Journal of Pathology and Translational Medicine

Yoo Duk Choi

14 Articles

Distinction of Pulmonary Large Cell Neuroendocrine Carcinoma from Small Cell Lung Carcinoma Using a Panel of Bcl-2, p63, and 34betaE12.: Jun Zhe Li, Chan Choi, Yoo Duk Choi, Kook Joo Na; Korean J Pathol. 2011;45(2):170-174.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.2.170

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Abstract PDF: BACKGROUND
Making the distinction between large cell neuroendocrine carcinoma (LCNEC) and small cell lung carcinoma (SCLC) is difficult in some samples of biopsy tissues, but we have to separate LCNEC from SCLC because the two types of cancer may need different therapy and they have different prognostic implications. Thus far, there are no specific immunohistochemical markers that allow distinguishing these two kinds of tumors.
METHODS
We performed an immunohistochemical analysis to study the expressions of p63, Bcl-2, and 34betaE12 and to investigate whether these 3 molecules have correlations in LCNEC and SCLC. We also evaluated the expression of the neuroendocrine markers chromogranin, synaptophysin and CD56.
RESULTS
A statistical analysis was performed for p63, Bcl-2, and 34betaE12 in separate and combined panels. According to the combinations of p63, Bcl-2, and 34betaE12, there were frequent expressions of p63-/Bcl-2+ or Bcl-2+/34betaE12- in the SCLC, and there was a superior proportion of them in the SCLC rather than that in the LCNEC. The p63-/Bcl-2+ and Bcl-2+/34betaE12- antibody combinations showed higher specificities compared to any single antibody for diagnosing SCLC.
CONCLUSIONS
Bcl-2 and selective p63 or 34betaE12 made up a most useful panel of markers for making the differential diagnosis of LCNEC and SCLC.

Odontogenic Keratocyst Associated with an Ectopic Tooth in the Maxillary Sinus: A Report of Two Cases and a Review of the Literature.: Hyuk Il Kwon, Won Bong Lim, Ji Sun Kim, Young Jong Ko, In Ae Kim, Suk Ja Yoon, Yoo Duk Choi, Hong Ran Choi, Ok Joon Kim; Korean J Pathol. 2011;45:S5-S10.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S5

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Odontogenic keratocysts are benign intraosseous tumors of odontogenic origin that occur most commonly in the jaw. In particular, they have a predilection for the angle and ascending ramus of the mandible. In contrast, odontogenic keratocysts arising in the maxillary sinus are relatively rare. Two such cases are reported herein. In addition, the English literature that concerns odontogenic keratocysts of the maxillary sinus is reviewed.

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Diagnostic Dilemma of Odontogenic keratocyst Mimicking a Dentigerous Cyst: A Case Report
Georgia Benitha, Syed Wali Peeran
International Journal of Head and Neck Pathology.2023; 6(2): 6. CrossRef
Keratocystic odontogenic tumor associated with impacted maxillary third molar extending to the antrum: A challenging diagnosis
Roozbeh Pahlevan, Farnaz Keyhanlou, Sahar Fazel, Fatemeh Shahsavari
Human Pathology: Case Reports.2019; 15: 59. CrossRef
Current Concepts and Occurrence of Epithelial Odontogenic Tumors: II. Calcifying Epithelial Odontogenic Tumor Versus Ghost Cell Odontogenic Tumors Derived from Calcifying Odontogenic Cyst
Suk Keun Lee, Yeon Sook Kim
Korean Journal of Pathology.2014; 48(3): 175. CrossRef
Keratocystic Odontogenic Tumor with an Ectopic Tooth in Maxilla
Basavaraj T. Bhagawati, Manish Gupta, Gaurav Narang, Sharanamma Bhagawati
Case Reports in Dentistry.2013; 2013: 1. CrossRef
A Large Keratocystic Odontogenic Tumor
Saurabh Jolly, Jeevan Lata
World Journal of Dentistry.2013; 4(2): 138. CrossRef

HPV Genotyping in Squamous Cell Carcinoma of Upper Aerodigestive Tract.: Young Kim, Eun Hui Jeong, Byung Woo Min, Sung Sun Kim, Yoo Duk Choi, Woon Jae Jung, Jong Hee Nam, Chang Soo Park; Korean J Pathol. 2010;44(5):483-487.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.483

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Abstract PDF

BACKGROUND
Smoking and alcohol consumption are the main risk factors for squamous cell carcinoma of the upper aerodigestive tract (SCCUAT). However, human papillomavirus (HPV) has been etiologically linked with tonsillar squamous cell carcinoma (TSCC). Therefore, we investigated the etiologic role of HPV in the context of SCCUAT in Korea.
METHODS
Archival paraffin block samples from 136 cases previously diagnosed as SCCUAT were randomly selected. A commercial HPV DNA chip was used for HPV genotyping.
RESULTS
One hundred and seventeen cases were available after checking beta-globin (47 cases of tonsil and 70 of non-tonsil). A HPV-positive result (HPV 16 and 18) occurred in 13 cases of SCCUAT, and 12 cases were tonsil (25.5%, 12/47). Among the 12 HPV-positive patients with TSCC, nine were non-smokers and non-drinkers. Most HPV-negative patients with TSCC had a history of alcohol drinking and smoking (32/35, 91.4%). HPV infection status was not significantly associated with histological grade, clinical stage, or survival in patients with TSCC.
CONCLUSIONS
HPV infection was significantly higher in patients with TSCC among those with SCCUAT. HPV may be independent risk factor in development of TSCC, such as smoking and alcohol drinking.

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Prevalence of high-risk human papillomavirus and its genotype distribution in head and neck squamous cell carcinomas
Yuil Kim, Young-Hoon Joo, Min-Sik Kim, Youn Soo Lee
Journal of Pathology and Translational Medicine.2020; 54(5): 411. CrossRef

DNA Methylation Profiles of MGMT, DAPK1, hMLH1, CDH1, SHP1, and HIC1 in B-Cell Lymphomas.: Sung Sun Kim, Young Hyo Choi, Chang Woo Han, Yoo Duk Choi, Youngkyu Park, Je Jung Lee, Hyeoung Joon Kim, Il Kwon Lee, Ji Shin Lee, Sang Woo Juhng, Chan Choi; Korean J Pathol. 2009;43(5):420-427.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.420

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Abstract PDF

BACKGROUND
This study was designed to examine the prevalence of aberrant promoter methylation in a selected panel of genes potentially involved in lymphoid tumors.
METHODS
The promoter hypermethylation status of MGMT, DAPK1, hMLH1, CDH1, SHP1, and HIC1 was measured by methylation-specific PCR for 82 cases of B-cell lymphoma. Immunohistochemical staining using MGMT and SHP1 antibodies was conducted on 43 out of 82 cases.
RESULTS
The number of MGMT aberrant methylations was lower in diffuse large B-cell lymphoma (DLBCL) than in other malignant lymphomas. The methylation of DAPK1 was frequently detected in follicular lymphoma (FL), marginal zone B-cell lymphoma (MZL) and DLBCL. With one exception, methylation of hMLH1 was not observed in B-cell lymphomas. The methylation frequency of CDH1, and HIC1 was similar in B-cell lymphomas. However, the methylation of SHP1 gene was more frequently observed in cases of FL, DLBCL, and MZL than in chronic lymphocytic lymphoma. MGMT and SHP1 promoter methylation were inversely correlated with the protein expression observed upon immunohistochemical staining.
CONCLUSIONS
Aberrant promoter methylation of multiple genes occurs with variable frequency throughout the B-cell lymphomas, and methylation of hMLH1 is rarely observed in B-cell lymphomas.

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Plasma DNA methylation of p16 and shp1 in patients with B cell non-Hodgkin lymphoma
Kai Ding, Xiaoshuang Chen, Yihao Wang, Hui Liu, Wenjing Song, Lijuan Li, Guojin Wang, Jia Song, Zonghong Shao, Rong Fu
International Journal of Clinical Oncology.2017; 22(3): 585. CrossRef
Hypermethylation of p15 Gene in Diffuse – Large B‐Cell Lymphoma: Association with Less Aggressiveness of the Disease
Milena Krajnović, Maja Peruničić Jovanović, Biljana Mihaljević, Boško Anđelić, Olivera Tarabar, Slavica Knežević‐Ušaj, Koviljka Krtolica
Clinical and Translational Science.2014; 7(5): 384. CrossRef

Cytologic Diagnosis of Malignant Pleural Effusion in Multiple Myeloma: Two Case Reports.: Yoo Duk Choi, Sung Sun Kim, Chang Woo Han, Ji Shin Lee, Jong Hee Nam, Sang Woo Juhng, Chan Choi; Korean J Pathol. 2009;43(4):382-385.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.4.382

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Abstract PDF

Malignant pleural effusion in multiple myeloma (MM) is extremely rare and is associated with poor prognosis. We experienced two cases of MM IgA type with malignant pleural effusion. The diagnoses were based on characteristic cytology and CD138 immunocytochemistry. The patients received several cycles of combination chemotherapy, since symptoms were more aggressive with an uncontrolled pleural effusion. We review the clinical features of these cases and literature concerning myelomatous pleural effusion.

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Características de los pacientes con derrame pleural mielomatoso. Revisión sistemática
V. Riveiro, L. Ferreiro, M.E. Toubes, A. Lama, J.M. Álvarez-Dobaño, L. Valdés
Revista Clínica Española.2018; 218(2): 89. CrossRef
Characteristics of patients with myelomatous pleural effusion. A systematic review
V. Riveiro, L. Ferreiro, M.E. Toubes, A. Lama, J.M. Álvarez-Dobaño, L. Valdés
Revista Clínica Española (English Edition).2018; 218(2): 89. CrossRef
A 76-Year-Old Man With Anemia, Bone Pain, and Progressive Dyspnea
Thitiporn Suwatanapongched, Prapaporn Pornsuriyasak, Wasana Kanoksil, Thotsaporn Morasert, Warapat Virayavanich
Chest.2014; 145(4): 913. CrossRef

Analysis of HPV-other Samples by Performing HPV DNA Sequencing.: Yoo Duk Choi, Chang Woo Han, Woon Jae Chung, Woon Won Jung, Ji Shin Lee, Jong Hee Nam, Min Cheol Lee, Sang Woo Juhng, Ho Sun Choi, Chang Soo Park; Korean J Pathol. 2009;43(3):250-253.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.250

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Abstract PDF

BACKGROUND
HPV-other samples are designated as being positive on HPV-PCR, but negative when using specific HPV hybridization probes. We wanted to determine the types on the HPV-other samples by performing sequencing, and to know the pathologic status of the uterine cervix according to the HPV type detected on sequencing.
METHODS
For HPV genotying, we used the commercially available HPV DNA Chip test, which contains 15 types of high-risk HPV and 9 types of low-risk HPV. The HPV DNA sequencing was performed for the HPV-other samples of 209 patients who subsequently underwent cervical biopsy.
RESULTS
For 204 of the 209 samples, the HPV types detected by sequencing were absent types at used HPV DNA chip. For the remaining 5 samples, sequencing was impossible due to mixed peaks. HPV-81 (19.6%), HPV-61 (18.6%), HPV-62 (16.7%) and HPV-84 (13.9%) were frequently detected. For the HPV-81, -62, -71, and -72 samples, most of the samples displayed normal or LSIL. However, HPV-84 and -61 were more associated with HSIL or worse, as compared to the other types.
Conclusion
HPV-81, -61, -62 and -84 were frequently found on sequencing analysis of the HPV-other samples. The pathologic status was diverse, according to the HPV type detected on sequencing.

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Changes in microbial composition and interaction patterns of female urogenital tract and rectum in response to HPV infection
Yong-Hong Dong, Yu-Hua Luo, Chen-Jian Liu, Wen-Yu Huang, Lin Feng, Xing-Yuan Zou, Jin-Yan Zhou, Xiao-Ran Li
Journal of Translational Medicine.2024;[Epub] CrossRef
Cervical Dysplasia, Infection, and Phylogeny of Human Papillomavirus in HIV-Infected and HIV-Uninfected Women at a Reproductive Health Clinic in Nairobi, Kenya
Agnes Omire, Nancy L. M. Budambula, Leah Kirumbi, Hillary Langat, Danvas Kerosi, Washingtone Ochieng, Raphael Lwembe
BioMed Research International.2020; 2020: 1. CrossRef
Molecular characterisation of genital human papillomavirus among women in Southwestern, Nigeria
Yewande T. Nejo, David O. Olaleye, Georgina N. Odaibo, Jason Blackard
PLOS ONE.2019; 14(11): e0224748. CrossRef
Sequencing analysis of HPV-other type on an HPV DNA chip
Min-Jeong Kim, Jin Ju Kim, Sunmie Kim
Obstetrics & Gynecology Science.2018; 61(2): 235. CrossRef
Molecular epidemiology and genotype distribution of Human Papillomavirus (HPV) among Arab women in the state of Qatar
Devendra Bansal, Asha A Elmi, Sini Skariah, Pascale Haddad, Laith J Abu-Raddad, Aysha H Al Hamadi, Nady Mohamed-Nady, Nahla M Affifi, Randa Ghedira, Elham Hassen, Asma AJ Al-Thani, Afaf AHM Al-Ansari, Ali A Sultan
Journal of Translational Medicine.2014;[Epub] CrossRef
HPV Prevalence and Detection of Rare HPV Genotypes in Hong Kong Women from Southern China with Cytological Abnormalities
Ngai Na Chloe Co, Lai-On Chu, Joseph K. F. Chow, Joseph W. O. Tam, Enders K. O. Ng
ISRN Virology.2013; 2013: 1. CrossRef
Type-specific prevalence of high-risk human papillomavirus by cervical cytology and age: Data from the health check-ups of 7,014 Korean women
Min-Jeong Kim, Jin Ju Kim, Sunmie Kim
Obstetrics & Gynecology Science.2013; 56(2): 110. CrossRef

Solitary Splenic Metastases from Uterine Cervical Cancer: Case Reports and Review of the Literature.: Jo Heon Kim, Yoo Duk Choi, Jae Hyuk Lee, Jong Hee Nam, Sang Woo Juhng, Yang Seok Koh, Chol Kyoon Cho, Chan Choi; Korean J Pathol. 2008;42(5):317-322.

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Abstract PDF: Splenic metastasis from gynecologic tumors is extremely rare, especially in the absence of apparent disease at other sites. We report two patients that underwent splenectomy for a solitary splenic metastasis from uterine cervical carcinoma. In case 1, a 54-year-old woman with FIGO Stage IIb squamous cell carcinoma of the uterine cervix treated with radiotherapy and chemotherapy developed a solitary splenic metastasis 10 months after initial treatment. In case 2, a 46-year-old woman with FIGO Stage IIb adenocarcinoma of the uterine cervix treated with radiotherapy and chemotherapy was found to have a solitary splenic metastasis 11 months after treatment. Thus all abdominal organs including the spleen must be evaluated for metastases during follow-up of gynecologic tumors.

Progressive Multifocal Leukoencephalopathy in the Immunocompromised Patients - 3 Cases Report.: Min Keun Shim, Jo Heon Kim, Chang Soo Park, Hyung Seok Kim, Yoo Duk Choi, Min Cheol Lee; Korean J Pathol. 2007;41(5):358-361.

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Abstract PDF: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from infection of oligodendrocytes with JC virus. PML was a rare disease, but nowadays not uncommon as AIDS prevailed. Histopathologic features of the affected lesion shows infiltrations of foamy macrophages and hyperchromatic, pleomorphic, reactive astrocytes that may raise the suspicion of a brain tumor. We recently met with 3 cases of PML. Two of the patients had AIDS and the other had been treated for lymphoma. All cases were diagnosed by histopathologic examination in stereotactic brain biopsies.

Tetranucleotide Repeat Microsatellite Instability in Uterine Cervical Carcinomas.: Yoo Duk Choi, Ji Shin Lee, Chan Choi, Chang Soo Park, Sang Woo Juhng, Ho Sun Choi, Jong Hee Nam; Korean J Pathol. 2007;41(1):30-37.

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Abstract PDF: BACKGROUND
Elevated levels of microsatellite alterations at selected tetranucleotide repeat regions (EMAST) have been recently described, and they are a distinct type of microsatellite instability (MSI). We investigated the prevalence of EMAST in squamous cell carcinoma (SCC) of the uterine cervix and we determined the correlation between EMAST and the clinicopathologic parameters, HPV infection and the p53 mutation.
METHODS
We examined the 3 mono-, 3 di-, and 5 tetranucleotide repeat markers in 47 cases of SCC, and we performed immunohistochemical staining for p53. HPV detection and genotyping was performed using a commercially available HPV DNA chip.
RESULTS
Thirteen out of 47 cases (27.7%) were EMAST(+) with at least one of five tetranucleotide repeat markers. However, MSI at mono- and dinucleo- tide markers was noted in only one case (2.1%). EMAST was not related with stage, size, lymph node metastasis, vascular/lymphatic invasion or the depth of invasion. Positive immunostaining for p53 was significantly more common in EMAST(+) tumors than in the EMAST(-) tumors (p=0.04). HPV-infection was positive in 32 cases. EMAST was not correlated with the state of HPV infection state or the HPV genotype.
CONCLUSIONS
27.7% of the invasive SCCs of the uterine cervix exhibited EMAST, and EMAST in the SCC of the uterine cervix was significantly associated with the p53 mutation.

Polycystic Kidney Disease Presenting as Subarachnoid Hemorrhage Due to Ruptured Cerebral Aneurysm: An Autopsy Case.: Yoo Duk Choi, Han Young Lee, Youn Shin Kim; Korean J Pathol. 2006;40(6):469-471.

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Abstract PDF: Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary disorder characterized by multiple expanding cysts in both kidneys, and they ultimately destroy the renal parenchyma and cause renal failure. Intracranial aneurysms are found in approximately 10% to 15% of ADPKD patients. Subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm is a frequent complication in patients with ADPKD and it makes up a considerable proportion of the causes of death in this group of patients. We report here an autopsy case of polycystic kidney disease that was morphologically identical to ADPKD, and the patients had presented after death with SAH due to a ruptured cerebral aneurysm.

Neurofilament Protein Subtype Expression in Neuronal Migration Disorders.: Hyun Sik Oh, Yoo Duk Choi, Hyun Joong Kim, Kyung Hwa Lee, Myoung Kyu Kim, Young Jong Woo, Jae Hyu Kim, Min Cheol Lee; Korean J Pathol. 2003;37(6):413-420.

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Abstract PDF: BACKGROUND
Neuronal migration disorder (NMD) is one of the causes of medically intractable epilepsy. As neurosurgical treatments for medically intractable epilepsy have expanded recently, precise histopathologic diagnosis is required. Histopathologic grading of NMD is important due to its association with neocortical development and expectation of prognosis. Many studies revealed abnormalities of neuronal cytoskeletal protein in abnormal neuronal cells of NMD.
METHODS
We performed immunohistochemical staining for neurofilament protein (NF) subtypes, one of the neuronal cytoskeletal proteins, and investigated the staining pattern of specific cells in each grade of NMD.
RESULTS
NF-L was more intensely labeled in perikarya, dendrites, and axons of normal or small sized dysplastic neurons, cytomegalic neurons, and balloon cells than of normal-looking neurons. Furthermore, positive reaction was more intense in high-grade lesion. NF-H and NF-M were mainly positive in the axons of gray and white matter and weakly positive in a few cytomegalic neurons and some balloon cells.
CONCLUSION
NF-L is a better marker than NF-H and NF-M for the detection of normal or small sized dysplastic neurons, cytomegalic neurons, and balloon cells and for grading of NMD.

Clonal Analysis of Neurofibroma by PCR Amplification of HUMARA Gene.: Jae Hyuk Lee, Seung Sang Han, Hyun Sik Oh, Yoo Duk Choi, Hyun Joong Kim, Kyung Hwa Lee, Jong Hee Nam, Chan Choi, Sang Woo Juhng; Korean J Pathol. 2003;37(6):421-428.

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Abstract PDF: BACKGROUND
While neurofibromas have generally been regarded as polyclonal hyperplastic lesions, it remains unclear whether the tumor is a true neoplasm or a hyperplastic lesion.
METHODS
Determination of clonality by X chromosome inactivation pattern was investigated in twenty-one cases of neurofibroma employing enzyme digestion and PCR of the HUMARA gene. The histological, immunohistochemical, and ultrastructural characteristics of the tumors were also examined.
RESULTS
Immunohistochemically, most of the tumor cells showed vimentin and S-100 protein positivity. Axons were demonstrated by neurofilament protein positivity and were seen mainly at the periphery and rarely in the central portion of the tumor. Ultrastructurally, the tumors were composed of a variety of cell types: perineurial cells, Schwann cells, fibroblasts, and axons. X chromosome inactivation analysis was completed on thirteen out of fifteen cases in which DNA was successfully extracted. Of thirteen neurofibromas that were heterozygous at the HUMARA loci, eleven showed a polyclonal pattern. The remaining two cases were considered as indeterminate for clonality because of unequal band intensity and failure to obtain the normal control DNA.
CONCLUSION
The results from this study suggest that neurofibromas are polyclonal in origin and might be a neoplastic lesion comprising non-neoplastic cells among constituent components.

Stromelysin-3 Expression in Squamous Intraepithelial Lesions and Invasive Squamous Cell Carcinoma of the Uterine Cervix.: Yoo Duk Choi, Eun Jung Park, Jong Hee Nam, Chang Soo Park; Korean J Pathol. 2002;36(6):389-393.

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Abstract PDF: BACKGROUND
Matrix metalloproteinase (MMP) plays an important role in the invasion and metastasis of epithelial neoplasms. Currently, detected stromelysin-3 (ST-3) (MMP-11) is thought to be associated with invasiveness in epithelial neoplasms. However, the study of the expression of stromelysin-3 in the uterine cervix is yet to be delineated.
METHODS
Stromelysin-3 expression in cervical invasive squamous cell carcinoma (SCC) and in squamous intraepithelial lesions (SIL) having potentiality to become invasive was studied by immunohistochemical analysis. We examined the correlation between ST-3 expression and the histopathological parameters of the invasive carcinoma, including growth pattern, lymph node involvement, and degrees of differentiation.
RESULTS
The stromelysin expression rates were as follows; 8.3% in low grade SIL (LSIL), 18.9% in High grade SIL (HSIL), and 75.6% in SCC. A statistical difference in the expression difference was exhibited only between invasive SCC and SIL, but not between LSIL and HSIL, even though HSIL showed a higher expression rate than LSIL. No significant association was found in invasive SCC between ST-3 expression and histopathological parameters.
CONCLUSIONS
ST-3 expression is associated with tumor invasiveness in squamous lesions of the uterine cervix and not with histopathological parameters in invasive SCC.

Clonality Study in Carcinosarcomas and Malignant Mixed Epithelial Tumors.: Eun Jung Park, Yoo Duk Choi, Jong Hee Nam, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng, In Seon Choi, Kyung Hee Kim, Chan Choi; Korean J Pathol. 2002;36(4):205-211.

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Abstract PDF: BACKGROUND
Tumors are usually considered to be clonal progeny of single transformed cells. Carcinosarcomas and malignant mixed epithelial tumors are examples where controversies exist regarding the singularity or multiplicity of their cell of origin.
METHODS
The authors examined the clonality of carcinosarcomas (7 cases) and malignant mixed epithelial tumor (5 cases) in female patients by X-chromosome inactivation as a marker. Each component of the tumors were picked up by the laser capture microscope. The polymorphic exon 1 CAG trinucleotide repeat in the X-linked human androgen receptor (HUMARA) gene was amplified by a polymerase chain reaction before and after treatment of the methylation-sensitive endonuclease HpaII.
RESULTS
Eleven cases were informative for clonality determination. Six out of seven carcinosarcomas and three out of four malignant mixed epithelial tumors revealed the same patterns of X-chromosome inactivation, which suggests that they are monoclonal. In contrast, the patterns of X-chromosome inactivation were different between the two tumor components in each cases of carcinosarcoma and malignant mixed epithelial tumor, indicating that they are of polyclonal origin.
CONCLUSIONS
These observations show that although most of carcinosarcomas and malignant mixed epithelial tumors are of monoclonal origin, some of them are of polyclonal origin. This finding suggests that these tumors are genuinely polyclonal, and that they originated in the neoplastic transformation of more than one somatic cells

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