Journal of Pathology and Translational Medicine

Case Study

An Adult Case of Bartter Syndrome Type III Presenting with Proteinuria: Eun Jung Cha, Won Min Hwang, Sung-Ro Yun, Moon Hyang Park; J Pathol Transl Med. 2016;50(2):160-164. Published online January 11, 2016; DOI: https://doi.org/10.4132/jptm.2015.08.31

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Bartter syndrome (BS) I–IV is a rare autosomal recessive disorder affecting salt reabsorption in the thick ascending limb of the loop of Henle. This report highlights clinicopathological findings and genetic studies of classic BS in a 22-year-old female patient who presented with persistent mild proteinuria for 2 years. A renal biopsy demonstrated a mild to moderate increase in the mesangial cells and matrix of most glomeruli, along with marked juxtaglomerular cell hyperplasia. These findings suggested BS associated with mild IgA nephropathy. Focal tubular atrophy, interstitial fibrosis, and lymphocytic infiltration were also observed. A genetic study of the patient and her parents revealed a mutation of the CLCNKB genes. The patient was diagnosed with BS, type III. This case represents an atypical presentation of classic BS in an adult patient. Pathologic findings of renal biopsy combined with genetic analysis and clinicolaboratory findings are important in making an accurate diagnosis.

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Bartter’s syndrome: clinical findings, genetic causes and therapeutic approach
Flavia Cristina Carvalho Mrad, Sílvia Bouissou Morais Soares, Luiz Alberto Wanderley de Menezes Silva, Pedro Versiani dos Anjos Menezes, Ana Cristina Simões-e-Silva
World Journal of Pediatrics.2021; 17(1): 31. CrossRef
Association of Adult-Onset Bartter Syndrome With Undifferentiated Connective Tissue Disorder
Nida Saleem, Humaira Nasir, Danyal Hassan, Momena Manzoor
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Acquired autoimmune Bartter syndrome in a patient with primary hypothyroidism
Noreen Nasir, Deepali Mohanty, Arun Kumar Pande, Dhanita Khanna, Kavita Vishvakarma, Latika Gupta
Rheumatology International.2021; 43(3): 567. CrossRef
A novel mutation associated with Type�III Bartter syndrome: A report of five cases
Yanhan Li, Chengcheng Wu, Jie Gu, Dong Li, Yanling Yang
Molecular Medicine Reports.2019;[Epub] CrossRef
Pathophysiology of antenatal Bartterʼs syndrome
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Current Opinion in Nephrology and Hypertension.2017; 26(5): 419. CrossRef

Brief Case Report

Dedifferentiated Endometrioid Adenocarcinoma of the Uterus: Highly Aggressive and Poor Prognostic Tumor: Shin Young Park, Moon Hyang Park, Hyoung Suk Ko, Eun Jung Cha, Jang Sihn Sohn, Un Suk Jung, Chul Jung Kim, Jin Suk Kim; Korean J Pathol. 2014;48(4):327-330. Published online August 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.4.327

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Treatment and outcomes in undifferentiated and dedifferentiated endometrial carcinoma
Sarah Nicole Hamilton, Anna V. Tinker, Janice Kwon, Peter Lim, Iwa Kong, Sona Sihra, Martin Koebel, Cheng Han Lee
Journal of Gynecologic Oncology.2022;[Epub] CrossRef
Cytological aspects of an endometrial dedifferentiated carcinoma that was associated with a highly aggressive clinical course
Takako WAKAHARA, Sumiyo ADACHI, Kyota HANAMI, Takayoshi KOYASU, Yoshimitsu RYO, Kazunori FUGO, Kazuto YAMAZAKI
The Journal of the Japanese Society of Clinical Cytology.2022; 61(6): 385. CrossRef
Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium
Amir‐Hossein Akbari, Lu Wang, Robert A. Soslow, Rajmohan Murali
Cancer Cytopathology.2021; 129(2): 121. CrossRef
Magnetic resonance imaging findings in 11 cases of dedifferentiated endometrial carcinoma of the uterus
Nao Kikkawa, Kimiteru Ito, Hiroshi Yoshida, Mayumi Kobayashi Kato, Yuko Kubo, Yasuyuki Onishi, Haruto Sugawara, Tomoyasu Kato, Masahiko Kusumoto
Japanese Journal of Radiology.2021; 39(5): 477. CrossRef
High-grade Endometrial Carcinomas: Morphologic and Immunohistochemical Features, Diagnostic Challenges and Recommendations
Rajmohan Murali, Ben Davidson, Oluwole Fadare, Joseph A. Carlson, Christopher P. Crum, C. Blake Gilks, Julie A. Irving, Anais Malpica, Xavier Matias-Guiu, W. Glenn McCluggage, Khush Mittal, Esther Oliva, Vinita Parkash, Joanne K. L. Rutgers, Paul N. Staat
International Journal of Gynecological Pathology.2019; 38(Supplement): S40. CrossRef
Dedifferentiated endometrial adenocarcinoma with neuroendocrine differentiation and ballooning-cell features: Report of a rare entity with an unusual histology
Sara Makhdoum, M. Ruhul Quddus, Michele M. Lomme, Katrine Hansen, W. Dwayne Lawrence
Human Pathology: Case Reports.2019; 15: 92. CrossRef
Unique Molecular Features in High-Risk Histology Endometrial Cancers
Pooja Pandita, Xiyin Wang, Devin E. Jones, Kaitlyn Collins, Shannon M. Hawkins
Cancers.2019; 11(11): 1665. CrossRef
Dedifferentiated endometrioid adenocarcinoma with trophoblastic components and elevated serum alfa-fetoprotein
He Cai, Rong Zhou, Wanying Liang, Jianliu Wang
Medicine.2018; 97(17): e0551. CrossRef
Dedifferentiated endometrioid carcinoma of the uterus : report of four cases and review of literature
Jiheun Han, Eun Young Ki, Sung Eun Rha, SooYoung Hur, Ahwon Lee
World Journal of Surgical Oncology.2017;[Epub] CrossRef
Spontaneous Tumor Lysis Syndrome in a Patient with a Dedifferentiated Endometrial Adenocarcinoma
Shinichi Harada, Keiki Nagaharu, Youichirou Baba, Tetsuya Murata, Toshiro Mizuno, Keiki Kawakami
Case Reports in Oncological Medicine.2017; 2017: 1. CrossRef
Ampullary carcinosarcoma with osteosarcomatous, small cell neuroendocrine carcinoma and conventional adenocarcinoma components; First report
Pallavi Rao, Sadiq S. Sikora, Srikanth Narayanaswamy, Nandita Ghosal, Dinesh Kini
Pathology - Research and Practice.2016; 212(11): 1071. CrossRef

Original Article

Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis: Tai Yeon Koo, Gheun-Ho Kim, Moon Hyang Park; Korean J Pathol. 2012;46(2):105-114. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.105

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Abstract PDF

Background

IgA-dominant acute postinfectious glomerulonephritis (APIGN) is a recently recognized morphologic variant of APIGN, but its clinicopathologic features were not clearly characterized. We will present demographic, clinical and renal biopsy findings from seven patients with IgA-dominant APIGN with a literature review.

Methods

All renal biopsy specimens (n=1,119) processed by the Department of Pathology in Hanyang University Hospital from 2005 to 2009 were reviewed. Seven patients with IgA-dominant APIGN were identified, and their clinical data analyzed.

Results

All patients had renal failure, hematuria and proteinuria. One was diabetic, and none of the patients had previous renal diseases. Three had clinical infections at the time of presentation: 2 with methicillin-resistant Staphylococcus aureus and one with rickettsial infection. Light microscopically diffuse endocapillary proliferative and exudative glomerulonephritis was found in all cases. Immunofluorescence microscopy showed granular IgA deposits along peripheral capillary walls and in mesangium. Ultrastructurally, subepithelial 'humps' with mesangial deposits were noted. End-stage renal disease developed in two patients, chronic renal failure was stationary in two, and azotemia improved in three.

Conclusions

Various infections including rickettsiosis preceded IgA-dominant APIGN in both diabetics and nondiabetics. Because the prognosis of IgA-dominant APIGN is poor, early diagnosis based on renal biopsy is required.

Citations

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Staphylococcus aureus Infection-Related Glomerulonephritis with Dominant IgA Deposition
Mamiko Takayasu, Kouichi Hirayama, Homare Shimohata, Masaki Kobayashi, Akio Koyama
International Journal of Molecular Sciences.2022; 23(13): 7482. CrossRef
A rare case of Immunoglobulin A dominant post-infectious glomerulonephritis (IgA PIGN) in a young patient
A. Saghar, G. Klaus, B. Trutnau, M. Kömhoff, H. J. Gröne, S. Weber
BMC Nephrology.2022;[Epub] CrossRef
IgA-Dominant Infection-Associated Glomerulonephritis Following SARS-CoV-2 Infection
Aurora Pérez, Isidro Torregrosa, Luis D’Marco, Isabel Juan, Liria Terradez, Miguel Ángel Solís, Francesc Moncho, Carmen Carda-Batalla, María J. Forner, Jose Luis Gorriz
Viruses.2021; 13(4): 587. CrossRef
Relationship between blood neutrophil‐lymphocyte ratio and renal tubular atrophy/interstitial fibrosis in IgA nephropathy patients
Lingxiong Chai, Kedan Cai, Kaiyue Wang, Qun Luo
Journal of Clinical Laboratory Analysis.2021;[Epub] CrossRef
The Continuing Need for Electron Microscopy in Examination of Medical Renal Biopsies: Examples in Practice
Michifumi Yamashita, Mercury Y. Lin, Jean Hou, Kevin Y.M. Ren, Mark Haas
Glomerular Diseases.2021; 1(3): 145. CrossRef
Clinicopathologic features of infection-related glomerulonephritis with IgA deposits: a French Nationwide study
Elodie Miquelestorena-Standley, Charlotte Jaulerry, Marie-Christine Machet, Nolwenn Rabot, Christelle Barbet, Aurélie Hummel, Alexandre Karras, Cyril Garrouste, Thomas Crepin, Didier Ducloux, Maud Cousin, Catherine Albert, Joseph Rivalan, Emilie Cornec-Le
Diagnostic Pathology.2020;[Epub] CrossRef
IgA nephropathy and infections
Cristiana Rollino, Gisella Vischini, Rosanna Coppo
Journal of Nephrology.2016; 29(4): 463. CrossRef
<i>Staphylococcus</i>-associated Glomerulonephritis
Dong Yeol Shin, Sung Han Kim, Ji Wan Lee, Ki Ju Chang, Seung Ha Hwang, Yong Mee Cho, Soon Bae Kim
The Korean Journal of Medicine.2016; 90(2): 148. CrossRef
Use of steroid therapy in immunoglobulin A-dominant poststaphylococcal glomerulonephritis
Mahesh Eswarappa, Vijay Varma, K.C. Gurudev
Hong Kong Journal of Nephrology.2015; 17(2): 46. CrossRef
Clinicopathologic Features of IgA-Dominant Infection-Associated Glomerulonephritis: A Pooled Analysis of 78 Cases
Ru Bu, Qian Li, Zhi-yu Duan, Jie Wu, Pu Chen, Xiang-mei Chen, Guang-yan Cai
American Journal of Nephrology.2015; 41(2): 98. CrossRef
Garland-pattern postinfectious glomerulonephritis with IgA-dominant deposition
Makoto Kanno, Kenichi Tanaka, Hiroshi Kimura, Kimio Watanabe, Yoshimitsu Hayashi, Koichi Asahi, Masaaki Nakayama, Kensuke Joh, Tsuyoshi Watanabe
CEN Case Reports.2014; 3(1): 56. CrossRef

Case Report

Cytologic Features and BRAF Mutation of Hyalinizing Trabecular Adenoma of the Thyroid: A Case Report with Review of the Literature.: Se Min Jang, Young Ha Oh, Yoon Kyung Jeon, Yong Wook Park, Moon Hyang Park; Korean J Pathol. 2011;45(4):428-433.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.4.428

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Abstract PDF

A hyalinizing trabecular adenoma (HTA) is a rare benign thyroid tumor of follicular epithelial cell origin with a trabecular-alveolar growth pattern and marked intratrabecular hyalinization. The cytological and histological features of HTA are very similar to those of papillary and medullary carcinomas of the thyroid. Therefore, an accurate diagnosis of HTA is important to avoid unnecessary and potentially harmful management of patients. However, the results of BRAF gene mutation analysis shown by many studies are distinctly different between HTAs and papillary thyroid carcinomas. Herein, we describe a rare case of HTA of the thyroid in a 49-year-old female and consider its characteristic cytological features and BRAF gene mutation analysis results with a brief review of the literature.

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Hyalinizing trabecular tumor, a rare histologically unique tumor of the thyroid, coexisting with papillary thyroid carcinoma
Chiu-Hsuan Cheng
Tzu Chi Medical Journal.2021; 33(2): 198. CrossRef
A Case of Hyalinizing Trabecular Tumor of the Thyroid Gland
Kun Woo Kim, Sang Joon Lee, Phil-Sang Chung, Junghwan Moon
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2012; 55(12): 795. CrossRef

Original Articles

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.

Citations

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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

Cytohistologic Correlation of Phyllodes Tumors of the Breast: A Study on 17 Cases.: Young Ha Oh, Moon Hyang Park; Korean J Pathol. 2009;43(1):68-74.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.68

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Abstract PDF: Phyllodes tumor (PT) is a rare fibroepithelial tumor of the breast, and these tumors are subdivided into benign, borderline, and malignant tumors. The criteria for their histologic diagnosis have been relatively well-described. However, the cytologic diagnosis presents more difficulties and only a few cytologic studies concerned with their subclassification have been published. The objective of the current study is to describe the cytologic features of benign, borderline and malignant PTs in an attempt to distinguish one from the others. Cytohistologic correlation for 11 benign, 3 borderline and 3 malignant PTs was performed. For all these cases, the preoperative fine needle aspiration (FNA) findings were available for review. The features we examined were a necrotic background, cellularity, stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis. The overall diagnostic accuracy of FNA for the PT grading was 88.2% (15/17). Two benign PTs were cytologically misinterpreted as "atypical epithelial and stromal cells" and "highly suspicious for ductal carcinoma". Nevertheless, the cytologic diagnosis and the grading of PTs on FNA were relatively reliable. Semiquantitative analysis for the cellular stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis might be helpful for subclassifing PTs on FNA. In the case of encountering a markedly necrotic background, special concern about degenerative change such as infarction is needed.

The Morphologic Patterns of Diabetic Nephropathy in Koreans.: Si Hyong Jang, Moon Hyang Park; Korean J Pathol. 2009;43(1):36-42.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.36

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Abstract PDF

BACKGROUND
Diabetic nephropathy is the most common cause of end-stage renal disease and it has various pathologic features. We investigated the clinicopathologic differences between the histologic classes of diabetic nephropathy.
METHODS
A total of 46 patients with diabetic nephropathy were evaluated. Morphologically, the renal lesions were divided into three categories: class 1, diffuse or nodular glomerulosclerosis: class 2, vascular change without evidence of glomerulosclerosis: and class 3, non-diabetic renal disease superimposed on diabetic glomerulosclerosis. We evaluated the laboratory findings and the histologic findings, including mesangial expansion, interstitial fibrosis and inflammation, arteriolar hyalinosis and tubular atrophy.
RESULTS
The proportion of each class was 32 cases (70%), 4 cases (9%) and 10 cases (21%), respectively. The clinical and laboratory data showed no significant difference among the classes. For the groups of class 1, the group with nodular sclerosis showed a higher serum creatinine level than did the diffuse group (p=0.003). IgA nephropathy was the most common non-diabetic renal disease superimposed on diabetic glomerulosclerosis in our study.
CONCLUSIONS
The patients with nodular glomerulosclerosis presented with a more progressed clinicopathological features than did the patients with class 1 diffuse glomerulosclerosis. We also found 21% of all the patients with diabetic nephropathy had superimposed non-diabetic renal disease in a Korean population.

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Renal biopsy pattern in diabetes mellitus patients and their correlation with clinical parameters
G. Singh, B. Naik, U. Singh, A. Modi, R. Dave
Nephrology (Saint-Petersburg).2023; 27(3): 53. CrossRef
Non-diabetic renal disease in Croatian patients with type 2 diabetes mellitus
Ivica Horvatic, Miroslav Tisljar, Patricia Kacinari, Ivana Matesic, Stela Bulimbasic, Danica Galesic Ljubanovic, Tina Katic, Darko Kristovic, Kresimir Galesic
Diabetes Research and Clinical Practice.2014; 104(3): 443. CrossRef
Clinical versus histological diagnosis of diabetic nephropathy--is renal biopsy required in type 2 diabetic patients with renal disease?
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Case Report

Fibrous Pseudotumor of the Testicular Tunics: Two case reports.: Seung Sam Paik, Nam Hoon Kim, Young Hyeh Ko, Moon Hyang Park; Korean J Pathol. 1995;29(4):533-535.

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Abstract PDF: Fibrous pseudotumor of the testicular tunics is a rare benign fibrous proliferative disorder, but it is the second most common mass-forining lesion of the testicular tunics. While these lesions are not strict neoplasms, they do form nodules and are often mistaken for neoplasms. Herein, we report 2 cases of fibrous pseudotumor with characteristic histologic findings. Both cases had been incidentally found as slow growing scrotal masses and underwent excision. There were several nodules along the testicular tunics which had bulging whitish-gray cut surface with focal myxoid change and a whorling appearance. These two cases showed the histologic spectrum seen in fibrous pseudotumor from a haphazard arrangement of fibroblastic type cells with intervening collagen and focal lymphocytic infiltrates in case 1, to a densely collagenized lesion in case 2.

Original Articles

Cholesteatoma of the Renal Pelvis: A case report.: Nam Hoon Kim, Young Chun Moon, Moon Hyang Park; Korean J Pathol. 1995;29(5):691-693.

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Abstract: Cholesteatoma in the kidney and ureter are accumulations of waxy, gray flakes of keratin materials, secondary to squamous metaplasia of the transitional epithelium. Herein, we describe a case of cholesteatoma in the renal pelvis of a 69-year-old woman, and give a brief review of the literature. In the upper pole of the left kidney was a 6 cm cystic lesion filled with a thick, flaky, grayish, comified material. Microscopically, the cystic area showed calyceal and pelvic structures being replaced by keratinizing stratified squamous epithelium. The surrounding renal parenchyma was atrophic with features of chronic pyelonephritis.

Correlation between Tumor Angiogenesis and Metastasis in Invasive Breast Carcinoma.: Nam Hoon Kim, Moon Hyang Park; Korean J Pathol. 1995;29(6):740-745.

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Abstract PDF: Tumor angiogenesis(TA) refers to the growth of new vessels toward and within a tumor. TA is necessary both at the beginning and at the end of the metastatic cascade of events. Recently, experimental evidence suggests that the growth of a tumor beyond a certain size requires angiogenesis. To investigate how tumor angiogenesis correlates with metastases in breast carcinoma, the microvessels were counted (per 200 / field) in the most active areas of neovas-cularization by two investigators. The microvessels within breast carcinoma were highlighted by in imunohistochemical staining for factor VIII-related antigen. Microvessel count(MVC) in node-positive carcinoma(59.66=35) was significantly higher than in node-negative carcinoma(44.76=17)(p=0.009). MVC was also statistically correlated with tumor size and stage, but not with histologic grading, DNA ploidy, or hormonal receptors(estro-gen and progesterone). MVC in invasive breast carcinoma may be one of many prognostic predictors of node-positive breast carcinoma. Assessment of tumor angiogenesis may therefore be valuable in selecting patients with early breast carcinoma for aggressive therapy.

Case Report

Intraabdominal Desmoplastic Small Cell Tumors with Divergent Differentiation: Report of two cases with immunohistochemical and ultrastructural studies.: Young Ha Oh, Nam Hoon Kim, Joo Seob Keum, Moon Hyang Park; Korean J Pathol. 1996;30(1):40-49.

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Abstract PDF: We studied two intraabdominal desmoplastic small cell tumors. The patients were two men, 37 and 23 years old, with jaundice and palpable abdominal masses. On exploratory laparotomy, each patient revealed a huge mass in the greater omentum with disseminated peritoneal seeding, measuring 32 cm and 11 cm in its greatest dimension, respectively. The tumor involved the diaphragm, rectal shelf, and cul de sac in case 1, and it involved the porta hepatis, retroperitoneum, and serosal surface of the ascending and transverse colon in case 2. Omentectomy of the huge mass and satellite masses was performed in each patient. Both tumors showed nearly the same histopathologic features. The histologic pattern was suggestive of a metastatic small cell carcinoma, but there was no specific, single primary site. The tumors consisted of variably sized, discrete islands of epithelial-like small cells in dense desmoplastic stroma. The tumor cells revealed divergent epithelial, mesenchymal, and neural differentiation by histologic, immunohistochemical, and electron microscopic observations. Only one cycle of chemotherapy including cisplatin and VP-16 was given in case 1 because of a subsequent hepatic problem, who, thereafter, showed massive intraabdominal recurrent tumors 6 months after diagnosis. In case 2, the poor condition of the patient had made chemotherapy and radiotherapy impossible. Case 2 died of disseminated intravascular coagulation following progressive cachexia 7 months after diagnosis.

Original Article

Inflammatory Pseudotumor of the Urinary Bladder: An Immunohistochemical and Ultrastructural Study.: Seung Sam Paik, Joo Seob Keum, Moon Hyang Park, Jung Dal Park; Korean J Pathol. 1996;30(5):447-452.

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Abstract PDF: Inflammatory pseudotumor of the urinary bladder is an unusual, benign mesenchymal proliferative lesion of the submucosal stroma easily mistaken for a malignant neoplasm clinically and histologically. We present a case and describe the clinical presentation and radiologic, histologic, histochemical, immunohistochemical, and ultrastructural findings. A 23-year old patient presented with sudden onset of gross painless hematuria for 3 months. There was no previous instrumentation or surgery involving the genitourinary tract. Cystoscopy revealed a large polypoid and ulcerated bladder mass. The lesion consisted of plump spindle shaped, fibroblast-like cells embedded in a myxoid stroma. Mitotic figures were negligible and the lesion showed encroachment on the superficial muscle bundles. The spindle cells were immunoreactive for vimentin and muscle specific actin. Immunohistochemical and ultrastructural findings revealed the fibroblastic-myofibroblastic nature of this lesion. Complete surgical excision by partial cystectomy was successful in eradicating the lesion. The findings are described with a discussion of the pathogenesis and review of the literature.

Case Reports

Malignant Rhabdoid Tumor of the Kidney: A report of two cases: An immunohistochemical and ultrastructural study.: Seung Sam Paik, Moon Hyang Park; Korean J Pathol. 1996;30(8):706-714.

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Abstract PDF: Malignant rhabdoid tumor of the kidney(MRTK), an uncommon renal tumor found in children, is one of the most lethal neoplasms of early life. It was first recognized during a review of the first National Wilms' Tumor Study(NWTS) as an extremely aggressive neoplasm whose appearance often mimicks those of skeletal muscle tumors, but without histological, immunohistochemical, and ultrastructural markers of rhabdomyogenesis. Herein we present two cases of malignant rhabdoid tumor of the kidney, one occurring in a 6-month-old male baby, and the other in a 123-month-old girl. They presented a huge tender mass on the left upper quadrant of the abdomen. Microscopically, each case was very cellular and composed of sheets of round or polygonal cells with ample cytoplasm often containing eosinophilic filamentous inclusions and round vesicular nuclei with prominent nucleoli. Case 1 showed lymphomatoid pattern, but case 2 showed foci of several variant patterns associated with classic appearances. The tumor cells showed a strong reactivity for vimentin in both cases. Unusually, case 2 showed focal reactivity for epithelial membrane antigen(EMA), muscle specific actin, and smooth muscle actin. Ultrastructural study confirmed the presence of whorled bundles of intermediate filaments in paranuclear position, and a prominent nucleolus.

Ureteral Fibroepithelial Polyp: A report of four cases (One case with nephrogenic adenoma).: Won Mee Lee, Seung Sam Paik, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee; Korean J Pathol. 1996;30(8):715-720.

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Abstract PDF: Fibroepithelial polyps of the ureter are usually acquired rather than congenital. Most polyps are hamartomatous growths which tend to arise in the proximal portion of the left ureter. Most patients exibit either hematuria or persistent flank pain secondary to partial ureteral obstruction. Because of false positivity of urine cytology, as well as intravenous pyelogram, the correct diagnosis is confused with malignancy. Herein we report four cases of ureteral fibroepithelial polyp, which are associated with stones resulting in partial obstruction of the ureter. One of the four cases is associated with nephrogenic adenoma in the lamina propria of the adjacent ureter. The following report describes clinicopathologic findings of fibroepithelial polyp with review of literatures.

Original Article

Mucinous Adenocarcinoma of Anal Ducts.: Young Ha Oh, Wan Seop Kim, Eun Kyung Hong, Moon Hyang Park, Jung Dal Lee; Korean J Pathol. 1996;30(9):843-850.

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Abstract PDF: Anal duct carcinoma is a rare tumor, and accounts for less than 5 percent of all anal cancers, which typically present a long-standing perianal fistulas. Some authors suggest that the fistulous tracts are congenital duplications of the lower end of the hind gut lined by rectal mucosa which is prone to malignant change to mucinous adenocarcinoma. It is usually a well differentiated mucinous (colloid) adenocarcinoma. The prognosis after wide excision of the rectum is relatively good. Since 1985, we have had three cases of anal duct carcinoma with well differentiated mucinous adenocarcinoma involving the posterior wall of the anus. Two patients had a long history of perianal fistula with mucinous discharge. There was no spread to the regional lymph node except one patient who had regional lymph node metastasis, and post-operative chemotherapy and radiation therapy were then given. All patients have no evidence of any recurrent problem at 16 months to 3 years following the surgical treatment. Because of their rarity and the failure of recognition at an early stage, we are presenting three cases to emphasize the characteristic features of this insidious, slow-growing carcinoma.

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