Journal of Pathology and Translational Medicine

Yeong Jin Choi

32 Articles

Detection Limit of Monoclonal B-Cells Using Multiplex PCR and Laser-Induced Fluorescence Capillary Electrophoresis.: Sung Hak Lee, Yeonsook Moon, Byunghoo Song, Hyung Nam Lee, Ahwon Lee, Eun Sun Jung, Yeong Jin Choi, Kyo Young Lee, Chang Suk Kang, Gyeongsin Park; Korean J Pathol. 2011;45(6):582-588.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.582

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BACKGROUND
The identification of monoclonality has been widely used for making diagnoses of lymphoproliferative lesions. Awareness of the sensitivity and detection limit of the technique used would be important for the data to be convincing.
METHODS
We investigated the minimum requirement of cells and sensitivity of gel electrophoresis (GE) and laser-induced fluorescence capillary electrophoresis (LFCE) for identifying IgH gene rearrangement using BIOMED-2 protocols. DNA extracted from Raji cells were diluted serially with peripheral blood mononuclear cells (PBMNCs) DNA. DNA from mixtures of diffuse large B-cell lymphoma (DLBCL) and reactive lymph nodes were also serially diluted.
RESULTS
For Raji cells, the detection limit was 62 and 16 cell-equivalents for GE and LFCE, respectively. In the condition with PBMNCs mixture, 2.5% and 1.25% of clonal cells was the minimum requirement for GE and LFCE, respectively. In 23% of DLBCL cells in tissue section, the detection limit was 120 and 12 cell-equivalents for GE and LFCE, respectively. In 3.2% of DLBCL cells, that was 1,200 and 120 cell-equivalents for GE and LFCE, respectively.
CONCLUSIONS
These results show that LFCE method is more sensitive than GE and the sensitivity of clonality detection can be influenced by the amount of admixed normal lymphoid cells.

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Molecular pathology diagnosis of diffuse large B cell lymphoma using BIOMED-2 clonal gene rearrangements
Saeid Ghorbian
Annals of Diagnostic Pathology.2017; 29: 28. CrossRef

Prognostic Significance of Amplification of the c-MYC Gene in Surgically Treated Stage IB-IIB Cervical Cancer.: Tae Jung Kim, Ahwon Lee, Sung Jong Lee, Won Chul Lee, Yeong Jin Choi, Kyo Young Lee, Chang Suk Kang; Korean J Pathol. 2011;45(6):596-603.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.596

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Abstract PDF

BACKGROUND
Mutations of c-MYC have been described in cervical cancer. However, association between c-MYC gene status and its prognostic significance have not been clarified.
METHODS
Tissue microarray sections from 144 patients with stage IB-IIB cervical cancer treated by radical hysterectomy were analyzed by fluorescence in situ hybridization using a region-specific probe for c-MYC and a centromere-specific probe for chromosome 8.
RESULTS
Seventy five percent (108/144) of c-MYC gain and 6.9% (10/144) of c-MYC gene amplification were observed. c-MYC gene alteration was more frequently observed in squamous cell carcinoma than adenocarcinoma or adenosquamous carcinoma and were associated with low Ki67 labeling index (p=0.013). c-MYC amplification was not associated with clinicopathologic parameters except absence of bcl2 expression (p=0.048). Survival analysis revealed that patients with c-MYC amplification were significantly associated with higher risk of disease recurrence (p=0.007) and cancer related death (p=0.020). However, c-MYC gain was not associated with unfavorable outcome. Multivariate analysis proved c-MYC amplification as independent prognostic factors of shorter disease free survival and cancer-related death (p=0.028 and p=0.025, respectively).
CONCLUSIONS
c-MYC amplification, not gain, is an independent prognostic marker for shorter disease free and cancer specific survival in cervical cancer treated by radical hysterectomy.

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A Rare Case of Cutaneous Plasmacytosis in a Korean Male
Corey Georgesen, Meenal Kheterpal, Melissa Pulitzer
Case Reports in Pathology.2017; 2017: 1. CrossRef

The Usefulness of p16INK4a Immunocytochemical Staining in ASC-H Patients.: Kwang Il Yim, Yeo Ju Kang, Tae Eun Kim, Gyeongsin Park, Eun Sun Jung, Yeong Jin Choi, Kyo Young Lee, Chang Seok Kang, Ahwon Lee; Korean J Pathol. 2011;45(3):290-295.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.290

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Abstract PDF

BACKGROUND
The grey zone of cervical cytology, and in particular atypical squamous cells, cannot exclude HSIL (ASC-H) causes diagnostic difficulties and increases medical expenses. We analyzed p16INK4a expression in ASC-H liquid-based cytology specimens (LBCS) to develop more effective methods for the management of ASC-H patients.
METHODS
We carried out p16INK4a immunostaining with 57 LBCS of ASC-H diagnostic categories, all of which were histologically cofirmed and 43 cases of which were compared with the results of a human papillomavirus (HPV) chip test.
RESULTS
p16INK4a immunostaining with ASC-H LBCS was positive in 20% (3/15) of cervicitis, 25.0% (3/12) of tissue-low-grade squamous intraepithelial lesion, 75.0% (18/24) of tissue-high grade squamous intraepithelial lesion (HSIL), and 100% (6/6) of invasive cancer cases. The positivity of p16INK4a in LBCS was correlated with higher grade of histologic diagnosis (r=0.578, p=0.000). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of p16INK4a immunostaining for the prediction of tissue-HSIL+ were 80.0%, 77.8%, 80.0%, and 77.8%, respectively. The sensitivity, specificity, PPV, and NPV of p16INK4a immunostaining plus HPV chip test for predicting tissue-HSIL+ were 71.2%, 86.4%, 84.2%, and 79.2%.
CONCLUSIONS
p16INK4a immunostaining as well as HPV chip testing with remaining LBCS with ASC-H are useful objective markers for the prediction of tissue-HSIL+.

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Usefulness of p16INK4a Immunocytochemical staining for the Differentiation between Atrophy and ASCUS in Diagnosis of Uterine Cervical Cancer
Hye Ryoung Shin, Taekil Eom, Wan-Su Choi
Biomedical Science Letters.2023; 29(3): 144. CrossRef

Apocrine Carcinoma of the Axilla with Predominant Signet Ring Cell Features A Case Report.: Jeana Kim, Tae Eun Kim, Ah Won Lee, Yeong Jin Choi, Kyo Young Lee, Eun Sun Jung; Korean J Pathol. 2011;45(3):326-328.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.326

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Abstract PDF: Apocrine carcinoma arising from the apocrine sweat glands is a rare cutaneous malignant tumor which occurs predominantly in the axilla of elderly individuals. The typical histologic features of apocrine carcinoma is within a well developed glandular lumina with abundant eosinophilic cytoplasm and evidence of decapitation secretion. In rare instances, predominant signet ring cell features in apocrine carcinoma has been reported. We experienced a case that occured in the right axilla of a 59-year-old. Histopathologic examination showed a solid tumor that extended from the upper dermis into the subcutis, with a delicate infiltrate of epithelial cells. The cells had granular amphophilic cytoplasm, predominantly showed distinct signet ring cell morphology, and were strongly positive for epithelial mucin. Both lysozyme and gross cystic disease fluid protein-15 were identified in the tumor cells. We diagnosed this to be a case of primary signet ring cell apocrine carcinoma of the axilla after several immunohistochemical and clinical evaluations.

Practical Standardization in Renal Biopsy Reporting.: So Young Jin, Hyeon Joo Jeong, Sun Hee Sung, Beom Jin Lim, Jee Young Han, Soon Won Hong, Hyun Ee Yim, Yeong Jin Choi, Yong Mee Cho, Myoung Jae Kang, Kyung Chul Moon, Hee Jeong Cha, Seung Yeon Ha, Mi Seon Kang, Mee Young So, Kwang Sun Suh, Jong Eun Joo, Yong Jin Kim, Nam Hee Won, Moon Hyang Park; Korean J Pathol. 2010;44(6):613-622.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.613

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Abstract PDF

BACKGROUND
To standardize renal biopsy reporting and diagnosis, The Renal Pathology Study Group of the Korean Society of Pathologists (RPSKSP) has developed a renal pathology reporting format for the native and allograft kidney.
METHODS
A consensus checklist of a provisional renal biopsy format was sent to all members of the RPSKSP. Feed back opinions regarding the practical application of the checklist to the diagnostic work were received.
RESULTS
Kidney biopsies require three essential examinations: by light microscopy, immunofluorescence (IF), and electron microscopy (EM). A final report of a renal biopsy should include information on specimen adequacy and a description of the morphologic change using a systematic semiquantitative method for each of the compartments, with optional separate IF and EM reports.
CONCLUSIONS
A standard renal biopsy report format is important in establishing clinicopathologic correlations, making reliable prognostic considerations, comparing the findings in sequential biopsies and evaluating the effects of therapy.

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Additional antihypertensive effect of magnesium supplementation with an angiotensin II receptor blocker in hypomagnesemic rats
Kyubok Jin, Tae Hee Kim, Yeong Hoon Kim, Yang Wook Kim
The Korean Journal of Internal Medicine.2013; 28(2): 197. CrossRef
Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis
Tai Yeon Koo, Gheun-Ho Kim, Hyang Park
Korean Journal of Pathology.2012; 46(2): 105. CrossRef

Comparison of Detecting Methods of BK Virus Infection in Patients with Renal Allograft Recipients.: Sung Hak Lee, Youn Jun Park, Chul Woo Yang, Yong Soo Kim, In Sung Moon, Chang Suk Kang, Yeong Jin Choi; Korean J Pathol. 2010;44(6):636-641.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.636

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Abstract PDF

BACKGROUND
BK virus nephropathy (BKVN) is an emerging problem as a consequence of the use of potent immunosuppressive agents. Because optimal detection methods for the diagnosis of BKVN are required clinically, we compared the results of renal allograft biopsy, urine cytology, and urine and blood viral loads.
METHODS
Four hundred sixty two case notes from 2004 to 2009 at Seoul St. Mary's Hospital were reviewed. During that period, 286 cases of urine cytology for decoy cells, 938 cases of urine BKV reverse transcription-polymerase chain reaction (RT-PCR), and 1,029 cases of blood BKV RT-PCR were performed. All diagnostic methods were performed in 85 cases.
RESULTS
A histological diagnosis of BKVN was made in 2.4% of cases (11/462). Urine cytology for decoy cells was positive in 26.2% (75/286). BKV RT-PCR revealed viruria in positivity of 22.1% (207/938) and viremia in 5.2% (54/1,029). In cases of BKVN, the sensitivities of urine and blood BKV RT-PCR were all 100% and the specificities were 69% and 94.5%, respectively. In cases with positive urine decoy cells, the sensitivities of urine and blood BKV RT-PCR were 50% and 27.7%, with specificities of 77.7% and 100%, respectively.
CONCLUSIONS
BKV screening by RT-PCR assays may be a clinically useful noninvasive test to identify renal recipients with concurrent BKVN.

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Prevalence of BK Virus among Iranian Renal Transplant Recipients: A Systematic Review and Meta-Analysis
Mohsen Ebrahimi, Alireza Mohebbi, Mohammad Mostakhdem Hashemi, Mobina Ashrafi Shahmirzadi
Journal of Clinical and Basic Research.2020; 4(4): 50. CrossRef
Asymptomatic hematuria associated with urinary polyomavirus infection in immunocompetent patients
Sung Hak Lee, Sung Hoo Hong, Ji Youl Lee, Tae Kon Hwang, Kyoung Suk Kim, Hyoungnam Lee, Yeong Jin Choi
Journal of Medical Virology.2014; 86(2): 347. CrossRef

Evaluation of the HPV ISH Assay in Cervical Cancer.: Jung Uee Lee, Jung Ha Shin, Jong Ok Kim, Yeong Jin Choi, Kyo Young Lee, Jong Sup Park, Won Chul Lee, Ahwon Lee; Korean J Pathol. 2010;44(5):513-520.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.513

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Abstract PDF

BACKGROUND
Human papillomavirus (HPV) infection can be detected by in situ hybridization (ISH), in which a punctate signal pattern indicates integrated HPV DNA and a diffuse pattern denotes the presence of episomal viral DNA. This study was conducted to evaluate the usefulness of an HPV ISH assay for invasive cervical cancer.
METHODS
The HPV ISH assay for high-risk HPV and immunohistochemical staining for p16(INK4a), p53, bcl-2, and Ki-67 were performed in a tissue microarray of 279 cervical cancers.
RESULTS
High-risk HPV ISH was positive in 194 (69.5%) of the samples. Punctate, diffuse, and mixed signal patterns were observed in 157 (56.3%), one (0.4%), and 36 cases (12.9%), respectively. Positive results in high-risk HPV ISH were associated with p16 and bcl-2 expression (p = 0.01 and p < 0.01, respectively). According to a Cox regression analysis, HPV infection and its surrogate immunohistochemical markers such as p16, bcl-2, and Ki-67 were not independent prognostic factors, but stage and grade were independent prognostic factors.
CONCLUSIONS
Our results confirm that an HPV ISH assay is reasonably sensitive for HPV infection and that it might be useful to identify integrated HPV DNA in formalin-fixed and paraffin-embedded specimens. Further study encompassing HPV type, E2/E6 ratio, and therapeutic modality is necessary to understand the clinical meaning of HPV status in cervical cancer.

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Prevalence of human papillomavirus in eyelid carcinoma among Koreans: a clinicopathological study
Min Kyu Yang, Namju Kim, Hokyung Choung, Ji Eun Kim, Sang In Khwarg
BMC Ophthalmology.2023;[Epub] CrossRef
Cervical cancer screening by molecular Pap‐transformation of gynecologic cytology
Shaikhali M Barodawala, Kirti Chadha, Vikas Kavishwar, Anuradha Murthy, Shamma Shetye
Diagnostic Cytopathology.2019; 47(5): 374. CrossRef
Prognostic Significance of Amplification of thec-MYCGene in Surgically Treated Stage IB-IIB Cervical Cancer
Tae-Jung Kim, Ahwon Lee, Sung-Jong Lee, Won-Chul Lee, Yeong-Jin Choi, Kyo-Young Lee, Chang Suk Kang
The Korean Journal of Pathology.2011; 45(6): 596. CrossRef

Comparison of Various Detection Methods of Mycobacterium Species in Formalin-Fixed Paraffin-Embedded Tissue with Chronic Granulomatous Inflammation.: Hyun Seung Lee, Hyoungnam Lee, Soyoung Im, Yun Su Lee, Kyo Young Lee, Yeong Jin Choi; Korean J Pathol. 2010;44(3):259-266.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.3.259

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Abstract PDF

BACKGROUND
To determine the most effective method for detecting mycobacteria in formalin- fixed paraffin-embedded (FFPE) tissue, we compared the results of Ziehl-Neelsen stain (ZNS) and mycobacterial culture with those of polymerase chain reaction (PCR) and real-time quantitative PCR (RQ-PCR).
METHODS
We analyzed 54 cases diagnosed as chronic granulomatous inflammation. In all cases, ZNS and nested PCR using three different primers, IS6110, Mpb64 and IS6110/Rpobeta were done. RQ-PCR with the IS6110/Rpobeta primer was done in 51 cases.
RESULTS
Mycobacteria were identified by ZNS in 15/54 (27.8%) cases. RQ-PCR had the highest sensitivity (80.0%) compared to PCR with IS6110 (73.3%), Mpb64 (60.0%) and IS6110/Rpobeta (73.3%). Specificity was higher in all PCR experiments (79.5-82.1%) than in RQ-PCR (69.4%) experiments. The false negative rate was lowest for RQ-PCR (20.0%) than for PCR with IS6110 (26.7%), Mpb64 (40.0%) and IS6110/Rpobeta (26.7%). The false positive rate was highest for RQ-PCR (30.6%) compared to PCR with IS6110 (20.5%), Mpb64 (17.9%) and IS6110/Rpobeta (20.5%).
CONCLUSIONS
RQ-PCR had the highest sensitivity, and the lowest false negative rate, but it also had a higher false positive rate than PCR for detection of mycobacteria in FFPE tissues.

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Clinical Usefulness of PCR for Differential Diagnosis of Tuberculosis and Nontuberculous Mycobacterial Infection in Paraffin-Embedded Lung Tissues
Yo Na Kim, Kyoung Min Kim, Ha Na Choi, Ju Hyung Lee, Ho Sung Park, Kyu Yun Jang, Woo Sung Moon, Myoung Jae Kang, Dong Geun Lee, Myoung Ja Chung
The Journal of Molecular Diagnostics.2015; 17(5): 597. CrossRef
Usefulness of PCR to Mycobacterium Tuberculous and Nontuberculous Mycobacteria from Paraffin-embedded Tissues
Yeon-Il Choi, Hye-Young Kim
Korean Journal of Clinical Laboratory Science.2014; 46(2): 47. CrossRef

Clinicopathologic Significances of EGFR Expression at Invasive Front of Colorectal Cancer.: Yeo Ju Kang, Chan Kwon Jung, Yeong Jin Choi, Kyo Young Lee, Hyung Jin Kim, Won Kyung Kang, Seong Taek Oh; Korean J Pathol. 2010;44(1):16-21.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.16

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Abstract PDF: BACKGROUND
Epidermal growth factor receptor (EGFR) is frequently expressed in the invasive front of colorectal cancer (CRC), but its clinicopathologic significance remains unclear. We investigated the clinical value of the EGFR expression at the invasive front of CRC.
METHODS
We performed an immunohistochemical analysis in order to examine the expression and distribution of EGFR in 214 cases of CRC. The EGFR status was considered positive when > or =1% of the tumor cells had membranous staining.
RESULTS
Overall, an EGFR expression was observed in 144 (67%) cases and it had no significant relationship with the clinicopathologic parameters. However, an EGFR expression at the invasive front was correlated with lymphatic invasion, lymph node metastasis and a high level of serum carcinoembryonic antigen (p = 0.028, p = 0.043, and p = 0.045, respectively). For the budding-positive CRCs liver metastases were found in the cases with an EGFR expression at the budding, but no liver metastasis occurred in the EGFR negative cases at the budding (p = 0.030).
CONCLUSIONS
An EGFR expression at the invasive front has clinicopathologic significances in patients with CRC. An EGFR expression at tumor cell budding is a pathologic marker that suggests the high potential for liver metastasis in CRC.

C1q Nephropathy: A Distinct Pathologic Entity.: Jung Ha Shin, Tae Eun Kim, Kyo Young Lee, Sang In Shim, Yeong Jin Choi; Korean J Pathol. 2009;43(4):335-341.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.335

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Abstract PDF: BACKGROUND
C1q nephropathy (C1qN) is a controversial diagnostic entity defined by Jennette and Hipp in 1985. The prevalence is very low and a few large scale studies have been reported. Application of the criteria for clinical diagnostics of C1qN may cause confusion with other glomerulonephropathies, such as minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS). In order to clarify the confusion with glomerulonephropathies, we did this study to identify the clinicopathological characteristics and the exact disease entity of C1qN.
METHODS
A total of 5,258 kidney biopsies at Kangnam St Mary's Hospital were reviewed. Twenty three cases (0.44%) met the criteria of C1qN. Twenty eight cases showing dominant C1q deposits without electron dense depostis (EDD) grouped as C1q+EDD-, and previously diagnosed typical cases of MCD and FSGS were selected for this study. Four groups were compared to each other with regard to the clinical and pathological aspects of the disease. RESULTS: C1qN patients had an average age of 30.4 years. Eighteen were males and 5 were females. Eighty seven percent had proteinuria and 18% had hematuria. By electron microscopy analysis, 100% had mesangial EDD and 47.8% showed foot process effacement. C1qN had some significant differences compared with C1q+EDD-, MCD and FSGS. CONCLUSIONS: C1qN is clinically and morphologically different from MCD and FSGS. However, additional long term studies are needed to fully define C1qN from other glomerulonephritis with C1q deposits.

IgA Nephropathy: Correlation of WHO Classification and Morphologic Semi-quantitative Scoring System.: Kyung Jin Seo, Tae Jung Kim, Kyo Young Lee, Sang In Shim, Yeong Jin Choi; Korean J Pathol. 2009;43(3):244-249.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.244

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Abstract PDF

BACKGROUND
IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, and the clinical course of IgAN shows marked variability. Many efforts have made to histologically predict the clinical outcome. There are two methods to classify IgAN. One is mainly based on the glomerular changes, such as the WHO and the Lee and Haas classification systems. The other is a morphologic semi-quantitative scoring system, which counts the changes of the glomerular, tubulointerstitial and vascular structures, respectively. The purpose of this study is to determine whether the WHO classification properly reflects the various morphologic findings of IgAN.
METHODS
We analyzed 354 cases of IgAN by both the WHO classification system and the semiquantitative scoring system and evaluated the correlations of these two methods.
RESULTS
The severity of the glomerular lesions (glomerulosclerosis, capsular adhesion and mesangial matrix expansion) and the tubulointerstitial lesions (interstitial fibrosis, tubular atrophy and interstitial lymphocytic infiltration) are strongly correlated with the increase of the WHO classes of IgAN (Spearman's rho [R] > or =0.5, p<0.05). There is a weak correlation between crescent formation and the increase of the WHO classes (R=0.3, p<0.05).
CONCLUSIONS
This study shows that the WHO classification well reflects the severity of various morphologic findings and this suggests a complementary role for the semi-quantitative scoring system in classifying IgAN.

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The Oxford classification as a predictor of prognosis in patients with IgA nephropathy
S. H. Kang, S. R. Choi, H. S. Park, J. Y. Lee, I. O. Sun, H. S. Hwang, B. H. Chung, C. W. Park, C. W. Yang, Y. S. Kim, Y. J. Choi, B. S. Choi
Nephrology Dialysis Transplantation.2012; 27(1): 252. CrossRef

A Comparision of Surepath(TM) Liquid-Based Smear with a Conventional Smear for Cervicovaginal Cytology-with Reference to a Histological Diagnosis.: Kyung Chul Lee, Chan Kwon Jung, Ahwon Lee, Eun Sun Jung, Yeong Jin Choi, Jong Sup Park, Kyo Young Lee; Korean J Cytopathol. 2007;18(1):20-28.

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Abstract PDF: This study was performed to compare Surepath(TM) liquid-based smear and a conventional cervicovaginal smear with reference to a histological diagnosis. A hybrid capture test (HCII) was also performed and analyzed. We collected matched cases for cervicovaginal cytology- histology: 207 cases for conventional cytology (CC) and 199 cases for liquid-based cytology (LBC). HCII was performed in 254 patients. When a cytological diagnosis of ASCUS or above (ASCUS+) is classified as positive and a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 91.7% and 75.9%, respectively and the sensitivity and specificity for CC was 62.6% and 96.1%, respectively. When a cytological and histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 77.5 and 96.6%, respectively and the sensitivity and specificity for CC was 49.7% and 100%, respectively. When a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for HCII was 78.9% and 78.1%, respectively. The concordance ratio between the cytological and histological diagnosis was 80.4% (kappa=76.0) for LBC and 56.5% (kappa=55.1) for CC. LBC is more sensitive and less specific then CC, as a cytological cutoff level of ASCUS, but more sensitive and equally specific, as a cytological cutoff level LSIL or HSIL. LBC is more reliable with a high concordance ratio between the cytological and histological diagnosis.

Eosinophilic Cytoplasmic Globules in Papillary Renal Cell Carcinoma: A Case Report.: Ok Ran Shin, Jae Young Park, Hae Kyung Lee, Young Seok Lee, Chang Hee Han, Sung Hak Kang, Kyo Young Lee, Yeong Jin Choi; Korean J Pathol. 2006;40(6):466-468.

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Abstract PDF: Eosinophilic cytoplasmic globules may be seen in a variety of neoplastic and nonneoplastic conditions and are most often associated with alpha-1-antitrypsin deficiency, several pathologic liver conditions and yolk sac tumors. A few cases of eosinophilic cytoplasmic globules in renal cell carcinoma have been reported but there has only been one report of papillary type. We report another case of papillary renal cell carcinoma with eosinophilic cytoplasmic globules, which is similar to a Mallory body but with different properties.

Clinicopathologic Analysis of the Micropapillary Variant of Urothelial Carcinoma in Urinary.: Kyungji Lee, Ahwon Lee, Yeong Jin Choi, Kyo Young Lee, Chang Suk Kang, Sang In Shim; Korean J Pathol. 2006;40(4):263-268.

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Abstract PDF: BACKGROUND
Micropapillary urothelial carcinoma of urinary bladder is a rare and aggressive subtype of urothelial carcinoma (UC).
METHODS
AND RESULTS: Seven UCs with a micropapillary component (MPC) were identified by reviewing 135 cystectomy specimens of UC (5.2% in incidence). MPC was associated with conventional UC in 6 cases and the plasmacytoid variant of UC in 1 case. Lymph node metastasis, that characteristically contained MPC was present in 60% (3 out of 5 cases of regional lymph node dissection). Three patients with extensive MPC showed laminar propria invasion (pT1; 33%) and perivesical fat invasion (pT3; 67%). Two out of 3 patients with extensive MPC showed distant metastasis into the colon after cystectomy. The colonic lesions showed exclusively micropapillary differentiation. Four patients with focal or moderate MPC (pT2, 25%; pT3, 75%) were alive without disease at the time of writing this article. All 3 cases with extensive MPC had surface and/or invasive MPC on the prior TURB specimen. Immunohistochemically, the tumor cells were positive for cytokeratin 7, cytokeratin 20, EMA and E-cadherin and tissue retraction spaces that simulate lymphatic spaces were negative for CD34 in all 7 cases.
CONCLUSIONS
This study suggests that the micropapillary growth pattern in UC is a manifestation of aggressive behavior and UC with MPC must be included as part of the differential diagnosis when dealing with a metastatic lesion with a micropaillary structure.

ISUP/WHO Classification of Papillary Urothelial Neoplasms of Urinary Bladder: Consensus Study Conducted by Korean Society of Urogenital Pathology.: Jung Weon Shim, Jae Y Ro, Nam Hoon Cho, Young Sik Kim, Yong Wook Park, Sang In Shim, Dong Wha Lee, Yeong Jin Choi, Woon Sup Han; Korean J Pathol. 2006;40(4):282-288.

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Abstract PDF: BACKGROUND
Pathologic grading, one of the most important prognostic factors of papillary urothelial neoplasia (PUN) of the urinary bladder, has been revised continuously. The current study focused on the analysis of interobserver agreement on PUN of the urinary bladder bet- ween 1973 WHO classification (WHO 1973) and 1998 WHO/ISUP classification.
METHODS
Seventy five cases from 15 institutions were collected, and after review by Korean Society of Urogenital Pathology (KSUP), 30 cases were selected as follows; group I, WHO grade 1 and papillary urothelial neoplasm of low malignant potential by ISUP (7 cases), group II, WHO grade 2 and low-grade papillary urothelial carcinoma (16 cases), and group III, WHO grade 3 and high-grade papillary urothelial carcinoma (7 cases). Seventy five general surgical pathologists who participated in this study were asked to grade the tumors based on WHO/ISUP classification. Interobserver agreement between the participants' diagnosis and KSUP consensus diagnosis was analyzed by kappa value.
RESULTS
Interobserver agreement assessed by kappa value for all diagnostic groups was very low; for group I, kappa value was -0.900893722; for group II, -0.944650025, and for group III, -0.876728996. The overall kappa value of pathology residents was better than that of practicing pathologists.
CONCLUSIONS
The 1998 WHO/ ISUP classification could not be easily translated from the 1973 WHO classification and because of poor interobserver agreement, it appears that further work would be needed before it can be practically applied.

Epidermoid Cyst in the Kidney with Nephrolithiasis: A Case Report.: Changyoung Yoo, Yeong Jin Choi, Kyoyoung Lee, Sang In Shim, Chang Suk Kang; Korean J Pathol. 2005;39(5):348-350.

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Abstract PDF: Epidermoid cysts in the kidney have rarely been reported, and in most cases its pathogenesis has not been well understood. We report a case of an epidermoid cyst in a kidney with nephrolithiasis in a 61-year-old man. A pyelonephrolithotomy was performed on the patient four years ago to treat nephrolithiasis of the left kidney. During the follow-up, a newly developed mass was discovered three years ago and the mass has recently increased in size. A unilateral nephrectomy was performed under the clinical impression of renal cell carcinoma. Gross examination revealed a well encapsulated cystic mass measuring 3.0 x 2.0 x 2.0 cm and containing lumps of soft whitish material, in the upper pole of the left kidney. This location was the same as that of previous nephrolithiasis. Microscopic examination revealed typical findings of an epidermoid cyst. We suspect that the chronic irritation induced by renal stones may be associated with the development of the epidermoid cyst in this case.

Combined IgA Nephropathy and Membranous Glomerulonephritis : A Report of Six Cases.: Ji Han Jung, Yeong Jin Choi, Yong Soo Kim, Yoon Sik Chang, Byung Kee Bang, Sang In Shim, Chang Suk Kang; Korean J Pathol. 2005;39(4):278-283.

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Abstract PDF: IgA nephropathy (IgAN) and membranous glomerulonephritis (MGN) are common in adults. However, it is unlikely that these two distinct glomerulonephrites coexist in a renal biopsy. Here, we report clinical and pathological data of six patients with concomitant existence of IgAN and MGN in renal biopsy specimens from 1990 to 2004. Five patients were male and one was female, and their ages ranged from 29 to 71 years. Four patients had microscopic hematuria, five had nephrotic range proteinuria, three had hepatitis B virus infections, three had rheumatoid factors, one had antinuclear antibodies. Two cases were developed after kidney transplant. Immunofluorescence microscopy showed characteristic findings of mesangial IgA deposits and granular IgG deposits on the capillary walls. These were confirmed by electron microscopic findings of immune-type electron-dense deposits in the mesangium and subepithelial capillary basement membranes. The pathogenesis and prognosis of the patients are discussed in this report.

The Apoptotic Molecular Changes of Cellular Injury in Mouse Testis Induced by Endocrine Disrupting Chemicals.: Eun Hui Wang, Kweon Heang Lee, Ki Hwa Yang, Jinsuk Lee, Eun Sun Jung, Chang Suk Kang, Yeong Jin Choi; Korean J Pathol. 2004;38(4):228-237.

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Abstract PDF: BACKGROUND
Spermatogenesis is regulated by various cellular reactions, and especially cell proliferation and apoptosis.
METHODS
We investigated the morphological changes and the apoptotic molecular changes in mouse testis induced by the endocrine disrupting chemicals. ICR mice were treated with bisphenol A (BPA), 2-bromopropane (2-BP) and diethylstilbesterol (DES). Histological examination and immunohistochemical staining, TUNNEL staining and RNAse protection assay were conducted.
RESULTS
Testes treated with BPA showed normal spermatogenesis and the proliferation activity, and the density of the cells was similar with those in the control. 2-BP and DES groups, which showed a decrease of germ cells near the basal layer and degenerative changes. The proliferative activity identified by PCNA staining was significantly decreased in the 2-BP and DES groups (p<0.05). The apoptosis was significantly increased in the 2-BP group however, a significant decrease was noted in the BPA group (p<0.05). Among apoptosis-related molecules, the expression of Fas, Fas ligand, TRAIL, TNFp55 and caspase 1, 3, 6 and 8 were changed according to the change of the degree of apoptosis in all groups.
CONCLUSIONS
Endocrine disrupting chemicals induced cellular injury in mouse testis through the changes of proliferative activity and apoptosis which was regulated by a number of apoptosis-related molecules. This probably results in the abnormality of spermatogenesis in mouse testis.

Chromophobe Renal Cell Carcinoma.: Yeong Jin Choi, Tae Kon Hwang, Youn Soo Lee, Eun Jung Lee, Seok Jin Kang, Byung Kee Kim, Sang In Shim; Korean J Pathol. 1999;33(4):259-266.

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Abstract PDF: We report 13 chromophobe renal cell carcinomas (10.8%) observed among 120 renal cell carcinomas in adults. The average age was 53 (range: 34-72) years old, and 6 were males and 7 females. The mean tumor size was 10 (range: 5-17) cm, mean nuclear grade 2.4, and mean Robson's stage was 1.9. There were two distinct histologic variants; typical variant (n=9) and eosinophilic variant (n=4). Both of them showed typical light microscopic features and positive reaction with Hale's colloidal iron and carbonic anhydrase II, a marker protein of intercalated cells of renal collecting ducts. A strong positive immunoreactivity for epithelial membrane antigen was noted in the cytoplasm in 12 of 13 tumors. Numerous microvesicles, 180~440 nm in diameter, were identified ultrastructurally. DNA aneuploidy was found in 3 out of 10 cases. Neither local recurrence nor metastasis have been identified during the following period of 4~144 (mean 48) months.

Sarcomatoid Transitional Cell Carcinoma of the Renal Pelvis A report of two cases.: Kyo Young Lee, Mi seon Kwon, Yeong Jin Choi, Chang Suk Kang, Seok Jin Kang, Baying Kee Kim, Sang In Shim; Korean J Pathol. 1999;33(2):128-132.

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Abstract: Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.

Papillary Adenocarcinoma of Nonpigmented Ciliary Epithelium of the Eye.: Hyun Joo Choi, Yeong Jin Choi, Youn Soo Lee, Eun Jung Lee, Seok Jin Kang, Byung Kee Kim, Sang In Shim; Korean J Pathol. 1998;32(12):1104-1107.

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Abstract: Adenocarcinoma of the ciliary epithelium is a rare tumor, usually occuring in elderly patients who have a history of severe ocular trauma or chronic inflammation. We report an adenocarcinoma of the nonpigmented ciliary epithelium found within the phthisical globe of a 36-year-old female whose eye had been loss of vision since infancy. The mass, measured 4.0 x 4.0 cm, was relatively limited by sclera but had invasion to posterior portion. Histologically, the tumor was a compact mass which consisted of tubular and papillary structures with foci of the pleomorphic area. Strands of cells and individual cells were invested with thick basement membrane that have positivity for periodic acid-Schiff stain. Immunohistochemical staining showed strong reactivity for cytokeratin and epithelial membrane antigen, and focal for neuron-specific enolase and S-100 protein.

Histopathology and Mainz Classification of Renal Cell Tumors: A Histogenetic Study and DNA Content Analysis.: Yeong Jin Choi, Tae Kon Hwang, Youn Soo Lee, Byung Kee Kim, Sun Moo Kim, Sang In Shim; Korean J Pathol. 1998;32(7):511-520.

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Abstract: The Mainz classification for renal cell tumors was introduced in 1986 and it's utility has been reported in several histogenetic and genetic studies of renal cell tumors. We present a study of 127 cases of renal cell tumors with clinicopathologic correlation, DNA content analysis, and histogenesis studied by histochemical and immunohistochemical staining. The 127 renal cell tumors classified by the Mainz classification were 87 clear cell, 17 chromophilic, 13 chromophobe and 3 sarcomatoid renal cell carcinomas, 5 oncocytomas and 2 adenomas. These subtypes showed significant correlation not with age, sex, Robson's stage, DNA ploidy or tumor recurrence but with nuclear grade (p=0.001) and tumor size (p=0.001). Hall's colloidal iron (p=0.002) and carbonic anhydrase II (p=0.013) stains, representing the origin of distal nephron especially of collecting duct, were significantly correlated with specific subtypes of renal cell tumors, especially chromophobe cell renal carcinoma. This study demonstrates that the Mainz classification suggests several morphologically different subtypes and variants of renal cell tumors and that some of them may have originated from the distal nephron, particularly from the collecting duct.

Acanthamoeba Keratitis: Microscopic and Ultrastructural Findings: A case report.: Hee Jung Lee, Yeong Jin Choi, Tae Won Hahn, Seok Jin Kang, Byung Kee Kim, Sang In Shim; Korean J Pathol. 1998;32(6):466-469.

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Abstract: Acanthamoeba keratitis is uncommon and rarely reported in Korea. It has been reported in world literature as a very severe, progressive necrotizing stromal keratitis due to a non-parasitic free-living amoeba. It is frequently associated with minimal corneal trauma especially from contact lens but sometimes occurs in patients without any past history. We report a case of acanthamoeba keratitis without a specific past history in a 42-year-old man. Light and electron microscopy demonstrated severe stromal keratitis with numerous thick-walled cysts, 10~15 m in diameter, scattered in the superficial and deep stroma. Because this keratitis is most often mistaken for fungal, bacterial or herpetic keratitis, early confirmatory diagnosis by direct smear, biopsy or culture is essentially required for the prevention of visual loss or devastating eyeball loss.

Pigmented Squamous Cell Carcinoma Arising from Pigmented Actinic Keratosis.: Hyun Joo Choi, Gyeong Sin Park, Seok Jin Kang, Yeong Jin Choi, Byung Kee Kim, Sun Moo Kim, Sang In Shim; Korean J Pathol. 1998;32(1):76-79.

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Abstract PDF: Pigmented squamous cell carcinoma is a very rare malignant, pigmented, epidermal tumor. The rarity of pigmented squamous cell carcinomas may reflect in part their misdiagnosis as other pigmented neoplasms, particularly malignant melanoma. To our knowledge, only five cases have been reported in literature. We recently experienced a case of pigmented squamous cell carcinoma arising from pigmented actinic keratosis in a 77 years old female. Physical examination showed a 0.8 0.6 cm, smooth, dark brown pigmented patch with irregular but sharply defined borders located on the upper left chest. The biopsy specimen showed histologic findings of pigmented actinic keratosis with abundant melanin pigments, which became pigmented squamous cell carcinoma. Most of pigments in the squamous cell carcinoma were contained within the melanocytes along with the neoplastic squamous cells.

Fine Needle Aspiration Cytology of Intracystic Papillary Carcinoma of the Breast.: Ah Won Lee, Yeong Jin Choi, Kyo Young Lee, Byung Kee Kim, Sun Moo Kim, Sang In Shim; Korean J Cytopathol. 1997;8(2):179-184.

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Abstract PDF: Intracystic papillary carcinoma(IPC) of the breast is a distinctive and very rare variant of intrductal carcinoma. The cytologic features of IPC have been rarely reported, and there are difficulties in distinguishing between benign and malignant papillary breast lesions. Herein we report a IPC of the breast in a 80 year-old female. Fine needle aspiration cytology revealed monotonous cuboidal epithelial cells in small clusters and individually scattered on bloody background. The tumor cells did not show overt cytologic atypia. With the histologic features of this case and review of the literature, the cytologic differential points are discussed.

Cytologic Findings of Polyomavirus Infection in the Urine: A Case Report.: Mi Seon Kwon, Young Shin Kim, Kyo Young Lee, Yeong Jin Choi, Chang Suk Kang, Sang In Shim; Korean J Cytopathol. 1996;7(2):192-196.

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Abstract PDF: The principal significance of the urothelial changes caused by polyomavirus activation is in an erroneous diagnosis of urothelial cancer; however, the clue to their benign nature is the smooth structureless nuclear configuration and the relative paucity of affected cells. Though virologic studies and electron microscopy are usually needed to firmly establish the diagnosis, cytology is the most readily available and rapid means of establishing a presumptive diagnosis of human polyomavirus infection. A urine specimen of a 24-year-old man with hemorrhagic cystitis beginning two months after bone marrow transplantation for acute myeloblastic leukemia(M2) was submitted for cytologic evaluation. Cytologic findings revealed a few inclusion-bearing epithelial cells intermingled with erythrocytes, neutrophils, lymphocytes, and macrophages. Most of the inclusion-bearing -cells had large, round to ovoid nuclei almost completely filed with homogeneous dark, basophilic inclusion. The chromatin was clumped along the periphery and the cytoplasm was mostly degenerated. The other cells exhibited irregular inclusions attached to the nuclear membrane surrounded by an indistinct halo. These findings were consistent with polyomavirus infection.

Cytologic Features of Renal Cell Carcinoma: Clear Cell, Granular Cell and Oncocytoma.: Yeong Jin Choi, Youn Soo Lee, Mi Seon Kwon, Kyo Young Lee, Byung Kee Kim, Sang In Shim; Korean J Cytopathol. 1996;7(1):31-37.

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Abstract PDF: It is well known that fine needle aspiration biopsy(FNAB) is very useful and has a high accuracy rate in the diagnosis of renal neoplasms. Although there is some indecision to perform the FNAB for a rare possibility of tumor seeding along the biopsy needle tract, it tends to be used increasingly. As in the cytologic diagnosis of metastatic lesion through out the body, renal cell carcinoma should nearly always be considered in the differential diagnosis, the precise understainding of cytologic features of renal cell carcinoma with various cell types and architectural patterns is necessarily required. In this report, we present three cases of primary renal cell tumors, two of renal cell carcinomas and one of oncocytoma, preponderantly emphasizing the cytologic differential points in the FNAB specimen.

Well-Differentiated Thymic Carcinoma, Spindle Cell Type, Arising from Anterior Mediastinum: A case report.: Hun Kyung Lee, Yeong Jin Choi, Seok Jin Kang, Byung Kee Kim, Sun Moo Kim, Sang In Shim; Korean J Pathol. 1995;29(6):800-803.

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Abstract PDF: Well differentiated thymic carcinoma(WDTC) was recently separated from cortical thymoma. It is characterized by a predominance of epithelial cells with usually low mitotic rate, an epidermoid differentiation with slight to moderate cytologic atypia and lobular growth pattern. In recent reports, an uncommon spindle cell variant of WDTC, which is composed of spindle shaped epithelial cells, has been described. We investigated an unusual case of WDTC consisted of purely spindle shaped epithelial cells in a 66-year-old female. Radiologically, the well demarcated mass was located in the anterior mediastinum with focal invasion into the surrounding left upper lung. The tumor, 10 x 8 x 5 cm, was encapsulated with thin fibrous tissue and showed a pale yellow solid and lobulated cut surface. Microscopically, it consisted of solid sheets of purely spindle shaped epithelial cells with mild atypism, a low mitotic rate and focal epidennoid differentiation.

Kaposi's Sarcoma: A report of three cases.: Yeon Soo Lee, Yeong Jin Choi, Mi Kyung Jee, Seok Jin Kang, Byoung Kee Kim, Sun Moo Kim; Korean J Pathol. 1995;29(3):385-390.

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Abstract PDF: The classic type of Kaposi's sarcoma, or multifocal hemorrhagic sarcoma histologically characterized by proliferating fibroblastic and microvascular elements was described by Kaposi as a relatively rare neoplasm. During the past nine years, we experienced three cases of sporadic, classic Kaposi's sarcomas. They were presented as multiple papules, macules and nodules on the skin of the hands, lower logs and feet without systemic involvement. Histologically, Kaposi's sarcoma is divided into three stages, early patch, plaque and nodular stages. The nodular lesions(case 1, 2 and 3) showed extensive proliferatiion of spindle shaped, somewhat pleomorphic cells having dark prominent nuclei, proliferation of small vessels with solid aggregates of endothelial cells, and extravasation of erythrocytes. In early patch stage(case 3), widely dilated, anastomosing, thin-walled vascular spaces are noted in the upper half of the dermis. In plaque stage(case I and 3), there are proliferation of spindle shaped cells with extravasated erythrocytes and aggregates of blood vessels lined by prominent endothelial cells.

Crescentic Glomerulonephritis in a Patient with Rheumatoid Arthritis: A case report.: Ki Ouk Min, Yeong Jin Choi, Byoung Kee Kim, Sun Moo Kim, Sang In Shim; Korean J Pathol. 1995;29(1):116-118.

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Abstract PDF: Crescentic glomerulonephritis in rheumatoid arthritis is described recently with increasing frequency. It can occur directly as a manifestation of rheumatoid arthritis or may be a reaction to drugs such as D-penicillamine and bucillamine. We report a case of crescentic glomerulonephritis in a 46-year-old woman with rheumatoid arthritis for 20 years who had been treated intermittently with herb medicine or nonsteroidal anti-inflammatory drugs (NSAIDS). Light microscopic examination showed severe focal segmental and global necrotizing glomerulonephritis with crescent formation in 50% of the glomeruli. Immunofluorescent study revealed scanty amount of mesangial granular deposits of IgA, IgM, C3 and fibrinogen in a diffuse pattern.

Proliferating Trichilemmal Tumor: Report of four cases.: Yeong Jin Choi, Mi Kyung Jee, Seok Jin Gang, Byoung Kee Kim, Sun Moo Kim, Soo Il Chung; Korean J Pathol. 1990;24(2):176-182.

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Abstract PDF: Proliferating trichilemmal tumor is relatively rare, and is generally considered to be a benign tumor that can be histologically mistaken for well-differentiated squamous cell carcinoma. The proliferating trichilemmal tumor is thought to be a tumor with differentiation toward the hair structure because the characteristic trichilemmal keratinization in this tumor is analogous to that of the outer root sheath of anagen hair or the trichilemmal sac surrounding catagen hair. We report four cases of proliferating trichilemmal tumor removed by surgical excision.

Tumorlet of Lung Associated with Congenital Bronchogenic Cyst: Report of a case.: Yeong Jin Choi, Mi Kyung Jae, Seok Jin Kang, Byoung Kee Kim, Sun Moo Kim; Korean J Pathol. 1989;23(1):141-144.

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Abstract PDF: Tumorlet is a rare lesion of disputed origin that was first described by whitwell in 1955, and about one-third of the reported cases have been associated with underlying lung disease. Patient was a 60-year-old female who was admitted with a histroy of chest discomfort and dyspnea. Right lower lobe was partially resected under the clinical diagnosis of the bronchogenic cyst. Grossly, lung tissue around round cystic lesion appeared brown firm and somewhat fibrotic, and showed several scattered ill-defined whitish gray nodules. Microscopically, lung tissue around bronchogenic cyst was partially obliterated by dense fibrous scar tissue. Within this areas of fibrosis, and in the wall of alveolar ducts and respiratory bronchioles, innumerable microscopic tumorlets were found and argyrophilic granules were also demonstrated in scattered tumorlets with Grimelius stain.

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