Journal of Pathology and Translational Medicine

Original Article

Prognostic Significance of a Micropapillary Pattern in Pure Mucinous Carcinoma of the Breast: Comparative Analysis with Micropapillary Carcinoma: Hyun-Jung Kim, Kyeongmee Park, Jung Yeon Kim, Guhyun Kang, Geumhee Gwak, Inseok Park; J Pathol Transl Med. 2017;51(4):403-409. Published online June 9, 2017; DOI: https://doi.org/10.4132/jptm.2017.03.18

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Background
Mucinous carcinoma of the breast is an indolent tumors with a favorable prognosis; however, micropapillary features tend to lead to aggressive behavior. Thus, mucinous carcinoma and micropapillary carcinoma exhibit contrasting biologic behaviors. Here, we review invasive mucinous carcinoma with a focus on micropapillary features and correlations with clinicopathological factors.
Methods
A total of 64 patients with invasive breast cancer with mucinous or micropapillary features were enrolled in the study. Of 36 pure mucinous carcinomas, 17 (47.2%) had micropapillary features and were termed mucinous carcinoma with micropapillary features (MUMPC), and 19 (52.8%) had no micropapillary features and were termed mucinous carcinoma without micropapillary features. MUMPC were compared with 15 invasive micropapillary carcinomas (IMPC) and 13 invasive ductal and micropapillary carcinomas (IDMPC).
Results
The clinicopathological factors of pure mucinous carcinoma and MUMPC were not significantly different. In contrast to IMPC and IDMPC, MUMPC had a low nuclear grade, lower mitotic rate, higher expression of hormone receptors, negative human epidermal growth factor receptor 2 (HER2) status, lower Ki-67 proliferating index, and less frequent lymph node metastasis (p < .05). According to univariate analyses, progesterone receptor, HER2, T-stage, and lymph node metastasis were significant risk factors for overall survival; however, only T-stage remained significant in a multivariate analysis (p < .05).
Conclusions
In contrast to IMPC and IDMPC, the micropapillary pattern in mucinous carcinoma does not contribute to aggressive behavior. However, further analysis of a larger series of patients is required to clarify the prognostic significance of micropapillary patterns in mucinous carcinoma of the breast.

Citations

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Pure mucinous adenocarcinoma of the breast with the rare lymphoplasmacytic infiltration: A case report with review of literature
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Expression of autocrine motility factor receptor (AMFR) in human breast and lung invasive micropapillary carcinomas
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International Journal of Experimental Pathology.2023; 104(1): 43. CrossRef
The Spectrum of Mucinous Lesions of the Breast
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On Ultrasonographic Features of Mucinous Carcinoma with Micropapillary Pattern
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Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis
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Breast Cancer: Targets and Therapy.2022; Volume 14: 41. CrossRef
Mucinous carcinoma of the breast: distinctive histopathologic and genetic characteristics
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Kosin Medical Journal.2022; 37(3): 176. CrossRef
Triple-Positive Breast Carcinoma: Histopathologic Features and Response to Neoadjuvant Chemotherapy
Jennifer Zeng, Marcia Edelweiss, Dara S. Ross, Bin Xu, Tracy-Ann Moo, Edi Brogi, Timothy M. D'Alfonso
Archives of Pathology & Laboratory Medicine.2021; 145(6): 728. CrossRef
HER2 positive mucinous carcinoma of breast with micropapillary features: Report of a case and review of literature
Dinesh Chandra Doval, Rupal Tripathi, Sunil Pasricha, Pankaj Goyal, Chaturbhuj Agrawal, Anurag Mehta
Human Pathology: Case Reports.2021; 25: 200531. CrossRef
Sonographic Features of Pure Mucinous Breast Carcinoma With Micropapillary Pattern
Wu Zhou, Yong-Zhong Li, Li-Min Gao, Di-Ming Cai
Frontiers in Oncology.2021;[Epub] CrossRef
Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho
Journal of Pathology and Translational Medicine.2020; 54(1): 95. CrossRef
Mucinous carcinoma with micropapillary features is morphologically, clinically and genetically distinct from pure mucinous carcinoma of breast
Peng Sun, Zaixuan Zhong, Qianyi Lu, Mei Li, Xue Chao, Dan Chen, Wenyan Hu, Rongzhen Luo, Jiehua He
Modern Pathology.2020; 33(10): 1945. CrossRef
Micropapillary pattern in pure mucinous carcinoma of the breast – does it matter or not?
Xiaoli Xu, Rui Bi, Ruohong Shui, Baohua Yu, Yufan Cheng, Xiaoyu Tu, Wentao Yang
Histopathology.2019; 74(2): 248. CrossRef
An Update of Mucinous Lesions of the Breast
Beth T. Harrison, Deborah A. Dillon
Surgical Pathology Clinics.2018; 11(1): 61. CrossRef
The clinicopathological significance of micropapillary pattern in colorectal cancers
Jung-Soo Pyo, Mee Ja Park, Dong-Wook Kang
Human Pathology.2018; 77: 159. CrossRef
The sonographic findings of micropapillary pattern in pure mucinous carcinoma of the breast
Heqing Zhang, Li Qiu, Yulan Peng
World Journal of Surgical Oncology.2018;[Epub] CrossRef
Diagnostic dilemma of micropapillary variant of mucinous breast cancer
Geok Hoon Lim, Zhiyan Yan, Mihir Gudi
BMJ Case Reports.2018; : bcr-2018-225775. CrossRef

Brief Case Report

Inflammatory Pseudotumor-like Follicular Dendritic Cell Tumor of the Spleen with Extensive Histiocytic Granulomas and Necrosis: A Case Report and Literature Review: Hyun-Jung Kim, Ji Eun Kim, Gu-Hyun Kang, Jung Yeon Kim, Kyeongmee Park; Korean J Pathol. 2013;47(6):599-602. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.599

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Epstein-Barr virus-positive inflammatory follicular dendritic cell sarcoma with significant granuloma: case report and literature review
Chenchen Nie, Xun Xie, Hangyan Li, Yangcan Li, Zhihong Chen, Yanchun Li, Zhenfeng Li
Diagnostic Pathology.2024;[Epub] CrossRef
Case report: Hepatic inflammatory pseudotumor-like follicular dendritic cell sarcoma: A rare case and minireview of the literature
Fan Ding, Chao Wang, Chi Xu, Hui Tang
Frontiers in Medicine.2022;[Epub] CrossRef
Inflammatory pseudotumor-like follicular dendritic cell sarcoma: Literature review of 67 cases
Hao Wu, Peng Liu, Xiao-Ran Xie, Jing-Shu Chi, Huan Li, Can-Xia Xu
World Journal of Meta-Analysis.2021; 9(1): 1. CrossRef
Granuloma With an Underlying Lymphoma: A Diagnostic Challenge and a Wider Histologic Spectrum Including Adult T-Cell Leukemia/Lymphoma
Chih-Ying Wu, Ren-Ching Wang, Bo-Jung Chen, Wei-Yu Chen, Jie-Yang Jhuang, Ming-Chih Chang, Yu-Hung Wu, Norihiro Nakada, Kennosuke Karube, Shih-Sung Chuang
Applied Immunohistochemistry & Molecular Morphology.2020; 28(4): 316. CrossRef
A Case of Laparoscopically Resected EBV-related Inflammatory Pseudotumor-Like Follicular Dendritic Cell Tumor of the Spleen
Tomoya HIRAI, Yuki HOMMA, Yasuhiro SHIMIZU, Takahumi KUMAMOTO, Ryusei MATSUYAMA, Shoji YAMANAKA, Itaru ENDO
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2020; 81(8): 1631. CrossRef
Histiocytic and Dendritic Cell Neoplasms
Zenggang Pan, Mina L. Xu
Surgical Pathology Clinics.2019; 12(3): 805. CrossRef
Inflammatory pseudotumor-like follicular dendritic cell sarcoma: A brief report of two cases
Bi-Xi Zhang, Zhi-Hong Chen, Yu Liu, Yuan-Jun Zeng, Yan-Chun Li
World Journal of Gastrointestinal Oncology.2019; 11(12): 1231. CrossRef
Diagnosis of EBV-Associated Inflammatory Pseudotumor in the Spleen: A Case Report
Dmitrii Il'ich Chebotarev, A.M. Kovrigina, S.M. Korzhova, K.I. Danishyan, K.R. Sabirov
Clinical oncohematology.2019; 12(4): 68. CrossRef
Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia
Aline Caldart Tregnago, Diogo Lago Morbeck, Felipe D’Almeida Costa, Antonio Hugo José Froes M. Campos, Fernando Augusto Soares, José Vassallo
Applied Cancer Research.2017;[Epub] CrossRef
Clinicopathological features of inflammatory pseudotumour‐like follicular dendritic cell tumour of the abdomen
Yanyang Chen, Huijuan Shi, Hui Li, Tiantian Zhen, Anjia Han
Histopathology.2016; 68(6): 858. CrossRef
Inflammatory pseudotumour-like follicular dendritic cell tumour of the spleen
R. Nishiyama, S. Baba, Y. Watahiki, H. Maruo
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Case Study

ThinPrep Cytological Findings of Desmoplastic Small Round Cell Tumor with Extensive Glandular Differentiation: A Case Study: Hyun-Jung Kim, Byeong Seok Sohn, Ji-Eun Kwon, Jeong Yeon Kim, Kyeongmee Park; Korean J Pathol. 2013;47(2):182-187. Published online April 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.182

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Abstract PDF

Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive neoplasm. The cytological diagnosis of this tumor has only been reported in a few cases. In most of these cases, the diagnosis was made using fine-needle aspiration cytology. Most DSRCTs resemble disseminated carcinomatoses in their clinical manifestation as well as cytomorphologically, even in young-adult patients. These authors report a case of using peritoneal-washing and pleural-effusion ThinPrep cytology to diagnose DSRCT, with extensive glandular differentiation and mucin vacuoles. We found that fibrillary stromal fragment, clinical setting, and adjunctive immunocytochemical staining were most helpful for avoiding misdiagnosis.

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Desmoplastic Small Round Cell Tumor Involving Serous Fluid: Cytologic Features and Diagnostic Pitfalls: A Series of 8 Cases
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American Journal of Clinical Pathology.2023; 160(4): 417. CrossRef
A Review of Effusion Cytomorphology of Small Round Cell Tumors
Lucy M. Han, Christopher J. VandenBussche, Mads Abildtrup, Ashish Chandra, Poonam Vohra
Acta Cytologica.2022; 66(4): 336. CrossRef
Intra-abdominal desmoplastic small blue round cell tumor: A case report
Tareq Hamed Al Taei, Hasan Al Fardan, Sarah Ali Al Mail
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Desmoplastic Small Round Cell Tumor of the Kidney: Report of a Case, Literature Review, and Comprehensive Discussion of the Distinctive Morphologic, Immunohistochemical, and Molecular Features in the Differential Diagnosis of Small Round Cell Tumors Affec
Carlos A. Galliani, Michele Bisceglia, Antonio Del Giudice, Giuseppe Cretì
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Intra-abdominal desmoplastic small round cell tumors: CT and FDG-PET/CT findings with histopathological association
JINGJING CHEN, ZENGJIE WU, BINBIN SUN, DACHENG LI, ZHENGUANG WANG, FANGJUN LIU, HUI HUA
Oncology Letters.2016; 11(5): 3298. CrossRef
Desmoplastic small round cell tumor with sphere‐like clusters mimicking adenocarcinoma
Yukinori Hattori, Akihiko Yoshida, Naoshi Sasaki, Yasuo Shibuki, Kenji Tamura, Koji Tsuta
Diagnostic Cytopathology.2015; 43(3): 214. CrossRef
Tumor intraabdominal desmoplásico de células pequeñas y redondas
Andrés Alejandro Briseño-Hernández, Deissy Roxana Quezada-López, Lilia Edith Corona-Cobián, Agar Castañeda-Chávez, Alfonso Tonatiuh Duarte-Ojeda, Michel Dassaejv Macías-Amezcua
Cirugía y Cirujanos.2015; 83(3): 243. CrossRef
Intra-abdominal desmoplastic small round cell tumour
Andrés Alejandro Briseño-Hernández, Deissy Roxana Quezada-López, Lilia Edith Corona-Cobián, Agar Castañeda-Chávez, Alfonso Tonatiuh Duarte-Ojeda, Michel Dassaejv Macías-Amezcua
Cirugía y Cirujanos (English Edition).2015; 83(3): 243. CrossRef
Diagnostic Pitfalls of Differentiating Desmoplastic Small Round Cell Tumor (DSRCT) From Wilms Tumor (WT)
Michael A. Arnold, Lynn Schoenfield, Berkeley N. Limketkai, Christina A. Arnold
American Journal of Surgical Pathology.2014; 38(9): 1220. CrossRef

Case Reports

Cystic Nephroma: A Case Report and Comparing Literature Review with Mixed Epithelial and Stromal Tumor of Kidney.: Hyun Jung Kim, Choong Hee Noh, Giyoung Kwon, Eunah Shin, Jung Yeon Kim, Kyeongmee Park; Korean J Pathol. 2011;45:S25-S28.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S25

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Abstract PDF: Cystic nephroma (CN) is a benign cystic neoplasm composed of mixed epithelial and stromal elements. Less than 200 cases have been reported. We had a patient, a 41-year-old woman, who had a huge typical CN. The patient was admitted for a right renal mass that was found incidentally. On laparaoscopic right nephrectomy, there was an encapsulated 7 cm multilocular cystic mass at the upper pole. Microscopically, the cystic wall was lined by a single layer of low cuboidal or hobnail epithelium without a solid area. The thin septa were composed of bland, ovarian type spindle cells. The main differential diagnoses were mixed epithelial and stromal tumor (MEST), low grade multilocular renal cell carcinoma, and tubulocystic carcinoma. The results of immunohistochemical staining were cytokeratin 7/19(+/+) and CD10(-) in lining epithelium, estrogen receptor/progesterone receptor(+/+) in stromal cells. After surgery, she was free of recurrence for 10 months. We report this rare case and compare it with other cystic renal tumors, especially MEST.

Bronchial Brushing Cytologic Finding of Primary Pulmonary Adenoid Cystic Carcinoma Misinterpretated as Small Cell Carcinoma: A Case Report with Literature Review.: Hyun Jung Kim, Sangbong Choi, Jieun Kwon, Jeong Yeon Kim, Kyeongmee Park; Korean J Pathol. 2011;45(4):441-444.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.441

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Abstract PDF

An adenoid cystic carcinoma is a very rare primary pulmonary neoplasm. Bronchial washing and brushing cytological findings of pulmonary adenoid cystic carcinoma have rarely been described. Here, we report the bronchial brushing cytological findings of an adenoid cystic carcinoma, finally diagnosed in a 71-year-old female patient. The low-power view showed moderate cellularity and cohesive clusters of small to medium-sized cells. The high-power view revealed distinct nuclear moldings, a coarse chromatin pattern, and inconspicuous nucleoli, which was favorable to a diagnosis of small cell carcinoma. However, apoptotic bodies, nuclear debris, and mitoses were not seen frequently. The bronchial biopsy showed solid, trabecular, and cribriform patterns in small cells. Periodic acid Schiff staining disclosed globular basement membrane-like materials, and the immunohistochemical staining revealed the presence of myoepithelial cell components, strongly suggestive of a salivary gland type tumor, compatible with an adenoid cystic carcinoma. In this report, we describe the exfoliative cytological features of a pulmonary adenoid cystic carcinoma with emphasis on some diagnostic pitfalls.

Citations

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Bronchial cytology of pulmonary adenoid cystic carcinoma – A multi-institute series with emphasis on immunocytochemistry
Joanna K.M. Ng, Ka Pang Chan, Gary M. Tse, Joshua J.X. Li
Annals of Diagnostic Pathology.2023; 64: 152132. CrossRef
Comprehensive Cytomorphologic Analysis of Pulmonary Adenoid Cystic Carcinoma: Comparison to Small Cell Carcinoma and Non-pulmonary Adenoid Cystic Carcinoma
Seokhwi Kim, Jinah Chu, Hojoong Kim, Joungho Han
Journal of Pathology and Translational Medicine.2015; 49(6): 511. CrossRef

Hairy Polyp of Soft Palate in an Infant.: Kyeongmee Park, Yeonmee Kim, Hoonyoung Woo; Korean J Pathol. 1998;32(12):1101-1103.

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Abstract: Hairy polyp is an uncommon lesion of the nasopharynx and oropharynx. It is most frequently seen as a pedunculated mass at birth or in the first year of life. It generally has been classified as dermoid derived from the ectoderm and mesoderm. The symptoms depend on the size and location of the lesion. We report the clinico-pathological features of a hairy polyp arising from the right nasopharyngeal side of soft palate in a 21-day-old girl. Grossly, a well demarcated brownish yellow solid mass, measuring 2.7x1.5x1.2 cm, showed fine hairs on the surface. The cut surface was a yellowish brown solid appearance. Microscopically, it was covered with keratinizing squamous epithelium and was composed of mature adipose tissue, skeletal muscle, a few peripheral nerve bundles, and blood vessels in the center and mature pilosebaceous units in the periphery. Knowledge of this type of malformation facilitates early intervention and avoids significant morbidity.

Original Articles

Comparing Fluorescence In Situ Hybridization and Immunohistochemistry to Determine the HER-2/neu Status in Breast Carcinoma.: Kyeongmee Park, Jungyoen Kim, Sungjig Lim; Korean J Pathol. 2002;36(4):243-248.

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Abstract PDF: BACKGROUND
Identification of HER-2/neu status is important in predicting the response to specific chemotherapy in breast carcinoma patients and HER-2/neu status is associated with poor clinical outcome even with systemic chemotherapy. Introduction of fluorescence in situ hybridization (FISH) allows an accurate assessment of the level of gene amplification with information about distribution of gene copies in histologic sections.
METHODS
HER-2/neu status was performed on paraffin sections of 176 primary breast carcinomas by FISH, using PathVysion and by immunohistochemistry (IHC), using HercepTest. The results of HER-2/neu amplification was compared with clinical and pathological prognostic factors.
RESULTS
HER-2/neu amplification and overexpression were detected in 51 tumors (29.0%) by FISH and 32 tumors (18.2%) by IHC. The results of each method agreed with each other in 157 tumors (concordance: 89.2%, kappa=0.783). HER-2/neu amplification was associated with poor nuclear grade, marked nuclear pleomorphism, and presence of the combined ductal carcinoma in situ in the invasive ductal carcinomas as well as Van Nuys grade of the ductal carcinoma in situ component (p<0.05).
CONCLUSIONS
The comparison of FISH and IHC demonstrated an excellent correlation of HER-2/neu overexpression 2+ and 3+ with gene amplification. However, FISH may be a more accurate and reliable method for negative and 1+ cases. HER-2/neu amplification proves to be of prognostic relevance.

Pilomatricoma (calcifying epithelioma of malherbe): a case report.: Kyeongmee Park, Jungweon Shim, Illhyang Ko; Korean J Cytopathol. 1991;2(2):168-171.

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Abstract PDF: No abstract available.

Immunocytochemical Assay of Cathepsin D in Fine Needle Aspiration Cytology of Breast Carcinoma and Benign Breast Diseases .: Kyeongmee Park, Illhyang Ko; Korean J Cytopathol. 2000;11(2):75-81.

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Abstract PDF: Cathepsin D is a protease which is known to facilitate invasion and metastasis of breast carcinoma. Overexpression of cathepsin D is associated with poor clinical outcome and biologic aggressiveness of the breast cancer. We underwent immunocytochemical assay(ICA) for cathepsin D in fine needle aspiration cytology(FNAC) specimens from the breast carcinoma and benign breast diseases. In FNAC specimens cathepsin D was expressed in 21(42.9%) out of 49 cases of invasive ductal carcinoma, whereas negative result was observed in all 15 cases of benign breast diseases including 7 fibroadenomas, 6 fibrocystic diseases, and 2 benign ductal hyperplasias. Among the 11 FNAC specimens from ductal carcinoma in situ(DCIS), cathepsin D was expressed in 3 cases(27.3%). In FNAC specimens immunocytochemistry for cathepsin D showed positive result in 24 out of 60 carcinomas(sensitivity, 40%) and negative result in 15 out of all 15 benign breast diseases(specificity, 100%). No significant correlation was noted between cathepsin D expression in FNAC specimen and clinicohistological characteristics of the breast carcinoma, such as hormone receptors and cell differentiation. In conclusion, ICA of cathepsin D in FNAC specimens thought to be a good adjunct to differentiate malignancy from benign breast diseases.

Case Report

Fine Needle Aspiration Cytology of Metastatic Alveolar Rhabdomyosarcoma Misinterpreted as Carcinoma: A Case Report.: Hyun Jung Kim, Sung Jik Lim, Kyeongmee Park; Korean J Cytopathol. 2005;16(1):52-56.

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Abstract PDF: Fine-needle aspiration cytology(FNAC) has been used extensively in the diagnosis of metastatic malignancies. However, metastatic soft tissue sarcomas are often overlooked, primarily due to the low frequency with which they occur. Here, we report a rare case of metastatic rhabdomyosarcoma in both cervical lymph nodes, which was detected by FNAC. A 45-year-old woman presented with anosmia, postnasal drip, and sneezing, symptoms which had persisted for 1 month. The patient was found to have a tumorous lesion at the upper portion of the mid-turbinate, with multiple enlarged cervical lymph nodes, and this lesion was examined closely at our facility. FNA cytology smears obtained from both cervical lymph nodes revealed a high degree of cellularity, and displayed cohesive clusters with gland-like spaces, as well as single isolated cells with abundant karyorrhectic debris. The tumor cells exhibited round to oval nuclei containing fine chromatin, occasional small nucleoli, and scanty cytoplasm, or a total lack of cytoplasm. Some of the tumor cells were arranged in multinucleated forms and abundant dense eosinophilic cytoplasms, reminiscent of a rhabdomyoblast. The histological findings of the lymph nodes revealed an outstanding sinusoidal infiltration and a prominent alveolar growth pattern, interspersed with occasional typical rhabdomyoblasts. The immunohistochemical results [desmin(+), myoglobin(+), myogenin (+), pan CK(-), synaptophysin(-), neuron specific enolase(-)] supported a confirmative diagnosis of alveolar rhabdomyosarcoma. Alveolar rhabdomyosarcoma is a representative sarcoma, which typically manifests with nodal metastasis and carcinoma-like clustering. The cytopathologist should remain alert upon encountering unusual morphology, so that the possibility of this condition, although somewhat remote, should not be dismissed or overlooked.

Review

Diagnostic Pitfalls in Breast Fine Needle Aspiration Cytology: False Positive and False Negative.: Kyeongmee Park; Korean J Cytopathol. 2007;18(2):112-118.

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Abstract PDF: Fine needle aspiration cytology (FNAC) has become a highly preferred, minimally invasive diagnostic tool of choice in the diagnosis of a palpable breast mass owing to its sensitivity, specificity, cost-effectiveness, and expediency. Although breast needle biopsies have been widely employed recently due to the increased detection rate of nonpalpable early lesions, the importance of the use of FNAC cannot be underestimated. It comprises part of the diagnostic triad for the breast along with a physical examination and mammography, which together contribute to an increasing diagnostic accuracy. The differential diagnosis of a benign and malignant lesion is of the utmost importance in the diagnosis of breast lesions, and therefore the understanding of the possible diagnostic pitfalls is of great importance.

Case Reports

Ki-1 Positive Extranodal NK/T Cell Lymphoma, Nasal Type, Mistaken as Dermatomyositis: A Case Report and Literature Review.: Hyun Jung Kim, Eunah Shin, Jung Yeon Kim, Kyeongmee Park, Young Jin Yoo, Seung Sook Lee; Korean J Pathol. 2007;41(4):278-283.

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Abstract PDF: We report a case of a 38-year-old male with extranodal NK/T-cell lymphoma, nasal type, showing unusual clinical and pathological features. The patient was admitted for soft tissue swelling and tenderness in both legs. The patient had been treated intermittently 8 months prior for repeated muco-cutaneous ulcers. A muscle biopsy showed medium-sized atypical lymphoid cells with bizarre nuclei and plump cytoplasm, infiltrating to the skeletal muscle fibers with angiocentricity. The immunoresults were Ki-1+, CD56+, cytoplasmic CD3+, with EBV-in situ hybridization +. The patient rapidly deteriorated and died of sepsis and respiratory failure shortly after initiation of low-dose chemotherapy. A careful review of previous biopsies revealed scarce atypical lymphoid cells around vessels with similar immunoprofiles without the presence of Ki-1 positive cells. This case emphasizes that an extranodal NK/T-cell lymphoma may have a dermatomyositis-like diffuse presentation. Ki-1 co-expression can be an unexpected event in a process of the disease course; however, this should be validated with future studies.

Synchronous Invasive Ductal Carcinoma and Metastatic Ovarian Serous Papillary Adenocarcinoma in the Same Breast: A Case Report.: Hyun Jung Kim, Sung jig Lim, Sehwan Han, Ji Young Kim, Kyeongmee Park; Korean J Pathol. 2006;40(1):66-69.

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Abstract PDF: A 59-year-old woman displayed multiple palpable right breast masses along with ipsilateral cervical and axillary lymphadenopathy. She had a previous history of bilateral salpingo-oopho- rectomy for serous papillary adenocarcinoma two and half years ago. She underwent mastectomy for the lesions located in the upper inner breast quadrant. A 1 cm-sized primary ductal carcinoma was present; however, the other breast lesions and the metastatic axillary lymph nodes were confirmed as showing papillary serous adenocarcinoma, which were similar to the previous ovarian tumor. After the patient underwent postoperative adjuvant chemotherapy, of 8 cycles of doxorubicin and docetaxel, she has been stable during the clinical follow-up for 10 months with decreases in size of the metastatic nodules.

Original Article

Expressions of CD44s Is Associated with the Expression of Cyclooxygenase-2 in Non-Small Cell Lung Cancers.: Sung Jig Lim, Hyun Jung Kim, Jung Yeon Kim, Kyeongmee Park; Korean J Pathol. 2006;40(1):17-23.

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Abstract PDF: BACKGROUND
The overexpression of Cox-2 in tumors is important for tumor invasion, angiogenesis, resistance to apoptosis and the suppression of host immunity. Moreover, a tumor's CD44 expression plays an important role in tumor invasion and metastasis. We examined the expression of COX-2 and also CD44 and its variants as well as the biological implications and relationship between Cox-2 and the CD44 variants in non-small cell lung carcinoma.
METHODS
The expressions of Cox-2 and also CD44s and its variants (CD44v3 and CD44v6) were examined by performing immunohistochemistry on 98 surgical specimens.
RESULTS
The expressions of CD44s, CD44v3 and CD44v6 were significantly more frequent in squamous cell carcinoma specimens than in the adenocarcinoma (CD44s, p=0.033; CD44v3, p=0.007; CD44v6, p=0.022). The loss of CD44s and CD44v3 were significantly correlated with poor tumor differentiation (CD44s, p=0.03; CD44v3, p=0.011). Patients with Cox-2 positive-adenocarcinoma tumors had a significantly worse cumulative survival than did those adenocarcinoma patients without the Cox-2 (p=0.048). The expression of Cox-2 was significantly associated with the CD44s expression in non-small cell lung cancer, and especially in squamous cell carcinoma.
CONCLUSIONS
These findings suggest that expression of CD44s is associated with the expression of Cox-2 in NSCLC, and especially squamous cell carcinoma.

Case Report

Multifocal Epithelioid Angiosarcoma of the Stomach: A Case Report.: Kyeongmee Park, Sungjig Lim, Jungyeon Kim, Young Jin Yuh, Sung Rok Kim, Hong Yong Kim; Korean J Pathol. 2003;37(6):435-437.

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Abstract PDF: Angiosarcoma is a very rare neoplasm, and even more so in the gastrointestinal tract where its distinction from adenocarcinoma may be extremely difficult. We report a case of multifocal epithelioid angiosarcoma of the stomach in a 65-year-old woman. Histologically, the tumor foci were composed of haphazard, anastomosing channels lined by malignant endothelial cells with epithelioid features. Those neoplastic cells stained positive for CD31, CD34, and factor VIII-related antigen.

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