Korean J Pathol. 1996;30(2):121-131.
-
-
-
Abstract
PDF
- Bcl-2 oncoprotein is being localized to mitochondria and interfering with programmed cell death (apoptosis) independent of promoting cell division in the lymphoid and nonlymphoid cells. The bcl-2 oncoprotein expression has been reported in follicular lymphomas as well as in diffuse non-Hodgkin's lymphoma, leukemia and a variable propotion of Hodgkin's lymphoma cases. Recent evidence suggests that some lymphomas protected from apoptosis is conferred through expression of Epstein-Barr virus(EBV) latent membrane protein which turn to cause upregulation of bcl-2. To define the role of the bcl-2 oncoprotein and EBV in lymphoid malignancy, we tried immunohistochemical studies with anti-bcl-2 antibody and In situ hybridization (ISH) with EBV-encoded small nuclear RNAs(EBER) in the paraffin embedded sections of 46 non-Hodgkin's lymphoma (NHL) cases and 20 Hodgkin's lymphoma (HL) cases. Bcl-2 oncoprotein expression was found in 37 of 46 cases (80%) of NHL with relatively strong cytoplasmic staining, and in 14 of 20 cases (70%) of HL with weak cytoplasmic staining in limited small numbers of RS, Hodgkin and lacunar cells. The widespread presence of bcl-2 oncogene in many different types of both NHL and HL supports that the extended cell survival through overexpression of bcl-2 gene protein may be a growth advantage of neoplastic lymphoid cells. In the ISH analysis for EBV, the presence of EBV was detected in 17 of 20 cases (85%) of HL, compared to 6 of 44 cases(13.6%) of NHL. It appears to be no direct correlation between overexpression of bcl-2 oncoprotein by neoplastic lymphoid cells and the presence of EBV in NHL but it seems to be a definite association between EBV and HL.
- Fine Needle Aspiration Cytology of Metastatic Cell Carcinoma of Lymph Nodes: Comparison to Non-Hodgkin's Lymphoma on 5 Cases.
-
Yeon Mee Kim, Hye Je Cho, Ill Hyang Ko
-
Korean J Cytopathol. 1996;7(1):44-50.
-
-
-
Abstract
PDF
- Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration(FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small cell carcinoma of classic oat cell type may simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of intermediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear molding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.
- Fetal Death Secondary to Constriction and Torsion of Umbilical Cord: An autopsy case.
-
Yeon Mee Kim, Je G Chi
-
Korean J Pathol. 1995;29(2):238-240.
-
-
-
Abstract
PDF
- Localized constriction and torsion of the umbilical cord are rare cord abnormalities. The seg- mental absence of Whartion's jelly in the involved area of the cord is believed to be an etiologic factor of the constriction and subsequent torsion. In the past, constriction and torsion were thought to occur after the death of the fetus as a result of maceration. However, recently it has been suggested that the torsion of the constricted area might cause fetal death. We report an autopsy case of a localized constriction and torsion of the umbilical cord in a stillborn baby. The baby was delivered to a 27-year-old primiparous woman after 28 weeks gestation. The fetus was of 24 gestational weeks in size and weight. And the placenta weight was 259 gm. A grossly macerated fetus showed a cystic hygroma in the posterior neck. There were two areas of constriction in the umbilical cord, one at the squamoamniotic junction and the other, 15 cm from the fetal end. Torsions were noted in both constricted areas, more severe than in the mid portion of the cord. Microscopically, the Whartion's jelly was deficient and partly replaced by fibrosis in the constricted areas. It is believed that these two areas of constrictions and torsion are causally related to the intrauterine fetal death in this case.
- Urinary Cytologic Findings of Transitional Cell Carcinoma: Analysis of 83 Cases.
-
Yeon Mee Kim, Hye Je Cho
-
Korean J Cytopathol. 1995;6(2):148-155.
-
-
-
Abstract
PDF
- Urinary cytology has become an essential element in the diagnosis and management of transitional cell carcinoma(TCC) of the urinary tract. It has the advantage of being noninvasive, inexpensive, and easily accessible. Besides that it can even detect malignancy when unsuspected at cystoscopy. We report a retrospective review of urine cytology in the diagnosis of 83 TCC cases that underwent 295 cytologic evaluation. All patients had biopsy-proven TCC of the bladder, ureter and renal pelvis. The overall incidence of the positive cytology cases was 66.2%. To define the cytologic features of tumor cells, we tried to use three cytologic gradings such as "grade 1", "grade 2", and "grade 3" according to the cytologic degree of anaplastic neoplastic cells. These cytologic gades of TCC were relatively well correlated with the histologic grade and tumor invasiveness. This result suggests that the recognition of characteristic cellular features of TCC can suspect the histologic grade and tumor stage. The false negative TCC cases were 78.9%. They showed severe inflammatory or bloody background and a few neoplastic cells. Therefore, a cautious approach for accurate interpretation, personal experience, and proper fixation and processing could expand the role of urinary cytology.
- Fine Needle Aspiration Cytology of Kimura's Lymphadenitis with Characteristic Warthin-Finkeldey Type Polykaryocytes: A Case Report.
-
Yeon Mee Kim, Hye Je Cho
-
Korean J Cytopathol. 1995;6(1):48-53.
-
-
-
Abstract
PDF
- Kimura's disease is a chronic inflammatory disorder of unknown etiology, presenting usually as a painless subcutaneous swelling in the head and neck region or in the lymph nodes. We experienced a case of Kimura's lymphadenitis with characteristic Warthin-Finkeldey type polykaryocytes by fine needle aspiration cytology. The patient was a 10 - year old male, with two enlarged lymph nodes in the postauricular area. Fine needle aspiration cytology from the lymph nodes disclosed hypercellular smears with some scattered eosinophils and polykaryocytes in a polymorphous lymphoid background. There were also fragmented vessel walls and activated endothelial cell clusters in the slightly necrotic background. The Warthin-Finkeldey type polykaryocytes had three to thirty nuclei and prominent nucleoli with ill defined cytoplasmic borders. Their nuclei were arranged in grapevine or ring shaped clusters. As these polykaryocytes could also be found in lymph nodes and extranodal tissues of both reactive and neoplastic lymphoid disorders, polykaryocytes themselves are clinically nonspecific.
However, the morphologic features of the Warthin-Finkeldey type giant cells are quite different from the foreign body type or Langhans' type giant cells. When the characteristic cytologic features of Kimura's disease such as significant number of eosinophils in a background of lymphoid cells asd proliferation of vessels and endothelial cells are also observed in the smear, it is possible to suggest this diagnosis in the appropriate clinical setting.
|
E-submission
