Journal of Pathology and Translational Medicine

Original Article

Immunohistochemical Classification of Primary and Secondary Glioblastomas: Kyu Sang Lee, Gheeyoung Choe, Kyung Han Nam, An Na Seo, Sumi Yun, Kyung Ju Kim, Hwa Jin Cho, Sung Hye Park; Korean J Pathol. 2013;47(6):541-548. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.541

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Background

Glioblastomas may develop de novo (primary glioblastomas, P-GBLs) or through progression from lower-grade astrocytomas (secondary glioblastomas, S-GBLs). The aim of this study was to compare the immunohistochemical classification of glioblastomas with clinically determined P-GBLs and S-GBLs to identify the best combination of antibodies for immunohistochemical classification.

Methods

We evaluated the immunohistochemical expression of epidermal growth factor receptor (EGFR), p53, and isocitrate dehydrogenase 1 (IDH-1) in 150 glioblastoma cases.

Results

According to clinical history, the glioblastomas analyzed in this study consisted of 146 P-GBLs and 4 S-GBLs. Immunohistochemical expression of EGFR, p53, and IDH-1 was observed in 62.6%, 49.3%, and 11.1%, respectively. Immunohistochemical profiles of EGFR(+)/p53(-), IDH-1(-)/EGFR(+)/p53(-), and EGFR(-)/p53(+) were noted in 41.3%, 40.2%, and 28.7%, respectively. Expression of IDH-1 and EGFR(-)/p53(+) was positively correlated with young age. The typical immunohistochemical features of S-GBLs comprised IDH-1(+)/EGFR(-)/p53(+), and were noted in 3.6% of clinically P-GBLs. The combination of IDH-1(-) or EGFR(+) was the best set of immunohistochemical stains for identifying P-GBLs, whereas the combination of IDH-1(+) and EGFR(-) was best for identifying S-GBLs.

Conclusions

We recommend a combination of IDH-1 and EGFR for immunohistochemical classification of glioblastomas. We expect our results to be useful for determining treatment strategies for glioblastoma patients.

Citations

Citations to this article as recorded by

Cutaneous Melanoma and Glioblastoma Multiforme Association—Case Presentation and Literature Review
Olguța Anca Orzan, Călin Giurcăneanu, Bogdan Dima, Monica Beatrice Dima, Ana Ion, Beatrice Bălăceanu, Cornelia Nițipir, Irina Tudose, Cătălina Andreea Nicolae, Alexandra Maria Dorobanțu
Diagnostics.2023; 13(6): 1046. CrossRef
Primary Extra-axial Glioblastoma: Case Report and Literature Review
Baraa Dabboucy, Philippe Younes, Abdallah Rahbani, Elie Fahed, Gérard Abadjian
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery.2021; 40(04): e368. CrossRef
TERT Promoter Mutation in Adult Glioblastomas: It's Correlation with Other Relevant Molecular Markers
Mukesh Barange, Sridhar Epari, Mamta Gurav, Omshree Shetty, Ayushi Sahay, Prakash Shetty, Jayantsastri Goda, Aliasagar Moyiadi, Tejpal Gupta, Rakesh Jalali
Neurology India.2021; 69(1): 126. CrossRef
Immunohistochemical characterisation and histopathology of astrocytic neoplasms at a tertiary Nigerian hospital
Michael Nweke, Gabriel Ogun, Amos Adeleye, Clement A. Okolo, Adekunle Adesina
International Journal of Clinical Practice.2021;[Epub] CrossRef
Cytotoxic Effects of Blue Scorpion Venom (Rhopalurus junceus) in a Glioblastoma Cell Line Model
Laura A. Lozano-Trujillo, Diana K. Garzón-Perdomo, Andrea C.R. Vargas, Lina M. de los Reyes, Marco F. Avila-Rodriguez, Olivia T.G. Gay, Liliana F. Turner
Current Pharmaceutical Biotechnology.2021; 22(5): 636. CrossRef
Molecular Subgroups of Glioblastoma– an Assessment by Immunohistochemical Markers
Ádám Nagy, Ferenc Garzuly, Gergely Padányi, Iván Szűcs, Ádám Feldmann, Balázs Murnyák, Tibor Hortobágyi, Bernadette Kálmán
Pathology & Oncology Research.2019; 25(1): 21. CrossRef
Proteomic Advances in Glial Tumors through Mass Spectrometry Approaches
Radu Pirlog, Sergiu Susman, Cristina Adela Iuga, Stefan Ioan Florian
Medicina.2019; 55(8): 412. CrossRef
Isocitrate dehydrogenase 1 mutant glioblastomas demonstrate a decreased rate of pseudoprogression: a multi-institutional experience
Homan Mohammadi, Kevin Shiue, G Daniel Grass, Vivek Verma, Kay Engellandt, Dirk Daubner, Gabriele Schackert, Mercia J Gondim, Dibson Gondim, Alexander O Vortmeyer, Aaron P Kamer, William Jin, Timothy J Robinson, Gordon Watson, Hsiang-Hsuan M Yu, Tim Laute
Neuro-Oncology Practice.2019;[Epub] CrossRef
Calvarium mass as the first presentation of glioblastoma multiforme: A very rare manifestation of high-grade glioma
S. Taghipour Zahir, M. Mortaz, M. Baghi Yazdi, N. Sefidrokh Sharahjin, M. Shabani
Neurochirurgie.2018; 64(1): 76. CrossRef
Malignant Gliomas as Second Neoplasms in Pediatric Cancer Survivors: Neuropathological Study
Ewa Izycka-Swieszewska, Ewa Bien, Joanna Stefanowicz, Edyta Szurowska, Ewa Szutowicz-Zielinska, Magdalena Koczkowska, Dawid Sigorski, Wojciech Kloc, Wojciech Rogowski, Elzbieta Adamkiewicz-Drozynska
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Azza Abdel-Aziz, Mie A. Mohamed, Dina Abdallah, Fatma M.F. Akl, Ghada E. Eladawy, Ahmed N. Taha, Hossam Shata
Egyptian Journal of Pathology.2018; 38(1): 27. CrossRef
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John Bianco, Chiara Bastiancich, Aleksander Jankovski, Anne des Rieux, Véronique Préat, Fabienne Danhier
Cellular and Molecular Life Sciences.2017; 74(13): 2451. CrossRef
Development of Glioblastoma after Treatment of Brain Abscess
Hiroaki Matsumoto, Hiroaki Minami, Shogo Tominaga, Yasuhisa Yoshida
World Neurosurgery.2016; 88: 686.e19. CrossRef
Clinical, immunohistochemical, and molecular genetic prognostic factors in adult patients with glioblastoma
N. V. Lobanova, L. V. Shishkina, M. V. Ryzhova, G. L. Kobyakov, R. V. Sycheva, S. A. Burov, A. V. Lukyanov, Zh. R. Omarova
Arkhiv patologii.2016; 78(4): 10. CrossRef
Concordance analysis and diagnostic test accuracy review of IDH1 immunohistochemistry in glioblastoma
Jung-Soo Pyo, Nae Yu Kim, Roy Hyun Jai Kim, Guhyun Kang
Brain Tumor Pathology.2016; 33(4): 248. CrossRef
Methyl Guanine Methyl Transferase Methylation Status and Epidermal Growth Factor Receptor expression in a cohort of Egyptian glioblastoma patients
Soheir M. Hamam, Bassma M. El Sabaa, Iman M. Talaat, Rasha A. Nassra, Doaa A. Abdelmonsif
Egyptian Journal of Pathology.2016; 36(2): 282. CrossRef

Case Reports

The Wolf-Hirschhorn Syndrome in Fetal Autopsy: A Case Report.: Sun Ju Byeon, Jae Kyung Myung, Sung Hye Park; Korean J Pathol. 2011;45:S15-S19.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S15

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Abstract PDF

Wolf-Hirschhorn syndrome (WHS) is a malformation associated with a hemizygous deletion of the distal short arm of chromosome 4. Herein we report a fetal autopsy case of WHS. A male fetus was therapeutically aborted at 17(+0) weeks gestational age, due to complex anomaly and intrauterine growth retardation, which were found in prenatal ultrasonography. His birth weight was 65 g. Mild craniofacial dysmorphism, club feet, bilateral renal hypoplasia, edematous neck, and left diaphragmatic hernia of Bochdalek were found on gross examination. On GTG-banding, the fetus revealed 46,XY,add(4p) karyotype and the mother revealed 46,XX,t(4;18)(p16;q21.1), with normal karyotype of the father. Array comparative genomic hybridization performed on the autopsied lung tissue revealed loss of 4p16.2-->4pter and gain of 18q21.1-->18qter, suggesting 46,XY,der(4)t(4;18)(p16.2;q21.1)mat of fetal karyotype. This suggested deletion of 4p, compatible with WHS inherited from the mal-segregation of a maternal translocation t(4;18)(p16.2;21.1). Therefore, our fetus was both genotypically and phenotypically compatible with WHS.

Citations

Citations to this article as recorded by

A Case of Wolf-Hirschhorn Syndrome with Periventricular Nodular Heterotopia Presenting with Status Epilepticus
Bong Sul Suh, Keun Hyeok Ko, Kon Hee Lee, Tae-Jung Sung
Neonatal Medicine.2015; 22(4): 233. CrossRef
Rhabdoid glioblastoma is distinguishable from classical glioblastoma by cytogenetics and molecular genetics
Sun-Ju Byeon, Hwa Jin Cho, Hae Woon Baek, Chul-Kee Park, Seung-Hong Choi, Se-Hoon Kim, Hee Kyung Kim, Sung-Hye Park
Human Pathology.2014; 45(3): 611. CrossRef

Composite Pheochromocytoma or Paraganglioma of Adrenal Gland: A Case Report with Immunohistochemical Studies and Electron Microscopic Examination.: Hyeyoon Chang, Hoiseon Jeong, Younghye Kim, Sung Hye Park, Aeree Kim; Korean J Pathol. 2011;45(3):306-310.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.3.306

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Abstract PDF

Composite pheochromocytoma or paraganglioma of the adrenal gland is a well-recognized, yet extremely rare tumor with only one case reported in Korea. We report a case of incidentally found composite pheochromocytoma and ganglioneuroma of the adrenal gland in a 44-year-old female composed of intermingled components of pheochromocytom, ganglioneuroma, and cells with intermediate features. On immunohistochemical staining, the pheochromocytoma component was positive for synaptophysin and chromogranin, but negative for S-100 protein. Staining for the S-100 protein revealed sustentacular cells which formed a peripheral coat around the "Zellballen" and Schwann cells. The Fontana-Masson stain defined neuromelanin granules of ganglion cells and the ganglion cells expressed neural markers such as neurofilament proteins. Ultrastructural findings revealed pheochromocytes with a round or ovoid nucleus and occasionally prominent nucleolus containing numerous adrenaline and noradrenaline granules.

Citations

Citations to this article as recorded by

Bilateral pheochromocytoma with ganglioneuroma component associated with multiple neuroendocrine neoplasia type 2A: a case report
Boubacar Efared, Gabrielle Atsame-Ebang, Soufiane Tahirou, Khalid Mazaz, Nawal Hammas, Hinde El Fatemi, Laila Chbani
Journal of Medical Case Reports.2017;[Epub] CrossRef

Original Article

CD44 and MMP14 Expression Associated with WHO Grade of the Astrocytoma and the Prognostic Implications.: Jaekyung Myung, Bogun Jang, Heae Surng Park, Woongjae Yon, Hyun Ju Lee, Sung Hye Park; Korean J Pathol. 2010;44(1):35-41.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.35

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Abstract PDF: BACKGROUND
CD44 is a cell surface receptor that has been implicated in tumor cell invasion and metastasis in a range of tumors of various organs, including breast, ovary, colon, lung, and brain. CD44 stimulates the invasive ability by interacting with matrix metalloproteinase 14 (MMP14). The expression of MMP14 on the cell surface is thought to trigger multiple proteinase cascades and to stimulate cell migration.
METHODS
A total 54 astrocytoma patients were eligible for this study. We performed a retrospective clinicopathological review and CD44 and MMP14 immunohistochemistry.
RESULTS
The expressions of CD44 and MMP14 were significantly correlated with the World Health Organization (WHO) grade. On univariate analysis, the WHO grade and the expression of CD44 were the significant prognostic factors affecting overall survival (OS) and disease progression free survival (DPFS). On the multivariate analysis by the Cox regression model, the only WHO grade was shown to be a significant independent prognostic factor for predicting the DPFS and OS.
CONCLUSIONS
In this study, the CD44 and MMP14 expressions were related to the WHO grade of astrocytoma. The CD44 expression status was a prognostic factor for DPFS and OS on univariate analysis, but it was not an independent prognostic factor on the multivariate analysis.

Case Report

Congenital Fiber Type Disproportion Myopathy: A case report .: Sung Hye Park, Kwang Kuk Kim, Suk Yoon Kang, Shin Kwang Kang; Korean J Pathol. 1999;33(4):303-306.

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Abstract PDF: Authors report a typical case of congenital fiber type disproportion (CFTD) with unique clinicopathologic characteristics. The patient was a 13-year-old boy who presented with weakness of lower extremities, especially proximal muscle, since his infancy. He has suffered from severe scoliosis which got worse since the age of 12. He showed mild dysarthria, high arched palate, and fish face. All routine laboratory data were within normal limits. EMG findings suggested myopathy. The muscle biopsy revealed fiber type disproportion with type 1 predominance. While most of the type 1 myofibers were atrophic or normal in size, the type 2 fibers showed universal hypertrophy. The difference of mean diameter between the larger and the smaller fibers was 27.9%. The patient's clinicopathologic settings fulfilled the criteria of CFTD.

Original Articles

Immunophenotype of Thymic Epithelial Tumors According to the New World Health Organization Classification.: Sung Hye Park, Han Seong Kim, Han Kyeom Kim, Bong Kyung Shin, Seung Mo Hong, Jae Y Ro; Korean J Pathol. 2001;35(4):278-285.

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Abstract PDF: BACKGROUND
To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs).
METHODS
Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications. CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out.
RESULTS
There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively. Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes.
CONCLUSIONS
Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.

Ganglion Cell Tumors.: Sung Hye Park, Harry V Vinters; Korean J Pathol. 2002;36(3):167-174.

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Abstract PDF: BACKGROUND
In ganglion cell tumos, immunohistochemical characteristics and malignant changes of neuronal cells and the usefulness of the MIB-1 (Ki67) indices for granding ganglion cell tumors and abnormalities of the adjacent nonneoplastic cortex have been issued.
METHODS
The clinicopathologic features of 34 surgically resected ganglion cell tumors (32 gangliogliomas and 2 gangliocytomas) were retrospectively analysed, and immunohistochemical characteristics and malignant changes of neuronal cells and the usefulness of the MIB-1 (Ki67) indices for grading ganglion cell tumors and abnormalities of the adjacent normal cortex were investigated using various immunohistochemical studies.
RESULTS
According to the Daumas-Duport grading system, there were 24 (70.6%) grade II, 8 (23.5%) grade III, and two (5.9%) grade IV cases. Malignant transformation was present only in the glial (7 cases) or both glial and neuronal (3 cases) components. The MIB-1 indices were statistically significant (p<0.001): grade II was 0.0-1.05% (0.27+/-0.3%), grade III was 0.8-8.02% (2.8+/-3.2%), and grade IV was 3.0-4.99% (3.99+/-1.0). Anaplasia and MIB-1 positivity was observed among the neurons in the three cases. Perikaryal cytoplasmic expression or surface punctate accentuation of synaptophysin were noted only in the neoplastic neurons in some cases. Fifteen out of 20 cases, which included the nonneoplastic cerebral cortex, displayed mild cortical dysplasia (microdysgenesis).
CONCLUSIONS
The neuronal component also showed malignant transformations with proliferating activity. In our study, synaptophysin-immunoreactive patterns of neoplastic neurons were unique. The MIB-1 indices were helpful for grading ganglion cell tumos. Only mild cortical dysplasia was present in the normal cortex adjacent to the tumor.

Case Reports

Type 2 Fiber Predominance in Patients with Muscle Cramp and Exertional Myalgia: A Report of Three Cases.: Na Rae Kim, Sung Hye Park, Lim Suh Yeon, Byung Joon Kim; Korean J Pathol. 2003;37(1):58-61.

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Abstract PDF: Type 2 fiber predominance or a decrease of the type 1/type 2 ratio was rarely reported as the only abnormal pathologic finding in patients suffering from muscle cramp and myalgia. Here, we describe the clinicopathologic findings of three cases of type 2 fiber predominance, presented with muscle cramp and myalgia in otherwise healthy patients. All of them were young men (18, 19 and 22 years). Light microscopic and neurologic examinations, and laboratory data showed mere nonspecific findings that were not concordant with their subjective symptoms. However, enzyme histochemistry performed on muscle biopsy revealed an increased fraction of type 2 fibers; 73%, 80%, and 75%, in each case. The pathogenesis of this entity remains unclear, but the recognition of this unusual clinicopathologic entity is important for both pathologists and neurologists so they can avoid misdiagnoses or unnecessarily tiresome studies. We emphasize that type 2 fiber predominance should be included in the underlying causes of unexplained muscle cramps and exertional myalgia, especially among young adults, although it remains unclear whether the fiber type predominance is a separate entity or a part of other underlying neurologic or systemic disorders.

Cytohistologic Features of Chordoma Arising in Thoracic Spine: A Case Report.: Seung Yeon Ha, Insun Kim, Sung Hye Park, Heum Rye Park; Korean J Cytopathol. 1995;6(2):199-203.

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Abstract PDF: Chordoma is relatively uncommon tumor comprising 1~4% of primary malignant bone tumors, and believed to arise from the remnants of notochordal tissue. Because of its occurrence in the thoracic spine, we report a case of chordoma in volving the thoracic spine. A 45-year-old male was suffered from chest pain radiating to the back. Chest CT showed a well marginated, round huge mass with multiseptated enhancement at the thoracic spine from T5 to T8 level, After percutaneous needle aspiration, piecemeal resection of the tumor was done. On cytologic smears. two types of neoplastic cells were arranged in sheets and cords in mucinous background. One type of cells consisted of medium sized cells with pink cytoplasm and round nuclei. The other type had voluminous bubbly or clear cytoplasm divided by intracytoplasmic septae imparting a feathery or basket-like appearance. Histologically, the tumor showed lobulated feature divided by fibrous septae and the tumor cells were pink eosinophilic or physaliphorous in morphology. Immunohistochemically, the tumor cells revealed strong positivity for low(AE1) and high (AE3) molecular weight cytokeratins.

Original Article

Cytologic Analysis of Fibroadenomas of Breast Overdiagnosed as High Risk Group in Fine Needle Aspiration Cytology .: Sung Hye Park, Gil Sook Yoon, Misun Choi, Shin Kwang Khang; Korean J Cytopathol. 1999;10(2):127-127.

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Abstract PDF: Among total 108 cases of biopsy-proven fibroadenomas of the breast, which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-leading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) in 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proliferative breast lesions with atypia(26.1%). None were subject to the category of carcinoma. Cytologic features leading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pleomorphism without nuclear enlargement, and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.

Case Report

Fine Needle Aspiration Cytology of Mantle Cell Lymphoma: A Case Report .: Han Seong Kim, Sung Hye Park; Korean J Cytopathol. 2001;12(1):53-56.

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Abstract PDF: Cytologic features of a case of mantle cell lymphoma is presented, which was obtained by fine needle aspiration cytoloby and confirmed by excisional biopsy of axillary lymph node. A 67-year-old female alleged palpable masses in both axillae for several months. Additional multiple lymphadenopathies were found in the both neck and inguinal areas. The main cytologic feature was carpeting of monotonous slightly atypical small lymphocytes without heterogeneous components. The nuclei of these lymphocytes are slightly larger than benign small lymphocyte and relatively round with some indentation. Nucleolus was not prominent and no mitosis was found. Their cytoplasm was scanty and cyanophilic in Papanicolaou's stain. The histiocytic cells, which had bland-looking banded nuclei and abundant cytoplasm, corresponding to pink histiocytes were shown. Excisional biopsy of lymph nodes was diagnosed as mantle cell lymphoma, diffuse type.

Original Articles

Fine Needle Aspiration Cytology of Periductal Mastitis (Subareolar Abscess) and its Clinical Significance of Cytological Diagnosis.: Han Seong Kim, Mee Joo, Sun Hee Chang, Ji Eun Kwak, Sung Hye Park, Byung Ju Song; Korean J Cytopathol. 2006;17(1):27-31.

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Abstract PDF: Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.

Causes of Hydrops Fetalis: Analysis of 149 Autopsy Cases.: Ho chang Lee, Je G Chi, Sung Hye Park; Korean J Pathol. 2007;41(2):103-108.

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Abstract PDF: BACKGROUND
Hydrops fetalis is defined as abnormal accumulation of serous fluid in two or more fetal compartments, and this malady is known to be associated with various pathologic conditions.
METHODS
We collected 149 cases of hydrops fetalis out of 2,312 autopsies, and we tried to elaborate the underlying causes of hydrops fetalis. The diagnosis was based on the material from either antenatal termination or intrauterine death.
RESULTS
The relative incidence of hydrops fetalis was 6.44% of all the pediatric autopsies we performed. The gestational age was evenly distributed from 18 to 33 weeks, except for 30 to 31 weeks. There was no sex difference in the incidence of hydrops fetalis. The main causes were cardiovascular diseases (30.9%), cystic hygroma (13.4%), chromosomal anomaly (8.05%), thoracic conditions (7.38%), followed by urinary tract malformation (4.03%), infection (4.03%) and anemia (3.36%). The most common chromosomal anomaly was Turner syndrome and the second one was Down syndrome.
CONCLUSION
Since various conditions can be the cause of hydrops fetalis, pathologists should pay attention to elaborate the underlying causes in every single autopsy.

Case Report

Hydrops Fetalis Due to Parvovirus B19 Infection: Report of Two Autopsy Cases.: Ho Chang Lee, Hee Eun Lee, Pil Gyu Hwang, Je G Chi, Sung Hye Park; Korean J Pathol. 2006;40(3):245-249.

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Abstract PDF: Hydrops fetalis (HF) is a disease characterized by generalized subcutaneous edema and cavity effusion in the fetal stage. We report here on two autopsy cases of HF that were caused by parvovirus B19 (PVB19) infection. The human PVB19 is an erythrovirus that cause diverse clinical manifestations ranging from an asymptomatic or mild presentation to more severe effects such as hydrops fetalis, and this is the only known human pathogenic parvovirus. The gestational ages of the two fetuses were 21 weeks and 23 weeks, respectively. Both fetuses were hydropic and anemic. Hepatic tissues of both fetuses demonstrated erythroblasts with eosinophilic intranuclear inclusions, the so called "lantern cells". PVB19 was confirmed by electron microscopy and immunohistochemical staining. For the diagnosis of this disease, recognition of parvovirus infection as a cause of hydrops fetalis and careful examination of red blood cells with a high-power view are required.

Original Article

Survivin and Fas Ligand Expressions Are Correlated with Angiolymphatic Tumor Spread in Medullary Thyroid Carcinoma.: Min Kyung Kim, Jin Hee Sohn, Mee Joo, Hanseung Kim, Sung Hye Park, Seong Hoe Park, Eo Jin Kim, Seoung Wan Chae; Korean J Pathol. 2005;39(5):320-325.

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Abstract PDF: BACKGROUND
Medullary thyroid carcinoma (MTC) that originates from C cells comprises about 10% of all the malignant thyroid tumors. Activating mutations of the RET proto-oncogene have been found to be involved in the anti-apoptotic pathway of MTC that harbors the RET mutation. We investigated the correlation between the clinicopathologic parameters and the expressions of survivin, a novel anti-apoptotic molecule, and the other apoptosis-related proteins, and the known prognostic markers.
METHODS
Immunohistochemical staining was performed using antibodies for survivin, Fas, Fas ligand (FasL), bcl-2, calcitonin, CEA and cyclin A in 19 case of MTC; 10 sporadic MTCs, eight multiple endocrine neoplasia (MEN) type 2A MTCs and one familial MTC (FMTC).
RESULTS
Survivin protein expression was found in five cases (26%) and this was correlated with the presence of angiolymphatic tumor emboli (p=0.019). FasL was expressed in 14 cases (74%) and it had correlation with the presence of lymph node metastases (p=0.029). The cyclin A-labeling indices were correlated with local invasiveness (p=0.001).
CONCLUSIONS
Survivin and FasL might be involved in the lymphatic tumor spread of MTC.

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