Journal of Pathology and Translational Medicine

Original Article

Usefulness of BRAF VE1 immunohistochemistry in non–small cell lung cancers: a multi-institutional study by 15 pathologists in Korea: Sunhee Chang, Yoon-La Choi, Hyo Sup Shim, Geon Kook Lee, Seung Yeon Ha; J Pathol Transl Med. 2022;56(6):334-341. Published online October 27, 2022; DOI: https://doi.org/10.4132/jptm.2022.08.22

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Background
Next-generation sequencing (NGS) is an approved test to select patients for BRAF V600E targeted therapy in Korea. However, the high cost, long turnaround times, and the need for sophisticated equipment and skilled personnel limit the use of NGS in daily practice. Immunohistochemistry (IHC) is a rapid and relatively inexpensive assay available in most laboratories. Therefore, in this study, we evaluate the usefulness of BRAF VE1 IHC in terms of predictive value and interobserver agreement in non–small cell lung cancers (NSCLCs).
Methods
A total of 30 cases with known BRAF mutation status were selected, including 20 cases of lung adenocarcinomas, six cases of colorectal adenocarcinomas, and four cases of papillary thyroid carcinomas. IHC for BRAF V600E was carried out using the VE1 antibody. Fifteen pathologists independently scored both the staining intensity and the percentage of tumor cell staining on whole slide images.
Results
In the lung adenocarcinoma subset, interobserver agreement for the percentage of tumor cell staining and staining intensity was good (percentage of tumor cell staining, intraclass correlation coefficient = 0.869; staining intensity, kappa = 0.849). The interobserver agreement for the interpretation using the cutoff of 40% was almost perfect in the entire study group and the lung adenocarcinoma subset (kappa = 0.815). Sensitivity, specificity, positive predictive value, and negative predictive value of BRAF VE1 IHC were 80.0%, 90.0%, 88.9%, and 81.8%, respectively.
Conclusions
BRAF VE1 IHC could be a screening test for the detection of BRAF V600E mutation in NSCLC. However, further studies are needed to optimize the protocol and to establish and validate interpretation criteria for BRAF VE1 IHC.

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Dedifferentiated Leiomyosarcoma of the Uterine Corpus with Heterologous Component: Clinicopathological Analysis of Five Consecutive Cases from a Single Institution and Comprehensive Literature Review
Suyeon Kim, Hyunsik Bae, Hyun-Soo Kim
Diagnostics.2024; 14(2): 160. CrossRef
Differentiating BRAF V600E- and RAS-like alterations in encapsulated follicular patterned tumors through histologic features: a validation study
Chankyung Kim, Shipra Agarwal, Andrey Bychkov, Jen-Fan Hang, Agnes Stephanie Harahap, Mitsuyoshi Hirokawa, Kennichi Kakudo, Somboon Keelawat, Chih-Yi Liu, Zhiyan Liu, Truong Phan-Xuan Nguyen, Chanchal Rana, Huy Gia Vuong, Yun Zhu, Chan Kwon Jung
Virchows Archiv.2024;[Epub] CrossRef
BRAF V600E Mutation of Non-Small Cell Lung Cancer in Korean Patients
Hyo Yeong Ahn, Chang Hun Lee, Min Ki Lee, Jung Seop Eom, Yeon Joo Jeong, Yeong Dae Kim, Jeong Su Cho, Jonggeun Lee, So Jeong Lee, Dong Hoon Shin, Ahrong Kim
Medicina.2023; 59(6): 1085. CrossRef
Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy
Chan Kwon Jung
Journal of Pathology and Translational Medicine.2023; 57(4): 208. CrossRef

Reviews

Molecular biomarker testing for non–small cell lung cancer: consensus statement of the Korean Cardiopulmonary Pathology Study Group: Sunhee Chang, Hyo Sup Shim, Tae Jung Kim, Yoon-La Choi, Wan Seop Kim, Dong Hoon Shin, Lucia Kim, Heae Surng Park, Geon Kook Lee, Chang Hun Lee; J Pathol Transl Med. 2021;55(3):181-191. Published online May 11, 2021; DOI: https://doi.org/10.4132/jptm.2021.03.23

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Abstract PDF

Molecular biomarker testing is the standard of care for non–small cell lung cancer (NSCLC) patients. In 2017, the Korean Cardiopulmonary Pathology Study Group and the Korean Molecular Pathology Study Group co-published a molecular testing guideline which contained almost all known genetic changes that aid in treatment decisions or predict prognosis in patients with NSCLC. Since then there have been significant changes in targeted therapies as well as molecular testing including newly approved targeted drugs and liquid biopsy. In order to reflect these changes, the Korean Cardiopulmonary Pathology Study Group developed a consensus statement on molecular biomarker testing. This consensus statement was crafted to provide guidance on what genes should be tested, as well as methodology, samples, patient selection, reporting and quality control.

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Clinical utility of the Oncomine Dx Target Test multi‐CDx system and the possibility of utilizing those original sequence data
Ayaka Saito, Hideki Terai, Tae‐Jung Kim, Katsura Emoto, Ryutaro Kawano, Kohei Nakamura, Hideyuki Hayashi, Hatsuyo Takaoka, Akihiko Ogata, Katsuhito Kinoshita, Fumimaro Ito, Lisa Shigematsu, Masahiko Okada, Takahiro Fukushima, Akifumi Mitsuishi, Taro Shino
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Yurimi Lee, Boram Lee, Yoon-La Choi, Dong-Wook Kang, Joungho Han
Modern Pathology.2024; : 100490. CrossRef
FACILITATE: A real-world, multicenter, prospective study investigating the utility of a rapid, fully automated real-time PCR assay versus local reference methods for detecting epidermal growth factor receptor variants in NSCLC
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Tuberculosis and Respiratory Diseases.2023; 86(3): 176. CrossRef
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Yurimi Lee, Kiyong Na, Ha Young Woo, Hyun-Soo Kim
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Landscape of EGFR mutations in lung adenocarcinoma: a single institute experience with comparison of PANAMutyper testing and targeted next-generation sequencing
Jeonghyo Lee, Yeon Bi Han, Hyun Jung Kwon, Song Kook Lee, Hyojin Kim, Jin-Haeng Chung
Journal of Pathology and Translational Medicine.2022; 56(5): 249. CrossRef
Biomarker testing of cytology specimens in personalized medicine for lung cancer patients
Hyojin Kim, Jin-Haeng Chung
Journal of Pathology and Translational Medicine.2022; 56(6): 326. CrossRef
Usefulness of BRAF VE1 immunohistochemistry in non–small cell lung cancers: a multi-institutional study by 15 pathologists in Korea
Sunhee Chang, Yoon-La Choi, Hyo Sup Shim, Geon Kook Lee, Seung Yeon Ha
Journal of Pathology and Translational Medicine.2022; 56(6): 334. CrossRef
Lung Cancer in Korea
Sehhoon Park, Chang-Min Choi, Seung-Sik Hwang, Yoon-La Choi, Hyae Young Kim, Young-Chul Kim, Young Tae Kim, Ho Yun Lee, Si Yeol Song, Myung-Ju Ahn
Journal of Thoracic Oncology.2021; 16(12): 1988. CrossRef

Current status and future perspectives of liquid biopsy in non-small cell lung cancer: Sunhee Chang, Jae Young Hur, Yoon-La Choi, Chang Hun Lee, Wan Seop Kim; J Pathol Transl Med. 2020;54(3):204-212. Published online April 15, 2020; DOI: https://doi.org/10.4132/jptm.2020.02.27

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Abstract PDF

With advances in target therapy, molecular analysis of tumors is routinely required for treatment decisions in patients with advanced non-small cell lung cancer (NSCLC). Liquid biopsy refers to the sampling and analysis of circulating cell-free tumor DNA (ctDNA) in various body fluids, primarily blood. Because the technique is minimally invasive, liquid biopsies are the future in cancer management. Epidermal growth factor receptor (EGFR) ctDNA tests have been performed in routine clinical practice in advanced NSCLC patients to guide tyrosine kinase inhibitor treatment. In the near future, liquid biopsy will be a crucial prognostic, predictive, and diagnostic method in NSCLC. Here we present the current status and future perspectives of liquid biopsy in NSCLC.

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Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
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Alveolar Soft Part Sarcoma of the Uterus: Clinicopathological and Molecular Characteristics
Yurimi Lee, Kiyong Na, Ha Young Woo, Hyun-Soo Kim
Diagnostics.2022; 12(5): 1102. CrossRef
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Molecular biomarker testing for non–small cell lung cancer: consensus statement of the Korean Cardiopulmonary Pathology Study Group
Sunhee Chang, Hyo Sup Shim, Tae Jung Kim, Yoon-La Choi, Wan Seop Kim, Dong Hoon Shin, Lucia Kim, Heae Surng Park, Geon Kook Lee, Chang Hun Lee
Journal of Pathology and Translational Medicine.2021; 55(3): 181. CrossRef
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Future Perspectives in Detecting EGFR and ALK Gene Alterations in Liquid Biopsies of Patients with NSCLC
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Journal of Clinical Medicine.2020; 9(11): 3674. CrossRef
Expanding opportunities in precision oncology
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Original Article

Interobserver Reproducibility of PD-L1 Biomarker in Non-small Cell Lung Cancer: A Multi-Institutional Study by 27 Pathologists: Sunhee Chang, Hyung Kyu Park, Yoon-La Choi, Se Jin Jang; J Pathol Transl Med. 2019;53(6):347-353. Published online October 28, 2019; DOI: https://doi.org/10.4132/jptm.2019.09.29

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Abstract PDF

Background
Assessment of programmed cell death-ligand 1 (PD-L1) immunohistochemical staining is used for treatment decisions in non-small cell lung cancer (NSCLC) regarding use of PD-L1/programmed cell death protein 1 (PD-1) immunotherapy. The reliability of the PD-L1 22C3 pharmDx assay is critical in guiding clinical practice. The Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists investigated the interobserver reproducibility of PD-L1 staining with 22C3 pharmDx in NSCLC samples.
Methods
Twenty-seven pathologists individually assessed the tumor proportion score (TPS) for 107 NSCLC samples. Each case was divided into three levels based on TPS: <1%, 1%–49%, and ≥50%.
Results
The intraclass correlation coefficient for TPS was 0.902±0.058. Weighted κ coefficient for 3-step assessment was 0.748±0.093. The κ coefficients for 1% and 50% cut-offs were 0.633 and 0.834, respectively. There was a significant association between interobserver reproducibility and experience (formal PD-L1 training, more experience for PD-L1 assessment, and longer practice duration on surgical pathology), histologic subtype, and specimen type.
Conclusions
Our results indicate that PD-L1 immunohistochemical staining provides a reproducible basis for decisions on anti–PD-1 therapy in NSCLC.

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Reviews

Thyroid Fine-Needle Aspiration Cytology Practice in Korea: Yoon Jin Cha, Ju Yeon Pyo, SoonWon Hong, Jae Yeon Seok, Kyung-Ju Kim, Jee-Young Han, Jeong Mo Bae, Hyeong Ju Kwon, Yeejeong Kim, Kyueng-Whan Min, Soonae Oak, Sunhee Chang; J Pathol Transl Med. 2017;51(6):521-527. Published online October 11, 2017; DOI: https://doi.org/10.4132/jptm.2017.09.26

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Abstract PDF

We reviewed the current status of thyroid fine-needle aspiration cytology (FNAC) in Korea. Thyroid aspiration biopsy was first introduced in Korea in 1977. Currently, radiologists aspirate the thyroid nodule under the guidance of ultrasonography, and cytologic interpretation is only legally approved when a cytopathologist makes the diagnosis. In 2008, eight thyroid-related societies came together to form the Korean Thyroid Association. The Korean Society for Cytopathology and the endocrine pathology study group of the Korean Society for Pathologists have been updating the cytologic diagnostic guidelines. The Bethesda System for Reporting Thyroid Cytopathology was first introduced in 2009, and has been used by up to 94% of institutions by 2016. The average diagnosis rates are as follows for each category: I (12.4%), II (57.9%), III (10.4%), IV (2.9%), V (3.7%), and VI (12.7%). The malignancy rates in surgical cases are as follows for each category: I (28.7%), II (27.8%), III (50.6%), IV (52.3%), V (90.7%), and VI (100.0%). Liquid-based cytology has been used since 2010, and it was utilized by 68% of institutions in 2016. The categorization of thyroid lesions into “atypia of undetermined significance” or “follicular lesion of undetermined significance” is necessary to draw consensus in our society. Immunocytochemistry for galectin-3 and BRAF is used. Additionally, a molecular test for BRAF in thyroid FNACs is actively used. Core biopsies were performed in only 44% of institutions. Even the institutions that perform core biopsies only perform them for less than 3% of all FNACs. However, only 5% of institutions performed core biopsies up to three times more than FNAC.

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Daniel Javier Velez Bohorquez, Nohora Bibiana Varon Arce, Sandra Milena Tellez Olaya, Sebastian Camilo Mora Garcia, Anggi Margarita Velez Bohorquez, Mabel Elena Bohorquez Lozano
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The Asian Thyroid Working Group, from 2017 to 2023
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Diagnostic value of thyroid imaging reporting and data system combined with BRAFV600E mutation analysis in Bethesda categories III–V thyroid nodules
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Na Rae Kim, Jae Yeon Seok, Yoo Seung Chung, Joon Hyop Lee, Dong Hae Chung
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The History of Korean Thyroid Pathology
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BRAFV600E Mutation is a Strong Preoperative Indicator for Predicting Malignancy in Thyroid Nodule Patients with Atypia of Undetermined Significance Identified by Fine Needle Aspiration
Hye Rang Choi, Bo-Yoon Choi, Jae Hoon Cho, Young Chang Lim
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2018; 61(11): 600. CrossRef
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
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Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
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The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
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Molecular Testing of Lung Cancers: Hyo Sup Shim, Yoon-La Choi, Lucia Kim, Sunhee Chang, Wan-Seop Kim, Mee Sook Roh, Tae-Jung Kim, Seung Yeon Ha, Jin-Haeng Chung, Se Jin Jang, Geon Kook Lee; J Pathol Transl Med. 2017;51(3):242-254. Published online April 21, 2017; DOI: https://doi.org/10.4132/jptm.2017.04.10

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Abstract PDF

Targeted therapies guided by molecular diagnostics have become a standard treatment of lung cancer. Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements are currently used as the best predictive biomarkers for EGFR tyrosine kinase inhibitors and ALK inhibitors, respectively. Besides EGFR and ALK, the list of druggable genetic alterations has been growing, including ROS1 rearrangements, RET rearrangements, and MET alterations. In this situation, pathologists should carefully manage clinical samples for molecular testing and should do their best to quickly and accurately identify patients who will benefit from precision therapeutics. Here, we grouped molecular biomarkers of lung cancers into three categories—mutations, gene rearrangements, and amplifications—and propose expanded guidelines on molecular testing of lung cancers.

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Original Article

Mesothelin Expression in Gastric Adenocarcinoma and Its Relation to Clinical Outcomes: Song-Hee Han, Mee Joo, Hanseong Kim, Sunhee Chang; J Pathol Transl Med. 2017;51(2):122-128. Published online February 15, 2017; DOI: https://doi.org/10.4132/jptm.2016.11.18

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Background
Although surgical resection with chemotherapy is considered effective for patients with advanced gastric cancer, it remains the third leading cause of cancer-related death in South Korea. Several studies have reported that mesothelial markers including mesothelin, calretinin, and Wilms tumor protein 1 (WT1) were positive in variable carcinomas, associated with prognosis, and were evaluated as potential markers for targeted therapy. The aim of this study was to assess the immunohistochemical expression of mesothelial markers (mesothelin, calretinin, and WT1) in gastric adenocarcinoma and their relations to clinocopathological features and prognosis. Methods: We evaluated calretinin, WT1, and mesothelin expression by immunohistochemical staining in 117 gastric adenocarcinomas. Results: Mesothelin was positively stained in 30 cases (25.6%). Mesothelin expression was related to increased depth of invasion (p = .002), lymph node metastasis (p = .013), and presence of lymphovascular (p = .015) and perineural invasion (p = .004). Patients with mesothelin expression had significantly worse disease-free survival rate compared with that of nonmesothelin expression group (p = .024). Univariate analysis showed that mesothelin expression is related to short-term survival. None of the 117 gastric adenocarcinomas stained for calretinin or WT1. Conclusions: Mesothelin expression was associated with poor prognosis. Our results suggest that mesothelin-targeted therapy should be considered as an important therapeutic alternative for gastric adenocarcinoma patients with mesothelin expression.

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Brief Case Report

Malakoplakia Affecting the Umbilical Cord: Song-Hee Han, Mee Joo, Sunhee Chang, Han-Seong Kim; J Pathol Transl Med. 2015;49(2):177-179. Published online March 12, 2015; DOI: https://doi.org/10.4132/jptm.2015.02.04

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PDF

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Rectal malakoplakia
Ted George Achufusi, Kegan Jessamy, Philip Chebaya, Sekou Rawlins
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Review & Perspective

Guideline Recommendations for EGFR Mutation Testing in Lung Cancer: Proposal of the Korean Cardiopulmonary Pathology Study Group: Hyo Sup Shim, Jin-Haeng Chung, Lucia Kim, Sunhee Chang, Wan-Seop Kim, Geon Kook Lee, Soon-Hee Jung, Se Jin Jang; Korean J Pathol. 2013;47(2):100-106. Published online April 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.100

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Abstract PDF

Mutations of the epidermal growth factor receptor (EGFR) are the strongest predictive factor for response to EGFR tyrosine kinase inhibitors (TKIs), such as gefitinib and erlotinib. EGFR TKIs are approved in Korea as a first-line treatment for lung cancer patients with mutated EGFR. Rapid and accurate EGFR mutation testing is essential for patient selection and establishing targeted therapies with EGFR TKIs. Thus, a standard set of guideline recommendations for EGFR mutation testing suitable for the Korean medical community is necessary. In this article, we propose a set of guideline recommendations for EGFR mutation testing that was discussed and approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.

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Case Reports

Cytologic Findings of Thyroid Carcinoma Showing Thymus-like Differentiation: A Case Report: Sunhee Chang, Mee Joo, Hanseong Kim; Korean J Pathol. 2012;46(3):302-305. Published online June 22, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.3.302

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Abstract PDF

Carcinoma showing thymus-like differentiation (CASTLE) is a rare carcinoma of the thyroid or adjacent soft tissue of the neck with a histologic resemblance to thymic epithelial tumors. Although the fine-needle aspiration (FNA) plays a central role in the initial evaluation of thyroid nodules, few reports about the cytologic findings of CASTLE have been found according to a review of literatures. We report cytologic findings of a case of CASTLE. A 34-year-old woman presented with a 2-month history of sore throat. The FNA showed that the smear was composed of three dimensional clusters and sheets. The tumor cells were round to ovoid with high nuclear : cytoplasmic ratios. The nuclei were vesicular with small nucleoli. There were some tumor cells showing keratinization. Some lymphocytes were found on the background and within clusters. The presence of poorly-differentiated tumor cells with a focal keratinization and a lymphocytic background on the FNA is suggestive of CASTLE.

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Takahito Kimura, Keisuke Enomoto, Masamitsu Kono, Masanobu Hiraoka, Saori Takeda, Naoko Kumashiro, Shun Hirayama, Eri Kimura, Shunji Tamagawa, Makiko Ohtani, Shin-Ichi Murata, Muneki Hotomi
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Thyroid carcinoma with thymus-like differentiation (CASTLE) tumor: а сase report
A. A. Ilyin, V. V. Polkin, P. A. Isaev, F. E. Sevrukov, N. Yu. Dvinskych, M. I. Ryzhenkova, S. A. Ivanov, A. D. Kaprin
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Intrathyroidal thymic carcinoma exhibiting neuroendocrine differentiation: Case report with cytomorphology, immunocytochemistry, and review of the literature focusing on cytology
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Diagnostic Cytopathology.2019; 47(11): 1197. CrossRef
Management and Prognostic Factors for Thyroid Carcinoma Showing Thymus-Like Elements (CASTLE): A Case Series Study
Rui Gao, Xi Jia, Ting Ji, Jinteng Feng, Aimin Yang, Guangjian Zhang
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Heather Gage, Elizabeth Hubbard, Laurentia Nodit
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Clinical analysis of 82 cases of carcinoma showing thymus-like differentiation of the thyroid
WEI GE, YONG-ZHONG YAO, GANG CHEN, YI-TAO DING
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Jennifer A. Collins, Bo Ping, Justin A. Bishop, Syed Z. Ali
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Carcinoma Showing Thymus-Like Elements of the Thyroid Gland: Report of Three Cases Including One Case with Breast Cancer History
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A Case of Endocrine Mucin-Producing Sweat Gland Carcinoma Co-existing with Mucinous Carcinoma: A Case Report.: Sunhee Chang, Sang Hwa Shim, Mee Joo, Hanseong Kim, Yong Kyu Kim; Korean J Pathol. 2010;44(1):97-100.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.1.97

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Abstract PDF

An endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare skin tumor that most commonly occurs on the eyelids of elderly women. This tumor is morphologically analogous to endocrine ductal carcinoma in situ and solid papillary carcinoma of the breast. We describe one case of a 51-year-old male with an EMPSGC co-existing with mucinous carcinoma of the eyelid. The tumor was composed of dilated ducts with a smooth border and was partially filled with a papillary proliferation. Tumor cells were uniform, small-to-medium in size, and oval-to-polygonal with light eosinophilic cytoplasm. Nuclei were bland with diffusely stippled chromatin and inconspicuous nucleoli. Tumor cells expressed chromogranin, synaptophysin, estrogen and progesterone receptors, cytokeratin 7, and epithelial membrane antigen.

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Original Article

Cytologic Findings of Fine Needle Aspiration Biopsy of 23 Schwannomas.: Sunhee Chang, Mee Joo, Hanseong Kim; Korean J Cytopathol. 2008;19(1):41-46.; DOI: https://doi.org/10.3338/kjc.2008.19.1.41

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Abstract PDF

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or oval-shaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.

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Multiple Cervical Schwannomas Mimicking Metastatic Lymph Nodes from Papillary Thyroid Cancer
Ji-Sun Kim, Chang-Young Yoo, Rae-Hyung Kim, Jung-Hae Cho
Journal of Korean Thyroid Association.2014; 7(1): 102. CrossRef

Case Reports

Posttransplant Lymphoproliferative Disorder: A Report of 4 Cases.: Sunhee Chang, Jooryung Hugh, Kyung Mo Kim, Duck Jong Han, Seung Kyu Lee, Eunsil Yu; Korean J Pathol. 2002;36(1):45-50.

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Abstract PDF: Posttransplant lymphoproliferative disorder (PTLD) is a proliferation of B-cells associated with Epstein-Barr virus (EBV) infection as a complication of immunosuppression, especially by FK506. We investigated four cases of PTLD which developed either in allografts or in other organs.
Case
1 was a 38-year-old woman, who developed monomorphic PTLD in a kidney 7 years and 7 months after renal transplantation. Case 2 was a 37-year-old man, who developed monomorphic PTLD in the right submandibular lymph node 4 months after liver transplantation. Case 3 was a 60-year-old man, who developed monomorphic PTLD in the liver 8 months after liver transplantation. Case 4 was a 2-year-old female child, who developed polymorphic PTLD in the colon, liver, and mesenteric lymph node 10 months after liver transplantation. FK506 was administered to case 4. EBV was identified in the tissues of all cases by immunohistochemistry and/or in situ hybridization.

Recurrent Viral Hepatitis Following Liver Transplantation: Report of 4 Cases.: Sunhee Chang, Kwangseon Min, Jaegul Jung, Ghil Suk Yoon, Seung Kyu Lee, Yung Sang Lee, Eunsil Yu; Korean J Pathol. 2002;36(2):122-127.

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Abstract PDF: The recurrence of viral hepatitis B or C after liver transplantation is almost universal but their clinical courses and outcomes are vary widely. We investigated four cases of rapidly progressive and fatal recurrent viral hepatitis following liver transplantation, which were rapidly progressive and fatal. Case 1 was a 58-year-old male, who developed recurrent viral hepatitisC. Case 2, 3, and 4 were a 59-year-old female, a 42-year-old male, and a 50-year-old male, respectively, who developed recurrent viral hepatitis B. In cases 1 and 2, the histopathological features of the first liver biopsies were prominent ballooning degeneration of the hepatocytes but later biopsies revealed significant lobular activity. Case 3 began with a marked fatty change and mild lobular and porto-periportal activity and progressed to severe lobular activity and septal fibrosis. In case 4, the first liver biopsy revealed minimal lobular activity but the second biopsy revealed severe lobular activity.

A Diagnostically Challenging Case of an Infarcted Adenomatoid Tumor of the Epididymis.: Sunhee Chang, Sang Hwa Shim, Ji Eun Kwak, Mee Joo, Hanseong Kim, Je G Chi, Keon cheol Lee; Korean J Pathol. 2008;42(4):229-231.

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Abstract PDF: We describe a case of an infarcted adenomatoid tumor of the epididymis that was challenging to diagnose. A 20-year-old man presented with acute left scrotal pain. He was found to have a 2x1.5x1 cm tumor that was relatively well circumscribed on gross examination. There was a central necrotic area that exhibited gaping spaces and ghost outlines of epithelial cells. The periphery of the necrotic lesion showed focally viable adenomatoid tumor. The majority of the tissue adjacent to the necrosis consisted of granulation tissue, fibroblastic and myofibroblastic proliferation, and neutrophils. The fibroblasts and myofibroblasts showed plump nuclei, often with small nucleoli. No mitotic activity was present. The differential diagnosis for an infarcted adenomatoid tumor includes malignant mesothelioma, inflammatory myofibroblastic tumor, and inflammatory conditions. The key to diagnosing an infarcted adenomatoid tumor is to consider it in the differential diagnosis of any spindle cell tumor with necrosis occurring in the genital tract.

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